Tasmania pitches for entitlement trial

Aged and Community Services Tasmania CEO Darren Mathewson is calling for Tasmania to be the trial site for an entitlement-based aged care system in the wake of the latest AIHW report highlighting the lengthy delays many face in accessing aged care services.

He said the aged care supply and demand equation could only be dealt with if government releases its control over aged care places and he wants an entitlement trial on the agenda before the end of the year.

A Tasmania-based pilot has the support of the Tasmanian Government as well as consumer advocacy organisation COTA Australia, which last week reiterated its calls for the Commonwealth to end the rationing of aged care places.

Mr Mathewson said Tasmania was the perfect site to trial an entitlement-based system because it was a fairly specific region, a good test size and controllable.

Such as system in Tasmania could deliver a broad range of health, preventative health and wellbeing services that have an increased focus on reablement early in a person’s aged care journey, he said.

“If we can build a more responsive aged care system that can connect with people in the earlier stages and focus on reablement, health and wellbeing, it will take pressure off the acute system and also reduce the high costs of health because we currently have such a reactive health system,” Mr Mathewson said.

The trial has the support of the Tasmanian Government following a forum in August, attended by a range of industries, which was organised by the Tasmanian Chamber of Commerce and Industry in conjunction with the Premier’s office and looked at generating employment and economic activity in the state, he said.

ACST’s idea was for the State Government to approach the Federal Government to discuss Tasmania trialling an entitlement-based aged care system, and it was one of 13 recommendations that came out of that event, Mr Mathewson said. “The recommendations that were picked up at the end of the forum were supported by the State Government and they agreed they would then pursue those,” he said.

Consumer support

COTA Australia chief executive Ian Yates added his support for an entitlement trial in Tasmania.

“We think it is a good idea. We are strong supporters of the two components of entitlement, which are removing ratios and giving the resources to the consumer, so we would support it if it has got both of those elements,” Mr Yates said.

Following on from his and others calls for research to be done into the amount of unmet demand in aged care, Mr Yates said Tasmania was a small but sufficiently representative sample that a trial could be an action research exercise. “We could actually see how much demand exceeds the current levels if we take the ratios away,” he said. “You could do other kinds of research as well, and we would still be encouraging that, but it would be a live trial in that sense and you would see what happened and we support that.”

Getting it on the agenda

While acknowledging the Tasmanian aged care sector is not immediately ready to move to an entitlement system, Mr Mathewson said it had already done a significant amount of work preparing for consumer directed care. “Our members are starting to think strategically around how they approach consumers and a more deregulated market environment.

“We would not only prepare for a test in Tasmania in a reasonable amount of time but would create the perfect evidence for how you would undertake its implementation across the nation,” he said.

“Because we are able to do things in our three regions, you also have the flexibility of looking at having a control group in one region, a partially deregulated group in one region and trying a more open process in the other.”

Mr Mathewson acknowledged it was optimistic but he said he was keen to push the idea to the point of it being considered in the next federal budget. “We absolutely want it on the agenda this year. If at the end of the day if it is not Tassie, my view is it is someone else and it is starting the ball rolling.”

ACST is in the process of organising follow-up meetings with the Premier, as well as talks with other State and Federal Government representatives from all parties, Mr Mathewson said.

There was also a need to build clinical support for the trial and have further discussions with COTA to ensure consumers were on board, he said.

Mr Yates said he expected and welcomed further discussion and that there would have to be negotiations amongst all the stakeholders so that it would be a trial people could have confidence in.

Related AAA coverage:

Renewed call to abolish aged care rationing

Lengthy wait for aged care beds