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Addressing the unfinished reform agenda


Transferring residential aged care funding to consumers, adapting to consumer directed home care and increasing community-based palliative care are among the key aged care reform measures still incomplete or missing from the agenda, Professor Michael Woods tells Australian Ageing Agenda.

University of Technology Sydney health economics professor Michael Woods said the potential transfer of residential care funding to consumers rather than providers was among unfinished business that was on the agenda.

The Federal Government announced in the May budget that it provided its in-principle support to putting residential places in the hands of consumers and allocated $300,000 towards a study to investigate the impact of this measure.

If it happens, it is going to cause more change in the system, Professor Woods said.

“It will introduce more competition and reduce the certainty that providers have had in terms of occupancy rates and profiles of residents, but it will allow the agile provider to respond to community needs more quickly,” Professors Woods told Australian Ageing Agenda ahead of his appearance at an upcoming conference on aged care reform.

Michael Woods. Photo: ©Nathan Rodger

While putting residential places in the hands of consumers is on the agenda, but yet to play out, Professor Woods argued that consumer directed control of home care packages had a way to go, with the agenda still not complete.

He said that greater numbers of packages were going to increase the number of people that could remain at home longer, including up to end-of-life care and avoiding going into residential care, but the sector was yet to see the full effects of consumer directed home care reforms.

“It’s been implemented but the system’s responses are yet to be fully played out.”

The budget allocated an extra 14,000 high-level home care packages over four years to address the increasing demand for home care, however that falls short of meeting the needs of the 82,000 older people currently waiting in the national queue for a Level 3 or 4 package.

But the budget did not include a commitment to introduce a Level 5 home care package as recommended by David Tune to increase the options for older people with high-care needs to be cared for at home.

The delivery of more community-based palliative care is also among other unfinished reform items not yet high enough on the agenda, Professor Woods said.

The impact of this measure on aged care will make “the person at pre-end-of-life care and their carers more comfortable knowing that they would get sufficient end-of-life support,” he said.

Professor Woods will also address whether there is a need to grow overall aged care funding, the role of equitable user fees in system sustainability and the way forward at the upcoming conference.

He said in order to know how much aged care funding needed to grow by, it first needed to be understood what aged care services Government should subsidise.

“The government and the community need to collectively have ongoing discussions about why government is subsidising some services, who it is subsidising and by how much to so that there is equity, including equity between consumers and taxpayers.”

The Aged Care Reform after the 2018 Federal Budget conference will be held on 25-26 July at the Hilton in Sydney.

Australian Ageing Agenda is a media partner of the conference.

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3 Responses to Addressing the unfinished reform agenda

  1. val fell July 13, 2018 at 12:23 pm #

    Maybe putting residential funds in the hands of the consumer would stop some facilities charging extra fees that were not used. Or having a premium extra service fee in addition !!!

  2. Michael July 13, 2018 at 12:30 pm #

    Another bit of nonsense from the lofty certainty of our unemotional economists. On the ground the problem is not consumer directed care but the sort of competitive market that it is intended to bring about and on which its success is supposed to depend.

    We have just seen what has happened with this competitive market in banking, in the jobs market, in vocational training, in franchising and in almost every other sector where people are vulnerable and some basic humanity is required. Aged care is the most vulnerable of all and it is already bleeding!

    As human beings we define who we are and who we become by what we think about and do. In providing services like aged care we express our compassion and our capacity to empathise. We build caring relationships and through them our value systems. These are the qualities that make us human. We become socially responsible citizens.

    In aged care compassion has been replaced by entrepreneurialism, a process in which self-interest and unrestrained individualism are the driving force. In this sort of market compassion, empathy and caring relationships are not competitive. When they occur it is in spite of and not because of the system. We need a very different sort of market in human services like aged care.

    Not only are the elderly at greater risk than bank customers but society’s humanity and value systems suffer from disuse atrophy. We are all poorer for it.

  3. Felicity Chapman July 19, 2018 at 3:33 pm #

    Michael a very eloquent, down-to-earth and humane reply. Thank you!

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