L-R Minister for Health Greg Hunt, Prime Minister Scott Morrison and Minister for Aged Care Ken Wyatt at a press conference announcing a Royal Commission into Aged Care at Parliament House in Canberra, Sunday, September 16, 2018.

Press Conference with the Minister for Health and Minister for Senior Australians and Aged Care

Transcript
16 Sep 2018
Parliament House, Canberra
Prime Minister, Minister for Health, Minister for Senior Australians and Aged Care
Royal Commission; aged care; Four Corners; food safety
E&OE
Health and Social Services

Image: AAP  Image / Mick Tsikas

PRIME MINISTER: Good afternoon everyone. I’m very pleased to be joined by the Minister for Health, Greg Hunt and the Minister for Senior Australians and Aged Care, Ken Wyatt. One of the hardest decisions any Australian makes is when they are entrusted with the complete care of their partner, their husband, their wife, their mum, their dad, auntie their uncle, niece - these are hard decisions. We make a lot of hard decisions in this place, but that would have to be one of the toughest decisions you make. They are relying on you, 100 per cent, in their time of greatest vulnerability, about the decisions you’re making about their care.

Every Australian who makes that decision and for every Australian whom that decision is being made for, they deserve to have great confidence about the care that their loved ones will receive in our aged care sector, our residential aged care sector, our in-home care provision of service. That also includes young Australians with disabilities who live in a residential aged care facility.

Over the past three weeks coming into this role, you’d appreciate that I receive many, many briefings. There is a lot of information that is presented to you. One of the briefings and one of the sets of information I just could not get past, was what was occurring in our residential aged care sector. As a result of the work that the Government has been doing - the unannounced visits, the compliance audits - it has revealed a very disturbing trend in what is happening in terms of non-compliance, abuses and failures of care that have been occurring across the sector.

Now that said, we know that across our residential aged care sector and in-home care, we have some of the finest facilities anywhere in the world, indeed better than anywhere in the world. Indeed this is an area of export growth actually, training in services, building of facilities,  this is something that Australians are very good at. I want to pay tribute to all of those who work in these facilities. I and Ken and Greg have visited many as you’d expect, as local members, as Ministers, as Treasurers and as Prime Minister. What that says to us is that we have great people doing a great job. They’re a great team, but every great team wants to do better. Every great team wants to be able to ensure that where there are problems in their sector, in their industry, that they want them to be addressed.

A 177 per cent increase in services with serious risk identified in the past year. A 292 per cent increase in services with significant non-compliance, one service being shut down by the Department of Health every month. 154 notices of non-compliance, that’s an increase of 185 per cent. Sanctions up 136 per cent. That's impacted some 2,000 residents out of what is a standing group of just over 200,000, who are living in residential aged care and over 80,000 who are living with in-home care support, including those who receive that within retirement villages. 2,000 residents were impacted by that. Some 300 had to be placed in other services.

So when you're confronted with that, you ask a simple question; “How widespread is this? How far and wide does it go? Does it touch on the whole sector?” Now, until we can have clear answers to those questions, I think Australians will be unsure. That's why as Prime Minister, last week, we discussed this together as a Cabinet and we decided it was necessary to move forward with a Royal Commission into the aged care sector, which includes the care provided to young Australians living with disabilities in the residential aged care sector.

It is our intention to keep doing what we're doing and I will ask Ken to talk more about that. We are not going to stop and wait for this Royal Commission to finish before we keep getting on with the important work that we're already doing. We will walk and chew gum at the same time when it comes to this issue and that is important because there is great work that is being done. But more needed to be done in my view and that's why I've brought this forward.

Secondly, we've got to take the politics out of this issue. I spoke to the Leader of the Opposition last night. We've had good bipartisan support, when Labor was in government and when the Coalition has been in government. We want that to continue and we want the issues to be identified as the facts. We want there to be an impartiality to this. We want political agendas taken out of it.

So let's get an independent, credible, honest look at what's happening in the sector and let that be the basis for our continued working in partnership all around this place, focusing on the care and needs of Australians and the choices Australians are having to make about aged care. That will be an important opportunity I think, with this Royal Commission, to ensure that that's the case. When you pull all that together, I think, combined with the work we are already doing, we will be in a better place to be able to give Australians the assurance they’re seeking.

The Royal Commission terms of reference will be worked up over the next few weeks. We will be consulting with the sector of course and we will be listening carefully. As various teams around the country are preparing for the finals, we’ll be preparing for this, the terms of reference, to finalise the commissioners and the model that will be used to pursue this Royal Commission and to finalise that terms of reference ultimately and letters patent, with the commissioners that are selected. So there is a lot of work to do there, but to just run through what we expect it to cover, it will be as follows.

The quality of care provided to older Australians and the extent of substandard care. The challenge of providing care to Australians living with disabilities living in residential aged care, particularly younger people with disabilities. The challenge of supporting the increasing number of Australians suffering dementia and addressing their care as they age. The future challenges and opportunities for delivering aged care services in the context of changing demographics, including remote, rural and regional Australia, and any other matters the Commission wishes to pursue that they believe is necessary.

So, the issue isn't just in metro centres or just in rural centres. It’s not just in for-profit or non-profit. It is right across, as best as we can determine from the compliance work that has been done today. So we do want to look right across the board at what is occurring.

So I want to thank particularly Greg and Ken for the great work they've been doing in this area. You know, you put a cop on the beat, they’re going to find the problems. That's why you put the cops on the beat. So these figures that we've seen today are a result of taking that action and then you ask yourself; "Well, what do you do next?"

You do this. That's what you do. Greg?

THE HON. GREG HUNT, MINISTER FOR HEALTH: Thanks very much, Prime Minister. Scott is right, one of the hardest decisions and one of the highest responsibilities that anybody can take, is to see that their parents have the best care at the moment they’re going into care. I know that as a son. Six years ago we were looking at the circumstances for my own father and I remember the weight of the decision and I remember the absolute focus that myself and my family put on that. We were lucky, we had tremendous care and the overwhelming majority of Australians in care and of sons and daughters who are looking to care for their parents, are able to have absolute confidence that their parents are getting the highest quality and standard of care that they can.

But we also know, precisely because of the work that has been done, that we have seen an increase in evidence of cases where not everything that can be done has been done, not everything that should be done has been done. We know from the work of the quality agency that we've gone from two, to 22, to 61 cases identified, where facilities would have residents at risk over the last three years. In the last year, that's 177 per cent increase. Now, in part that may be a case of changing practices, but in particular it’s about shining a light on the challenge and then recognising what that challenge is and responding to it. So that's why we need to deal, now, on a level never before done, with the challenges facing the current sector, where the overwhelming majority of facilities and overwhelming majority of staff do an amazing job. But we need to give all the support we can.

But looking forwards to the future which is also a key part of the Royal Commission, we know that from 2015 to 2055 there will be an almost fourfold increase in the number of Australians over the age of 85, from 500,000, to 1.9 million. That means we will have a systemic demographic challenge on a basis never before seen in Australia. So we need a systemic demographic response. In other words, this Royal Commission is about the safety and quality of care for Australians who are in facilities and receiving Commonwealth care now, but it's also about ensuring that we have a system that is planned for, to last for the coming decades.

PRIME MINISTER: Thank you, Greg. I'm going to ask Ken to talk about how we've got to this point here, but also how the Royal Commission will be supporting him and the important work that he’s doing.

THE HON. KEN WYATT, MINISTER FOR SENIOR AUSTRALIANS AND AGED CARE: Thank you very much Prime Minister. I want to say it is an incredible privilege representing in many senses senior Australian who’ve given this country everything that it has. In our work, which commenced with the road map, co-designed by the aged care sector, we've made significant reforms. But following Oakden, we went one step further and we looked at the circumstances that senior Australians found themselves in, in their vulnerable state of both frailty and in their mental state.

What was important was bringing together the relevant agencies to provide an organisation that focuses very sharply on the quality of care within residential care, but also home care. What's important is that we look after the mothers and fathers, uncles and aunties of families who are in aged care. When we talk of the crisis in aged care, I don't see it as a crisis in aged care per se, I see it as a crisis for the families affected. The families who expect that the love and attention will be given to each of those entrusted to a provider. I have no compunction saying I’d stand beside and support the workforce that is in the aged care sector, they’re an outstanding, compassionate group of people whose commitment to looking after senior Australians with love and devotion, so much so that I see some of them at the funerals attending and acknowledging the passing of a significant Australian.

So we’ll continue to work towards a workforce that we need for 2050. That workforce activity will be undertaken by John Pollaers working with the sector, so the sector is redesigning it’s thinking it’s direction for the workforce it’ll need. It’ll consider not only the horticulture, the gardeners who work within their facilities, but the whole spectrum of people involved in caring for senior Australians, including those careers that will evolve with technology and with artificial intelligence. But we as a Government are committed to making sure that when you put somebody into a residential aged care facility, they’re given all of the assistance and care that they need.

I want to make a point that there are two points in our life in which we are frail; when we are born, we are frail and we rely on others to nurture and to love us and provide the growth that we need. The other point is when we become frail and aged. At that point, we need to ensure that that same consideration is given to senior Australians. I've been into more than 100 aged care facilities across this nation, I have talked with senior Australians about their hopes and aspirations living in their home, living with people that look after them. So this Royal Commission will enhance and complement the ongoing work that we will continue to do. It will look at the systems, systemically, but equally we won't take our eyes off the way in which we consider the needs of all senior Australians.

JOURNALIST: Prime Minister, the man to your left told Four Corners a few short weeks ago that a Royal Commission would be a waste of time and money. A royal commission, after two years and maybe $200 million being spent on it, will come back with the very same set or very similar set of recommendations that the Government will respond and put into place similar bodies. Haven't you just thrown him under the bus here, with a needless Royal Commission, as he regards it?

PRIME MINISTER: I believe it's important to do this Royal Commission and I've consulted closely with my colleagues. We all believe it's important that it be done. I’m not going to get into those sorts of comments. I’m just going to focus on supporting senior Australians and ensuring that their care is up to the standard that they all expect. I'm not interested in the politics of it, I’m not interested in the media commentary on it. I'm only interested in the care provided for senior Australians. Phil?

JOURNALIST: PM, you also flagged a Royal Commission into the energy sector.

PRIME MINISTER: I couldn’t hear you.

JOURNALIST: Sorry, you also flagged a Royal Commission into the energy sector?

PRIME MINISTER: I just said I wasn't ruling it out.
 

JOURNALIST: Well okay, what would be your trigger point for calling that?

PRIME MINISTER: Again, I'm not ruling that out. But the difference here is that the residential aged care sector and in-home care arrangements, plus those younger Australians living with disabilities in residential aged care, these are areas where the Commonwealth is directly involved. We’re spending $1 billion extra every year on aged care in this country. We've increased the number of in-home care places just recently, by 20,000 in the last MYEFO and this Budget. Over the forward estimates, we will go with high care places in at-home care from just over 40,000 to over 70,000. So this is an area where we are very much involved. There are other parts of this sector and retirement villages and things like that, where state governments have their responsibilities.

We will be responsible for what we're accountable for and making sure that we act in those areas. So this is very much a core area of both fiscal and direct service provision responsibility in what we’re getting in and supporting, so that's why it needs to have the focus and that's why we're giving it that focus.

JOURNALIST: Prime Minister, when you were Treasurer you cut $2 billion from aged care.

PRIME MINISTER: No, no. That’s what the Labor Party says –

JOURNALIST: No, no, you did.

PRIME MINISTER: No, I didn’t. The Labor Party says that –

JOURNALIST: You cut $1.2 billion from the aged care funding.

PRIME MINISTER: No, I don't accept that. If people want to put questions, they’re not allowed to put lies.

JOURNALIST: Aged care funding had $1.2 billion –

PRIME MINISTER: No, no. We’re increasing aged care funding by $1 billion every year.

JOURNALIST: No, it’s a direct question, Prime Minister –

PRIME MINISTER: We’ve put in place compliance measures to ensure that public funds don’t get misused. So, this is why we are going to have a Royal Commission -

JOURNALIST: Are you ignoring the facts?

PRIME MINISTER: No, I'm not ignoring facts. That's why I'm calling a Royal Commission, if you just let me finish the answer. This is why I'm having a Royal Commission, because I'm not going to put up with lies being told about what's happening in the aged care sector. Policy must be based on facts. Not facts that are dreamt up, not facts that are misinterpreted, not facts that have agendas sitting behind them. A Royal Commission doesn’t have any of those maladies. A Royal Commission will actually look at the actual facts, not at the agendas of advocates, not at the agendas of media, not at the agenda of politicians. A Royal Commission will be focused 100 per cent on the needs of residential aged care residents.

JOURNALIST: Mr Wyatt, can you perhaps explain your comment to Four Corners?


MINISTER FOR SENIOR AUSTRALIANS AND AGED CARE: In my comment to Four Corners, when I was asked about a Royal Commission, I said I would rather spend the money on frontline services for aged care than a Royal Commission, at that point. But there are a set of circumstances that I’ve seen in aged care since that time, including in my own electorate, that takes me to the point that there’s a crisis issue that individual families face when a daughter wants to get her father into aged care, has him placed and then the aged care provider in that circumstance saying; "We can't take him." She went through incredible emotional experiences in trying to accept the fact that her father had been rejected. On that basis, I gave reconsideration to the need for a Royal Commission, it's something that I had been talking to the Prime Minister about in terms of senior Australians when I first took on the portfolio. We had a lengthy discussion in Perth about senior Australians and what we needed to do -

JOURNALIST: Do you mean Mr Turnbull?

MINISTER FOR SENIOR AUSTRALIANS AND AGED CARE: Scott Morrison as Treasurer.

PRIME MINISTER: As Treasurer, it was about a year ago.
 

JOURNALIST:  But these comments, you made these comments on 16 August, Mr Wyatt. I mean, is it one case since 16 August that has changed your mind ,where you think it’s a waste of time and money?

MINISTER FOR SENIOR AUSTRALIANS AND AGED CARE: No, Andrew let me correct you. If you read the transcript it says I didn’t support a royal commission, I would rather spend the money – no, hold on – I would rather spend the money on frontline services that were important, because among senior Australians in aged care –

JOURNALIST:  [Inaudible] said you’d rather spend the money on frontline services?

MINISTER FOR SENIOR AUSTRALIANS AND AGED CARE: Andrew, let me finish. We have senior Australians in aged care who need mental health support. We have senior Australian who need palliative care support. We have senior Australians who need support at home, in terms of emotional, social wellbeing issues. That's where I wanted to put the money. That's where I wanted to look at the changes that we put into place to help those who are vulnerable. Now, a Royal Commission is necessary, it will build on what we are doing.

JOURNALIST:  When will the Royal Commission begin, Prime Minister and are you prepared for what it will find? Whenever we have one of these Royal Commissions, we turn over rocks and we have all sorts of cockroaches. It might end up looking very damaging for the Coalition that this Royal Commission wasn’t commenced much sooner.

PRIME MINISTER: Well in the first three weeks I’ve been Prime Minister, I've taken the action to initiate a Royal Commission into this sector. I don’t know if I can look at it more properly than that, as a new Prime Minister looking into these areas. I think you're right, I think we should brace ourselves for some pretty bruising information about the way our loved ones, some of them, have experienced some real mistreatment. I think that's going to be tough for us all to deal with, but you can't walk past it. You can't not look at it and that's what the Government is ensuring that we don't do –

JOURNALIST:  Have you got a date?

PRIME MINISTER: Well, the date we will seek to finalise the terms of reference, as I said, over the next few weeks. We would then seek to ensure we have the commissioners appointed. I’ve been consulting on the appointment of commissioners and the letters patent –

JOURNALIST:  I’m just wondering if this is before or after the election?

PRIME MINISTER: Well, this Royal Commission will take until at least the second half of next year. I have no doubt about it.

JOURNALIST:  But will it start before the election?

PRIME MINISTER: Of course it will. It will start as soon as possible, but we're not going to rush the terms of reference and letters patent and the appointment of commissioners. We’ll be working carefully through this to make sure it gets set up on the right basis. There is some consultation to do now and so that's the work immediately before us. Then I would anticipate it reports some time in the second half of next year.

JOURNALIST:  Prime Minister, you made your last Budget an aged care Budget. Then this week, we saw you come out with the same Ministers again, bringing forward some of those measures, but [inaudible] starting immediately for aged care and you released one of the Workforce Strategy Report the next day on Thursday. It looks like you are clearing the decks and that maybe the Budget in May didn’t quite get the messaging right for older voters. Do you think the Coalition has missed those moments over the last five years?

PRIME MINISTER: No, I think that's a very cynical view Rick. I mean the media are paid to be cynical and that's fair enough, I get it. But what we've been focusing on over the last few weeks as I’ve been in this role, I’ve been working with Greg and with Ken, as I have been confronted with this data.

Now, it is true that in the Budget, we put in place some very significant initiatives and our plan for a longer life for Australians. It is true that we've provided another 20,000 places, another $106 million which is toughening up the cop on the beat, providing capital grants to regional and rural residential aged care centres and improving the standards of care. So we are going to keep doing all of that. This is not a binary proposition. This is a comprehensive proposition and that is the work that we’re doing will continue, so people can have more choices as they grow older. Everything from their physical activity to working longer where they choose to and having that support, plus when they’re at their most frail and their most vulnerable, then they can rely on the support they are getting.

I mean, this is a never-ending task and we will always have to be lifting the standards. That's why I make the point that our residential aged care, when you look at it at an international level, it’s a very strong sector, there is no doubt about that. We have a lot of things to both to present to the rest of the world in how you we go about this, but the best of industries, the best of sectors, the best of teams, is always looking for ways to do better. That's what this process is seeking to do. David?

JOURNALIST:  Prime Minister, there are millions of older Australians who are living in retirement villages, sometimes their issues may be different to those living in full-time care. Sometimes their issues may be financial in terms of the arrangements they make as they transition to one place to another.

PRIME MINISTER: Sure.

JOURNALIST:  Should they be part of the Royal Commission as well, should financial factors as well as care factors be investigated?

PRIME MINISTER: Well, I don't want to delay this by seeking to incorporate matters that fall under state jurisdictions. But where the states and territories wish to participate or wish to suggest an involvement or have the matters for which they are responsible brought into this, then the Government would be very open to that. But I always take the position that you must be accountable for the things that you're responsible for. That's what we're making the subject of this Royal Commission.

That's right, there are a lot of other issues that go well beyond the residential aged care sector and in-home care, that is very true, but this Royal Commission will have a very strong focus and it’s important that we both do this and keep doing the things we are doing. In politics, in public life, you've got to learn from the things you've been involved with in the past.

You all know my view previously about the banking royal commission and you’ve heard what I said in the House last week. It has been my learning that it's important to go forward with a Royal Commission in this area, because I can see the value that it will create in addressing these serious issues. But the other learning is this; you just don't stop and wait for a royal commission to finish. You keep doing the things that you know you can do day to improve the lives of ordinary Australians.

JOURNALIST:  Prime Minister, what is this going to cost? Do have an allocated budget for it?

PRIME MINISTER: At this stage we’re working that through with the Treasurer, but there is a standard cost that sits around this. The Royal Commission into the Banking and Financial Sector, we’re looking at about 50 to 75. But that will all depend ultimately on the terms of reference, the letters patent, the number of commissioners, the length of the Royal Commission itself and it’s reporting date. So there are a lot of factors there to take into account and we’ll be working that out and taking that up through the normal budget process.


JOURNALIST:  The staff issue is one of the most [inaudible] getting enough staff, qualified staff. I mean, what's your gut feeling? Do they need to pay more, to get more?


PRIME MINISTER: Well, it is not for me to have a gut feeling, it’s for me to commission a Royal Commission. That's what I'm focused on. Now, the issues that you've referred to will be taken up and they’ll be clearly available, there for the Royal Commissioner to be there to look at the issues and to address those in the Royal Commission and to do the work on that. So I look forward to them undertaking that work and them reporting back and then, as I say, not just to the Government, but one of the reasons I'm doing this is because there has been good bipartisanship on this issue over the last eight years, hasn't it, Greg, Ken? I want to see that continue and the discussions I've had with the Leader of the Opposition, I believe he does too. That means you can allow the Royal Commission to proceed without all the fighting. I don’t want us to fight about what’s happening in aged care, I just want us to fix it.

JOURNALIST:  Your own workforce strategy suggests that nurses and aged care workers [inaudible] are underpaid by about 15 per cent compared to [inaudible] in the industry. The [inaudible] that nurses were underpaid by about 10 per cent compared to hospitals. So we’re not working on gut feelings anymore, you do have evidence that the pay rates are not –

PRIME MINISTER: We’ve got a Royal Commission going and we’ll continue to review all the evidence –

JOURNALIST: Can I ask the Health Minister –

PRIME MINISTER: With the action we’re taking.

JOURNALIST:  About strawberries or just to flag an interest in asking the question, I don’t want to take you away from the Royal Commission. But is enough being done with the strawberry crisis we have at the moment? Is Queensland Health meeting the challenge and are the strawberries safe to eat?

MINISTER FOR HEALTH: Sure, look firstly, this is a very vicious crime and it’s a general attack on the public and it’s also obviously an attack on a specific industry.

Secondly, it’s primarily the responsibility of the states through their policing mechanism and Queensland has taken strong steps, I’m not critical of that. But thirdly, I have also through my Department, asked for an immediate appraisal by the Food Safety Authority of Australia and New Zealand. So I’ve made that request, but in the meantime though, the police through Queensland are taking steps and I’m not critical of that. I think they’re doing the right thing.

It’s a vicious crime and it’s attacking the general public and a part of the agricultural sector.

JOURNALIST:  Back on aged care, Prime Minister, can you say now, your own terms of reference, is it clear that pay rates and staff ratios will be subjects for the Royal Commissioner to look into and make findings on?

PRIME MINISTER: It’s all encompassed in the areas I’ve already outlined. So I would absolutely expect it to be and that along with all other issues like this for example; one of the things that has been my observation for some time now is, because more Australians – happily - are choosing to take the opportunity of in-home aged care places and remain home for longer, I’m pleased to see that more and more in the housing industry, we’re seeing more private accommodation and other accommodation built for people’s own home where they can live longer in their own homes. That means you’re there for birthday parties of the grandkids. You’re there for important family events. Now, I know in retirement homes and I know in residential aged care facilities, they’re doing a wonderful job in trying to maintain as much of that home feel to where those Australians live.

But with more Australians staying at home for longer, it means that when they’re going into residential aged care, they’re going in at a more advanced stage, at a more acute level of need.

MINISTER FOR HEALTH: Exactly right.

PRIME MINISTER: That has real, serious implications for this sector. So, we want to get ahead of that problem. That’s the constant feedback I get from people who are working in aged care facilities. It’s the one issue above every other issue by the way. They put those they care for all the time, above themselves in these things and that’s why they’re such amazing Australians. But that’s the issue they are most concerned about and that they can meet the needs of those that are coming into those facilities now. That’s a real gear change from what we’ve seen over the last 25 years. It is a very different environment. Yep, last one.

JOURNALIST:  Did you ask Ann Sudmalis not to announce that she’s quitting Parliament until after the by-election?

PRIME MINISTER: I don’t speculate on media speculation and that’s going to be a golden rule. Thanks very much.