Aged care reform: slow, disjointed and understaffed
The Federal Government is changing the aged care system, but its own reform overseer says it has six months to do better.
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Fact file – the recommendations
The 2018 Royal Commission into Aged Care Quality and Safety investigated whether older people who live in an aged care home or get help to live in their own homes, are safe and well looked after.
The commission made 148 recommendations to the Federal Government.
The Office of the Inspector General of Aged Care was established as an independent statutory agency in October 2023 to provide independent oversight of the aged care system through core functions of reviews, monitoring, and reporting. To do this, the office:
Reviews and reports on the aged care system
Identifies systemic and significant problems
Recommends changes
Increases accountability and transparency by reporting findings to parliament, including on the implementation of Royal Commission recommendations.
The agency set up to monitor the implementation of recommendations made by the Aged Care Royal Commission says the Federal Government must do more, do it better, more quickly and with more funding.
In its report on the government’s progress in implementing the recommendations, the Office of the Inspector General of Aged Care was particularly critical of delays in:
Bringing forward new aged care legislation
Establishing the new support at home program
Providing more funding for home support services and more Home Care Packages in response to unmet need and long waiting times.
The report emphasised “the critical importance of there being no further delays” and set a six-month timeframe for the government to lift its performance.
Accessing aged care: Not everyone who needs care can get it when and where they need it. People find it difficult to access the aged care system, for reasons including due the rationing of services, and then navigating to timely and appropriate care within it.
Improving information: Older Australians find it hard to know where to start when looking for aged care. The starting point – the government’s My Aged Care system – is not easy to use or to understand.
Wait times are too long: People must wait a long time for their assessment then for care, which causes problems if they get sick or injured, or less able to look after themselves while they are waiting. The Inspector General wants the process to be faster and for people to get more face-to-face support when they are looking for aged care.
Workforce shortage: The report gets to the point, “There aren’t enough workers in aged care” and governments across the board must do more and faster.
National Seniors Australia has told the Federal Government that workforce numbers can be boosted by retaining the older aged care workers, who are leaving the sector in increasing numbers at a time they are needed the most.
This can be done by exempting employment income from the income test for pensioners working in the care economy (aged, disability, child care). This will give older workers greater income and retain more people in the care sector, ensuring care services can be delivered.
We have also called for greater emphasis on home care and for funding to boost the number of home care places available. This is a must if we are to meet growing demand, but only if the workforce exists.
Improving access to health care and allied health care: Aged care home residents don’t get enough visits from a doctor or other medical help including a dentist, physio, occupational therapist or a podiatrist – and the report says the way the government funds the program is to blame for not always covering these services.
Improving access to respite care: There are not enough funded respite places, nor the right type of respite available (home respite) to meet demand. The report found that the government is not paying enough money to aged care services to make them want to provide respite care and employ enough staff.
Improving dementia support: People with dementia and their carers have complex needs and more needs to be done to provide enough services and pathways to those services, inform the public what’s available, and ensure staff are adequately trained in dementia care.
Designing for diversity in aged care: The report calls for more action on redesigning the aged care system to better include and support minority groups and First Nations people, especially those who have experienced trauma.
Improving access in regional, rural and remote communities: The report calls on the government to review services and funding to these communities as part of the redesign of the aged care system.
According to the Inspector General, over the next six months, the government should prioritise:
More whole-of-system reform planning, engagement, and communication, in addition to initiative-specific activities.
Ensure providers have sufficient time to plan for change and that reforms are appropriately sequenced.
Monitor whether individual elements of the reform agenda are working optimally together, with a view to increasing complementarity and resolving conflicts.
More information is available here.