The government’s funding commitment to aged care in the Federal Budget is too little to make lasting change, an aged care royal commissioner has told an industry conference.
Aged care royal commissioner Lynelle Briggs said she was pleased to see the government had accepted the majority of the recommendations in their final report and committed an additional $17.7 billion over five years.
“That’s a lot of money in anyone’s terms, but it’s still not enough money to do the job properly in order to fix the system’s problems comprehensively so that all Australians have got confidence in the system,” Ms Briggs told the Aged and Community Services Australia National Online Summit on Wednesday.
“Older people’s interest should be paramount. It shouldn’t matter if a proposed reform will make life harder for service providers. If it benefits people receiving care, it should be supported,” Ms Briggs said.
In a keynote presentation, Ms Briggs welcomed the commitment to introduce a star rating system and mandatory staff ratios via minimum care minutes and registered nurse time.
However, she said there were doubts over whether these and other key recommendations would be implemented in full.
“These reforms are long overdue, but there remain questions about whether they’ll be implemented in full. Will the waiting list be fully removed? It should be.
“Will the second stage and mandatory staff ratios ever see the light of day given that the government has not accepted either the important next step to move from 200 minutes of care a day to 215 [minutes] which would have delivered high quality care universally,” Ms Briggs said.
“Nor have they agreed to the requirement to preference direct employment of staff rather than contractors,” she said.
“I was so delighted that the government accepted most of my recommendations about keeping aged care institutions within government but it’s disappointing that they did not put all the quality standards setting in one body.”
Ineffective primary, allied care response
Ms Briggs said the government also “failed” to embrace the commissioners’ recommendation for a voluntary primary care model where general practices apply to become accredited for aged care and receive an annual payment for all enrolled residents.
“[It] would have provided a more comprehensive healthcare service to other people. I don’t believe that the continuation of the GP fee for service arrangements will work to increase the provision of fair and equitable health care services to this group,” Ms Briggs said.
“Similarly, I hope that you will not give up on the provision of effective allied health services in residential care. Older people deserve the opportunity to retain and maintain their health for as long as possible rather than be written off.”
As previously reported, the government’s commitments to allied health in its response and budget fall short of the commissioner’s recommendations for much more comprehensive funded support in residential care, drawing concerns from several stakeholders.
Reform more than “tick the box” exercise
The royal commission’s success will be judged by the extent the government and sector accepts the need for fundamental reform and also by the extent that reform is delivered and embedded, Ms Briggs said.
“It’s relatively easy for government to tick off the recommendations and say that the work is done. But you don’t get transformational change by recommendations alone. You need to focus on behaviours, attitudes and positioning the environment so that it’s conducive to major change,” she said.
Real improvements in care quality will also come from embracing the detail in the recommendations and the philosophy behind them, Ms Briggs said.
“These are both fundamental to the reforms. And that’s why the response to our final report needs to be more than a tick the box exercise and much more of a living, evolving stream of work and personal interventions to make the system better,” she said.
The ACSA National Online Summit takes place 17 – 21 May.