Standing up for Canberra

Aged Care (Single Quality Framework) Bill 2018

My electorate of Canberra is the largest by population in Australia. I proudly represent a very large number of older Australians, older Canberrans and older people who look to government to make sure that as they live longer they also live better. At the last census more than 26,000 people in Canberra were over 65. That is 13.8 percent of my electorate.

My mother is a feisty 78-year-old feminist and she lives by the mantra 'old ain't dead'. She is a fantastic feminist. She is a big fan of Betty Friedan. She read Betty from when Betty was a feminist in the seventies, in her 20s, 30s and 40s. Then Betty got older and started talking about the invisibility of women in their old age. My mother is a signed-up card-carrying member of the Betty Friedan fan club and my mother is very much out there being vocal. She's also a very strong campaigner. She's a fantastic campaigner. She comes out with me during elections and to help with pre-polling.

No, you're not getting her, member for Eden-Monaro. You get a large chunk of the Canberra community helping you out in elections, but you ain't getting my mamma! As I said, Mum is a very feisty feminist. She is 78 years old and lives by the mantra 'old ain't dead'. And that's definitely the case. As Australians live longer they are living better. And we want them to live better. It's a sign of a great civilisation. It is a sign of a society that is prosperous and wealthy, and that is what we want for our future. This is what we want for our older Australians.

I also heard this message at my positive ageing forum that I held last year with the shadow minister for ageing and mental health and the member for Franklin—and I again thank her for attending that event and speaking at that event. More than 80 Canberrans turned up to discuss how older members of our community can stay fit and healthy and contribute to our nation's capital. Issues were very broad-ranging. It was terrific. It was quite exceptional in terms of the range of issues—from aged care and retirement villages to the role of pets. It is a very important thing—particularly if you're at home on your own, like my mother is—to have a companion animal. But there are also challenges with companion animals. For Mum, it is when she travels to be with her grandchildren and my sisters or comes up to see me in Canberra. If people are going into a home or aged care, what happens to the pets? So that was one thing we talked about: the role of pets in keeping people well and happy at home and feeling as if they are loved and they've got something to love.

We talked about the role of nutrition and how vitally important it is. The Minister and other colleagues and I were recently at the launch of the fabulous Maggie Beer's book on the importance of nutrition for ageing Australians. It is vitally important. And I've seen it with my mum. My mother has a very good appetite and is well known for her appetite. But, as she has aged, her appetite has diminished. She is eating less than she used to. But she is very mindful of it. She has been living at home. She was a single mum and brought up three girls on her own, so she has been very mindful of the need to stay healthy through nutrition. So each night she cooks for herself a beautiful meal; she enjoys that and takes great pride in that. But she tells me, whenever I see her, that most of her girlfriends might have just a bit of grilled cheese on toast or a boiled egg for dinner, if they can be bothered; otherwise it's just some crackers and something very basic, rather than something nutritious and well-rounded and covering all the food groups. Nutrition is vitally important for older Australians.

Exercise is also vitally important for keeping those bones strong. What is the name of the classes that mum goes to? 'Move it or lose it'—and that's very much the case. Move it or lose it. You need to exercise. You need to get out there. She's doing zumba; she's doing ChiBall; she's doing swimming—she's doing everything. As you can probably tell, I absolutely adore her, and she is an exceptional woman, and a proud feminist who has brought up three very proud feminists. Access to sunshine is also very important, for vitamin D. All these elements are so vital to health and wellbeing.

Aged care is a significant concern. It comes up time and again at my mobile offices and the coffee catch-ups, and it also came up at this positive ageing forum. Unfortunately, some people who were at the forum were in tears about their experiences. There are the inconsistencies in standards and fees. There is the complexity of the system. Anyone who has dealt with the aged-care system will highlight to you the enormous complexity of it. There are the endless rounds of paper and the duplication—it is extraordinarily complex. There is the guarantor clause. There are the mountains of paperwork, and the lack of digitisation, in this day and age. There is the absence of clear guidance on the steps that need to be taken to get a loved one assessed or in care. There is the delay in processing to support staying at home.

And, of course, there is the cost. I know that, when we were looking at putting my late father-in-law in care, I was just gobsmacked by the entry fees and then the weekly fees and then the daily fees and then the exit fees. It's breathtaking. You've got to sell the family home to be able to do it; I don't know what other way you can do it. And then the fees are just constant.

So it's not only complex, and dogged by mountains of paperwork and a lack of digitisation and delays. There is also this expense. And there is also such variation between one aged-care service and another in terms of the cost—and not just the cost: some have entry fees and some don't; some have exit fees and some don't; some have weekly fees and some don't; some have daily fees and some don't.

There are more than 1,700 residents living in 18 mainstream residential aged-care facilities across Canberra, and I've had the pleasure of visiting many of them. I've spent a lot of time talking with residents, and I've spent a lot of time talking to staff, and I've spent a lot of time talking to families. There are also 20 different home-care providers supporting the many, many older Canberrans who want to continue to live in their own homes as they age.

And I've been blown away by how many Canberrans are actually still staying on in their own homes when they are over 100! They are over 100 and they are still living at home—it's quite extraordinary. I've been to many Canberrans to present them with their 100th birthday congratulatory messages and my own message and a bunch of flowers, and to join in their celebrations, and I am always astounded by the numbers of them who are living at home at 100, 101, 102, 103—it is quite extraordinary. And we want that. We want that for our community.

Canberra is fortunate to have many quality aged-care providers and services. However, we all recognise that the system needs to be constantly improved to meet changing demands and to meet our expectations that our loved ones are cared for and are able to age with dignity. That's vitally important, regardless of their choice, whether it is to live in residential care or their own homes. And I know, from speaking to the many people in my electorate in aged-care services and the providers, that there are three things of particular concern to my community here in Canberra. The first is the quality of care that is being provided in the aged-care sector. The second is getting off that interminably long waiting list to access the necessary home care and support they need. And the third is the financial cost associated with aged care.

The single quality framework bill we're talking about today has become associated with the neglect and mistreatment of residents at the Oakden facility in South Australia. The images we all saw were heartbreaking and I'm sure all of us here and so many Australians in every city and country town, right across the nation, were thinking, when they saw those images: 'What if that was my mum?' or 'What if that was my dad? or 'What if that was my loved one?' The bill provides a single set of aged-care quality standards that will apply to all aged-care providers under the Aged Care Act. The changes include four new standards for residential aged care, two standards for home care and two standards for the National Aboriginal and Torres Strait Islander Flexible Aged Care Program, all to be introduced by 1 July next year.

The new standards have all been driven by the aged-care sector—recommendations to improve the quality of care of our loved ones coming from the hardworking aged-care workers. How important is that, despite the comments that the Prime Minister has been making in recent days? He might think it's witty, but it's not, and he's being disrespectful to this hardworking community, people in my community. These people help us care for our loved ones—the people who have brought us up, cared for us and nurtured us—as they age. The new standards fought for by aged-care workers were signalled as a 2015-16 budget measure, so I think we have to ask: why have they taken so long to be introduced? If these standards were introduced earlier, could Oakden have been avoided?

A number of other changes in the bill are based on the 10 recommendations from the Review of national aged care quality regulatory processes. One of these recommendations was adopted by the government a few months ago, establishing an independent aged-care quality and safety commission, but unfortunately we're still waiting on the detail. And, as we all know, the devil is in the detail. One thing that I have noticed about this bill and the discussion around it so far is the focus on providers delivering in a residential aged-care environment. Where is the discussion on the protections for older people who choose to age at home? How will the quality framework in this bill be implemented, monitored and evaluated in the homes of those who choose to receive a home care package? How will the newly established commission integrate home care into its regulatory framework?

One Canberran who receives a home care level 2 package has asked me in a letter, and I also ask this question: what responsibility of the providers is there to ensure good care of their clients? After reading through this bill, I still don't have an answer. But that particular Canberran is lucky compared to the many others who are on the waiting list for home care, many having been there for some time. According to community organisation Aged and Community Services Australia, recent data shows the number of people on the waiting list for a home care package has grown to nearly 105,000 people, including 40,000 people who've been allocated a lower level package than what they've been approved to receive. Also, more than half of those waiting for level 3 and level 4 packages are in the queue for more than six months, and it's still not clear how current funding commitments will meet the projected need of about 140,000 packages by 2021-22, or an extra 66,000 packages.

Whenever I hear about the delays that people have in accessing home care packages, I remember a particular story from one of my constituents. I was contacted last year by Ian, whose wife was waiting for access to a level 4 home care package. Home care packages have four levels, from level 1, for basic care needs, all the way through to level 4, which is for high-level care needs. Ian told me that, at her assessment, his wife was assessed as being eligible for full-time residential care, respite care or a level 4 home care package. When Ian and his wife took up the home care package with the local provider, they were told there were no level 4 packages available, so they opted to receive support at a level 2 until one became available. Ian's wife soon developed a strange paralysis and was hospitalised for weeks until home modifications could be completed. Some of the much needed equipment could have been subsidised under the level 4 package, which Ian's wife was assessed as needing but would not get until the letter of advice came through from My Aged Care. They were on their own. A key frustration I shared with Ian throughout his experience was the lack of available information: 'How long is the waitlist? Where am I on the waitlist? How often is it updated? Who will keep me informed of my application status?'

Ian's frustration is felt by so many others in my community. These are issues that were raised with the shadow minister at the Positive Ageing Forum last year. When it comes to caring for older Australians, this government needs to do better; we all need to do better. We need to do better in creating a system that is designed around people and not process. We need a system that not only addresses residential aged-care facilities but also addresses the risks our older Australians could face with home care. We need to give it the Faye test, the mum test. I ask, 'Is it good enough for my mum? Is it good enough for fabulous, feminist Faye? Is it good enough for anyone in my family?' (Time expired)