industry & reform
800,000 people annually : by far the largest number of them being aged care consumers . Importantly , this care can keep people more active and independent and defer the time when they may have to go into residential care . Yet its costs are low : just under $ 70 for each consumer per week , according the data released in 2021 by ACFA .
Home Care Packages , provided to a much smaller group , cost $ 387 per week on average . Both forms of support , it should be added , are far less costly than residential care , which comes in above $ 1,000 per week per recipient . Looking at these figures , the question needs to be asked , why would anyone seek to abolish such an effective and efficient program as the CHSP ?
For the department ’ s advocates , the amalgamation of the two programs and their common adoption of fee-for-service funding is all presented as a done deal . It has not been tested in practice . Nor has any modelling of the potential explosive rise in costs been released . Yet if we look at the costs for the NDIS , it seems likely that costs per individual will rise . To manage this those with lower levels of support may miss out , as happens in the disability field . Similarly , the approach would damage prospects for developing a more professional and secure workforce employment system .
The SAH Alliance rejects the fee-forservice model and calls for a common approach to payments across the aged care field . Its scheme would be similar to the new funding system being introduced for residential aged care , the Australian National Aged Care Classification ( AN-ACC ). This , they argue , would be able to respond to a mix of both ongoing ( fixed costs ) and episodic ( or variable ) service interventions , and would combine some of the clear benefits of the existing block funding provided to the CHSP , and the flexibility of case-mix funding .
The new program and the proposals for regulation seem to have a low profile at present . It has been presented as a modernisation of regulation that would enable the SAH program to operate like the NDIS . But there are many who argue that such a system would undermine care standards entirely , and promote the development of insecure employment based on the labour system evident in the US – hardly the model of professional career focused workforce called for by the Royal Commission .
But if the SAH Alliance and others concerned about the future of aged care at home have their way , the future of aged care in Australia is not yet a foregone conclusion . Before we destroy the social capital built up over the past 40 years through the largely non-profit CHSP system , there is still time to get it right . And there is a federal election . ■
Michael Fine is honorary professor in the School of Social Sciences at Macquarie University .
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