I too rise to speak on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. It is great to hear the member for South-West Coast say she will be supporting this bill. I might remind the member for South-West Coast that almost for a decade we had a federal Liberal government who did absolutely nothing in this sector. I know this because my long-suffering mother was working in the sector for that decade where workers and homes were absolutely falling down around the ears of that federal Liberal government, and they did nothing. It was not until an Albanese Labor government was elected and the Honourable Anika Wells became the Minister for Aged Care, got off her butt and started doing things in that sector, that something was done. So I am really pleased that the member for South-West Coast is going to support this bill, but saying that this side of the house and Labor governments have never done anything to reform this sector is absolute and utter nonsense.
The aim of this bill is to make a number of important changes to the settings that govern our state-run residential aged care facilities here in Victoria. At the core of this bill is the principle that older Victorians living in these residential aged care settings deserve quality care. I am pleased to say that compared to the privately regulated aged care facilities, our state-managed care facilities, of which there are about 180 here in Victoria, outperform the private sector again and again. We certainly saw that during the height of the COVID-19 pandemic.
It goes without saying that an important part of our aged care setting is the administering of medication. For years I had conversations with my mother about the settings in New South Wales in which to prescribe medication to elderly residents. These were people who live in the facilities and experience all kinds of vulnerabilities and conditions, things like Alzheimer’s and dementia, that mean some of those folks require extra assistance in taking their daily medications. My father-in-law has recently been diagnosed with Alzheimer’s. He is taking stroke medication and blood pressure medication and the whole gamut, and he requires assistance from my mother-in-law to help him on a daily basis take all of that medication. When you go into an aged care facility, quite often residents do need that kind of assistance as well. What we know is that, according to the Pharmaceutical Society of Australia, about 20 per cent – one in five – of unplanned hospital admissions from residential aged care facilities are the result of inappropriate and unsatisfactory medicine use. We also know that the Royal Commission into Aged Care Quality and Safety clearly identified that medication management and safety is a key area that needs improvement. That is what this bill is doing here in this place this afternoon.
We heard reports of medicine not being administered correctly and residents being given medication with no oversight to ensure that they actually take them. I know that here in this place we can agree that this kind of neglect is just simply unacceptable in any form of aged care setting. We know that in our aged care facilities here in Victoria about 36 per cent of residents are actually prescribed – get this; this is just so many tablets – more than nine medications, and that is the highest rate of polypharmacy anywhere in Australia. About 19 per cent of residents are prescribed antipsychotics, which, if not managed correctly, can present major risks to the safety of residents and also to the safety of staff – such as my mum, who has worked in those facilities.
Fortunately, we have seen the federal government make some really positive improvements to the aged care sector since the royal commission handed down its recommendations. Mandatory care minutes were introduced so that residents have an appropriate amount of dedicated care time, which includes 44 minutes with a registered nurse. The federal government have also reformed funding to the sector through a new funding model that gives providers greater clarity over the funding they receive. In fact one of the things we are hearing is that these changes are actually delivering better outcomes for aged care workers themselves. We are hearing it is becoming faster to attract and keep aged care workers. I will say that that is a stark contrast from the disaster the industry was in under the previous federal Liberal government that led to the royal commission’s initial report simply titled – remember this – Neglect.
As for our government, we here in this state have been working on reforms in this space for much longer, and that started back in 2018 with a review of the administration of medication in residential aged care settings. What this review went ahead and identified was that there was room for improvement in this space to meet basic practice. So in 2022 we undertook sector-wide consultation to strengthen medication management and administration in our state residential care centres. We consulted with unions, with providers, with personal care workers and, most importantly, with those with lived experience in care. I think it is quite often forgotten that for those in aged care facilities, it is not an aged care facility to them; it is their home, it is their bedroom and it is the place where they are going to see out the end of their days. We needed to be able to consult with them, and we did.
What this bill delivers on is it makes a number of critical changes in this sector, which will come into effect by July next year, in order to give the sector the time it needs to adjust or make workforce changes. What this bill will actually do is place a requirement on all Victorian aged care providers to make sure that only registered and enrolled nurses can administer prescribed and dispensed drugs of dependence, as well as schedule 4, 8 and 9 medications. In addition, the bill is going to go ahead and allow for regulations to prescribe any exemptions where this obligation may not apply, as well as how these circumstances, most importantly, going ahead should actually be managed.
The regulatory framework is not something that we have made up. It has been implemented based on the feedback we have heard from the industry, which is that we need to account for unforeseen circumstances that may limit nursing ability. We are talking about things like serious residential emergencies, temporary unexpected staff shortages or other factors that may go ahead and impact the ability of nurses to administer that really important medication on time. This does not always cover insufficient nursing all of the time, but it does account for those unplanned situations that can happen in these settings, and there will be no need for providers to go ahead and seek an exemption.
What I will say is that registered nurses – and my mum actually used to be one, until she gave up being a registered nurse to become a family day care worker when she had children; she could not do the shift work as a registered nurse, having given birth to me and with her husband being a milkman – are the ones that work regularly in aged care settings. Mum would often comment that in New South Wales those registered nurses would come in and dispense the medication. They are also equipped with the skills and the training to administer medications safely.
That is just so important when you are dealing with elderly people who are vulnerable and have all kinds of challenges ahead of them and that they are experiencing based on their age. The skills and the training to administer that medication safely are so important. That is something, as any aged care worker will attest, that aged workers do not always have experience in. My mum said in her experience a lot of aged care workers quite often did not or would not have the confidence to administer those drugs at the levels and the volumes that people needed to take them. They did not have the confidence to go ahead and actually administer them in the first place, so it was a no-brainer to have the registered nurses come in.
I do want to give a big shout-out, in summing up in the last 40-odd seconds, to the aged care workers. They do a really tough job day in, day out. They often do not get thanked. They have to deal with immense challenges. I know that there is job satisfaction; people that really enjoy being there and enjoy that kind of work get immense job satisfaction in looking after our elderly, quite often at the end stages of their life. Like I said, some of them are facing significant challenges when we are talking about Alzheimer’s and dementia. They get to know the families of their aged care residents. I know my mum felt very deeply and was passionate about the work that she did, which is why I wholeheartedly commend the bill to the house.
