industry & policy
New gold standard is scary
Market-based reforms have caused great uncertainty in the community-care sector, where not everyone will emerge a winner.
By Michael Fine
The Olympic Games are an exciting celebration of competition, something to look forward to every four years. Despite the inevitable controversies beforehand, once they start, people everywhere are roused by the performances of the world’ s greatest athletes. The thrill of the excitement becomes part of the glory of the winners. We may even pause to ponder the great performances of those who lost, before we lose ourselves in the excitement of the next event, or the prospect of a rematch in four years.
But this time we won’ t need to wait until the next Olympics to see more winners and losers. In Australia, the aged-care system is also increasingly organised as a competition.
The recently released Aged Care Roadmap presents the prospect of moving the system to become a more commercial and competitive market for services in an entirely positive light – a big win for consumers, a glorious opportunity for providers, a satisfying policy outcome and big long-term savings for government.
But whether the new market-based competition will deliver glory or pain depends very much on where you come in the results. Will you be a winner or a loser? That is the question being asked by many of those from the aged-care sector with whom I have spoken over the past few months.
Will your job be safe? Will your organisation continue to be a player? Will you, as a consumer, end up being able to pay for what you need, let alone what you’ d like? What will happen if you are a carer?
The question on everyone’ s lips is:‘ What is going to happen?’ The answers, funnily enough, can’ t be found on the My Aged Care or My Carergateway website. While new players prepare themselves on the sidelines, those who have worked for years, and dedicated their lives to trying to build good-quality services and supports in communities where there were none, are left not knowing what is going to happen next.
Should community care organisations amalgamate or restructure? Should they spend more on marketing, or get a public relations consultant to help? Should they get a new logo? Fix up their web site? Or is the future one in which powerful new commercial corporations or innovative digital disrupters will enter the field unforeseen, like Uber or AirBnB have, destroying careers and laying waste to organisations that have been built up slowly, brick by brick, over the past 30 years?
The services most at risk are undoubtedly those that belong to the Home and Community Care Program. HACC stimulated the development of an amazing array of community-based care services across Australia, in every local area. While a number were run by local or state governments, many others were locally based community initiatives.
Such non-profit, non-government services brought many women into their first paid jobs in their local community. These locally based organisations provided a wide range of care at very low cost that today supports over half a million people remaining in their own home. They also fostered careers for paid staff and opened up opportunities for volunteers that had not previously existed. The result has been a wonderful growth of community enterprise and voluntary support. The achievement is an amazing form of social capital, available in every neighbourhood.
One would think that any government would be proud of this achievement. If reform is needed, bring it on. But do so with respect, working with the existing players to demonstrate more effective ways of working and help them transform to do so in the future. Tell people, proudly, what changes are needed and how they will be introduced.
But no one seems to know what will actually happen to the Home Support Programme( HSP) which is scheduled to soon replace HACC.
Instead, many community care services are sadly unsure of what the future will bring. What they expect is that they will need to compete with the commercial system, and they feel at a disadvantage.
They should feel confident of their achievements, and confident that the benchmarks they have set will be hard to beat. After all, their costs are minimal, their overheads almost non-existent. And volunteers working alongside paid staff are always going to be hard to beat. They should feel confident that the changes they make over the next year are the right ones, ones that will build on their existing profile and cost-effective results.
But fear, insecurity and uncertainty have been let loose. The losers in this competition won’ t be around in four years to compete again. This is not like the Olympics. If we kill off our non-profit community sector, we can’ t expect it to simply bounce back in four years when government realises what has been lost. ■
Michael Fine is an adjunct professor in sociology at Macquarie University.
14 agedcareinsite. com. au