Introduction of the Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023
Ms WELLS (Lilley—Minister for Aged Care and Minister for Sport) (10:09): I move:
That this bill be now read a second time.
A good leader never asks a person to do something they would not.
Since being elected to government almost 12 months ago, the Albanese government has demanded accountability and transparency from the aged-care sector.
It was a demand almost everyone welcomed, except of course the coalition, who predictably criticised oversight as being unrealistic and unfair.
The Inspector-General of Aged Care Bill reinforces the Albanese government's commitment to be open and transparent with the Australian public.
To hold ourselves to the same high standards we demand of the sector.
This bill will establish an independent Inspector-General of Aged Care, who will monitor and investigate the Commonwealth's administration and regulation of the aged-care system.
An inspector-general who will shine a light on uncomfortable, systemic issues and investigate their root cause.
An inspector-general who will report their findings and recommendations to government, to parliament, and to the public, to instil greater accountability and transparency across the aged-care system, and, in turn, facilitate positive change for older Australians and their families.
Through nine years of neglect, the Australian public lost trust of how our most vulnerable Australians were being cared for.
This bill is another step to restoring that trust.
Systemic problems must be thoroughly understood if they are to be effectively corrected.
But successive Australian governments have brought a level of ambivalence, timidity and detachment to its policy and administration.
Some changes to the system have been far reaching, others have been incremental.
But all have contributed to the ad-hoc and piecemeal development of aged care reflecting the circumstances and concerns of the day.
We can list every error or fault in the aged-care system until we are blue in the face—and some try, if you just look at the comments on my Twitter.
But pointing out faults does not address the root causes of the problems that are embedded in the structural design of the aged-care system.
The royal commission found that these factors have hindered the smooth administration of the system. They have made it more difficult to provide high-quality and safe services.
As the needs of older Australians have evolved over time, so too has our aged-care system.
We are at the precipice of the next great test of our aged-care system, the baby boomer generation.
If we do not address these issues now, we will not be prepared for the greatest challenge our aged-care system has faced in the past century.
The Royal Commission into Aged Care Quality and Safety highlighted a clear need for independent oversight of the administration and regulation of the aged-care system.
The commission recommended that the governance of the aged-care system be subject to such ongoing scrutiny.
That government bodies responsible for governance, regulatory and pricing roles within the aged-care system must be held accountable for their processes, their decisions, and, above all, their performance.
Aged care is not a single service.
It is a large and complex system that involves several agencies and a range of programs and policies designed to care for and support Australians as we age.
The commission saw the Commonwealth having four distinct roles in the governance and administration of the aged-care system.
The system governor—the Australian government and the Department of Health and Aged Care.
The policy owner, the market steward, working to ensure equitable access and appropriate policy settings across the system.
Designing and driving an aged-care system that provides older Australians with access to aged-care services and appropriate care.
The quality regulator—the Aged Care Quality and Safety Commission, charged with regulation of aged-care providers, ensuring they deliver the safe, dignified, and quality care that our mums, dads, grandmas and grandpas all deserve.
The prudential regulator—an expanding role within the Aged Care Quality and Safety Commission which ensures a strong, financially viable, aged-care sector that is compliant with prudential obligations, where quality and safety of care is not compromised by financial instability.
And the pricing authority—whose functions were recently consolidated in the Independent Health and Aged Care Pricing Authority, providing independent advice to ensure that aged-care funding is driven by the actual cost of delivering care.
These four roles comprise the framework that the aged-care system operates within.
The inspector-general will be independent from these bodies, but they will each fall within the scope of the inspector-general's oversight.
Importantly, the inspector-general will not duplicate the functions of the existing bodies within the aged-care system.
The inspector-general will be empowered to review these government agencies, to consider their actions, their decisions, and their performance.
To consider how the programs and grants they administer are meeting their objectives. To consider whether regulatory settings are right and drive compliance with the standards which keep older Australians safe.
To ask 'Have they got it right?' To question whether these bodies are bringing about positive change, whether the aged-care system is getting better as a whole.
The inspector-general will also focus their attention on reviewing existing complaints mechanisms to consider how complaints are handled and provide recommendations to support a continuous improvement model for all complaints processes to make sure people's concerns get a fair hearing.
One benchmark against which these bodies will be measured is the implementation of the royal commission's recommendations. The inspector-general will monitor and evaluate the progress of implementation of these recommendations and ask 'Is that what the royal commissioners envisaged? Is it something better?' And if not, why not?
Independence and impartiality are cornerstones for the inspector-general who will have autonomy and discretion as to how they perform their functions and exercise their powers.
The bill gives the inspector-general coercive information gathering powers. The powers enable the inspector-general to compel the production of any information or documents relevant to their functions. The power to compel someone to appear and to answer questions or to enter premises for the purposes of performing their functions.
These powers extend to anyone the inspector-general reasonably believes has information that supports the exercise of their functions. They override secrecy provisions and they abrogate privileges. They ensure the inspector-general can access all the information necessary to investigate systemic issues, to identify and promote best practice and innovation across the aged-care sector, and to make recommendations that will bring about real change.
The inspector-general's functions can be seen broadly as monitoring, reviewing and reporting.
Independent oversight means understanding what is going on across the aged-care system.
The bill enables the inspector-general to use their information gathering powers to monitor decisions, programs, operations and funding under aged-care laws to maintain a comprehensive understanding of what is occurring, what trends are emerging, what systemic issues are prevailing, and what insights can be seen from a holistic view.
The bill does not prescribe a framework for how the inspector-general will monitor the aged-care system. It gives the inspector-general the discretion to apply information-gathering powers in the most appropriate manner, to seek the most appropriate information to analyse, and to interpret and report their findings to the public, government and the parliament on the health of the aged-care system.
The bill sets out a more prescriptive framework for the inspector-general to investigate systemic issues through targeted reviews. More prescription to reflect the investigative and resource intensive nature of these reviews.
To give assurance to the public and aged-care government bodies on the priorities of the inspector-general, the bill requires the inspector-general to publish a work plan each year, outlining the reviews they intend to conduct and when they intend to commence each review. This plan may be varied at the discretion of the inspector-general.
While the inspector-general will consult on the plan, the bill gives the inspector-general discretion to determine what will be reviewed, and when and how they will do so, within the framework outlined in the bill. We know that deciding what to review will be a critical matter for everyone. We have heard already, while consulting on the bill, that people want to contribute to the work plan. But we need to be smart and targeted and allow the inspector-general to hear, then focus their resources on the most pressing systemic issues.
The inspector-general will focus reviews on pervasive, systemic problems in aged care. Detailed investigations that dig into the root cause of issues, not just addressing the symptoms on the surface that everyone can see. Looking at the why and the how.
The bill does not allow the inspector-general to review a single case, complaint or breach under an aged-care law. Their role focuses on broad, systemic problems. This avoids duplication between the inspector-general's functions and those of the Aged Care Quality and Safety Commission or the Commonwealth Ombudsman, as well as minimising confusion as to where complaints should be directed.
The review framework focuses on transparency and procedural fairness.
When necessary, the bill allows the Inspector-General to use their information-gathering powers to obtain the information they need. This could be documents or data. The Inspector-General may conduct interviews, access premises and interrogate computer systems.
The bill allows the Inspector-General discretion to seek information through submissions from the public, or to target certain people, or sectors of the community or aged care, in order to understand lived experience or seek an opinion or knowledge from the specialist sectors or groups.
The bill provides protection from victimisation and immunities to those who provide information or assistance to the Inspector-General's performance of their functions, with strong penalties for those that breach secrecy or protection provisions.
The bill requires the Inspector-General to be transparent and produce a report for each review they conduct, to be tabled in parliament and published. These investigations will not be conducted in secret, and findings and recommendations will not be hidden from the Australian public.
These reports will be fair. Where anything is expressly or impliedly critical of a person, whether it be a government official or a member of the public, that person will receive a fair hearing. They will be given a reasonable opportunity to respond and to present their case. The Inspector-General will consider any responses, any comments on any drafts, and any recommendations where they have asked for one.
The Inspector-General will report on more than just their reviews.
The Inspector-General may at their discretion report on the outcomes of their ongoing monitoring, reporting publicly and to parliament on whether the aged-care system is meeting the objectives of the aged-care legislation, whether Australian government bodies are performing in a way that enables an effective aged-care system and whether they are driving excellence.
The bill also empowers the Inspector-General to report to the government, the parliament and the public on the progress of implementing the recommendations of the royal commission.
Progress reports from the Inspector-General will occur annually to ensure that aged-care reform remains a priority. To ensure that older Australians see the benefit of the reform coming from these recommendations, this bill requires the Inspector-General to undertake a detailed review and report to the government, the parliament and the public by the five- and 10-year mark.
In the hearing for the royal commission, both Uncle Brian Campbell and Professor John Pollaers asked the royal commissioners essentially the same question. Will anything get done following this royal commission? Will anyone be held accountable for its learnings and implementing the recommendations?
This bill makes sure of it.
It makes sure that the royal commission is not just another missed opportunity, another report completed. It makes sure that someone is watching over and someone is making sure things gets done, someone who has the autonomy to say whether those things are effective or not.
The bill I introduce today will steer a course to an aged-care system that delivers safe and high-quality aged care and underlines our commitment to holding ourselves accountable.
We can't demand accountability from the sector without turning that mirror to ourselves.
Reforms like the Inspector-General will help avoid a repeat of the previous nine years of malaise and mismanagement from the previous government and uplift the standards of aged care.