By Stephen Easton
Yesterday was the final day for written submissions to the Productivity Commission regarding January’s draft report, Caring for Older Australians, and also marked the first in a series of public hearings about the report in capital cities around the country, held at the PC’s Melbourne headquarters.
When commissioners Robert Fiztgerald, Sue Macri and Mike Woods present their final report to the government in late June, the training wheels will be off and it will be seen if the extensive reforms suggested in the report and largely approved by the industry will survive the dash through the political gauntlet.
Many of the 41 post-draft submissions on the PC website are from interested members of the public, and tell of aged care and retirement services horror stories experienced by staff, allied health professionals, consumers, carers, friends and families.
But by and large, the huge number of responses to the PC have been largely positive, with final submissions from COTA, Alzheimer’s Australia and the Royal Australian College of General Practitioners (RACGP) all giving broad support to many of the recommendations.
The RACGP would like the Commission to pay more attention to the overlap between the aged care system and the health care provided to those cared for within it, through the injection of funding to support in-reach services and higher pay for personal care and nursing staff.
Dr Beres Wenck, Chair of the RACGP General Practice Advocacy & Support National Standing Committee, said huge financial disincentives discouraging GPs from working in residential aged care facilities were caused by a lack of support for in-reach services through Medicare and other forms of health funding.
“We’ve wanted the government to improve the funding of in-reach services for a while but there has been little response.” Dr Wenck said. “The residential aged care system runs on the smell of an oily rag and the goodwill of the service providers. Personal care workers are often paid less than their children working in Hungry Jack’s, and the nurses are underpaid too.”
“Because it’s so poorly funded, a lot of nurses want to do agency work, and don’t feel any responsibility for continuity of care to that patient.”
Alzheimer’s Australia CEO Glenn Rees said the organisation had felt their core area of advocacy was “underdone” in the draft, leading them to “unashamedly put the spotlight on dementia” and emphasise how central the condition would be to the structure of the system.
Alzheimer’s Australia also thinks the final report should do more in general to empower consumers, like recommending a trial of the option to ‘cash out’ individual funding for care and respite services, and suggesting the definition of an approved respite service provider be broadened to include friends, family and neighbours.
“We’re still very concerned about the interface between aged care and disability – particularly in respect to younger onset dementia,” Mr Rees said. “And we’re particularly concerned about the interface between mental health and aged care, which the commission discussed, but didn’t go on to suggest anything.”
Mr Rees said there were two groups with younger onset dementia in danger of falling between the cracks – those who had a disability before developing dementia, who should be able to receive outsourced dementia care services within the disability system, and those who had no prior connection to the disability system, who he believes are best looked after by dementia experts in the aged care sector.
Seniors’ advocacy group COTA prepared its own particularly detailed position on March 15, which expressed concern over several areas, including commonwealth-supported residents, who COTA says could receive less choice and a lower standard of care than other residents under the PC’s proposals.
COTA also wants to see providers required to show they comply with prudential standards every year, a national approach to elder abuse coordinated through COAG, better training for non-care staff who work in aged care and more information for consumers through a ‘MyAgeCare’ website, similar to the MySchool and MyHospital sites currently run by the government.
The authors of the response, CEO Ian Yates and National Policy Manager Jo Root, were not available for comment as they were participating in the Melbourne public hearing, which had to be extended by two extra days due to strong interest.