Models like Better Caring are simply responding to the shift in seniors’ expectations, and are the result of disruption in the aged care sector, not the cause of it, writes Peter Scutt.
I write in response to an opinion piece from Paul Sadler, ‘Keeping the mission in the market’ (Australian Ageing Agenda magazine, March-April issue) to clarify some misconceptions about new care service models like Better Caring.
Aged care service provision in Australia is undergoing massive and rapid change, involving a necessary rethink of existing modes of delivery that have dominated the industry for years.
These changes to existing models are not being brought about by new players, but by the changing demographics of our ageing population and the shift in behaviours and expectations of people as they age.
Increasingly, people expect to age well and actively, empowered by choice in and control over their lives – an expectation clearly identified by older people in the ‘Conversations on Ageing’ project conducted by Council on the Ageing (COTA) Australia and former Minister for Ageing Mark Butler back in 2011-2012, and in turn reflected in the government’s consumer directed care reforms.
Models like Better Caring are simply responding to this shift. They are not the cause of disruption in the aged care sector, but the result of it. Models like ours are gaining traction as consumers seek out alternatives to what currently exists – alternatives that provide them with flexibility, better value for money and ultimately better life outcomes.
The roots of the Better Caring concept was borne out of my personal experiences in finding care for my parents, who struggled with their lack of control over the process. In establishing Better Caring, I’ve learned that this struggle is widespread. But it is not a struggle any of us want to face.
I want to be extremely clear that we do not believe that the emphasis on individual choice and control means there is no place for case management in the new aged care world. Indeed, with individualised funding and more choices than ever before, the role of an independent advisor becomes even more crucial.
At Better Caring, we strongly support the vital role that case managers play, particularly in providing impartial advice – not influenced by having a product to sell – that supports a consumer’s right to choose.
We have never suggested that cutting out the ‘middleman’ is cutting out case managers. We simply believe that service providers do not need to sit between a consumer and their care worker for every hour of service delivered.
We believe in enabling, whenever possible, a direct relationship between a care worker and their client. Consumers are experts in their own life and in the best position to judge who is right to provide services to them. That doesn’t mean they don’t require support to do so – but the level of support will differ from person to person. Recognising these differences is consumer directed care in action.
We also believe that Australian care workers should have the choice to work for individuals who have chosen them. In a society that is increasingly moving towards independent workforces, the desire for care workers to drive their own career is only going to grow. And if we are to attract the large and diverse workforce we need to support our ageing population, we need to attract a mix of people who prefer the flexibility that can come with running your own business, alongside people who prefer to be employed.
We fundamentally refute the statement that independent contractors are being lowly paid or are providing low quality care.
In terms of providing quality care, being successful in any small business is about delighting your clients. On platforms like Better Caring, where clients have the ability to provide feedback about their carers, delivering the best experiences and outcomes for clients is even more critical.
From a remuneration perspective, Better Caring enables care workers to set their own rates. Independent contractors who deliver a high quality service will be greatly in demand and their hourly rates will reflect this over time, offering them the potential to earn more. In this context, training and competency assessments will remain particularly relevant, as workers invest in themselves and their business.
As Sadler argues, in this new market-driven world, NFPs play a vital role in supporting the most needy in society. However, in a confusing and changing landscape, some of the most needy will be those with limited understanding about the choices they now have. A crucial role for NFP’s moving forward will be to enable this understanding. Both traditional and emerging players have a responsibility to provide clear, transparent information to all members of the community to enable them to make informed and balanced decisions about their own life and care.
While some traditional non-profits have chosen to see us as a challenge, many more see us as an opportunity to collaborate, evolve, and improve their offering. If we truly want to place consumers and workers at the centre, then the future of aged care must be about working together in the best interests of those who need care and support – embracing new models, rather than “taking them head on.”
Peter Scutt is founder and executive director of Better Caring.