A consensus on consensus

After years of frustrated attempts, the key to achieving structural reform for the aged care system seems to have been broad unity and consensus among the many stakeholders. According to the Minister, it’s been essential.

Above: Amigos…the three NACA spokespeople at the press conference. L-R: Martin Laverty, Ian Yates and Sue Lines

By Keryn Curtis  [written Friday 20 April 2012]

‘’A new era”, “a remarkable achievement”, “a huge leap forward”, “a real ‘road to Damascus’ moment”.  These are the phrases being used across the many aged care stakeholder groups to describe the $3.7 billion package of reforms for the aged care sector announced today by the Prime Minister, Julia Gillard and Minister for Ageing, Mark Butler.

‘Furious agreement’ was the term used by chief political correspondent and Canberra bureau chief for SBS Television, Karen Middleton, after listening to the chorus of positive responses from National Aged Care Alliance (NACA) spokespeople.

The seasoned press gallery reporter and author fired a barrage of questions to NACA spokespeople, Ian Yates, Martin Laverty and Sue Lines at the NACA press conference in the Senate courtyard shortly after the Prime Minister’s announcement.  Middleton dominated questioning at the forum, doggedly testing new angles, looking for cracks in the smooth face of their beaming solidarity.

“How can you all be in such furious agreement on this?  How often does this happen?” she finally said in disbelief.

She was right to be astonished.  Consistency and unity between apparently disparate stakeholders is indeed an uncommon event in politics and social and national affairs.  Unions and employers on the same team?  Service providers and customers all in accord?  Unheard of!

And while, come Monday, there will of course be questions and concerns, requests for detail and calls to retain the pressure and momentum, today was a day for elation and celebration, as well as relief.

COTA CEO and NACA spokesperson for consumers, Ian Yates said it was an excellent beginning. “The system now has a sense of direction.  And continuing to work collaboratively, we can ensure we can iron out any unintended consequences along the way.”

Mr Yates congratulated the government and the opposition and said the sector should congratulate itself too.

“We’ve worked hard for many years to achieve this.  For many years but especially since 2009 when we first launched the Campaign for the Care of Older Australians.

“Government after government has put aged care in the too-hard basket and all the disparate voices within the sector have made it easier for that to happen.”

CEO of Catholic Health Australia and NACA spokesperson for aged care providers, Martin Laverty, said consensus among the voices had been critical in achieving this outcome.

“Employers, unions and consumers have shown their consensus and commitment to reform; now it is up to the Parliament to do the same,” Mr Laverty said.

Assistant National Secretary of United Voice, the union representing most aged care workers,  Sue Lines said there was a new maturity in the relationship between employers and unions.

“Both the unions and the employers recognise that we are stronger together than when we are apart.  The Workforce Compact [announced in the package of reforms] will give us the opportunity to agree to things.  And it will be up to us to be innovative and bold and to get the sector and the workforce that Australians want and deserve. It’s a very exciting future for us,” Ms Lines said.

The Minister, speaking personally

Above: Minister for Ageing, Mark Butler at the joint press conference for the announcement.

Minister for Ageing, Mark Butler agreed that consensus among the many stakeholders had been critical in getting the reforms over the line.

“I think that’s been a problem in the past to some degree. If the sector talks of different priorities and disagrees on some of the fundamental building blocks, it’s hard for the government and the parliament to be confident about what direction is the best,” said Mr Butler.

“The wonderful thing about this process for some years has been just how hard the sector has worked at achieving consensus as far as they possibly can around the building blocks.  

“Now you can’t agree on everything and there will be disagreements around priorities and there will be disagreement on issues around the edge, but the work that has been done in the sector to achieve consensus, as much as they can, has been essential for the government and the parliament to have the confidence that what we are proposing is the right direction,” Mr Butler said.

“I know that, just from talking to cross benchers and from back benchers in the government who have talked to the NACA members over the last few months as they’ve been stomping the halls of parliament. 

“When they look at the [NACA] Blueprint and they see the list of organisations signing up to the same set of principles – the diversity of those organisations, the fact that those organisations in the past and in some other forums disagree profoundly about things; they have a level of confidence that the direction is the right one,” Mr Butler said.

Tags: ian-yates, julia-gillard, living-longer-living-better, martin-laverty, naca, naca-blueprint, prime-minister, reform-announcement, sue-lines,

5 thoughts on “A consensus on consensus

  1. Well done NACA, AgeWell, Minister Butler,(&let’s not forget th Productivity Commission) and all others concerned with achieving this outcome. Keryn is right, come Monday the future path will be the issue (the Sunday papers in fact revealed one or two concerns with the finer print). If this is to be a paradigm shift to consumer centred agedcare there is more work ye to be done – a decade’s woth in fact!

  2. Is it just me? The bulk of the commentariat seems to singing from the same hymn book, but I seem to be missing a few pages from mine. There are some very positive initiatives in recognition of the preference for people to stay at home, and while additional Home Care packages will be available much of the restructure of community based services is reuse of old money from existing programs. While this is a good initiative to maximise and integrate the many services available to support home based care a significant amount is being spent in the first instance on the administrative effort to get this don.
    There will remain a place for residential aged care, mostly dementia services given the projected growth in numbers and smart operators have already transitioned to ageing in place. Most providers will welcome the removal of the distinction between low and high care and permitting accommodation bonds for ‘high care’ comes with a sting. How many Providers feel comfortable with the Aged Care Financing Authority deciding how much a bond should be or how much a resident should pay in accommodation fees? We need to see more detail about how the authority will operate, what pricing mechanisms will be developed, and, if providers must have charges approved by the authority what will be the timeframes we can expect to see application processed and approved. The cooling off period has both benefits for residents but a sting for providers. If a resident changes their mind from say a lump sum bond to a periodic payment provider’s have less reliable information to project capital available for future developments. It seems that we are in for more regulation and not less.
    The appeal by ACSA and statements that it would not support a reduction in ACFI payments seem to have fallen on deaf ears. ADL and Complex Care payments are to be clawed back to historic levels. What does this mean? What historic levels are we talking about? The justification that aged care costs has fallen behind ACFI payments is a rouse. There is no way any sort of analysis of General Purpose Finance Accounts could identify this dissection of expenditure. The increase in payments for behaviour are not likely to make up the short fall arising from the loss of subsidy for ADL and Complex Care, and given that behaviour accounts for the smallest percentage contribution to ACFI funding it is unlike that we will be able to maintain the levels of care that our assessments suggests residents require. The government has had a validation process in place to confirm that ACFI claims represent care planned (the original intention of ACFI), and I have not seen any reports from Government of the outcomes of ACFI validations or indeed the reports of the analysis of the General Purpose Financial Statements that have been released in the past. As this is public information the Industry should demand the release of the information to support the Government’s claim that there is ‘prima facie’ evidence to support a reduction in ACFI payments. And how about the new CAP to support increases in salaries for aged care workers? Commendable yes, but what is happening to the old CAP currently 8.75% of subsidy. There is no mention of the existing CAP in the document and no commitment to maintain it. As others have said seems like the reduction of ACFI payments will offset the increase in wages with no appreciable benefit for providers struggling to meet the cost of resident care at existing wage levels.
    Of more concern is the idea that independent assessors might be given authority to decide the ACFI funding a provider will receive, as they are independent of profit motives! Who are these people, where will they come from and under what conditions will their assessments be based.

    There is significant expenditure proposed to expand the bureaucracy – Aged Care Financial Authority $26.4m, Aged Care Reform Implementation Council $15.2m, Commonwealth Home Support Program $75m, and Aged Care Gateway $198.2m.
    Finally I am greatly surprised by the way in which this package has been announced and praised by the industry. A call to Canberra for the major stakeholders to attend a meeting – with no agenda. An announcement of a package and within hour’s reports of universal praise for the reforms from key industry bodies – where is the detailed analysis? This is a major reform and before the commentariat wholeheartedly embraces it we need detailed analysis of the impacts right across the sector.

    John Stuart, CEO Twilight Aged Care

  3. As a provider there are a lot of questions to be answered about what was annouced on Friday.

    I would like somebody to advise me if the following analysis is correct or have I got it terrible wrong.

    If you look at what consumers wanted – An entitlement system – not delivered, consumer choice in who providers care for them – not delivered, an ability for to “shop around” for the best mixture of care – not delivered, an overall increase in home care so that demand is met and nobody is left out – not delivered (we stilol ahve a quota system), a simple way for people to navigate the system – not delivered.

    From a providers perspective – An increase in community care packages – delivered, an increase in funding to meet the fair wages claims being made – not delivered, a system where funds are available for building infrastructure into the future for those who cannot stay in their own homes – much confusion and as John Stuart states, the confusion is over what the new regulator will and will not allow.

    I am struggling to see how the annoucements met what the PC inquiry recommended?

    Please explain.

  4. The enthusiasim displayed by some industry representatives does make you wonder – there are some potential positives but overall I am not sure that the enthusiasim will last once the implications / realities / practicalities of some of the detail of the announcements become apparent – certainly low care operators that can’t transition their buildings to high care will do it tough as former likely low care residents stay at home even if medically that is not what is best for them – greater uncertainty re maintaining even existing bond levels is quite possible and is the industry ROE / profitability issue going to be improved by the announcements? I doubt it from what I have seen/heard so far – Red tape? I suspect we might well look back and think we had it good before some of these new departments/authorit ies were formed.I truely hope I am wrong and the overall package does result in meaningful positive reform for all parties in the sector i.e. residents,families operators and the taxpayer – right now unfortunately I am having difficulty seeing it.

  5. I heartily agree that the consensus reached via the National Aged Care Alliance has been critical in achieving the reform package. It is the most far reaching package of reforms since 1997, and some of the changes (especially wages improvements, community care restructuring, and dropping the distinction between high and low care in residential care) are major moves forward.
    But it also true that Living Longer, Living Better is far from perfect. No one in NACA was arguing for a major cut in ACFI, nor were we seeking greater regulation of aged care – rather moves to deregulation in the right places (such as an entitlement to care and removal of caps on supply).
    The onus is now on the Government to work with NACA to ensure the reforms are implemented sensibly, and where necessary to be open to adjust directions if we can show that some of their ideas are impractical.

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