Patrick has high hopes for 24-7 nursing care bill, but concerned lower house may veto amendments

Twenty-four hour nursing requirements in residential aged care facilities (RACFs) have been added to the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021, which was read for the third time and ultimately passed in the Senate last night.

Independent Senator Rex Patrick introduced the amendment, noting in a statement today that the move was informed by close consultation with the Australian Nursing and Midwifery Federation (ANMF).

“Proper care for our elderly is critical and it requires aged care homes to have registered nurses on site at all times,” he said.

“Having a registered nurse present in an approved aged care facility will improve the quality of end of life care; improve communication between residents, family and other health care professionals; and promote wellbeing issues that affect restorative care.”

The bill will also implement a range of other reforms, including:

• establishing new professional standards for aged care workers, including a code of conduct with legal liability if breached;
• increased information-sharing by the Aged Care Quality and Safety Commission, Department of Health and Department of Veterans’ Affairs to ensure consistency across health systems;
• expanding the Serious Incident Response Scheme (SIRS) by extending the definition of a ‘reportable incident’; and
• a new financial and prudential monitoring, compliance and intervention framework to oversee provider operations and eliminate the misappropriation of resident contributions, such as their refundable desposits.

ANMF federal secretary Annie Butler told Aged Care News that she applauds Senator Patrick for standing-up for older Australians and the nurses and care workers who care for them.

“Our members continue to experience chronic understaffing and cuts to hours,” she said.

“The longer the Morrison Government delays fixing the dangerously inadequate staffing levels in nursing homes, the longer the pain and suffering will continue for those older Australians.

“The ANMF and its members encourage all MPs to now support this important Bill.

“Surely, a law requiring a registered nurse to be on shift 24 hours per day in nursing homes is not too much to ask?”

Greg Hunt, minister for health and aged care, said that the reforms in the bill will deliver the high quality and safe aged care that our senior Australians deserve.

“This bill responds to a number of recommendations of the Royal Commission into Aged Care Quality and Safety, ahead of further reforms that have been committed to by this Government.”

“Expanding the Serious Incident Response Scheme will reduce the risk of abuse and neglect, and protect vulnerable senior Australians receiving aged-care services in their home and the community.  

“[Greater financial oversight] will enable the Government to identify at-risk providers earlier, and help ensure providers meet their obligations to refund deposits to residents.”

Hunt also indicated that while he supported 24/7 nursing in RACFs in principle, such requirements should be delayed until July, 2024 to provide facilities adequate time to prepare for increased staffing requirements.

The bill has not been without controversy, however, with advocates concerned about a last minute addition in the lower house, which will provide aged care providers and their employees immunity from civil or criminal liability in relation to the use of a restrictive practice in certain circumstances.

This provision remains in the bill, after being deemed appropriate by the Senate Standing Committee for the Scrutiny of Bills in February.

“The committee expects that if a bill seeks to provide immunity from civil or criminal liability, particularly where such immunity could affect individual rights… [it] should be soundly justified,” the committee wrote in its explanatory report.

“In light of the explanation set out in the explanatory memorandum, the committee leaves to the Senate as a whole the appropriateness of providing immunity to aged care providers and their staff from any civil and criminal liability in circumstances where informed consent has been provided by a person specified in the Quality of Care Principles…”

This committee comprises a cross-section of the political parties, including Labor Member Kim Carr, Liberal Senator Paul Scarr and Greens Senator Janet Rice.  

Despite the many promising elements of the bill, Patrick has cited his concerns that upon the bill returning to the lower house, his amendments may be vetoed.

“Since October last year, the Government has deliberately delayed the Parliament in dealing with this bill because they knew the Senate would support my amendment to implement the Royal Commission’s 24/7 registers nurse recommendation.

“It’s highly likely the Government will now try to bury their own bill in the House in order to resist imposing the royal commission recommendation on aged care providers.

“They are more interested in helping their business constituents, rather than the elderly.”

Patrick has alerted Labor’s Aged Care shadow minister, Clare O’Neil to the Bill’s passage through the Senate and has asked her to try to get the bill brought on for debate today, the last sitting day of the 46th Parliament.

​​​​​​​”For the sake of our loved ones in the aged care system, I am calling on the Government to do the right thing and deal with this Bill in the House as a matter of urgency.”