MOTIONS: Aged Care (Royal Commission)

23 August 2021

I rise to speak to the motion from the member for Indi, and I thank her for this motion. Like every other failure of leadership by this government, with respect to aged care we seem to be 'dawdling to destruction'—to use the Age's Peter Hartcher's phrase—rather than running to victory. The government would have you believe that they have listened to the evidence given to the royal commission into aged care, and, thankfully, there is a commitment to billions in extra money and a commitment to a new aged-care act. But with this government there is always the need to read the fine print.

This motion refers to recommendation 86, which is where the royal commission into aged care recommended the adoption of a minimum staff time standard. Specifically, they recommended:

From 1 July 2022, the minimum staff time standard should require approved providers to engage registered nurses, enrolled nurses, and personal care workers for at least 200 minutes per resident per day for the average resident, with at least 40 minutes of that staff time provided by a registered nurse.

In addition, from 1 July 2022, the minimum staff time standard should require at least one registered nurse on site per residential aged care facility for the morning and afternoon shifts …

They also recommended that from July 2024 at least one registered nurse be on site at all times. How did the government respond? You hear from them a commitment to 200 minutes of care per resident per day, but the only reference to registered nurses is a reference to the very minimal requirement of one registered nurse on site in the morning and afternoon shifts.

I raise this not to diminish the role of the enrolled nurse or the personal care worker. Of course they are integral to the care team. But they should not be expected to deal on their own with the complex and advanced care that is now part and parcel of every aged-care facility. As one registered nurse, who's been the manager of a number of aged-care facilities, wrote to me: 'Currently, in residential aged care, it's not uncommon to support residents with intravenous therapy for antibiotics, syringe pumps for complex pain management, indwelling and suprapubic catheters, subcutaneous hydration, and PEG feeds.' This clinical management requires a level of complex nursing knowledge and skill that would be applicable to nursing patients in an acute hospital setting. Despite this, all the Morrison government could manage was to affirm the minimum requirement for an RN on site 16 hours a day.

For many older residents, this could well be the difference between life and death in an emergency. It's the difference between proper palliative care and poor palliative care. It's the difference between running from crisis to crisis over a shift and being able to provide consistent care. It means supervising and mentoring the rest of the care staff and building on their knowledge and care practice. It means that registered nurses will be able to respond to emergencies. It was for all of these reasons that the royal commission made its recommendations. I would add that getting a registered nurse 24/7 and minimum staffing ratios is especially essential in rural and remote areas and small facilities.

Aged-care facilities have grown from having an average of 30 to 60 beds back in the 1990s to now having around 80 to 150 beds. On top of that, the standards of single rooms with ensuites, multiple dining and lounge rooms, and wider corridors mean that the footprint of each facility is larger than ever and makes it harder to monitor and access residents. We now have consumer directed care and resident choice: when to get up, when to shower, when to eat. That all increases the workload of the care team.

Like many Australians, and as a former nurse, I am sick of the stories of neglect in aged care. I'm sick of the penny pinching. Even as I speak, and despite the royal commission, there is a long list of major aged-care providers out there right now who are trimming their rosters and cutting staff hours. I'm prepared to name, in Melbourne, Menarock Aged Care and the Royal Freemasons, for example, who are doing just that.

The Morrison government's failure to lead on climate change makes Australia look like a rogue nation. Their failure of urgency on the 'it's not a race' vaccination rollout has put us all in the most perilous of positions. Their failure to heed the calls to get Australians and those who have helped Australians out of Afghanistan is both a political failure and a moral failure. And now our elderly, our most vulnerable, are left at risk. The government act as if they were mere bystanders and not the government they were elected to be. Our elderly citizens deserve much better.