Dissenting Report - Australian Greens

1.1The Australian Greens are deeply grateful to the advocates, participants and workers who engaged with the committee process. The Greens understand the immensity of the task considering the size of the bill and the short timeframes provided to submit.

1.2The Australian Greens hold concerns about how this process has unfolded to date. The bill and accompanying rules are extensive, and the frustration of participants and advocates in getting across the available details in such a short time frame is appreciated.

I don't think there has been enough consultation. We had less than two weeks, after the bill was presented in parliament, to do the submission, which, for volunteer groups and advocacy groups, is really challenging. For example, I don't think there are many lived-experience people today. So I think the balance, even on other webinars, is that there is more time given to providers than there is to individuals and grassroots advocacy groups.[1]

1.3Feedback throughout the inquiry has highlighted the complex task for participants and advocates in coming to terms with the changes. Further, the delegation of many key details to the rules makes it difficult to appraise fully the implications for participants.

We're kind of shooting in the dark here. I would love to be able to say, 'This and this needs to be changed,' to you, but you've got this big-picture, overarching framework, and then you've got the rest that's going to come.[2]

1.4Many lived experience panels and advocates raised similar concerns about the process. A theme throughout has been the emphasis on provider perspectives.

The airwaves have been dominated by government and corporate provider lobbyists, and our voices have not been heard and certainly not sought. So we are indeed grateful that this committee is prepared to hear evidence from us, although hearing time still seems to be dominated by commercial interests.[3]

1.5The Australian Greens have long called for and supported a shift to a rights-based framework. Advocates and older people have made clear that these rights must be unequivocally clear and enforceable.

1.6Following the flagged removal of criminal penalties from the bill, witnesses and submitters raised the strength of the rights-based framework as a concern.

1.7Advocacy Tasmania stated:

We hope that, through our clients' experiences, you will see that this bill, whilst it is an improvement, is unlikely to properly protect people's human rights.[4]

1.8National Older Women’s Network canvassed similar concerns:

It appears that the framers have been convinced that the aged-care sector is too big to fail, and so their demands remain a priority. The act, by not making the rights enforceable and actually spelling out the fact that they aren't enforceable, means that we know the words of rights are window dressing to offer appeasement and focus our attention.[5]

1.9Patricia Sparrow of Council on the Ageing:

With the removal of criminal penalties and the watering down of civil penalties, as well as what penalties the commission can issue without reference to a court, older people tell us they are concerned the act won't do that. Penalties need to be proportionate to the breach and to whom they are being applied, but they need to be there.[6]

1.10Concerns remain about the increased co-contributions and accommodations costs within this bill and rules. Without safeguards and clear transparency, we risk giving over huge financial sway to for-profit providers without guaranteeing the rights and quality of care for participants.

1.11The co-contribution structures for different types of care was a recurring issue for witnesses. This mostly flows from a concern that these structures will disincentivise participants from accessing the care they need.

1.12The Office of the Inspector General of Aged Care stated:

The Royal Commission called for a paradigm shift to the architectural foundations of Australia’s aged care system, which is premised on access to care being rationed. Royal Commissioners recommended a new seamless aged care program be established, with access to care a universal entitlement based on an assessed need, coupled with certainty of funding … The Bill, however, retains the rationed approach that has always been a feature of Australia’s aged care system … Taken as a whole, the operation of the Bill is clearly designed to implement a system of rationing the provision of aged care, and maintaining a separation of care in the home and in residential facilities.[7]

1.13Further, the lack of safeguarding for financial hardship was a recurring theme throughout the inquiry. Corey Irlam, from Council on the Ageing raised:

The bill has zero protections on who and how much you can charge around higher everyday living fees compared to any other charge in the system. A full pensioner with no more income can be charged $100, $200 or $300 through higher everyday living fees. There's nothing to stop that from happening. There's nothing to stop them being charged through higher everyday living fees right the way down their assets to zero, because the way the bill is structured it doesn't have higher everyday living fees associated with other protections that are there around hardship supplements and those sorts of things. It's really important that, if we're going to maintain that lack of regulation around what's appropriate to charge and who it can be charged to, we at least address the issue of not forcing somebody to sign up in order to get in the front door.[8]

1.14Other issues of concern that were raised during the course of the inquiry included the loopholes that remain in relation to early entry into residential aged care for people aged under 65, as well as the need to further strengthen whistleblower protections.[9]

1.15We have seen appalling behaviour from industry consultants, lobbyists and aged care providers trying to game the system previously. Older people must have certainty that they will no longer suffer exploitation and abuse at the hands of these predatory operators.

1.16The key driver for aged care reform was never meant to be ‘budget repair’ or provider profitability, it was the urgent need to improve care, quality and enforcement in the sector after the shocking revelations of the Royal Commission.

1.17Every person fortunate enough to live into old age will need to be cared for. If this really is the once-in-a-generation opportunity for reform, then it is critical that we get it right.

1.18That the Government address many of the serious concerns raised throughout the inquiry, as well as provide the outstanding rules to enable a clearer assessment of the impact of the legislation in its totality.

Senator Penny Allman-Payne

Footnotes

[1]Yvonne Buters, Committee Member, Aged Care Reform Now, Committee Hansard, 11 October 2024, p. 45.

[2]Leanne Groombridge, Chief Executive Officer, Advocacy Tasmania, Committee Hansard, 4 October 2024, p. 14.

[3]Peter F, Lived Experience Witness, Committee Hansard, 14 October, p. 20.

[4]Leanne Groombridge, Chief Executive Officer, Advocacy Tasmania, Committee Hansard, 4 October 2024, p. 12.

[5]Beverly Baker, President, National Older Women’s Network, Committee Hansard, 16 October 2024, p. 7.

[6]Patricia Sparrow, Chief Executive Officer, Council on the Ageing Australia, Committee Hansard, 17 October 2024, p. 38

[7]Office of the Inspector-General of Aged Care (OIGAC), Submission 1, p. 2. Emphasis added.

[8]Corey Irlam, Deputy Chief Executive Officer, Council on the Ageing Australia, Committee Hansard, 17 October 2024, p. 41.

[9]Young People in Nursing Homes National Alliance, Submission 17, p. 3; Human Rights Law Centre, Transparency International Australia, School of Governmental and International Relations - Griffith University, Submission 23, p. 5; Individual submissions.