industry & policy
Illusion &
delusion
Without some serious changes
to the system, the idea that
consumer-directed care gives many
people more choices isn’t real.
By Michael Fine
T
he longer we experience the new consumer-directed
system of community care, the more its limitations,
shortcomings and misrepresentations become clear.
Perhaps it was inevitable that some of the ideals held out about
the new system would turn out to be difficult to realise in practice.
But it should serve as a lesson about naivety regarding the promise
of shiny new approaches that transform everything.
The way in which the Australian system prior to the introduction
of consumer-directed care was portrayed – rigid, moribund,
dominated by the narrow perspectives of professional staff,
offering little choice to clients and so on – was always a caricature
at best. Our gullibility was not just a case of collective belief in the
‘grass is greener’ syndrome; the salesmanship was very effective.
Who wants to oppose the empowerment of older people?
Would-be critics of the CDC approach often held back their
warnings about unrealistic expectations of change because they,
too, hoped for something better than what we had. Truth be told,
there had been little choice available to consumers. So we all held
our breath and hoped.
A key issue that needs to be confronted if we are to give
consumers the choice they have been promised is the existing low
levels of assistance available to those who need help to remain at
home. The existing home care packages are simply not intensive
enough to provide help to those who need more than a very
limited number of hours of help each week.
I recently encountered this first hand when I was required to
14 agedcareinsite.com.au
help a member of my extended family. Following discharge from
hospital, she was unable to stand on her own. The CDC service
provider recognised the problem and doubled the number of care
workers who attended each visit. But the only way to achieve this
was to halve the number of hours and v \