The new Aged Care Act will be implemented in less than a week, introducing the Statement of Rights, the new Support at Home model, new rules, strengthened standards and stronger regulation.
It is a defining moment for aged care reform, with the Act providing a solid foundation on which a quality aged care system can be built, Council on the Ageing Australia chief executive Patricia Sparrow tells Australian Ageing Agenda.
No system is perfect from day one and change of this scale takes time, but the Act will provide the tools to create a care system that “truly supports older Australians,” Ms Sparrow said.
“For the first time, the Statement of Rights puts older people at the centre of the system – not as passive recipients of care, but as individuals whose rights must be respected and upheld,” she said.
But older Australians need confidence that the government’s promise that no one will be worse off will be kept, Ms Sparrow continued.
“The government has a mandate to make sure the new system delivers care that is accessible and affordable for every older Australian, no matter their background or where they live,” she noted.
Sector will watch for ‘unintended outcomes’
Ms Sparrow said that as the changes take effect, COTA Australia will be watching closely to make sure the system delivers on its commitments, particularly in relation to the impact of co-contributions.
“We remain deeply concerned that showering is excluded from clinical care under Support at Home. We’ve raised this directly with government and will continue to advocate strongly for this to be addressed,” she said.
Speaking with AAA last week, Ageing Australia chief executive officer Tom Symondson said the peak body’s early focus will be on making sure the new system is working as it should and that there are no “unintended outcomes.”
This includes people’s concerns that pensioners will stop seeking domestic assistance due to the new co-contribution system.
“My strong feeling is that that is not going to happen 100 per cent. I don’t think anybody thinks that every pensioner in the home care system who is not grandfathered just will simply not seek support with showering because of the five per cent charge,” he said.
But he questioned how many will and whether it will be an issue that hardship processes cannot resolve, emphasising that if problems do arise, the policy settings may need to be readdressed.
Sector capacity needs attention
Beyond concerns about the new co-contribution system is the need to “start getting serious about capacity,” Mr Symondson said.
He welcomed the 83,000 packages that will be released but warned that more and more will be needed each year as demand for the system grows.
“Every year we have to fight for the release of more packages. Every year the government releases packages, so there’s no reason to think they won’t continue to do it because they have done over the past decade – even if they don’t give as many as we think they should. But having to fight for it each year is the problem. It should just be the way it is,” he said.
The other key thing is beds, Mr Symondson added, because regardless of increases in package numbers or improvements to preventative health, there will always be people needing residential care.
“And we think that that will double as well over the next 20 years, and if we don’t start building more beds, we’ll be putting out no vacancy signs in places that have never had them before,” he said.
Many of the sector’s concerns were resolved with the delay from 1 July, Mr Symondson noted, but there are also some lingering worries related to digital readiness and ensuring issues can be escalated and fixed as quickly as possible.
He said that Ageing Australia has formal escalation processes with the Department of Health, Disability and Ageing, the Aged Care Quality and Safety Commission and Services Australia – and thanked them for that commitment.
These escalation processes mean that in the case of “mission-critical issues,” Ageing Australia can have them escalated rapidly, he explained.
“But really, it’s about what happens if you can’t get things fixed. So if the payment systems, let’s say for sake of argument, they did all fail, would providers still get paid for the services they need to deliver? And we’ve worked with the department to ensure that whilst nobody thinks that’s what’s going to happen, and I certainly don’t think it’s going to happen, if it did, do we have a fallback solution?” Mr Symondson added.
“But we’ve done all of that work and we’ve done all of that planning because if providers don’t get paid, a lot of home care providers are small, they don’t have the cash to keep going, older people would see their services fall over, and so you’d have a continuity of care issue, and that’s the priority for everybody.”
He added that Commissioner Liz Hefren-Webb and her senior staff have been “extremely generous” in the lead-up to 1 November, taking the time to talk to Ageing Australia members and make it clear that the commission will be focused on the safety of older people and the quality of service over technical non-compliance – a shift from what has been seen in the past.
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