I’m speaking here today because we cannot, and must not, forget about aged-care reform. It’s close to six months since the aged-care royal commission handed down its report, yet it has all but disappeared from the national conversation. In this casual way of forgetting, successive governments have overseen 30 years of slow collapse of the aged-care sector, and we can’t let that happen again. That’s why today I’m calling on the government to explain when and how it will deliver tangible progress on aged care—because, while the pandemic rages, millions languish in the same conditions the commissioners described. The heartbreak of residents who have returned to Zoom calls for contact with loved ones must be salved by clear evidence that, irrespective of lockdowns, the royal commission reforms are tangibly progressing.
System reform can be slow. It is, by definition, hard. That doesn’t mean, though, that we can delay. Aged-care services in rural and regional Australia have thin markets and workforce challenges, and their context-specific models of care call for fit-for-purpose funding responses. Residential aged care in the alpine town of Bright is one example. It has no high-care aged-care facility. Bright hospital is part of the Alpine Health multi-purpose service. This community has called for a dedicated high-care facility for three decades. Without one, older people are forced to leave the only place they know and move to another town. Their spouses may be too old to drive to visit them and public transport for relatives and friends is sporadic or non-existent. This is heartbreaking and emblematic of the epidemic of loneliness that so many older Australians face.
In Bright, the answer is answer is clear: Alpine Health’s feasibility study sets out a plan for the redevelopment of Bright Hospital as an integrated health service, with a dedicated high-care residential facility with co-funding by state, community and philanthropy. But they need federal support, and I’m calling on the government to step up for this support. Right now, the Commonwealth prohibits funding to capital infrastructure for multipurpose services such as Bright, and this simply doesn’t make sense. The facilities are outdated and deteriorating. Aged care is a Commonwealth responsibility. While the MPS model was established to be flexible and to integrate aged and acute services for small rural communities, this government excludes MPS from grants that every other aged-care provider can access, including the Aged Care Approval Rounds, which some non-MPS services in many towns across my electorate have received. The government agreed to revisit its ban on funding capital infrastructure in its responses to the 2019 MPS review and the 2021 royal commission report. Yet, that’s the last we hear of it: no money in the budget and no straight answers in ministerial meetings. So I call on the government to urgently implement the recommendations of the multipurpose services review without delay.
Quality aged care needs expert staffing. This government needs to fully commit to recommendation 86 of the royal commission report by mandating that a registered nurse is on site at residential aged-care facilities at all times. As a former nurse, at a rural bush nursing aged-care centre many years ago, and as a volunteer and director at a larger aged-care facility, I know that having nurses on site benefits not just the residents—whose care is complex, ranging from chronic pain management, diabetes control, wound management, mental health issues, cognitive care through to palliative care support—but also the personal care attendants by providing them with expert help and timely advice. Having registered nurses on site 24/7 supports an overworked and stretched rural GP workforce. Just ask the local doctors and they will tell you how many out-of-hours visits and avoidable hospital visits 24/7 registered nurse care prevents. And imagine if this included the expertise of nurse practitioners, who face non-sensical barriers to providing care to those who need it most.
The royal commission recommended that this be phased in from 16 hours a day in July 2022 to round-the-clock care by July 2024, yet the government committed to 16 hours per day, which will not be mandatory until October 2023. This is not good enough. The need for clinical care doesn’t operate in shifts and cannot wait for two years. I know that finding the workforce we need will not be easy, because of the long-term erosion of the sector, but we need to get cracking. I call on the government to act and act quickly to benefit the hundreds and hundreds of aged-care residents and workers in my electorate of Indi who are providing care, dignity and respect under difficult conditions.