Aged Care Insite Issue 118 | Apr-May 2020 | Page 23

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 agedcareinsite.com.au 21