The time has come for Australia to start having important community discussions about aged care, writes Jan Adams.
The projected increase in the number of Australians aged 65 and over to be in excess of 8 million by 2054-55 will more than double today’s numbers, drastically changing the shape of our country and economy.
We need to talk about it as a nation and plan for it now because it will affect us all.
Did you know that there is a 45 per cent chance you will need residential aged care if you make it to your 65th birthday?
A significant portion of baby boomers will eventually need aged care, which will mean being supported by around 614,000 new care workers by 2050, as estimated in the Future of Australia’s aged care sector workforce report from the Senate community affairs committee inquiry.
So, how do we prepare for this as a country, when Australians expect and deserve high-quality health and aged care?
These questions are especially timely with the government’s current inquiries into aged care quality and David Tune’s independent report on the legislated review of aged care.
In considering the Tune Report, we ask that all politicians continue to approach aged care reform in a bipartisan way. The bipartisanship shown in 2013 was a key factor to the success of the Living Longer, Living Better reforms. Aged care is simply too important an issue to be politicised.
We recognise Mr Tune’s recommendations to include the full value of the owner’s home in the means test for residential care and remove the annual and lifetime caps on means-tested fees are sensitive.
But these options should be seriously considered as part of a much-needed national conversation on ageing and aged care, and how best to fund it.
We strongly encourage the government to consider at least increasing the capped value of the owner’s home in the means test, which is currently $162,087.20, and increasing the annual and lifetime caps.
This is consistent with an original recommendation by the Productivity Commission to move to market-driven aged care funding, where people who can afford it contribute to the cost of their personal care while those who cannot afford it continue to be heavily subsidised.
In recent times, changes to residential aged care funding – particularly the indexation freeze and changes to the Aged Care Funding Instrument complex health care domain – are making it increasingly difficult to provide the high level of care required for residents with complex care needs, within the aged care home.
This follows sustained cuts since 2013, including the loss of bond retentions, removal of payroll tax exemptions for some providers, and the removal of dementia supplements.
These cuts have impacted our most vulnerable community members, those with complex care needs such as severe dementia or other chronic conditions.
Where care cannot be delivered in residential aged care, due to inadequate funding, people will increasingly need to be transferred to the more-costly hospital setting.
This is a very poor outcome for the resident, their family and the healthcare system.
More broadly, it is more costly and places unnecessary strain on a system already under stress.
Bupa recognises it is not realistic to expect the government to significantly increase funding to the industry in the current budgetary environment. This is why we need a sensible public discussion on other avenues to fund the sector, including greater contributions from those who can afford it.
We need to avoid a situation like that of the United Kingdom, where ongoing reductions to aged care funding have resulted in approximately 25 per cent of acute care beds in hospitals being occupied by people with dementia and aged care facilities continue to close.
Sustainable funding is key to providing quality aged care and attracting a strong workforce. Without reform to the existing funding model, it is inevitable that the quality of aged care delivered in Australia will diminish over time.
The current government focus on aged care reform is welcome and presents a great opportunity to look at innovative ways to meet the demands that will come from our ageing population.
We look forward to working with policymakers, industry and consumers so that we can deliver the best care outcomes for our oldest Australians. They need and deserve it.
Jan Adams is Bupa’s global chief nurse and acting managing director of Bupa Aged Care Australia.
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