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The Department has lost control



Above: CEO for Aged and Community Services WA (ACSWA), Stephen Kobelke

By Yasmin Noone

The Department of Health and Ageing has lost the trust of many in the sector, having failed to allocate the number of residential places and care packages, per state, that it promised in its five-year Aged Care Approvals Round (ACAR) indicative plan.

The CEO for Aged and Community Services WA (ACSWA), Stephen Kobelke, has lead a chorus of voices from within the sector, all expressing their discontent with the federal government’s recently released 2011 ACAR figures.

Only days ago, the Minister for Mental Health and Ageing, Mark Butler, announced that more than 12,000 new aged care places throughout Australia, worth over $400 million will be on offer as part of this year’s aged care allocations.

Since then, Mr Kobelke has slammed the department saying that the 2011 ACAR is a “shemozzle”, representing yet another failure, on behalf of the department, to properly provide for the sector.

Although he is happy enough with the total number of new care places for the country, Mr Kobelke says the devil is in the detail –  the state ACAR projections do not align with what is now on offer.

“…What they’ve done this year, excluding WA, is that they’ve ramped up the residential places in every state,” said Mr Kobelke.

“For instance, Tasmania this year was supposed to get 373 beds. They actually got 646. Now they’ve increased Tasmania and they’ve under subscribed WA. There’s no way in the wide world they will fill that number of beds. But at the same time Tasmania was supposed to get 23 community packages. But as you can see they got zero. Queensland also got no community packages even though they were supposed to get 280 based on the projections.

“After all that, another example of what I can’t  understand is that Victoria was supposed to get 350 packages and they get 665. Now what’s that about? It makes no sense and there’s no rhyme or reason to their planning.”

The government had indicated that this year, it would distribute 2,398 residential and 87 community places to Western Australia. Instead, it allocated 1,500 beds and 279 community packages.

“It just beggars belief they way they’ve approached the planning process. What was supposed to be on offer for WA this round was 2,300 plus beds. They’ve slashed nearly 900 beds from WA, packed them on a truck and sent them down [an] eastern highway, down to the eastern states.

“The total under-subscription in WA over the last three ACAR rounds has amounted to two and a half thousand beds. But all of the beds weren’t issued because nobody applied.

“This round they have slashed the beds by 900 beds so now we are already up to being three and a half thousand beds short. And they’ve taken the beds from WA and moved them to the eastern states.

“Why? Because the [department] wants to make the [total] figures look good and add up at the end. They did the same thing last year. That’s why there was also an under-subscription of beds in WA, Tasmania, QLD and NSW – meaning there wasn’t enough applications for beds that they could approve.

“The [department] lost control of ACAR two years ago when WA undersubscribed for the first time in Australian history. From that point onwards they’ve just stumbled and the minister knows that the department has stumbled.”

Mr Kobelke reasons that the government abandoned the original indicative ACAR figures for this year, having converted under subscribed bed places from one state to care packages another (or the same state) because it had overspent forward estimates.

“At WA’s April meeting with the Minister…what he said was there would be ‘No conversion of bed under subscription to packages’ because they have ‘overspent forward estimates’ and that if the ‘round under subscribes, it under subscribes’,” Mr Kobelke said.  
 
“There are incredible variations in this ACAR round to the indicative places outlined in the department’s long-term planning numbers.

“…The department lost all credibility around planning for the ACAR two years ago but what they have thrown out here is exceptional even by their standards.

“It’s just another one of the department’s failures to plan for an older Australia. The minister is aware that this [marks] a failure. He knows it’s a failure. The only people who don’t are [in] the department.

“This ACAR is an absolute shemozzle.”

An Australia-wide reaction to ACAR 2011

Unlike WA, Victoria recieved more residential places and more care packages than originally indicated – 2,430 residential spots compared to the 1,687 promised and 665 care places up from the intended 350.
 
CEO of Aged and Community Services Victoria, Gerard Mansour, commented that in the garden state’s case, there is both good and bad.

“We are very pleased the government has listened to our call for action on extra services and [these figures] will help in some of our regional areas,” Mr Mansour said.

“On the other side, my concern remains about the growing mismatch between the growing demand and supply.

“Let’s remember that Victoria has the worst occupancy rate, running at 92 per cent.

“I am unsure how we will support this increased ACAR allocation across Victoria.”

Mr Mansour said that, just like Mr Kobelke and other aged care CEO’s, he wanted clarification as to how the government arrived at the figures. 

“What these figures do is reflect the changes in population predictions. I am assuming that is the drivers for the figures are the estimated changes in the population. [So] what I call for is the full public release of all the planning data that has been used to inform the ACAR round.

“In the absence of that release we are going to struggle to get the right beds and packages in the right locations.

“It’s a mismatch question. [Correcting] that is the challenge in going forward.”

Deputy CEO of Aged Care Queensland, Barry Ashcroft, commented on the fact that the sunshine state was not allocated any community care packages at all at the expense of extra residential beds, even though the government intended to provide 280 care packages. 

“For the first time in recent memory, the ACAR almost exclusively focused on residential care, with no additional community care packages allocated in Queensland,” Mr Ashcroft said.

“This seems an ambitious target given during the last ACAR, applications for residential care places were 2,000 undersubscribed nationally. A further 786 bed licences have been handed back in the last two years because providers could simply not afford (or access finance) to build facilities to accommodate the beds based on the returns currently available.

“We have heard from some members who are extremely disappointed that there is no opportunity to expand community care.

“There will always be a need for residential care facilities to support our ageing population but… there is also a growing preference and market for people to access community care services in a range of accommodation settings that they either own, rent or lease.

“The current planning ratios used by the department to determine the aged care market and therefore the ACAR allocations do not account for this shift in demand nor do they adequately identify the need for the increasing number of people living into old age. 

“The most effective way forward is to be gathering the evidence of unmet demand and challenging the planning assumptions currently engrained within Australia’s aged care system.”

Even consumer groups are unhappy with this year’s approvals round. CEO of Council on the Ageing, Ian Yates, said that the figures highlight the problems captured within a system that is in dire need of change.

“I think the minister has done what he could but these figures just demonstrate that the system is broken,” said Mr Yates.

“This is the last gasp of a system that doesn’t work any more, that has had a lot of problems.

“…Reform is, in fact, overdue. But up until now, no government has been prepared to tackle the issue. But we believe that now, as the PM has given us a commitment to reform, we anticipate a final PC report that will do that, that we will all agree with.”



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0 Responses to The Department has lost control

  1. Greg Mundy June 21, 2011 at 4:28 pm #

    All in all an excellent argument for changing from regulating supply to regulating demand by allocating aged care funds on the basis of consumers with different characteristics rather in the form of places for providers. Moreover I think it shows that you can’t separate residential from community services in doing this, as some have proposed at least in a transition period. This would compound the confusion set out in the article above.

    I agree with Ian Yates’comment that this may be the last gasp of the old system. I am less confident that all the aged care stakeholders will support such a reform.

  2. David Fenwick June 21, 2011 at 4:58 pm #

    Smoke and mirrors together with magic and trickery may show that a greater percentage of residential care places will be taken up with this year’s ACAR in WA because the planning ratio has been abandoned and the indicative allocation committed to WA last year has been significantly cut. While WA may be 2600 rescare places places short of where the planning rations suggest we should be in 2010, guess what after the 2011 ACAR we will be 3500 or there abouts. Even blind Freddy can see the game is drawing to a close and crunch time is coming. Some how, the Dept of Health & Ageing will have to address the bed shortage in WA very soon.

  3. s .mckenzie June 22, 2011 at 6:47 am #

    Interesting that none of these industry “heavyweights”knew what was happening.

  4. nick mersiades June 22, 2011 at 10:22 am #

    As the Soviet Union discovered long ago, central planning does not work!

  5. Gerard June 22, 2011 at 7:17 pm #

    Seems a bit contradictory.The industry is claiming insufficient funding and providers going bust or running at a loss but now we want more beds.

    The magic pudding is alive and well
    Give us more beds so we can go bust faster!!

    Seems to be a consistency arguement.

    No wonder the politicians do not react to the bleating about funding and that staff get confused about the increased workloads and expectations and low wages

  6. David Fenwick June 23, 2011 at 12:01 pm #

    The point is not so much that we want more beds in WA because it is true that we cannot afford to build them with current funding, but rather that the intended allocation of beds as indicated in 2010 has been significantly reduced in order to make the Federal Government, namely the Minister for Ageing look better when so few beds will be applied for here in the West. The fact remains that WA is currently 2600 beds short of the figure that the planning ratios suggest we need and after this ACAR that figure will most likely grow to 3500. So what is the DoHA doing to address the deficit?

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