Labor Party Senators support positive action to reform the aged care sector and strongly believe that older Australians, who built this country and have earned our respect, deserve so much better from the system. Older Australians deserve to be supported by the aged care system and to be afforded safety, security and quality care.
Labor Senators support-in-principle the changes included in the Bill and their intentions to improve the quality of care and the safety of aged care users. However, they note that they have significant concerns about the Bill that they do not believe have been adequately addressed by the Government or the Department of Health. Labor Senators believe there needs to be further consultation and consideration by the Government on concerns raised by stakeholders including, but not limited to, the following:
(a)
Consultation with stakeholders and worker representatives—many important stakeholders have complained about the lack of consultation during the drafting of the Bill and concerns about whether there will be adequate consultation on the large amount of delegated legislation that this Bill provides the framework for. The lack of consultation does not fit with the Royal Commission into Aged Care Quality and Safety's (the Royal Commission) recommendation that the reform process be transparent and consultative to ensure its success and to rebuild confidence in the system.
(b)
The lack of detail surrounding the future implementation of AN-ACC—provider peak bodies have raised concerns about the lack of detail surrounding the future implementation of AN-ACC including issues such as:
(i)
access to shadow assessment information to assist with 2022/2023 Financial Year Budgets;
(ii)
aged care resident access to allied health services;
(iii)
whether AN-ACC assessment weighting will adequately cover those residents with cognitive impairments; and
(iv)
aged care resident access to social and emotional supports.
(c)
Screening of workers—whilst providing in-principle support and an acknowledgement that exclusion is an important mechanism for acts of abuse and neglect, both aged care providers and trade unions have expressed concerns that the unintended consequences of the screening process could include creating a barrier to entry for workers joining the sector due to high application costs; application timings; worker blacklisting; duplication for already registered healthcare workers; and privacy concerns.
(d)
Code of conduct and banning orders—whilst providing in-principle support for a code of conduct and banning orders, both aged care providers and trade unions have expressed concerns not limited to but including that:
(i)
the detail of the code of conduct is not yet available for scrutiny despite being connected to significant fines, of up to $55,000 for individual workers, and banning orders;
(ii)
the level of the fines may not be appropriate or proportionate given the low wages of aged care workers;
(iii)
this will create duplication of regulatory requirements for already registered healthcare workers;
(iv)
the opportunity of procedural fairness for those implicated by claims of breaching the code of conduct are not clear;
(v)
it will not apply to non-approved aged care providers;
(vi)
it could further disempower migrant and multicultural workers; and
(vii)
this could provide another barrier to entry for workers entering the aged care system or could lead to more workers leaving the system.
(e)
Serious Incident Response Scheme (SIRS) in Home Care—ensuring that the operation of the SIRS in Home Care is appropriate to that setting and recognising contextual differences between residential care and in-home care.
(f)
Governance of approved providers—making sure that the balance between strengthening governance arrangements, transitional support and ensuring that smaller providers stay viable is correct.
(g)
Independent Health and Aged Care Pricing Authority independence and transparency—a number of stakeholders raised concerns that changes to the appointment of the CEO and a lack of mandatory reporting requirements potentially threatened the independence and transparency of the Pricing Authority.
Labor Senators strongly believe there needs to be further consultation and consideration by the Government on these and other prominent concerns referenced in this report.
Of particular concern to Labor Senators are the concerns raised by a wide range of stakeholders, including providers, trade unions and the advocates of older Australians, regarding Schedule 2 (screening of aged care workers, and governing persons, of approved providers) and Schedule 3 (code of conduct and banning orders).
As noted by the United Workers Union and the Australian Aged Care Collaboration during the Inquiry hearing, aged care facilities across the country are currently experiencing high levels of unfilled shifts and worker shortages. This is, in part, due to the pressures created by Covid-19 but also due to long term under resourcing of the sector and a reluctance from Government to appropriately recognise and remunerate the aged care workforce.
Labor Senators note that the foundation to any successful reform of the aged care system requires meaningful and effective reform of the aged care workforce, including appropriate resourcing and remuneration. Without strong action to improve the recruitment and retention of aged care workers there simply cannot be successful aged care reform. This was reflected in the Royal Commission final report.
It is this fact that fuels concern regarding the barriers to entry to the workforce and workforce retention issues potentially caused by Schedule 2 and Schedule 3 of the Bill. These concerns are further exacerbated by the Government's failure to deliver meaningful support and recognition for the workforce in its response to the Royal Commission. Their response contained nothing to improve the wages for overstretched, undervalued aged care workers or to effectively attract more workers to the sector. Nor does it fully accept the Royal Commission recommendations regarding mandatory carer hours or Registered Nurse presence on site 24 hours a day, 7 days a week.
Labor Senators call on the Government to urgently address these workforce related issues in the Bill and in their response to the Royal Commission.
Recommendations
Recommendation
Labor Senators recommend that the Government seek further consultation with a wide range of stakeholders, including the advocates of older Australians, trade unions and providers, on further amendments to this Bill to address the significant number of concerns raised during the Inquiry and contained in this report.
Recommendation
Labor Senators urgently call on the Government to address issues surrounding workforce recruitment and retention both in this Bill and more generally.
Recommendation
Labor Senators support the recommendation of the committee report that the Bill be passed.
Senator Nita Green
Labor Senator for Queensland
Senator Helen Polley
Labor Senator for Tasmania