Providers, sector peaks and academics have expressed concern over the 89,000-long wait list for home care and urged the Federal Government to take further action to address the long-running problem.
Data released by the Department of Health last week revealed there were just as many people in home care each year as on the national queue.
Based on the 53,000 people currently without access to any home care packages services, the system would need to increase the number of available packages by more than 50 per cent.
The national wait list for home care far exceeds the median wait time of four months for hip surgery, where five per cent of people wait more than a year for a total hip replacement in Australian public hospitals.
According to the latest figures from the Australian Institute of Health and Welfare, nationally two per cent of patients waited more than a year for elective surgery in public hospitals and the median wait time was 37 days.
COTA Australia chief Ian Yates said the volume of people waiting for a home care package in Australia was “an unacceptable problem.”
“There are a lot of people who aren’t getting a package at all. Some people are receiving Commonwealth Home Support Program services or services through the allied health system, but a lot of them are just being looked after by a partner or family and friends and that is a real worry.”
He said there were hidden costs to residential care and the health system while unmet demand for home care packages continued.
While he, like many in the sector, applauded the Coalition Government for introducing transparency into the system for the first time and announcing additional high care places, he said the government must continue to address the problem in the Mid-Year Economic and Fiscal Outlook and in the next budget.
“The scale of the problem is so great that the government really faces no alternative but an injection over the next couple of years of new money into high care packages, while they look at the longer-term Tune recommendations around the balance between residential and home care places,” said Mr Yates.
ACSA CEO Pat Sparrow said transparency of the queue data was an important step forward for understanding consumer wait times and the level of unmet demand was a clear indication there was a need for increased investment in home care.
Ms Sparrow said it was also important the government moved to integrate the Commonwealth Home Support Program and home care packages as soon as possible to ensure that community aged care resources were being used most effectively.
“The data is reinforcing that people want to age at home and we need to look at the system overall in a way that ensures people can get residential care when they need it, but that the majority of people want to age at home, and they are supported to do so.”
Lee-Fay Low, an associate professor in ageing and health from the University of Sydney, said the data showed the home care system was significantly underservicing older people and many were missing out on care services altogether.
Without access to adequate support the health of people waiting on the queue could decline faster resulting in the need for residential care or increased hospital admissions, she said.
The impact on carer burden could also be significant, which had wider health and productivity costs from family carers leaving the workforce and experiencing high levels of stress, she said.
“What worries me is that there’s a whole lot of people who could be living at home with good quality of life and they are not.”
Average waiting times for high priority cases was not yet available from the public reporting.
She said another key issue was how effectively the system was reassessing older people’s changing needs while they waited, in some cases more than 12 months, for a package.
Associate Professor Low agreed there needed to be a discussion about what is the correct balance between home care places and residential aged care beds in Australia.
Resthaven CEO Richard Hearn urged the government to do everything it can to expedite access to services to people at their assessed level of need.
To address the extent of unmet demand, Mr Hearn called for the government to commit to uncapping the supply of home care packages and to introduce a Level 5 home care package, as recommended by the Tune Review.
As an initial step to uncapping supply, Mr Hearn said the aged care ratio should be adjusted to further increase the home care ratio from 45 to 50 packages per 1,000 people over 70 and reduce residential care places to 70.
Sandra Hills, CEO of Victorian provider Benetas, said unmet demand for packages has been a persistent problem in the home care sector and the report revealed the extent to which older people can’t access care that adequately meets their needs.
“We still need to understand the full extent of wait times across the program. People should be allowed to know when they could expect to receive services,” she said.
“If consumers know how long the wait time is, they can make interim arrangements, such as accessing private funded services. “
Ms Hills said more information was also needed on the take-up of assigned packages by consumers, including the number of package withdrawals.
“There is evidence that many consumers remain confused about the process and what they are being asked to do.”
Paul Sadler, CEO of Presbyterian Aged Care, said an undersupply of home care packages has been a significant and well-known problem in the industry and underscored the need for greater investment in home care.
However, to develop a fuller picture of the interim arrangements in place, Mr Sadler said it was necessary for the government to report on how many people waiting on the national queue were also receiving Commonwealth-funded home support services.
Mr Sadler said the Tune Review’s proposal to temporarily reallocate residential places to home care was a good idea in principle, but the practicalities of implementing the measure needed further consideration.
Rebalancing the residential and home care places as part of the aged care planning ratio was also a debate the sector needed to have, he said.
David Martin, the general manager of HammondCare at Home, said to help people in urgent need his organisation has been offering “early commencement of care” to people on the national queue who have not yet been assigned a package.
“It is a risk that we are prepared to take to help those, particularly with high needs, who are at risk,” he said.
Related coverage: Home care data reveals 90,000 package shortfall