Senator SIEWERT (Western Australia—Australian Greens Whip) (17:52): I rise to contribute to this discussion and debate on the Liberals' record of inaction and cuts which over the last six years have led to Australia's broken aged-care system. We've had a series of coalition senators stand up in the chamber today, articulating some of the things that they have done, but the fact is we still have a system that is failing older Australians. We have heard about the terrible abuses that have been occurring in our aged-care system, through the Royal Commission into Aged Care Quality and Safety. The coalition are the ones who had to set up the royal commission because they haven't been able to fix the system. There has been a lot said about a number of issues, but one of the areas that I don't think have been getting much attention during this debate is clinical care—actually looking after older Australians who are in residential care. The Senate Community Affairs References Committee, at the very end of the last parliament, did an inquiry into the effectiveness of the aged-care quality assessment and accreditation framework for protecting residents from abuse and poor practices, and ensuring proper clinical and medical care standards are maintained and practised. The final report of that committee, which was not that long ago, found that there is one overarching failure which underpins the systemic flaws in aged-care services, and that is the lack of appropriate regulation of clinical care standards within residential aged-care facilities—and this is still the case. I was quite shocked during that inquiry to hear providers say that they aren't responsible for clinical care. Well, who is responsible for clinical care in our aged-care system? You would think that addressing this would be very high on the agenda. There are gaps in the current framework for the delivery of clinical services in aged-care facilities, and these, too, often result in poor clinical care for older Australians in aged care. That was one of the findings in our report. The inquiry highlighted how much needs to be done to promote a higher quality of care for people living in aged-care facilities. We found that the sector needs person centred regulation to achieve person centred care. The lack of clear lines of responsibility around who has the ultimate duty of care towards residents remains a barrier to implementing the person centred care approach—that's what we found. We found that aged-care facilities ultimately hold a duty of care to all residents and are the last line of defence. Now, you'd think this would not be controversial, but apparently it is. If we haven't solved this issue, there's no way that the government can claim that residential care and aged care in this country is on track and all okey-dokey, because it simply isn't. If we are still having a debate about that and it can't be guaranteed, we are not hitting the mark. The committee recommended that the government clarify that residential aged-care providers ultimately hold a duty of care to all residents. We should be supporting aged-care facilities and driving them to ensure that there is continuous quality improvement, which supports early intervention to manage problems before they become compliance issues. These are issues that absolutely need to be dealt with. There has been discussion today about home care places, where we still have such a massive waiting list. Yes, there were changes there, but what has been very clearly articulated is that we have a growing list of people waiting for care. We also have people who are receiving inadequate levels of care because the system, again, is not working. We have inadequate assessment processes. We have people who have been assessed for care that's at too low a level. We have people who have been assessed for care at a higher level but who aren't able to access services to deliver that higher level of care, at levels 3 and 4, so they're not using all of their packages. There's money that is not being used to provide care for those people. So at the same time that we have people who are not receiving the level of care they need—129,000 on the waiting list—we have people who aren't using all of their level 3 or 4 packages because they've determined that they don't actually need some of that care at the moment. The rumour going around is that people are assessed at a higher level because the assessors think it's going to take them a while to access that level. They're then on a higher level of care than they perhaps need. Or perhaps it's that they're saving money to use later, or they can't actually get the services they need, depending on where they are living. The point is that there's a whole lot of money that's been allocated that is not then being made available to help people who are on the waiting list and need care. It is absolutely clear that that needs urgent resolution. Let me come to the workforce. We know that we are not providing enough care for residents. We're averaging only around 2½ hours of care, when we need at least four hours and 18 minutes for proper provision of care support for people in aged care. We need the workforce to be able to provide that care. We need a workforce that has proper ratios, with staff appropriate to the needs of particular residents. We need to resolve that issue now. We need more funding, for a start, to be committed to aged care to support a larger workforce so that they're able to provide more hours of care to meet residents' needs. We need a vast injection of resources and funding for that, but also to make sure that we actually have the workforce there to provide that care. We are not doing enough in this country to ensure that we have people who are able to provide that level of care. One of the issues that I have been very passionate about in this place is mental health in aged care. I was very pleased when the government finally listened to calls for funding to be provided for residents in aged care so that they could access mental health services, because they weren't able to access the Better Access—sorry, I'm using the word 'access' a lot, but the fact is the program is called Better Access and residents in aged care were not able to access that particular program. Funding has been allocated—not enough—but what we're now finding is the provision of that mental health support is varying across the country. The funding has been given to the PHNs, and the PHNs, in their wisdom, have decided on multiple different approaches as to how that care is being provided. There are various trials being done; there are various ways providers can access those funds. I'm not at all—not at all!—reassured that every resident in an aged-care facility who needs to access mental health support and care is in fact able to access that care. I've spoken to people around this country and, as far as I can tell, from the conversations I've had, that service is not being adequately provided. I'd like to quickly touch on the fact that we have a massive service provider in this country, Bupa, that has not been meeting, in many of its facilities, the standard of care that we expect in this country, and this government has overseen that. I know the government are now meeting weekly with them, but this system has been in operation while the government have supposedly been doing all those other reports that the coalition senators have been talking about—'they've done this, this and this'. Well that has not stopped one of the major providers of residential care in this country from being unable to guarantee top quality care at every one of its facilities. We know there have been compliance issues and accreditation problems for a number of the facilities. That should not have been allowed to occur. If this system was working, we wouldn't have that situation in this country. So the government may have been doing some stuff, and I give them credit for doing that, but it's simply not enough. It is not enough, because we still have a failing aged-care system. We have people who are not able to access home care, we have people who are not receiving the standard of care we expect in this country and we have the very fact that they still can't make sure providers can guarantee they provide and are responsible for their duty of care for their residents and for providing clinical self-service. (Time expired)