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Aged care ‘needs dramatic improvements’

National Seniors urges changes to ensure quality, accountability and transparency in the sector.

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National Seniors Australia is calling for dramatic improvements in the quality of care for older people.

We have also expressed our concerns about government and provider accountability in aged care, and called for reforms to create an efficient, transparent, and sustainable aged care and support sector.

These points have been made in submissions to the Department of Health and Aged Care on developing A New Model for Regulating Aged Care, and the Department of Prime Minister and Cabinet on the draft National Care and Support Economy Strategy 2023.

National Care and Support Economy Strategy

In the latter submission, NSA Chief Advocate Ian Henschke notes older people rely heavily on the services provided through the care and support economy, most notably via aged care services and programs.

“They expect and deserve a system of care delivering high quality, and to be able to receive these services when and where they need them,” he says.

The submission also notes that older people:

  • Are likely to stay within the National Disability Insurance Scheme (NDIS) because of the greater levels of support it provides in comparison to the aged care system.
  • Are a critical part of the care workforce, with almost one-third of residential care workers – and more than 40% of home-care providers – aged over 50.
  • Provide significant informal unpaid care to younger people as grandparents, allowing parents to engage in the workforce.

“For too long, the care of older people through the aged care sector has been substandard,” the submission says.

“The quality of care must be dramatically improved, as recommended by the Royal Commission into Aged Care Quality and Safety. 

“The system must be simple to navigate and accessible to those who need it, where they need it, and this will rightly require a focus on developing a larger and more highly skilled workforce. 

“It will also crucially require adequate support, training and respite for informal carers who complement and take pressure off the formal sector.” 

Noting the considerable amount of public funding and user contributions disbursed across the care and support economy – $60 billion in 2021-22 rising to $110 billion in 2026-27 – the submission to the draft Care and Support Economy Strategy says, “it is paramount there is an obligation to demonstrate efficiency and transparency in the use of these funds”.

It continues, “Requests to elicit further funding, either via higher taxes or from user changes, shouldn’t be accepted unless there is sufficient efficiency and transparency baked into the system, and, more importantly, improvements in the quality.

“Taxpayers, and older people and their families, will not support additional taxes or user contributions unless safe and quality care is delivered in tandem with transparency and efficiency.” 

The submission also addresses the staff crisis within aged care, calling for the removal of disincentives to workforce participation – in particular, the income tests rules for pensioners who might otherwise work in the sector. 

It also questions the particular focus on productivity within the strategy.

“It is important to acknowledge that productivity growth in sectors like aged care, which are heavily labour intensive, will only partially fix the growing workforce crisis,” Mr Henschke says.

“Ultimately, it will be people who hold someone’s hand, help them to eat, or take them to the bathroom; and these activities are unlikely to be partially, let alone fully, replaced by technology. What these workers need are technologies to help them to be more efficient in carrying out care activities in a safe and caring manner.” 

A new Aged Care Act

In the submission to the Department of Health, NSA has welcomed the proposal for a new public register of providers and published information about sanctions imposed on them, alongside support for the publication of star ratings for residential aged care homes and increased financial reporting obligations.

NSA also expressed concern about capacity in the sector, and welcomed a proposal that individuals and small businesses could offer subsidised aged care services. 

“Ongoing problems with thin markets (especially in regional, rural and remote areas), shortage of workers in general and in culturally appropriate service delivery, means the new regulatory model walks a tight rope between ensuring quality and safety while not exacerbating service and labour shortages,” the submission says. 

“To that end, the proposal to allow non-corporations, such as sole traders and partnerships to be eligible to deliver Commonwealth-subsidised aged care services in the home or community setting is an attractive development.”

You can read the full submissions on our website by clicking on the following links:

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