Aged Care Legislation Amendment (Financial Transparency) Bill 2020

30 November 2020

The title of the interim report of the Royal Commission into Aged Care Quality and Safety said it all: Neglect. That simple word cuts to the bone and speaks to the fears that we all share about aged care in Australia. It's not easy when a parent or a friend moves into care. It's a conversation many of us put off time and time again. We put it off because it is difficult to give up the care of someone we love to people we don't know, and we put it off because we don't know how to respond to the fears that are felt: the fear of abandonment, the fear of abuse, the fear of neglect. We want to believe that residential aged care in particular will be like home. We want to believe our loved ones will receive the attention that they need and the care that they deserve. The royal commission was gutting, because it showed comprehensively the standard of care we expect, and we should be able to expect, was often not being delivered. Some facilities were not like home. Some of our loved ones were not being cared for. And some of our fears were well and truly justified.

Aged-care providers have argued that they do their best with the limited financial resources available to them. Maybe that's true, maybe it's not. It's hard to know, because we don't have the information to judge their claims. The current reporting systems are totally inadequate. Some might argue that these are private businesses and they should be able to disclose as much or as little as they like, and normally I would agree. But these are businesses that are receiving over $21 billion in Commonwealth funding every year for residential and home-care services—$21 billion. For that sort of money you would expect real accountability, you would expect providers to show what that money is being used for, and you would expect the government to know how much is being spent on care. You would be wrong.

This bill amends the Aged Care Act. It will require residential aged-care providers to submit an annual report to the Aged Care Quality and Safety Commissioner. That report will show us how much income each provider is receiving and the sources of that funding. It will also show how much every facility is spending: how much they are spending on food; how much is being spent on medicine; how much is being spent on medical supplies; and how much is spent on training. It will also show us how many staff are employed for each classification and how much the executives are being paid. Financial transparency is a reasonable requirement for any sector receiving tens of billions of dollars of public funds, and the cost of compliance will be trivial. Providers already collect this information and no private information will need to be disclosed.

For every honest operator in the sector, financial transparency will be a godsend. It will show the facilities where residents are receiving the most care. For others, for those who take public money but neglect their residents, financial transparency will be a nightmare—a nightmare that I am pleased for them to have. It will show exactly how much money is being spent at each facility and how much is being siphoned off to other corporate entities. It will show their residents, their families and the community the types of facilities they are operating. It will show where they are spending and where they are investing. It will show us their priorities and what they value the most. This will allow residents and families to make informed decisions when choosing a facility. It will help us understand how far these dollars are going and whether we need to invest more so that good providers can do more. This is information that the public deserves to know. It is information that senior Australians deserve to know. There is absolutely no justification whatsoever for keeping this information secret or for allowing providers to remain unaccountable.

The inquiry into this bill is ongoing. Twenty-two submissions have been received to date, and they have been overwhelmingly supportive of financial transparency. I am grateful to everyone who took the time to share their experiences and their views, including care providers. But I do wish more had taken the opportunity to engage with the inquiry. All who made submissions made important, valuable contributions. In their submission the Australian Medical Association said:

… any older person entering aged care, including their carers, has the right to know how their chosen provider of aged care services spends the funds they receive from the Government on the consumer’s behalf and the co-funding provided by the consumer themselves. This was a fundamental premise of the Aged Care Roadmap adopted by the Government in 2016.

In their submission, Aged Care Crisis Inc said:

The absence of data has made it impossible to formulate policies that are based on evidence rather than wishful thinking. It has been impossible to make informed choice and has exposed many vulnerable citizens to the risk of exploitation by profit-focused operators.

On behalf of care providers, Aged and Community Services Australia said:

Transparency in reporting is important, but we must avoid duplication in reporting requirements or adding new reporting requirements that will not materially improve information for consumers, the regulator or Government.

I do understand the point that they are making, but if care-focused financial information was already reported then there would be absolutely no need for this bill. The royal commission showed a clear need for better information, better decision-making and better policy-making. Consumers, regulators and government all benefit from transparency.

Finally, the Aged Care Guild, who represents care providers, said it was:

… fair and reasonable to expect providers share information demonstrating how financial supports contribute to care services.

We are in wholehearted agreement with this. They go on to argue that regulatory requirements and costs are constantly increasing while overall funding has not kept pace. I don't know whether this is true, but that's not the point. The point of this bill is to give us the transparency we need in order to monitor costs and funding. It will give providers the statistical evidence they need in order to make the case for increased funding. And it will give the government the information they need in order to evaluate whether more funding is truly needed.

I would like to thank the groups who have expressed strong support for this bill. They include the Australian Medical Association, the Australian Nursing and Midwifery Federation, the Council of Trade Unions, the Health Services Union, National Seniors Australia and the Aged Rights Advocacy Service of South Australia. I thank them all for their support, particularly the ANMF, for their input into drafting this bill.

The inquiry on this bill will report at the end of March, after which I will bring this bill to a vote. I hope every senator will support it and I hope any senator who has concerns about the bill will come and discuss these with me. If you believe that financial information should not be reported, if you have concerns or if you have some suggestions, I will hear you out. But I hope you will hear me out, too, and I hope you will seriously consider whether the current approach is delivering for the residents of these facilities, for their families and for taxpayers.

The royal commission demonstrated that problems in the aged-care sector are systemic, and that the aged-care system is designed around transactions, not relationships or care. No single piece of legislation can transform the sector or solve all of its problems but there are things we can do, and things that we can very much do better. Financial transparency is well and truly one of them. My bill provides for a simple and fair change that will drive providers to do better. It will make a difference to the lives of aged-care residents. And it will help us be a little more certain that our loved ones are going to a good place: a place that they can call home, a place where they will truly be cared for.

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