The problems in rural aged care can teach Australia about the solution for the sector nationally, writes Nikita Weickhardt.

Aged care in rural Australia is broken. The availability of aged care in rural and regional areas is poor, so lack of access to care close to home makes it difficult to maintain social connection. It exacerbates feelings of isolation. It separates older Australians from their families, friends and communities.

Among the stark realities the royal commission into aged care has laid bare, it’s that finding that uniquely exposes the systemic issue we face.

These are some of our most vulnerable people. Older Australians in regional, rural and remote communities have lower incomes, poorer education and poorer health outcomes. Some 40 per cent of Australians aged 70 to 74 live outside capital cities – but the provision of care for this cohort is wholly inadequate. Over half of the ageing population in very remote communities were forced to move more than 100 kilometres from their homes to enter an aged care facility.

Nikita Weickhardt

This discrepancy, and the failure of aged care to service rural communities, comes down to the one-size-fits-all approach that has characterised the sector. The royal commission found that a lack of a strong consumer voice has led to this approach, and it’s allowed providers in populated areas to expand unchecked, while our rural communities are faced with a service deficit.

The government has committed to placing more residential aged care in the hands of consumers by 2024. It is reducing barriers to entry by creating more places – but, in the instance of the 40 per cent of Australians aged 70 to 74 who live in regional, rural and remote areas, the problem is not so much the number of places but the context in which they are provided.

The solution lies in better stewardship of the aged care system by our governments – at both state and federal levels. We cannot simply reduce barriers to competition or make more places available. We must learn from the situation in rural and regional Australia that the context of how these places are offered must be taken into account – which will be provided through good stewardship of the system by the government.

Good stewardship of a system like aged care relies on creating strong, mutually beneficial relationships between government, providers and consumers. It is about providing stability – reducing the risk that constant changes lead to unintended outcomes. Good stewardship is built on understanding – knowing consumers’ needs, behaviours and preferences and effectively collaborating among government, provider and other stakeholder groups to provide flexible, innovative and sustainable service delivery.

In aged care in regional and rural areas, the impact of good stewardship would be transformational. Understanding the diverse characteristics, risks and requirements of these different communities and acting accordingly is fundamental in establishing an effective and informed aged care system.

Knowing how best to serve a regional city with 50,000 residents, compared to how to serve a high growth regional area, compared to a remote and very small population area, is key. Each will require a different approach, and each will have different needs and priorities.

This is where change will be made. If we can move beyond the one-size-fits-all approach, beyond the solution being to simply add more places – the effects will be transformational. For aged care in Australia to be fixed – as the royal commission asserts it must be – it needs to be responsive and sensitive to the needs of the people it cares for.

Thankfully there are indications the government is taking on the stewardship challenge. The implementation of a regional network in aged care is a positive step to understand, engage, strengthen, and coordinate local and national aged care markets and systems. There is also the continued expansion of multi-purpose services facilities such as in Dorrigo, northern NSW. This 27-bed facility, which offers an emergency department, general medicine, community nursing and more, involves myriad agencies working together to sustainably meet community needs.

Effective stewardship can allow more people to benefit from services like this one. Now is the time for boldness and innovation. Now is the time for change.

Nikita Weickhardt is a director at Nous Group in Melbourne.

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