industry & reform
from within the medical community.
An open letter, supported by the
Australian Nursing & Midwifery Federation,
has urged the government to lock down all
non-essential services in Australia and has
called on the government to better prepare
and support frontline workers.
“We need more time and resources
at the front line. Preparations remain
incomplete. These include obtaining
adequate supplies of PPE, training to use
it properly, and environmental changes to
minimise the risk to staff from COVID-19,”
the letter says.
Colbeck remains unmoved and believes
the government is currently acting on the
best advice available.
“I’ll take the advice of the medical
experts that are advising government
through the AHPPC. I think that’s the
appropriate thing to do,” he says.
“I don’t think it’s helpful that we have
other organisations who are creating levels
of uncertainty in the community by making
demands that don’t line up with [that of]
the medical experts who are providing
advice to the government ... So I’ll continue
to take the advice of the AHPPC.”
LOOKING PAST THE PANDEMIC
Even if we discount the current pandemic,
Richard Colbeck has had a turbulent time
as aged care minister.
Constant criticism has come his way,
from his apparent lack of knowledge of
the aged care interim report in Senate
questioning, to the government’s handling
of a BUPA scandal, and most recently due
to a spat with the royal commission over
the ACAT process.
On the ACAT issue, Colbeck believes it
was all a misunderstanding.
“I can understand royal commissioner
Pagone’s statement because what he was
reacting to was a report of what I had said
in the media, not necessarily what I had
said. And I respect that and understand
it perfectly. I have no truck with the
commission at all,” he says.
Privatisation of ACAT was not the
plan, he adds. Rather, the main focus
was to bring ACAT and RAS together, a
recommendation David Tune made to
him personally.
“If you look at it, the government doesn’t
actually conduct any of those assessments
right now. All of it is outsourced to the
states or providers around the country.
“So, there are a number of providers
providing the RAS service. Some of it is
state based, some of it is not for profit,
some of it is private,” Colbeck says.
“The issue for me was how you brought
them together. That was always my
focus. And the reason that I made the
final decision that I made was that it’s
dependent on having the appropriately
qualified workforce.
“Once I got a better sense of what was
happening with that, that dictated the final
path for me in my process to bring them
together. We’re still working on that. That’s
still an intention – to bring the RAS and
the ACAT workforce together – and to
do that we’ll be negotiating directly with
the states.”
A WAITING GAME
Another constant criticism of the
government has been the ever-expanding
wait times for aged care places.
Data released by the Productivity
Commission in January shows that wait
times for those needing to enter residential
aged care have increased almost 50 per
cent since 2016–17.
The report also revealed that those
Australians waiting for the highest-level
home care package have an average wait
of 34 months.
Data for the 2018–19 period shows
that 41.9 per cent of older people entered
residential aged care within three months
of their ACAT approval. However, the
median wait time is now at 152 days, an
increase from 121 days in 2017–18 and 105
days in 2016–17.
Colbeck points to continued investment
from the Morrison government as proof
that this issue is being taken seriously.
“We’ve made significant inroads into
the provision of home care packages,”
he says. “Over the last couple of years,
we’ve invested about $2.7 billion since
the 2018–19 budget into our home care
packages. And the number of packages has
grown significantly in that period of time.
“In fact, I think the wait list is now down
under 110,000. There are about 146,000
Australians ... who have access to, or who
are in, a home care package,” he says.
“But we have also said that we want to
reform the way that home care packages
are delivered, because I think that we can
get more value for the investment that
we’re currently putting in.”
As for residential wait times, he disagrees
with the Productivity Commission’s 50 per
cent rise statistic. Instead, he says that this
is likely “decision-making time” that older
Australians are using to decide whether
residential care is for them.
“There’s no constraint on people taking
up a residential aged care place. The
occupancy right across the country has
dropped from 96–97 per cent about four
or five years ago, down to close to 90, so
there is capacity in the system.
“I think that is a decision-making process
on behalf of senior Australians. It’s not an
availability thing.”
BANG FOR YOUR GOVERNMENT BUCK
Aged care finance can, at times, seem like
the be all and end all. On the one hand, we
have the government announcing more
money and package after package. On the
other, peak bodies say it is still not enough.
However, studies have shown that
56 per cent of residential care facilities
are operating at a loss, with that figure
increasing to 65 per cent of regional
residential care facilities.
The royal commission interim report
says the aged care system needs a “reality
check” and to focus less on acting like an
“industry” and a “market” force that views
people as “clients” and “consumers”.
Is it time to take the free market out of
the provision of care for our elders?
“There are high-quality aged care
providers in a corporate perspective,
and there are very high-quality aged
care providers in the community and
That’s still an
intention – to bring
the RAS and the ACAT
workforce together.
not‑for‑profit perspective. So, I think
there’s room for all of them within the
sector,” Colbeck says.
“We need to make sure that there is
capacity where it’s needed, particularly
in thin markets out in regional Australia
and looking after people who are
disadvantaged. But the corporate providers
provide a significant amount of the aged
care in the Australian community, and they
provide a lot of the capital to actually build
that as well.”
And what of the large providers, such
as BUPA, which has been a consistent
offender when it comes to poor care
yet continues to receive millions in
government funding?
Continued on page 28
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