Source: https://www.openaustralia.org.au/senate/?id=2019-12-05.7.1
Timestamp: 2020-07-15 17:49:14
Document Index: 348198208

Matched Legal Cases: ['art 5', 'art 5', 'art 5', 'art 7', 'art 4', 'art 7', 'art 4', 'art 7']

Aged Care Legislation Amendment...: 5 Dec 2019: Senate debates (OpenAustralia.org)
Aged Care Legislation Amendment (New Commissioner Functions) Bill 2019; In Committee
If the Senate is agreeable I would like to ask a series of questions of the minister, which I hope I can do expediently, to get some issues on the record—issues that I think the minister is pretty aware I have some concerns about and would like a better understanding of—and then I'll move my amendment. I think that will probably be the quickest way. I don't want to hold up the place—I'm aware that there's a lot to get through today—but I do think this is an important matter, and there are a number of points that I'd like to make sure we address.
I want to ask a couple of questions about complaints. Through you, Chair, I ask the minister: what work is the government doing to reduce legislative barriers that prevent the publication of complaints and their resolutions?
As part of the process that we're going through with this piece of legislation—it is actually, as you would understand, the full establishment of the Aged Care Quality and Safety Commission—I've written to the advisory committee that supports the Aged Care Quality and Safety Commission, asking them to advise me and the commission what additional powers might be required. That can go to things like reporting. I'm happy to have some conversations with you as that report comes back to me; it's due very soon. I understand your desire to see transparency, particularly around reporting, and I support that process. It's important to the government that people who have issues that they want to report through the Aged Care Quality and Safety Commission can do that, and can do it in a way that provides them satisfaction as to the fact that their complaints have been addressed and resolved in a way that's satisfactory to them.
I thank the minister for his answer. You said you're expecting the report to come back fairly soon. What time frame are you talking about, and what's your intended process from there? Will that information become public or will you then go through a process of discussing it with various stakeholders?
I'll be briefed on that next week, when I meet with the advisory committee; I'll get an initial briefing then. The report will come to me subsequent to that. It will go through some consultation with stakeholders; I think that's an important part of the process. But I am also really cognisant of the fact that we do have a royal commission going on. The commission said to us in their interim report that they didn't want ad hoc changes made to the act. In fact, they may come back to us with a recommendation for a whole new act. They would prefer that any changes occur in that context. So I'm cognisant of respecting that process. It may be that we share those recommendations that come back from the advisory committee with the royal commission.
I appreciate what you've said about the amendments to the act, and I suspect, yes, there will need to be a whole new act. But there may be processes that you could put in place that don't require changes to the act that would improve transparency and accountability. Would you be prepared to look at changes that could be made either through delegated instruments or just the process, if changes to the act are not advisable, given the process that's going to happen next year through the royal commission?
I suppose that will depend a little bit on what comes back through the report that comes to me from the advisory committee. I will consider all of those things. I think we have demonstrated, as we did with the changes we made to the regulations around restraint, that, if there are things that we see that we can and should act on, we are prepared to consider those things.
As the chamber will be aware, I have amendments around enabling complaints about My Aged Care, ACAT and the RAS process. Minister, is the government prepared to support those amendments? If not, why can't community members lodge complaints about that—
The CHAIR: Senator Siewert, it's probably better if you move the amendments first, and then they're live.
by leave—I move Australian Greens amendments (1) to (3) on sheet 8811 revised together:
(1) Schedule 2, page 31 (after line 19), after item 19, insert:
19A Paragraphs 56 -1(k) and (l)
(k) to do the following:
(i) allow people acting for care recipients to have such access to the service as is specified in the User Rights Principles;
(ii) provide such people information relating to the residential care being provided by the service;
(l) to do the following:
(i) allow people acting for bodies that have been paid *advocacy grants under Part 5.5, or *community visitors grants under Part 5.6, to have such access to the service as is specified in the User Rights Principles;
19B Paragraph 56 -2(j)
(j) to do the following:
(i) allow people acting for bodies that have been paid *advocacy grants under Part 5.5 to have such access to the service as is specified in the User Rights Principles;
(ii) provide such people information relating to the home care being provided by the service;
19C Paragraphs 56 -3(j) and (k)
(ii) provide such people information relating to the flexible care being provided by the service;
(2) Schedule 2, page 49 (after line 14), after item 47, insert:
47A At the end of section 18
; (c) the performance of any assessment (however described) conducted, in accordance with the rules, for the purposes of accrediting an aged care service referred to in paragraph 19(a);
(d) the performance of any quality review conducted, in accordance with the rules, of a service referred to in paragraph 19(b);
(e) the performance of any monitoring, in accordance with the rules, of the quality of care and services provided by:
(i) approved providers of an aged care service referred to in paragraph 19(c); or
(f) the performance of any electronic platform established by the Commonwealth to provide information relating to the provision of aged care services or Commonwealth-funded aged care service.
47B At the end of subsection 21(2)
(3) Schedule 2, page 49 (after line 19), after item 48, insert:
48A At the end of Division 3 of Part 7
59B Publicly available report on complaints etc. relating to approved providers and service providers
(1) As soon as reasonably practicable after the end of each calendar month, the Commissioner must:
(a) prepare a report setting out the matters mentioned in subsections (2) and (3); and
(b) make the report publicly available.
(2) For approved providers the Commissioner received complaints or information about, the report must set out:
(a) the number of complaints or information received about each approved provider during the calendar month; and
(b) the number of complaints or information received about each approved provider during a previous calendar month that were not resolved or dealt with by the end of the calendar month;
(c) for each aged care responsibility that the complaints or information relates to—the number of complaints or information received relating to the responsibility; and
(i) the type of actions taken by the Commissioner to address the complaints, or to deal with the information, and
(ii) the number of those types of actions taken.
(3) For service providers of Commonwealth-funded aged care services the Commissioner received a complaint or information about, the report must set out:
(a) the number of complaints or information received about each service provider during the calendar month; and
(b) the number of complaints or information received about each service provider during a previous calendar month that were not resolved or dealt with by the end of the calendar month; and
(c) for each responsibility under the funding agreement that relates to the service that the complaints or information relates to—the number of complaints or information received relating to the responsibility; and
(4) The report must not include personal information unless the inclusion of the personal information is necessary to identify the approved provider or service provider (as the case may be).
I've got a series of questions, obviously, around these issues, which I will try to get through very quickly. Could I ask the government: what would be the issues with the complaints process addressing My Aged Care, the ACAT process and the RAS process?
The CHAIR: You started off by asking the minister if the government could agree to those amendments, so that's what you're asking? Yes? I call the minister.
The process for the quality and safety commissioner is designed to deal with complaints relating specifically to the provision of care, not to the assessment process. They are separate elements. The commission is intended to operate as a single point of contact for the regulation of quality of care in aged-care services. It's not intended to regulate the process by which consumers access Commonwealth subsidised or funded aged-care services. There are existing arrangements in place for those. So they're separate.
We take this opportunity to convey that Labor is sympathetic to those in this place who want to provide solutions to the many issues that exist across the aged-care sector, but, in saying this, Labor isn't in a position to support the Greens amendments. The interim report of the Royal Commission into Aged Care Quality and Safety conveyed a strong message from the commissioners. They said they would 'recommend comprehensive reform and major transformation of the aged-care system in Australia', but they also stated that they would 'chart a new direction for the sector', hopefully 'bringing a clear sense of purpose and of quality'. What mechanisms will be required to address the recommendations in the final report are not known, but I think it would be folly to try to pre-empt too much of the commissioners' directions now. So it is our strong view that any reform should now be done with a clear intention and it should be done in a holistic way.
We have not been consulted in the lead-up to these amendments being drafted. It's therefore difficult for Labor to support these amendments given the absence of any consultation. It's also difficult because we are concerned that the necessary consultation with the aged-care sector and consumers may not have occurred.
I assure the ALP that consultation with consumers has occurred. In fact, this comes directly out of consumers and the inquiry into the first phase of these changes. While I agree that fundamental changes to the act shouldn't be made in the run-up to the royal commission, let's be honest here. It's not reporting until late next year. It will take some time—let's face it—in the run-up to the next election for any action to be taken. I am not casting aspersions on the government, or anybody else for that matter; that's simply the reality of the way regulation works and making sure we've got an act that meets the recommendations from the royal commission in the future.
We're talking about changes that will help people now. Anybody who is involved in the aged-care system knows that My Aged Care is extremely complicated, very hard to navigate and means there isn't a single point of contact for the aged-care system. It makes sense to enable the commission to address these particular issues; otherwise they simply aren't addressed. It's a fallacy to say there's a single point of entry. So please don't come the one about: 'You haven't consulted with us about it.' As to the sector, consumers have asked for this. They've been complaining about My Aged Care a lot, as I addressed in my second reading contribution. So say you don't support them but don't use the excuse of not being consulted. Since when has the ALP consulted anybody else when they've brought in amendments? The fact is this is what consumers would like to see: a genuine single point of entry.
I ask: does the government intend to do anything about making My Aged Care, ACAT and RAS actually accountable and more usable in the at least 18 months that we will be waiting before we see any changes come through as a result of the royal commission's final report.
Senator Siewert, I think that you will see this system look very different over the ensuing period. I make the point again that the role of the Aged Care Quality and Safety Commissioner is to oversee aged-care providers. The ACAT process, the assessment process, is completely different. It's currently delivered by a number of providers, including state governments. As part of our response to the royal commission report, we said that we were going to move to a process of a single national provider. That work has now commenced. So that process is going to change—and I think the oversight mechanism around that will probably have to be modified as part of that reform. The whole delivery of aged care is at the point where it's starting to change quite significantly.
The point that I would make is: the Aged Care Quality and Safety Commissioner's role is to oversee the quality of service delivery—not assessment. The assessment process is about to change significantly. So we need to make sure that we identify the differences and, as the reform of the assessment process continues, there will have to be appropriate oversight processes for that.
Can I ask for the minister's undertaking that they will provide a briefing on how the continuing oversight will then be conducted on the new system once that is more in place?
Thank you. I have a couple of questions around the serious incident response scheme. I understand that the department has finished the consultation process. Is that correct? Has the government got the paper? If so, will it be publicly available and when? I will ask those questions first and then I have series after that.
I don't have the final documentation on the serious incident response scheme. It is due to me very soon—and by that I mean probably early in the new year. Once that's available to me, I'm happy to have a conversation with various parties about that.
Thank you, Minister. Is it intended that at some stage you will be releasing the actual report, or just your decision following the report?
Given that I haven't seen anything yet, I am not in a position to make a specific decision about that. Once I receive it, I will be in a position to do that and I would be happy to have a conversation in that context.
Given that, I don't know if you are in a position to answer my next question, but I'm going to give it a go. In terms of 'where to here from here' with the scheme, is it your intent that it sits within the remit of the commission or the department?
My expectation is that it will sit with the commission.
That's what I was hoping and expecting, but I thought I'd better check. I'm aware that you are considering another phase of changes for the commission functions. Given your expectation that it will sit with the commission, is it your intent that that will be included in that process?
Until I am briefed by the advisory council to the commission, I really can't answer that question definitively. From my perspective, this process will be quite open. It's not something that I'm looking to contest. I am genuinely looking to ensure that senior Australians receive high-quality and safe aged-care services. That is my motive in this process.
Thank you. Can I ask about the continuous quality improvement framework? Is this being developed alongside the Serious Incident Response Scheme? Is it separate, or is there little work being done on it?
I don't have anything specific on that, but my expectation would be that it's being developed alongside. Quite frankly, my expectation of the way that the quality system operates is that there is always a continuous process engaged in that, because that's how a good-quality system works.
I take your point, but it was not obvious to us, during the Senate inquiry into this process, that that was happening, which is why we recommended that it happen. I realise you haven't got the report yet, but is it your intent—or, should I say, your expectation—that the scheme would include the issue of sexual assault?
The Serious Incident Response Scheme will include issues of sexual assault. There are still some things, as I understand, being considered around the parameters of that, but it will include issues relating to sexual assault.
Thank you. Sorry, I should have asked this: going back very briefly to the continuous quality improvement framework, can I ask the minister to take that on notice and perhaps get back to us on where that's at?
Thank you. As you know, one of the other amendments I've moved as part of our amendments on sheet 8811 revised addresses the issues of advocates and access to premises and information. Can I ask the government to confirm whether the term 'persons assisting' refers only to employees of the commission and does not include advocates or community visitors?
It doesn't only include employees, but it would normally only include people with specialist skills—which I know is going to raise another question.
You could have just gone on to answer it! Who does that include?
Generally, it depends on the specific skills that are required. It could include a financial adviser. It could include someone with specialist nursing or health skills. That's the advice that I have. If you want me to take the specifics of that on notice and get back to you to save us some time, I'm happy to do that.
Yes, if you could. Would it, for example, include people with specialised skills in advocacy?
I'll take that on notice, Senator, and answer that specific question for you.
Thank you. One of the issues that advocates are finding through this process is that they find they can't get access to appropriate information. Is there a process being undertaken, or what is the government doing, to ensure that aged-care providers don't withhold information from advocates? Are you looking at any sanctions where that is in fact happening?
I think that I would suggest that that is a particular matter that's probably best addressed through an approach to the royal commission and seeing what recommendations they may bring back to us. I understand it's an issue that's been raised, but, rather than make a specific point on that at this stage, I think that's probably something best addressed through the royal commission process, which will come back to us with a whole range of recommendations, I expect, on those sorts of issues.
Has this matter been raised with the government previously? I'm aware that access to facilities has been raised repeatedly by advocates, because advocates are still being refused. The issue around information is particularly important because they can't always do their job if they can't get access to information. I understand what you are saying about the royal commission, but is there anything that you have looked at that you can do in the meantime, because, as I have already articulated, it's some time before we are going to see the changes via the royal commission?
I recognise this is a very difficult issue. Access to that sort of information and even premises is a difficult issue because appropriate permissions are obviously required and there are also privacy issues that come into these things. Rather than looking to make specific changes through this process, I go back to the point that even the opposition made a moment ago: we're best to address these sorts of things through a consolidated and considered process, particularly off the back of the royal commission, acknowledging that it is an issue.
To a certain extent, I take your point. My concern is very much about the issues that are happening right now and how we can ensure that in the interim there are actions taken to ensure that advocates can do their job, particularly in light of what we're hearing coming out of the royal commission. It's not fair to make people wait for the next 18 months. I know the royal commission is going to take time; I'm not having a go at that at all. What I'm saying is people need protection now, not in 18 months time.
The Carnell-Paterson review found the commission should have a systemic advocacy function, and this was highlighted previously when the commission was first set up. As this isn't being addressed in this bill, has the government got plans to actually address the systemic advocacy point?
This bill is about transferring functions between two agencies. That's what it's about. It's to happen on 1 January this year, and that is why it is important, so that's not specifically relevant to that. It may come up in some of the other processes we have already discussed.
I know it's not part of this bill. The point is there are a lot of things that are not part of this bill that should be part of this bill. I'm asking: is that on the government's agenda, and will it be part of the next lot of changes? This process could go a lot more easily if Senator Cormann hadn't walked over and asked the minister to stop answering my questions. I realise we want to get this bill through, but this is important. It's aged care, and the government knows very well what the findings out of the royal commission have been, which are horrifying. There are people in the sector who want to see changes now, not changes made some time down the track. So I can keep asking questions or the minister can answer the very legitimate questions I'm asking. I'm not trying to roll this out any longer than is necessary. I articulated to the government a while ago that I would have a series of questions to ask here. I would appreciate them being answered. I'm trying to get this done as quickly as possible. So, if the minister could answer my questions, that would be appreciated. Is the government considering a function of systemic advocacy for the commission, or is it off the agenda?
I take the silence as no answer coming forth.
Are you saying no, the government isn't considering a systemic advocacy approach for the commission?
The TEMPORARY CHAIR: The question is that the amendments be agreed to.
I move amendment (1) on sheet 8804, revised:
(1) Page 82 (after line 21), after Schedule 3, insert:
Schedule 3A—Transparency of approved providers
9-2A Obligation to provide Commissioner a report
(1) As soon as practicable within 3 months after the end of a financial year, an approved provider must provide the *Quality and Safety Commissioner with a written report for each facility operated by the provider that provided residential care in the financial year.
(a) the total income received by the provider from the facility;
(b) the sources of that income;
(c) the total amount spent in the financial year;
(d) the total cost of care expenditure which includes the itemised cost of the following:
(i) food and food supplements;
(ii) medical products;
(iii) continence aids;
(e) the total cost of accommodation;
(f) the total cost of staff members for each category of staff member referred to in subsection (3);
(g) the total cost of staff member training;
(h) the total amount of other operational expenditure itemised by category;
(i) any amount paid to a related body corporate within the meaning of section 50 of the Corporations Act 2011.
Note: Approved providers have a responsibility under Part 4.3 to comply with this obligation. Failure to comply with a responsibility can result in a sanction being imposed under Part 7A of the *Quality and Safety Commission Act. The expenditure report provided under this section is made publicly available (see section 96-11).
(3) For the purposes of paragraph (2) (f), the categories of staff member are the following:
(e) administrative staff;
(f) other staff members.
Note: The category of other staff members should be further broken down into appropriate categories.
96-11 Publication of reports by Commissioner
The *Quality and Safety Commissioner must make publicly available the report provided to the Commissioner under section 9-2A.
(2) Page 82 (after line 21), after Schedule 3, insert:
Schedule 3B—Staff to care recipient ratios
The CHAIR: The question is that amendment (1) on sheet 8804, as moved by Senator Griff, be agreed to.
I move amendment (2) on sheet 8804, revised:
(1) An approved provider must notify the *Quality and Safety Commissioner in relation to each facility operated by the provider that provided residential care, on each notification day for each rostered shift, ratios of:
Note: Approved providers have a responsibility under Part 4.3 to comply with this obligation. Failure to comply with a responsibility can result in a sanction being imposed under Part 7A of the *Quality and Safety Commission Act. Information notified under this section is made publicly available (see section 96-12).
The *Quality and Safety Commissioner must make publicly available any information about staff to care recipient ratios of residential care services notified to the Commissioner under section 9-2B.
The question is that amendment (2) on sheet 8804 be agreed to.