By Keryn Curtis
Members of the House of Representatives last night voted by a slim margin to reject the Opposition’s motion to delay a vote in the lower house pending the outcome of the current Senate Standing Committee on Community Affairs inquiry, and the five bills were passed.
Thirteen MPs rose to speak to the motion over the course of three hours before it was put to the vote just before 6.30pm. Seventy MPs voted to reject the delay motion put by Opposition spokesperson on ageing, Senator Concetta Fierravanti-Wells, described last week by Minister for Ageing Mark Butler as a ‘blocking manoeuvre’, in the face of 68 MPs supporting it.
The passing of the bills through the lower house is welcome news for Minister Butler, who said last week that he would be forced to delay the announcement of the Aged Care Approvals Round (ACAR), saying it would not be responsible to release the outcomes of a process that would essentially depend on the aged care reforms going ahead.
In a statement issued last night, he described the passing of the five bills as a major step forward for the Gillard Government’s $3.7 billion Living Longer Living Better aged care reforms.
Mr Butler said the changes to the Aged Care Act 1997 are part of a 10-year plan to build a better, fairer, sustainable and nationally consistent aged care system to meet the challenges of the nation’s ageing population, delivering more choice, easier access and better care for older Australians, their families and carers.
A fragile unity
The passage of the legislation through the lower house looked to be in doubt in recent weeks as multi-stakeholder unity around the reform agenda, achieved under the banner of the National Aged Care Alliance (NACA), appeared to fray.
A number of aged care providers and the two provider peak groups, Aged and Community Services Australia (ACSA) and Leading Aged Services Australia (LASA), made presentations to the Senate Standing Committee on Community Affairs [which has been undertaking an inquiry into the five bills, and is due to report on 31 May], criticising aspects of the legislation and urging MPs to seek a number of amendments to the bills before allowing them to pass.
As the deadlines drew closer, reports abounded of mixed messages being delivered to MPs and Senators with concerns expressed about whether the bills were being rushed into legislation without sufficient consideration.
A group of 22 aged care stakeholders representing many of the largest aged care providers, both not for profit and private, as well as consumer body, COTA, the two key unions, Alzheimer’s Australia and several other representative organisations, issued a joint letter to the Senate Standing Committee on 21 May, collectively urging “in the strongest terms that the current legislation pass this Parliament, with or without amendments that may be proposed by the Committee.”
“The Inquiry has heard criticism of some features of the legislation and also in relation to decisions that are yet to be made by future regulation. Without discounting suggestions for improvement that we know are being seriously considered by the Committee, we are concerned at any overall impression created that the legislation should not proceed. In particular concern about decisions that may in future be made by regulation, but which would be disallowable by Parliament, has in our view received undue attention, which we seek an opportunity to rebut.
“We therefore seek an opportunity to jointly appear before your Inquiry prior to its finalisation. We wish to outline the very substantial risks that arise for aged care recipients, providers, financiers and staff in the event of the legislation not passing, and to collectively ask the Inquiry to recommend multi-partisan endorsement of the legislation’s immediate passage,” the letter said.
These messages were reiterated to members of the House of Representatives in a second joint open letter from the group of 22 stakeholders last Friday 24 May.
The group warned that, “it has become apparent that because of the short time remaining for the Parliament to debate the legislation before it rises on 27 June, and with many other pieces of legislation also to be presented in this session, the aged care legislation risks simply not being finalised before Parliament rises.”
“Substantial risks will arise for aged care recipients, providers, financiers and staff in the event of the legislation not passing,” the letter said.
Social media mobilised
Alzheimer’s Australia issued its own strongly worded warning on the 23rd, together with a Facebook message template and image (pictured above) for use in social media and in lobbying members of the Senate Standing Committee.
National president, Ita Buttrose said in the statement that “perhaps the Senate Committee is under the impression that Australians don’t want aged care reform.
“Nothing could be further from the truth,” she said. “The Living Longer Living Better legislation presents the opportunity Australians have been waiting for.”
Ms Buttrose said that Alzheimer’s Australia was well aware of the issues that remain to be resolved by government and the aged care sector, “but many issues can be ironed out through sensible discussion and through a review that has been built into the legislation.”
Provider peaks respond
In a communique to internal stakeholders, ACSA CEO, Adjunct Professor John Kelly said the apparent confusion being felt by Senators involved in the Senate Standing Committee carried an implication that the two aged care provider peak bodies, ACSA and LASA, had contributed by not clearly advocating for the legislation’s passage.
He expressed “concern that the current Bills before the House of Representatives might be withdrawn by Government, purportedly because of a view by Senators within the Community Affairs Committee that the provider sector are ambivalent about the passage of the legislation. Can we make it clear at the outset that this is not correct.”
The matter even prompted an unprecedented joint statement from the two aged care provider peak bodies which Professor Kelly said was intended to return some stability to the sector.
The letter, addressed to senators, said “The Bills have generated wide interest and generally positive support with a number of key issues recommended to the Committee for consideration of amendment to make the package of legislation workable for the various stakeholders in the sector. We have contributed some suggestions via the Senate Inquiry for improvements that could be made to the legislation to ensure it delivers the policy and service outcomes that underpin the Reforms.
“We see the LLLB Reforms as a good first step in reorganising the framework within which community and residential aged care is delivered in Australia and we wholeheartedly support the legislation.
“We encourage you to support the passage of this legislation after appropriate consideration of amendments in the Senate.”
Moving forward
COTA Chief executive, Ian Yates said he welcomed the prompt passage of the bills by the house and looked forward to the report of the Senate Standing Committee on Community Affairs due this Friday.
“That report will presumably contain any proposals for amendments. And we look forward to having discussions with the government, the opposition and the Greens on the detail of the bills, which can only start being formally considered by the Senate from 17 June.
“If there are amendments, then they will have to go back to the house for approval and we would then expect a free passage and straightforward process without debate in the house.
“The key debate will be in the Senate. In the meantime, the sector will continue to monitor and be engaged with the process,” said Mr Yates. “It’s a continuing concern that time is tight and we want to see the legislation – with or without amendments – through before the Parliament rises on 27 June.”
Utlimately, key elements of the legislation will not be good for consumers as residential aged care providers withdraw capital and cancel new nursing home projects in the face of price controls, a unilateral choice of residents to decide how they’ll pay “We can think of no other circumstance where it is considered commercial or equitable to allow a person to take possession of property without agreeing the terms of payment” – Julie McStay, Partner, Hynes Lawyers. The intent of the Productivity Commission was that transparency in pricing of bonds and daily charges would provide consumer protection and foster competition. The present (outgoing) government has been Whitlamesque in its pursuit of market place intervention.
In the great words of bill the blackboard from Mr Squiggle……”Huuuurrrrry uuuuup….Huuuurry uuup”
To suggest that the LLLB represents a move forward in little “r” reform is reasonable – to present it as supported holus bolus by industry does not reflect the reality. By it’s own admission before the Senate Committee the DH&A has failed to model the impacts of this legislative change. By it’s own admission the LLLB represents a complex package built directly over an existing complex package. The delivery of the KPMG report on Friday could not be coincidental to the passage of the legislation. The scope of that report has not even contemplated, it would appear, the impact of cash outflows which by the reports own admission, will be a feature of the new structure. The conclusions within the report, particularly in relation to the level of RAD’s coming into high care is unsubstantiated in the report itself. The LLLB represents a bias towards both home care, and incentives for people to remain in their own homes for economic reasons – it does this by treating the family home differently, depending if it is bricks and mortar vs cash via sales. There are clear penalties if people sell their homes through higher care costs which offset government expenditure. To properly understand the reasons for consumer choice, the option of a DAF vs RADhas to be equal in economic consequence – it is not under the legislation. LLLB seeks to undertake an experiment in the aged care industry – an experiment at the cost of both consumers and providers – an experiment that as a society we must seek to avoid. The LLLB legislation had to be passed by the House but it must be amended in the Senate to ensure that ideology does not win over what is right and proper for consumers and those actually delivering care. The inherent bias in the legislation must be neutralized if we hope to have services available as we face the most significant demographic shift Australia has ever seen. This is not the time for experimentation – it is a time for evidence based decision making, so the legislation must be amended before passing through the Senate to remove the social engineering ideology it currently represents. The Australuan economy and society cannot afford this DH&A experiment.