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representatives vote 2024-11-07#6
Edited by
mackay staff
on
2024-11-17 15:03:13
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Title
Bills — Aged Care Bill 2024, Aged Care Legislation Amendment Bill 2024; Consideration in Detail- Aged Care Bill 2024, Aged Care Legislation Amendment Bill 2024 - Consideration in Detail - Advisory bodies
Description
<p class="speaker">Rebekha Sharkie</p><p>by leave—I move amendments (1) and (2) on the sheet revised 4 November 2024, as circulated in my name together:</p>-
- The majority voted in favour of a [government amendment](https://www.openaustralia.org.au/debate/?id=2024-11-07.44.1) to remove the subclauses set out below, which means those subclauses will no longer be part of the bill.
- ### Amendment text
- > *(1) Clause 158, page 167 (line 26) to page 168 (line 18), omit subclauses (5) to (7).*
- ### Subclauses (5) to (7)
- > *158 Advisory body requirements*
- >
- > *[...]*
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- > *(5) It is a condition of registration that a registered provider of a kind prescribed by the rules must offer, in accordance with any requirements prescribed by the rules, aged care workers of the provider the opportunity to establish a body (the quality care worker voice body ) to:*
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- >> *(a) give responsible persons of the provider feedback about the quality of the funded aged care services delivered by the provider; and*
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- >> *(b) give responsible persons of the provider feedback on any other matters prescribed by the rules; and*
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- >> *(c) work collaboratively with the responsible persons and governing body of the provider to address any such feedback.*
- >>
- >> *Note: A person may make a complaint to the Complaints Commissioner about compliance with this Act: see section 361.*
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- > *(6) If a quality care worker voice body is established, a registered provider must require the governing body of the provider to:*
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- >> *(a) comply with any requirements regarding membership of the body and the terms and conditions of members of the body prescribed by the rules; and*
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- >> *(b) consider feedback given by the body when making decisions in relation to the quality of the funded aged care services delivered by the provider; and*
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- >> *(c) advise, in writing, the body how the governing body considered such feedback.*
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- > *(7) It is a condition of registration that the registered provider must, if requested to do so by a quality care worker voice body, give the body information about the quality of the funded aged care services delivered by the provider.*
<p class="italic">(1) Clause 600, page 540 (line 25), omit "31 January 2029", substitute "the third anniversary of the commencement of this Act".</p><p class="italic">(2) Clause 600, page 540 (line 29), omit "no later than 31 March 2030", substitute "within 15 sitting days of that House after the report is given to the Minister".</p><p>Providers will newly be able to charge a maximum refundable deposit for residential aged care of $750,000 indexed over time, up from $550,000, without seeking separate regulatory approval. Depending on when each person enters aged care, a couple could be required to pay deposits of up to $1.5 million between them, as well as significant ongoing fees for each person.</p><p>I won't detain the House for too long, but I would just like it to make it clear that this will have profound impacts on people's lives. My constituent, Betty, whose husband is living with dementia has written to me. She said: 'Many people have mentioned that my husband should be in a nursing home, and I realise that this will be necessary, but I cope as long as I can. My concern is that the ridiculously high entrance cost proposed will force carers, many women like me, to struggle on as a carer at home, largely invisible. To me, this is a feminist argument—a carer role for children and then for aged relatives, with a token reward. I've been saving hard to have the nursing home upfront fee, but there's no way I could save $750,000. This is a ridiculously high amount. I don't have to pay, apart from private insurance, when he is in hospital, as he is ill. I can't see a difference, to be honest. It is not a universal service that we will all use when we are deemed old. It is for those who need specialist care. It's not a hotel. Comparisons of that with being the normal cost of living is highly offensive. I also wonder if I should place him in a nursing home earlier rather than later, before July next year, which is very soon, as soon as he comes under the new rules—a cruel decision to have to make.'</p><p>I note that if Betty and her husband were able to save the $750,000, which is what it potentially could be—this will no doubt, I think, become the default minimum refundable deposit—it will be expended on her husband's refundable deposit. This will likely leave Betty with few savings should she later require high-level care, and I suspect, as Betty has said to my office, that this burden will be borne predominantly by women. I think this is very true.</p><p>Over a five-year period, at a conservative six per cent rate, a provider of residential aged care will earn $253,669 in compound interest on the refundable deposit of $750,000, and providers will newly be permitted to retain two per cent of that refundable deposit. That's up to $75,000. So, as well as the compound interest, we're looking at a contribution of potentially $328,000. The parliament is being asked to provide a huge windfall for operators on an understanding that the additional capital will be spent and maintained on improving facilities, but it's not exactly clarified exactly how the government intends to monitor that. What we need to make sure is that it's not spent on Lamborghinis or Birkin bags—and we have seen media reports of that—and that it's actually spent on improving facilities. That is why I am moving these amendments. I commend these amendments to the House.</p> <p class="speaker">Anika Wells</p><p>I thank the member for Mayo for her genuine and ongoing advocacy for older Australians, particularly in the electorate of Mayo. I confirm that the government supports the amendment with respect to the act review. This bill will deliver once-in-a-generation reform that will have a profound impact on the lives of older Australians and their families and carers, aged-care workers and providers. We agree it's important that the review into the operation of the act is brought forward to ensure that it is delivering on its intended purpose, to create a forward-looking aged-care system that upholds the rights of older Australians receiving aged-care services.</p><p>Aside from the member for Mayo, who has worked tirelessly in this space for many, many years, I also recognise the stakeholders who have advocated for this amendment in particular, including National Seniors Australia, the Older Persons Advocacy Network, Council on the Ageing, Dementia Australia, Carers Australia, Catholic Health Australia, Australian College of Nursing and Wongaburra, an aged-care provider in Beaudesert in the electorate of Wright. I note this was also a recommendation put by the opposition in the community affairs committee report on the bill.</p><p>Question negatived.</p> <p class="speaker">Rebekha Sharkie</p><p>by leave—I move amendments (3) and (4) on the sheet revised 4 November 2024, as circulated in my name, together:</p><p class="italic">(3) Clause 601, page 541 (line 3), omit "fifth", substitute "third".</p><p class="italic">(4) Clause 601, page 541 (after line 4), after subclause (1), insert:</p><p class="italic">(1A) Without limiting subsection the matters to be covered by the review, the review must:</p><p class="italic">(a) have regard to the objects of the Act; and</p><p class="italic">(b) consider the following matters:</p><p class="italic">(i) the operation of the Statement of Rights and the Statement of Principles;</p><p class="italic">(ii) the effectiveness of the Act in delivering the objects, including enabling individuals to exercise choice and control;</p><p class="italic">(iii) the effectiveness of the Act in embedding the role of supporters in the aged care system;</p><p class="italic">(iv) the extent of unmet demand for funded aged care services in a home or community setting;</p><p class="italic">(v) the duration of waiting periods from application to service commencement for funded aged care services in a home or community setting;</p><p class="italic">(vi) the effectiveness of the governance (under Chapter 5) and regulatory mechanisms (under Chapter 6) of the aged care system in overseeing and ensuring the quality of funded aged care services;</p><p class="italic">(vii) the effectiveness of the Act in ensuring equitable access to funded aged care services for individuals, regardless of their location, background and life experience;</p><p class="italic">(viii) the effect of Part 3 of Chapter 4 (about individual fees and contributions) on the sustainability of the aged care system, service usage and outcomes for individuals accessing funded aged care services;</p><p class="italic">(ix) the use of refundable accommodation deposits and daily accommodation payments;</p><p class="italic">(x) the proportion of aged care accommodation payments being charged at the maximum accommodation payment amounts;</p><p class="italic">(xi) the proportion of registered providers who charge an accommodation payment approved under section 290 (that is, an approved accommodation payment that is higher than the maximum accommodation payment amount);</p><p class="italic">(xii) the quality and timeliness of data published about the performance of the aged care system.</p><p>This relates to clause 601, the statutory review. I have heard from key stakeholders, including National Seniors and Council of the Ageing, that the planned mechanisms for statutory review of the act after five years of operation are insufficient and too distant into the future. I've therefore moved amendments (3) and (4) in my name to require review of the operation of the act within six months after the third anniversary of the commencement of the act, with a report to the parliament to be tabled within 15 sitting days of the report being given to the minister.</p><p>I've also consulted with Council of the Ageing, COTA, regarding the inclusion of proposed terms of reference for the act's statutory review being an inclusive rather than exclusive list of matters required to be considered on review based on stakeholder feedback. They include the effectiveness of the act in delivering objects, including choice and control, for individuals; receiving funding for aged-care services; whether the act has been successful in embedding rights, principles and supported decision-making as the foundations of aged care delivered in Australia; whether the level of support and greater investment in support at home has improved access and reduced waiting times for individuals to receive care; the effectiveness of arrangements for regulation and governance of aged care; and the impact on ensuring the quality of funded aged-care services.</p><p>In the context of once-in-a-generation reform in the aged-care system coming out of a once-in-a-generation—we hope—royal commission, with huge impacts on older Australians' rights and the quality and cost of care, the importance cannot be overemphasised of building a meaningful statutory review to ensure that the effectiveness of the scheme is rigorously assessed so that improvements can be identified and promptly implemented when needed. I commend these amendments to the House.</p> <p class="speaker">Anika Wells</p><p>I thank the member for Mayo for her ongoing advocacy. I note, with respect to RAD reviews, we have committed to a phase-out of refundable accommodation deposits by 2035, following a review of sector readiness for this transition, which will be in 2029-30. The Aged Care Taskforce, which brought together aged-care stakeholders, experts and providers, found that time is needed to manage the transition away from refundable accommodation deposits and that a review should be undertaken in 2030. A change in the timeframe as recommended by the taskforce was not a key issue identified in the Senate Community Affairs Legislation Committee report on the Aged Care Bill.</p><p>With respect to the act review, we do agree it's important. We think the member for Mayo is correct on this. We think the review into the operation of the act can be brought forward to ensure it is delivering on its intended purpose to create a forward-looking aged-care system that will uphold the rights of older Australians receiving aged-care services. It was also a recommendation put forward by the opposition in the community affairs committee report on the bill. I thank the member for Mayo.</p><p>Question agreed to.</p> <p class="speaker">Sophie Scamps</p><p>by leave—I move amendments (1) and (2) as circulated in my name together:</p><p class="italic">(1) Clause 5, page 3 (line 3), after "Cultural Rights", insert ", the International Covenant on Civil and Political Rights".</p><p class="italic">(2) Clause 7, page 14 (after line 2), after the definition of <i>cost</i>, insert:</p><p class="italic"><i>Covenant on Civil and Political Rights</i> means the International Covenant on Civil and Political Rights done at New York on 16 December 1966.</p><p class="italic">Note: The Covenant is in Australian Treaty Series 1980 No. 23 ([1980] ATS 23) and could in 2024 be viewed in the Australian Treaties Library on 7 the AustLII website (http://www.austlii.edu.au).</p><p>The amendments I am introducing today go to the objects of the Aged Care Bill 2024. Section 15AA of the Acts Interpretation Act provides that statutes should be interpreted in accordance with their objects and that all other provisions of the bill are to be read as far as is possible as being designed to carry out these objects.</p><p>There can be no understating, therefore, of the importance of getting the objects provisions in the legislation right. Currently the bill's objects clause states, among other things, the objects are to:</p><p class="italic">give effect to Australia's obligations under the International Covenant on Economic, Social and Cultural Rights—</p><p>the ICESCR—</p><p class="italic">and the Convention on the Rights of Persons with Disabilities—</p><p>the CRPD. However, there is no reference in the objects to the International Covenant on Civil and Political Rights. The explanatory memorandum to the bill states:</p><p class="italic">This is because the objects specify only those conventions that the Bill upholds in reference to the External Affairs power, but it does not mean that the Bill does not endeavour to uphold these other international conventions.</p><p>Basically, the bill only includes those international human rights treaties that the minister considers relevant to the constitutional authority of the Aged Care Bill.</p><p>The Law Council takes a different view. In its submission on the bill's exposure draft, the Law Council queried the department's assessment that only the ICESCR and the CRPD are relevant to provide the constitutional foundation for the Aged Care Bill and to manage associated legal risk. The Law Council went on to say that various provisions in the bill may carry the risk that they do not have a proper constitutional foundation because there may not be a proper foundation for them in the Convention on the Rights of Persons with Disabilities. These include the right to be free from all forms of violence, neglect or abuse and the right to be treated with dignity. Only half of Australians over the age of 65 are living with a disability. To rely only on a treaty relating to disability to give the bill its constitutional foundation is a risk.</p><p>The International Covenant on Civil and Political Rights, on the other hand, applies to all persons and will eliminate this risk if incorporated into the bill. After all, the report of the aged care royal commission described aged care in Australia as 'a sad and shocking system that diminishes Australia as a nation' and said it tells a 'shocking tale of neglect'. It was the royal commission report that shocked the nation. The ICCPR is a foundational international human rights treaty, and it needs to be incorporated into what is, after all, a bill which seeks to establish a rights based framework for the older Australian.</p><p>Since publishing this amendment yesterday I've been contacted by Australia's Council on the Ageing, COTA Australia, expressing their appreciation for it. In their view, it will bolster the scope of powers the act sits upon. If we do truly want a bill that is based firmly on the rights of all older Australians, I ask for all my colleagues in this House to support this simple yet commonsense amendment.</p> <p class='motion-notice motion-notice-truncated'>Long debate text truncated.</p>-
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