industry & reform
from whether the assessment that’s being
done is actually correct.
People are often assessed at a time of
crisis, and they’re therefore assessed as
needing a higher level of care than perhaps
they need in an ongoing sense. So we
have to look right back and ask, “Is the
assessment actually correct, or is there
some work that we need to do upfront
with people before their ongoing level of
service is determined?”
We have to look at the whole issue of
unspent funds, and we know that there’s a
growing amount of money in the unspent
funds pool. But you can’t just look at that
and say, “Well, we’re going to use that to
create other packages.”
We have to look at, “Are people saving
up for a piece of equipment or respite?
Are people scared to use their funds
because they’re waiting for a rainy day?”
And if that’s the case, we need to say to
people, “If you’re on a package, it’s raining
and you need to spend it.”
There are questions about some of
the things that are being asked for and
authorised, in terms of whether they are
the right sorts of things that we would
want people to spend money on. We have
to have that conversation.
And ultimately we have to look at how
we just make sure that we are using the
resources that we have, to support people
in the best way possible.
And it may require some adjustment
around unspent funds, but it’s not as
simple as saying there’s this much money
in unspent funds, which we should take out
to fund new packages. We do have to look
at what people are spending the money
on, and that’s important because people
should be able to save up for something
that might be more expensive.
But if there really is capacity in the
system that’s never going to be used, then
we have to look at how that’s used.
If there was one thing that ACSA thinks
would help us go in the right direction,
and that we could change now, what
would it be?
I’m going to say two things. First, we
do actually need more packages. The
number that we have just shows that there
are a lot of people who need the support
who aren’t getting it. And I think the other
thing for me is looking at the assessment
and making sure it’s right, and the use of
unspent funds.
I think they’re interlinked, and it’s
important that those things are all looked
at to get a true picture of what’s happening
and what the best actions to fix the home
care crisis are going to be.
It’s terrific that we now have this data,
because before February 2017, when this
change came into effect, there were still
thousands and thousands of people on
wait lists, but they were hidden.
So we’re having a different level of
conversation now that we actually know
how many people are waiting for care.
Linked with this is the wider issue of
aged care funding. The indexation
increased for home and residential
aged care funding to 1.4 per cent. What
do you think about that?
We think it’s woeful. It’s a combination of
the average weekly earnings and the CPI,
and we understand that, but we know
that there’s a couple of things happening.
I mean each area, whether it’s home care
packages, residential care or CHSP, they’re
all being indexed at a lower rate than their
costs are rising.
Just to talk specifically about residential
in this instance, we know for example that
they have to provide a 3 per cent increase
into wages, which is clearly more than the
1.4 per cent indexation that government’s
now providing. We have a population in
our residential care facilities who have
higher and more complex health needs
than they’ve had in the past. And the
funding hasn’t kept pace with that.
So the base funding’s not right, and
then on top of that we’re continuing to
get inadequate indexation. So what’s
happening is we have more complex
needs that we’re needing to address. The
funding’s not keeping pace with that, and
the indexation is clearly inadequate.
The other thing that’s happened is the
government did put in a 9.5 per cent
increase into residential aged care at the
beginning of the year, which was good, but
that actually now comes to an end.
So, it’s a bandaid solution, if you like,
and we’re going to be back to square
one in a sense, with not having the
funds that we really need to deliver the
quality of care, and the types of service
that we want to deliver and that the
community expects.
So would you say then, at the very
least, that indexation has to keep up
with wage increases?
At the very least. But I think it’s more
fundamental than that. It’s fundamentally
that we have to look at the base funding
that’s going into all aged care to see if it’s
actually allowing providers to deliver the
care that the community expects, and that
the government is wanting us to deliver.
And then on top of that, we have to have
indexation. That means the funding keeps
pace with the increasing costs.
Do you think the upheaval in the
aged care department – we’ve now
got our fourth minister since 2013,
and the position is not being made
a cabinet position – do you think
this is contributing to the problems
we’re facing?
I would answer it a little bit differently.
Firstly, we’ve welcomed the royal
commission and the scrutiny – we want
to have the light shining. And I think what
we’re seeing with the royal commission
discussions is more nuanced and more
complex discussions about what’s facing
aged care, and what the challenges are
facing providers.
And sadly, along with that, there are
some stories coming out that nobody
wants to see.
But it is important that we have a
whole‑of-community conversation about
the challenges facing aged care. And
inevitably they focus on staffing, which is
linked to funding.
All of the things that are coming out
come back to the really important funding
pace. I think that in terms of the minister,
we’ve had some good ministers, and I’m
sure that Senator [Richard] Colbeck will
take it on and do the best that he can.
The issue that we really have to get
across is the way aged care is seen. And
we need to have the argument and force
central agencies – the prime minister
and cabinet, treasury and finance – to
really understand what’s happening in
aged care. So it’s important at all levels of
government, whichever level the minister
is, whether the minister’s in cabinet or not,
because we are represented in cabinet
and we will continue to be represented in
cabinet by Minister [Greg] Hunt.
It’s really important that the ministers at
each level, and the departments, and the
central departments, actually understand
what’s happening in aged care, because
that’s how we’re going to be able to get
the shift.
And importantly, the community has
to value and want to look after older
Australians, and value aged care, and put
pressure on for more funding to be spent
in this area. ■
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