Aged care is under enormous pressure - with many nursing home operators losing money, the demand for beds increasing and the cost to the federal budget ballooning. Advocates and providers are urging the government to deliver on the promised reforms before the next federal election.
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00:00This Act essentially implements everything that's left in the Royal Commission that hasn't
00:06been able to be done yet. So it puts into the new Act the human rights of older people.
00:12The Aged Care Act we deal with at the moment, which dates back to 1997, almost doesn't even
00:16mention older people. It's really out of date. The other thing that it does is it makes us
00:22financially sustainable. We've got 50 per cent of providers losing money on every bed
00:26that they operate, and we're not building anywhere near the number of beds that we need
00:30to have. We need to build about 10,000 beds a year from now on, and we're closing more
00:34beds than we're opening, and this legislation's intended to resolve that. So there's a lot
00:39that it's expected to do, but without it, we really cannot move forward.
00:43What are the main sticking points to agreement?
00:46Well, I actually think that agreement is either reached or almost reached. From what I hear,
00:53the two sides have worked really well in a bipartisan way. I know that's unusual in
00:58this country, and we're not used to hearing it, but we actually think that agreement is
01:01almost there. What we can't understand is why we're not there now. We don't think there
01:07are remaining sticking points, certainly not significant ones, and this negotiation's been
01:12going on between the government and the opposition for five, six months. We don't have much time
01:18left. If they don't introduce it in the first week, sitting week of September, which starts
01:22on the 9th, we will run out of time to pass this legislation before the election, and
01:26then we've got nothing, and then we will have completely betrayed the trust of all the people,
01:30frankly, as a nation.
01:32The government is hoping to achieve bipartisan support. You're saying that agreement is close.
01:38The aim of achieving the bipartisan support is that the eventual act would be more effective,
01:44more successful. It wouldn't change if there was a change in government. Do you think that
01:48agreement is necessary on this, that bipartisan support is necessary?
01:53Absolutely. It's completely critical. Every time we've seen reforms to aged care proposed
01:59in the past, they collapsed at the 11th hour because there wasn't the bipartisan support,
02:05and usually the opposition of the day, whether it was Labor or the coalition, were the ones
02:08that said, no, we're not going to support this. The problem is the reforms that are
02:12being proposed, they will see wealthier Australians pay more for the kinds of services that they've
02:17paid for throughout their lives, food and laundry, not care, and that can be politicised,
02:23massively politicised. The community, when they've heard these proposals, seems to have
02:26responded pretty well, but it's very easy to weaponise, and if we don't have the support
02:32of the coalition and the government, then it will fall in a heap and we'll have no reform
02:37and we'll be stuck in an aged care act that's out of date for another 20 years, and that's
02:41not where any of us want to be.
02:43On who pays for what, just explain to us that key change, because there has been a
02:49bit of controversy over that, as sort of a means-tested user pay system.
02:54Well, the taskforce that the government put together last year that I was a member of,
03:00it looked at a couple of options. One was a tax, which is what the Royal Commission
03:03recommended, but we thought that that was unfair on younger people and also in a cost
03:07of living crisis, just wasn't going to be sustainable, so that was ruled out. What was
03:12left was the option of asking people with wealth to pay more for things like food and
03:17laundry. At the moment, very, very wealthy people pay the same for that food and laundry,
03:22the daily services, as pensioners. You can only be asked to pay 85% of the pension, which
03:29if you've got millions of dollars in super, you have far more than that, and the cost
03:33of those services is much higher than the amount people pay. So we're looking at a model
03:39whereby people who do have wealth are asked to pay a small amount extra for the services
03:44that they're currently receiving and that are currently paid for by the taxpayer. So
03:48it will see wealthier people pay a bit more, but at the moment we're losing money on every
03:53single bed and we're closing beds because we can't simply afford to run them, and that's
03:58not a situation I think anybody wants to be in.
04:01If this is not addressed soon and not within enough time for it to be passed before the
04:05next election, what are the impacts of that, particularly for operators in terms of the
04:10preparation to implement these changes?
04:15Well this piece of legislation will probably run to about 400 pages, so that gives you
04:19some idea of how complicated it will be for a provider to implement it, to even get their
04:24heads across it, even to read it will be quite a challenge. If we do not see it until the
04:2911th hour and it were to be passed very, very close to the deadline date, which is the 1st
04:34of July next year, we would have to see a very long transition. We'll need a transition
04:40anyway, but we want it to be as short as possible because we want to start delivering these
04:44additional services older people need. That's another reason why this has to be in Parliament
04:49as soon as humanly possible so that we can all see it and start getting ready to deliver
04:54it. None of us have even seen what it says at this point.
04:58These reforms are in response to the Royal Commission into Aged Care and we saw terrible
05:02stories emerge from that Royal Commission. It's often forgotten in these conversations
05:06I think that we're talking about people's lives, obviously the people who are the residents
05:11who are in care, their families, the staff who work at these places as well. And the
05:17Royal Commission called for care to be people focused. What would that look like more broadly
05:23for care to be people focused in aged care?
05:28It was a big challenge that we were set and I think it's one that we have to take very,
05:33very seriously. What it means in the long term is that care adapts to you, not just
05:38to your needs. I get this feedback from older people a lot, particularly those who are being
05:42supported by our services in their own homes to keep them independent. Don't just give
05:46me what I need, give me what I want. Adapt to what I need and want at particular times.
05:53I will change those services over time as my desires change and think about my outcomes
05:59that I'm looking for and deliver services that enable that, not just the clinical. Clinical
06:03is really important but it's not all there is. We have been funded and regulated over
06:07decades to just focus on those clinical needs. There are people living in residential care
06:12who should have been supported by our services to live independently for longer and weren't
06:17because they couldn't get those services. If we have this Act and it says what we think
06:22it will say and what the Royal Commission said it should, then we will be able to be
06:26more flexible. We will be able to build smaller residential aged care facilities so that people
06:30are living amongst 8 older people rather than 100 older people. But all of that takes investment,
06:37it takes certainty over the long term, hence the bipartisanship, and it will take time
06:42to deliver. But if we don't start now, how can we possibly achieve it?
06:47Tom Simonson, the CEO of Aged Community Care Providers Association, thanks so much for
06:53your time this morning.
06:54You're very welcome.