House of Representatives
I rise to speak in support of the Aged Care Legislation Amendment (Emergency Leave) Bill 2020.
Mother’s Day, last Sunday, must have been particularly hard for thousands of mums in aged-care facilities. For many, it would have meant, for the first time, seeing their children and grandchildren through a pane of glass or a cold flat screen on this special day—horrible, but necessary. It’s likely that these restrictions have prevented widespread outbreaks in our aged-care facilities to date. But it is indeed the cruellest irony of this pandemic that the best way to love someone is to stay away from them. The heartbreak for families has been profound. The coronavirus pandemic is testing the aged-care sector in ways that it could never have imagined. Facilities have plans in place for infectious disease, such as influenza or gastro outbreaks. Coronavirus makes these pale in comparison.
These times, however, call for exceptional courage on all fronts. Older Australians living in aged-care facilities, having seen a lifetime of ups and downs, are now the ones most vulnerable to the pandemic. The aged-care workforce, working part-time or casually, and many from overseas, are doing hard work with dedication and with care, and I thank them. And the aged-care facility management are making tough calls, balancing the respect and dignity of their residents with the care and protection of them and their staff. I’ve been on such a board. I was formerly on the board of St Catherine’s aged care in Wangaratta and I know very well the difficult decisions that these boards have had to make in order to keep our aged and most vulnerable people safe —doing that while knowing that they were breaking the hearts of the people who so very much want to visit them.
I’ve received many calls from constituents about visiting their loved ones in aged-care facilities. At the end of March, the crisis seemed like it was on a trajectory to match the worst of what we’d witnessed overseas. Responding to the urgency of the crisis, providers set their own rules—in some cases, stopping visits completely. For many, this sudden change felt like a door being slammed shut. Families of residents were in tears on the phone, distressed and confused about why they were being denied entry. It seemed too much. This was likewise upsetting for residents, who look forward to seeing their families on a regular basis to share stories, show photos and, in better times, hold hands and have such a dearly beloved hug. Older Australians in aged care disproportionately experience loneliness. Loneliness in aged-care facilities is devastating, and this, of course, has been made so much worse by the necessary interventions of this pandemic. Social distancing has made that unbearable for many. In addition, with group gatherings and external excursions cancelled, visits in these circumstances would have been more important than ever. For our loved ones with cognitive challenges, the confusion must be absolutely terrible.
I’m glad to see that the industry led aged-care visitor access code, released yesterday, establishes a nationally consistent approach to continuing visits while managing the risks of COVID-19. This 13-point code will be reviewed in three weeks, which is important, as the consultation time frame was, understandably, very short. This code includes, as it should, a human rights approach to care which both protects and respects residents and their families. Importantly, the principles maintain that visits can take place in a number of ways, including using technology; through windows, courtyards and balconies; and in person upon arrangement. The digital divide, however, is very real for older people. FaceTime and Zoom are not intuitive if you’re not a regular user or indeed if you don’t have access to an iPad, an iPhone or any other device. Of course, nothing can replace seeing your loved ones face to face. My hope is that this code will clear up the confusion which has caused so much angst and distress. As this virus is likely to last many more months we need to move beyond a kneejerk response, appropriate at the time, towards measures that are sustainable and compassionate over the long term.
My truest hope, though, is that the Royal Commission into Aged Care Quality and Safety will bring about true reform across the sector that reduces variation across our aged-care facilities. There should not be an A team and a B team on this. It should be consistent, high-quality care. I am pleased to support this bill. This bill introduces a new type of leave that will enable providers to remain eligible for the residential aged-care subsidy in declared emergency situations. This means that approved providers cannot decide to charge aged-care residents a fee during declared emergencies to reserve their place in an aged-care service. This change increases flexibility in aged-care services, which is so important in uncertain times.
We all want our family to be safe, to be well cared for, to be healthy and to live in an environment where they feel comfortable, relaxed, loved and free. As we’ve seen, coronavirus outbreaks can be highly disruptive to the routines of our aged-care residents. These changes can be stressful and can cause concern about the residents’ physical and mental health and wellbeing. This change makes it easier for residents to decide to leave the aged-care service and temporarily relocate to another place if they’re concerned about their safety when there is a declared emergency. This also allows them to use their remaining allocation of social leave to maintain normal visiting and special events with families. I am so pleased to see that the bill ensures that providers are no worse off but ensures they continue to receive the residential subsidy while residents are taking this emergency leave. This is crucial, especially to rural health services, such as those in my electorate, that run residential aged-care facilities and run on very slim margins.
While the coronavirus pandemic is the emergency at the forefront of our mind, this bill also notes that an emergency may include a natural disaster. This is an important inclusion for communities in my electorate that experienced the devastating ‘black summer’ bushfires. For residents who wish to evacuate from a service with their families during an impending fire front, they should not have to draw down their social leave just to be safe, and this bill guarantees that is no longer the case. During these recent bushfires, Corryong Health, with its aged-care facility, came under direct attack, with flames only 300 metres away. What followed was immense fortitude shown by the service and its residents as the service experienced days-long blackouts, no phone reception, restricted access to water and significant workforce shortages as staff evacuated their families or left to defend their own homes and farms. Once the fire front passed, the 37 residents were convoyed out through the blackened landscape and temporarily re-homed in Yarrawonga and Numurkah aged-care facilities, returning to Corryong three weeks later. This extraordinary feat was undertaken by Corryong Health staff, with Ambulance Victoria and the SES. Credit is due to Yarrawonga Health and the Numurkah district health service for making the residents feel welcome, loved, safe and secure during their stay. When bushfires are approaching an aged-care centre and a town is being evacuated, this is exactly the circumstance in which the minister should exercise his powers under this new bill.
Like all of us, aged-care residents should have the freedom to choose to leave their homes when they’re in danger so they can have certainty over what happens next. This bill would remove any financial burden that would dissuade them from doing so, and I congratulate the minister on this amendment. The residential aged-care service of which I speak is run by Corryong Health, which serves the stunning and isolated town of Corryong and its surrounds. I was pleased to host Minister Hunt on his visit to Corryong in January when he heard firsthand what this service will need to keeps its residents and patients safe and secure in the next disaster. This includes an emergency fail-safe telecommunications system, an emergency water supply for firefighting—extraordinary, really—in their hospital, potable water and funding for capital works. Unfortunately, though, there’s been little substantial progress on these proposals since that visit, and I will continue to work with the minister to ensure that funding for these crucial supports, including the residential aged-care service, can be secured.
So what to do next? Despite the sense of optimism we might be feeling today with the easing of social-distancing restrictions, we know that the coronavirus will have a long tail, possibly stretching out for years. While the aged-care sector provides high levels of care and protection for its residents, those residents are also the most vulnerable to the disease. Now is the time for the government to look ahead, plan for the future, and address other aspects of the aged-care system that the coronavirus will exacerbate. A particular concern to me is the integrity of the aged care package assessment and service delivery. In response to coronavirus, many aged-care assessment providers have replaced in-person assessments with telehealth or phone based assessments to protect the health of both the assessors and the clients. But in-home visits are actually what’s needed and are, ultimately, critical to ensuring that vulnerable people receive the care that they need. Assessment teams are highly trained to identify the physical, emotional and social needs of clients, as well as identifying instances of elder or financial abuse. It’s impossible to fully deliver this over a phone. So we need a plan, and we need it soon, to ensure that people are assessed to get the support they need.
Concerningly, I have heard that some in-home aged-care residents are refusing visits from nurses and allied health professionals due to fear of infection. If continuity of care is disrupted for a long period, we risk deterioration in the health of older Australians, possibly causing an increased risk of hospitalisation. Older people should not be making do. They need to be confident that they can get the medical care that they need without jeopardising their health. And, likewise, the nurses and allied health professionals who treat them need adequate protection to do their jobs effectively and safely. I’ve written to the Prime Minister sharing these concerns and he’s assured me that his government will continue to review its response to the situation as it evolves, in order to ensure that older Australians are receiving the right support. I welcome the government’s investments to date and encourage the government to continue for looking for opportunities to improve the system of aged-care. This brings me to home care package wait times. Our focus now is on the coronavirus, but we cannot wait for the crisis to pass to fix the waiting times for home care packages.
The smartest way to keep ageing Australians safe from coronavirus is to let them stay in their homes, where they’re comfortable and secure. If supports are in place, they don’t need to enter residential aged care and become exposed to coronavirus or encounter the enormous stress of an outbreak or the necessary change in routine this might bring. Why isn’t reducing the shamefully long wait for home care packages part of the government’s coronavirus response? The wait time is still over 12 months for the highest level packages. In the quarter to December 2019, over 104,000 people were still waiting for their approved home care package. While they wait for the government to deliver what has been agreed to give them, their health may deteriorate. They may be hospitalised as there’s simply no other way to get their care. We can’t afford a bigger sickness burden on our hospitals at this time. Their families are doing the best they can to care for them, while maybe struggling themselves. While COVID-19 specific aged-care measures have been significant, the government needs to do more. It controls the levers. It can clear the waitlist. There cannot be any more excuses. It can and must do this to close the loop on the protection of our older people.
[13 May 2020]