It is a pleasure to rise and speak on the Aged Care Restrictive Practices Substitute Decision-maker Bill 2024. I would like to start at the outset by saying thank you to those who have given really thoughtful contributions today on this bill.

Whether it is today or tomorrow or in years to come, we are all going to face the challenges of ageing. Each day we are all a bit older, and hopefully a bit wiser, but as we age we will need to face those questions of our care, our health and our independence. I know as a community and a society we do care deeply about the dignity, the comfort and the rights of those who we love and, indeed, their own futures as we all move into those older stages of life. For many, the prospect of entering an aged care facility may be very daunting, a period of transition that means a shift in routines and environments and maybe even personal autonomy. However, when we ensure that there are choices in that decision-making and choices remain central to that care, we can preserve the individuality and dignity of those in the aged care setting. When individuals have choice in their care and their daily routines – it might be meals, social activities or their care plans – they continue to shape their own lives. These choices reinforce that autonomy, giving them control over their experiences in a way that truly gives aged care the continuity of their unique journey rather than a loss of independence.

Choices in aged care can lead to better mental and physical wellbeing. Studies have shown this – that when people have a say in the care, they are happier, healthier and more engaged. They feel respected, seen and valued. Families too find peace when they know their loved ones are supported in making decisions that reflect their wishes. Knowing that their parents or grandparents can decide what they want in their care plan can bring comfort and alleviate concerns for families in knowing that their loved ones are valued.

But in the event that a family member cannot make those decisions, there are further choices to be made, and this is the conversation that we are having today in this place. This does impact countless families and communities. The decisions that we make for our loved ones when they can no longer make decisions for themselves never involve easy conversation, but they are ones that we must face with empathy, responsibility and dignity. For many, there will come a time that cognitive decline or health challenges diminish their capacity to make decisions around their own care. When that time arrives, families, caregivers and professionals do face those profound responsibilities.

I would like to acknowledge the critical role of care providers and those who work in the aged care space. Doctors, nurses, aged care staff and social workers are all integral to providing that guidance, expertise and care. They are not only offering medical insight but providing passionate care that aligns with the dignity and respect that each person deserves.

We have heard a little bit today about the Royal Commission into Aged Care Quality and Safety, which investigated the Australian aged care system. Through that process there were significant concerns about the quality of care, the safety and the transparency. The commission’s findings revealed widespread neglect, inadequate staffing, overuse of chemical and physical restraints, which are what we are speaking to today, and a failure to support residents dignity and wellbeing. That final report offered nearly 150 recommendations for substantial reform to improve the standard of care, and I will note that the federal government has begun that journey of major reform to protect the safety, dignity and wellbeing of all of our older Australians. One of the areas, though, addressed in the royal commission was the restrictive practices – methods like physical restraints or sedatives often used to manage behaviours in aged care settings. In response to this the Commonwealth introduced new regulatory requirements aimed at ensuring that restrictive practices were only used as a last resort and under strict conditions.

I just want to talk a little bit about what this bill today does. This bill will establish a hierarchy of decision-makers who can act as a restrictive practice substitute decision-maker in a residential aged care setting in line with the requirements under the Commonwealth Aged Care Act 1997. This bill will allow aged care providers to identify a substitute decision-maker through that hierarchy, and under this bill decision-makers will be identified in the following order of precedence: a substitute decision-maker nominated by the aged care resident, a next of kin identified based on a close relationship and then further a decision-maker appointed maybe by VCAT should no other decision-maker be available. This bill is much needed in that for aged care residents who may not have that capacity to make decisions, such as in the instance of dementia, a substitute decision-maker can provide consent. It really is necessary to ensure that aged care recipients in that aged care setting have choice over who they want to act as a substitute decision-maker and, where there is no such nominee, who can be appointed as such. It will ensure that residents can trust that, if the time does come, a loved one will be able to act in their best interest.

This bill will ensure that all aged care providers are able to be compliant with the requirements of legislation. It will ensure, as I have said, that there is that trust that we can have someone that will act in our best interest, and the bill will ensure that the aged care providers can have that framework to go to. I do want to, though, just make clear that restrictive practices are actions that are intended to manage the behaviour of aged care residents which may pose a risk to the safety of themselves, staff or visitors. There are five categories that allow restrictive practices: chemical restraints such as medication, environmental restraints, mechanical restraints, physical restraints and seclusion. These are a last resort, where all other options have been explored. This approach today does give appropriate safeguards to protect the rights and interests of people who are living in residential aged care settings.

In conclusion, I would like to just reflect a little bit on a personal situation. I am currently in the situation where I am starting to have a conversation with my own parents. They are both fit. They both still work, volunteer and keep active. But with a recent medical episode we have had to start having the conversation about how at some point they may need assistance at home. Caring for any ageing parent is filled with that love and responsibility but a lot of worry. As our parents age we are in the reverse role, finding ourselves in the role of asking how to best support those who have raised us. I often feel, and I am sure others do, that weight of responsibility, ensuring that they have that comfort and dignity that they deserve. It does come with a bit of anxiety. Are we making the right decisions? Are we doing enough? Is it what they would like? How would they feel about the decisions being made? And if it does come to a point where care is needed, maybe in an aged care home, how will that transition look and feel for all involved?

Making these decisions is not easy, but our loved ones also may need round-the-clock care, and they need those resources to still continue to enjoy a life safely and comfortably. Although this bill does take a piece of legislation that has been devolved from the Commonwealth to the state, I think in this place we would all agree that every Australian and every older Australian should feel confident about accessing that care – high quality and safe care – where it is needed, whether it is at home or in residential care. In the end, how we care for our ageing loved ones I think speaks volumes to who we are as a society and as a community, and I would like to think that we will choose compassion when dealing with this issue. They may be our parents or our grandparents, and it is clear that we need to treat them with the respect, compassion and dignity that they have earned.