Aged care reform needs leadership:

One of the areas the Prime Minister, Julia Gillard, signalled out for attention in 2012 when she made changes to her Ministry at the end of last year was long overdue reform in aged care.

Australia’s current system of aged care was designed in another era. It is complex, confusing and cumbersome.

It is based on a ‘supply side’ model whereby funding by Government places limits on the availability and quality of services and reduces choice, rather than a ‘demand side’ model which is responsive to the needs of the people needing care and allows people to make choices about the type of care they receive and where they receive it. 

Aged care has come to prominence for a number of reasons.

First, low birth rates and people living longer will result in older people comprising more and more of our population.  By 2050 7% of our population will be aged more than 85 and 1 million Australians will have dementia.  People living longer is something to be celebrated, but there will come a time in most people’s lives when they will need aged care and support. The Productivity Commission, which released a major report on aged care last year, estimates that the cost to taxpayers of aged care will increase from $9.4 billion in 2010 to $69.4 billion in 2050 (in 2010 dollars) if the current system stays the way it is.

Second, this demographic – and consequent budgetary – pressure also comes at a time when older people today want to stay in their own home as long as possible rather than move to residential aged care, the model of care around which   our current system was designed. 

There will always be a need for residential aged care for the most frail in our community, particularly with the increasing scourge of dementia. Further, while we may not want to acknowledge it, the fact is also that if we live long enough most of us will spend some time in a nursing home. However, more often than not, older people can stay in their own home and familiar surroundings longer with the support of customised services relevant to their needs.

Finally, there are significant workforce pressures. Around 300,000 people work in aged care today but, by 2050, another 500,000 will be required. It is unclear where the skilled workers will come from particularly as aged care is not seen as an attractive career option, and nurses and carers in aged care are underpaid by community standards.

The Productivity Commission’s report entitled Caring for Older Australians recommended comprehensive reform to the aged care sector to provide an aged care system which is simpler, fairer, more affordable and more equitable. 

The Commission said that, without such reform, aged care will increasingly fail to meet community needs and expectations, will continue to inhibit the capacity to exercise choice and will compromise the quality of care provided to older Australians.  Because of the evolving demographic pressure and the lead time to effect change, the Productivity Commission recommended to the Government that reform should start without delay. To do otherwise, would just put off the inevitable and result in more long term cost to the taxpayer.

The good news is that the reforms recommended by the Productivity Commission have attracted widespread support from the aged care sector. A national alliance of aged care consumer groups, providers, unions and health advocacy groups agree with the direction put forward by the Productivity Commission and have joined together to advocate for change.

The Alliance has developed a blueprint which sets out in a staged and responsible way how the reforms can commence as part of this year’s Federal Budget. The key points include:

• services and support should be able to be customised to an individual’s needs and preferences
• an individual’s independence should be maintained as long as possible by building community care and wellness services
• building and developing a workforce able to meet the increasing challenges of providing high quality care and support to older people
• improving affordability of aged care through getting the right balance between individual responsibility and capacity to pay, taxpayer funding  and support for those most in need
• giving greater priority to research into dementia, as well as specific support services.

This week in Canberra the Alliance is launching their blueprint. The hope is that their broad base of support for the Productivity Commission reform recommendations will similarly encourage politicians from every side of the political fence to show leadership in supporting them.

In public policy terms, some of the recommendations from the Productivity Commission may not be popular with everyone. For example, it is unlikely that anyone will disagree with the need to make aged care more responsive to an individual’s needs and provide greater power to the individual to exercise choice. But some may also believe that the seemingly bottomless pit of taxpayers’ money should pay for aged care for all of us – even though, throughout our working lives , we have been responsible for our own accommodation costs and living expenses, subject to our capacity to pay and a ‘safety net’ for those in genuine financial disadvantage.

There is no doubt that the temptation could be to oppose some of these reforms. It would be the easy thing to do in the short term but it would not be the right thing to do.

Putting off in 2012 what we know is an impending social policy disaster would tell us that our politicians don’t have the leadership and vision we need for them truly to make the right and best decisions for our nation and for our community.

It is time for older people’s needs to be given priority by our representatives in Canberra: and that means laying the foundations today for real and sustainable long term change so our parents, our grandparents and – let’s face it – eventually ourselves, can age well.

Further information

• Over the coming months, motherpedia will provide further information on what the aged care reforms means for you (or your parents or grandparents). Please let us know if you have any specific areas of inquiry and we will do what we can to assist with an answer.