Speech: Improved Home Care Payment Administration No 1 Bill 2020

Speech: Improved Home Care Payment Administration No 1 Bill 2020 Main Image

Mrs PHILLIPS (Gilmore) (18:31): I'm pleased to rise tonight to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. This bill speaks to some very important issues, but in many ways it is the issues it doesn't speak to that are even more critical. The administrative changes it makes will have consequences, but the changes it isn't making have consequences as well. My electorate on the New South Wales South Coast has the second-highest number of people over the age of 65 in Australia. We have more than 40,000 people over the age of 65, nearly 27 per cent of my total electorate size. People come to our coast for many reasons, but many come to retire and live a good, relaxed life by the sea, so it is no surprise that legislation like this is extremely important to many people in our community—not only those who want to access homecare now but also those who may need to in the near future, their families and friends.

As our population continues to age, we need to make sure we are supporting older Australians to live in their homes for as long as possible. We know, now with agonising detail thanks to the aged-care royal commission, many of the problems that are facing our aged-care system. We have seen the tragedy that Covid-19 has wreaked throughout aged-care homes across Australia because the government was not prepared. What we need to be doing now more than ever is making sure people are supported to stay at home for as long as possible. Staying in your home for longer has so many benefits not just for the person receiving care but for their family, for our aged-care system as a whole, for our economy and for everyone, and the truth is that we need to be doing better. Across every aspect of aged care, that is true, but today I want to focus on home care.

We need to do better on home care. The interim report from the aged care royal commission, which was titled Neglect—and doesn't that just say at all—and which we received a year ago highlighted that urgent action was needed now to ensure older Australians are getting care at home when they need it most. It is no secret that the waitlist for home-care packages is out of control. More than 102,000 older Australians are waiting for home- care packages. Wait times have blown out, with older Australians in our community waiting almost three years for the high-level packages they have been approved for.

In this year's budget, the Morrison government announced 23,000 'additional' packages. But documents tendered at the aged-care royal commission showed that the government will deliver just 300 new home-care packages by 2024, despite their promises in the tens of thousands—only 300. What a disappointing response to a huge problem. Three hundred new packages are simply not enough, and that much is just glaringly obvious. We need urgent action on a huge scale, and it has to start now.

I want to share the stories of some of the people in my electorate who are struggling under the current home-care system. Perhaps this will finally help to put a human face on that figure I mentioned of 102,000 people, because it seems that the government keeps forgetting. These are people's mothers and fathers. They are aunties, uncles, friends and loved ones. They are people, and they deserve better than a three-year wait for help.

Aunty Joyce is a beloved Aboriginal elder from Gerringong. She is well known on the South Coast and has spent her life working hard to help other people and contribute to our community. But now Aunty Joyce is the one asking for help. She has applied for a home-care package and been approved for a level 2 package. But she has been told it will be at least two years before she is able to access one. Aunty Joyce has emphysema and she has sadly had a couple of recent falls. She wants some help with home services, like someone to mow her lawn and help her get out and about to visit friends in the local area. She's been told that, while she waits for a level 2 package, she can access a level 1 package—after she waits up to three months. We know that Indigenous people in our community have a unique set of challenges and we also know we need to be doing more to help close the gap. Aunty Joyce has told me how she just wants to make sure local Aboriginal people like her can access the aged-care services they need, when they need it.

I have spoken before in this place about the innovative home care program being run in the south of my electorate, the Illawarra Retirement Trust's Booraja Home Care program. This is a home-care program delivered by Aboriginal people for Aboriginal people, and it is exactly the type of program people like Aunty Joyce need. Unfortunately, Booraja is based in Moruya and doesn't extend up to the Gerringong area. But, as some people might remember from the many times I have raised it in this place, I have had to fight and fight to help Booraja continue to receive funding from this government, funding that would allow it to stay open. They wanted to extend the program to more local Aboriginal people, but the government had to be dragged kicking and screaming to support it. I could never understand why, when it is so clearly a no-brainer. I was so delighted when some funding did eventually come through. Common sense did prevail eventually.

I would like to thank all of the workers at Booraja and IRT who advocated for this funding: Booraja Home Care Manager Uncle Bunja Smith, and IRT Foundation Manager Toby Dawson, to name just two. Without their advocacy, I know that even more Aboriginal elders in the Batemans Bay area would be struggling to access services. But this is the type of pilot program we should be encouraging and replicating so that people like Aunty Joyce can access culturally appropriate services in an appropriate time frame that doesn't leave them languishing without adequate help for years. Years—sadly, that is no exaggeration.

Then there is Warren from St Georges Basin. Warren is in his 90s and he had hip surgery 12 months ago. He was told by My Aged Care at the time that the home modifications to his bathroom would be completed before he was discharged from hospital. But, here we are, 12 months later, and Warren is still waiting. Warren told me how he has paid $170 for the plans for the bathroom, but they have heard nothing back. It is not just this though; Warren was also assessed as needing a level 2 home-care package but is only receiving a level 1. Why, 12 months after it was promised, is Warren still waiting for help?

Adriana from Ulladulla was approved for a level 3 package almost a year ago. Since then, sadly, she has had a stroke and her needs have only increased. But Adriana and her husband are being told it will be at least another six to nine months before she can get a plan appropriate for her needs. In the meantime, Adriana is receiving a level 1 package, but it is simply not enough. She needs more help and she needs it now.

I could go on. Sadly, I hear the same story over and over again, and I am left asking the same question: why is the Morrison Government forcing people like Aunty Joyce, Warren and Adriana to struggle without the support we know they need? It is simply unfair and it is tragic.

The purpose of this bill is to change the payment of the home-care subsidy to approved providers from being paid in advance to being paid in arrears, but it doesn't impact the overall amount available to the home-care package recipient. According to the Aged Care Financing Authority, this legislation will be the first of three phases to reform the home-care payment arrangements. But even the explanatory memorandum for this bill acknowledges, as it states: Some of the submissions suggested that the new payment arrangements would be a risk to the viability of some providers.

Many of those submissions specifically reference providers in rural and remote locations. As is so often the case, country areas, the hardest hit, are being left behind once again by this government, when the truth is that our community is already struggling with the availability of local providers. It's another story I am hearing too often—local people approved for packages but no-one to deliver them. Service providers are also concerned that, if the new payment arrangements increase administrative costs, then these costs would be passed onto consumers. This in turn would reduce the level of goods and services available to a consumer under a package.

Tracy from Burrill Lake has been assessed as needing a level 3 package, but his provider was taking 46 per cent of the pool provided to him. Tracy's wife was finding it difficult to navigate the system and understand the fine print. She tried to find a provider that wouldn't charge so much but realised that there were really only two options in the local area. But what would happen if those providers couldn't afford the changes in this bill and were forced to close? Or what if they were forced to pass along even more costs to Tracy, leaving him with even fewer services? I don't want to see the changes in this bill making things even harder for people like Tracy and his wife. I don't want to see fewer providers—and of course that would also mean fewer jobs in our local community. Local people have had to deal with so much. We need to make sure we are supporting them now more than ever.

The truth is that the government has not detailed the savings associated with the change in these payment arrangements or what the funds will be used for. That is a big concern of mine, because we have seen their track record. Counsel assisting the royal commission released their final submission on 22 October. That includes a number of recommendations directly related to home care. This includes the government clearing the waiting list by December 2021 and making home care a demand driven system rather than one that is rationed. That is real reform. We need to be overhauling the system, not tinkering around the edges and making changes that could actually make things worse.

This government's record on aged care is nothing short of appalling. 'Neglect' was the word the royal commission used, and it is an apt word for it—neglect. We have heard how, in the last year, 10,000 older Australians have died waiting for a home-care package. Perhaps the most heartbreaking case of all was that of the poor gentleman in my electorate who tried to get some help for his wife. She had been approved for a level 4 package but was only receiving an interim level 2. She was terminally ill, but she waited six months for her home-care package. Devastatingly, she passed away before that assistance arrived.

This isn't about statistics. It isn't about numbers. It is about people—real people who are struggling. In the aftermath of COVID-19, I had a strong army of volunteers who were helping me call older Australians in my electorate to check in on them. Many of these calls centred around aged care and home care. Many of the stories I have told tonight come from these calls. They weren't people looking to complain or to get ahead; they were just getting on with it, struggling through on their own. What concerns me is all the people suffering in silence, all those people in my electorate whose story doesn't get to be told tonight—because we know they are out there.

The royal commission has been a heartbreaking and confronting exercise. We have seen so many experts stand up and give a bleak picture of a broken system that needs major reform now. We have heard heartbreaking and traumatic accounts from loved ones who have endured what no-one should have to. At the end of the day, our aged-care system is failing our community. It is failing our families. It is failing our mothers, fathers, grandparents, aunts and uncles. It is failing people like Aunty Joyce, Warren, Adriana and Tracy. It is failing Australia.

But the Morrison government just does not seem to be listening. Instead, the Treasurer made a flashy announcement during the budget of 23,000 home-care packages, but the reality was much different, with only 300 of those actually being new packages. We saw the interim report released a year ago, but here we are still talking about the same mess, still without any real policy plan to fix it. The commissioner described the waiting list for home care as cruel, unfair and discriminatory, but the government simply released an additional 10,000 packages to fix a waiting list that at the time consisted of 119,000 people. What we need is real reform, because the consequences of nonaction are too high. They are certainly too high for me. I will not accept it—not now, not ever. People in my electorate deserve better, and I will always be here standing up for them.