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David Tune. Photo: Supplied

Tune’s review of aged care reforms: the sector reacts

The recommendations laid out in the recently tabled Aged Care Legislated Review must be carefully considered and promptly acted upon by government, the sector’s peak bodies and representatives have said.

Led by David Tune, former secretary of finance and current chair of the Aged Care Sector Committee, the Legislated Review of Aged Care 2017 examined the Living Longer Living Better aged care reforms that stemmed from recommendations made by the Productivity Commission in its 2011 report, Caring for older Australians.

The resulting report includes 38 recommendations for future aged care provision.

The Government said it will consider all recommendations but has already ruled out two.

They include recommendation 13 that holds the government include the full value of the owner’s home in the means test for residential care when there is no protected person in that home and 15, which suggests the government abolish the annual and lifetime caps on income-tested care fees in home care and means-tested care fees in residential care.

Aged & Community Services Australia (ACSA) was disappointed to see this move. Chief executive Pat Sparrow said by ruling out these two financing options, the Government is limiting its own ability, as well as that of providers, to respond to the changing needs of Australia’s rapidly ageing population.

Chief executive of Leading Age Services Australia (LASA) Sean Rooney also expressed the peak’s disappointment about the Government’s decision to rule out some recommendations without due consideration.

Rooney said: “While LASA understands the sensitivities of any potential changes to consumer contributions for age services, the Government’s approach to ruling out any consideration of changes to life time caps and means tests involving the family home shuts down much needed discussion on how to fund the system now and into the future.”

Marking the release of the report, the Government announced initiatives in home care services and the My Aged Care system.

This included making available an additional 6,000 home care packages, and a $20 million investment in the My Aged Care information system to improve public access, with a focus on rural, regional and remote clients.

Home care packages

Yates said improving access to home care packages by increasing the number of packages and rebalancing the mix of lower and higher packages, including moving resources from residential to home care is a good move. “The government has made a good start by rebalancing current package levels to create more high care packages, but needs to act quickly on a more comprehensive solution.

“Obviously, what is needed is an increase in the number of packages so no one, whether with high or low needs, misses out. Now we know the extent of the problem, older Australian’s will expect the government will focus on fixing it as soon as possible.”

LASA’s Rooney said while the additional home care packages will ease frustrations of many older Australians who are unable to access appropriate services, the increase will not keep pace with demand and a long-term solution must be found.

COTA also highlighted the recommendation to consider transferring future funds from residential care to home care, including a temporary release of unused or vacant residential care funding into home care packages. “This measure should receive early consideration as there is no overall shortage of residential care,” Yates said. “However, it must be accompanied by placing residential care entitlements in the hands of consumers and families.”

Changes to My Aged Care

Tune recommended the government makes improvements to the functionality and performance of the My Aged Care ICT platform and invest in regular advertising and awareness activities for the website to explain the process for accessing government-funded aged care services.

He also suggested changes to the design and layout and a trial of a simplified assessment process for consumers seeking a short-term single, simple service.

ACSA welcomed the Government’s additional funding allocated to My Aged Care and said it will continue to cooperate with the Government to address implementation problems.

Rooney said LASA has petitioned the Government to further develop this service and looks forward to details of the enhancements planned.

Yates was pleased to see recommendations to provide consumer support services such as system navigators and outreach services to help consumers and their families to connect to, access and find their way through the aged care system.

More consumer choice

Yates said older people will strongly support the recommendations that residential aged care packages be put into the hands of residents and their families so they are free to use the provider of their choice and to move between them on their own accord.

“This consumer-led shift has already occurred in home care packages,” Yates said. “It needs to be introduced in residential aged care without further delay.”

Workforce building

The review recommended the aged care sector, in collaboration with the tertiary education sectors, acts to ensure education and training directly responds to the sector’s needs.

This included promoting and encouraging ageing and aged care as a specialisation in nursing education, exploring a range of workforce options such as potential partnerships or arrangements with existing non-aged-care training providers and making effective use of allied health workers.

Minister for Aged Care Ken Wyatt said a detailed aged care workforce strategy will be produced by a taskforce chaired by professor John Pollaers. It will be supported by a $2 million 2017-18 Budget commitment.

LASA acknowledge this appointment as an important step towards building and retaining a sustainable aged care workforce.

Australian College of Nursing chief executive adjunct professor Kylie Ward said the College was pleased by the Tune report’s focus on workforce but added there will be shortages in the future if workforce issues are not addressed quickly.

Ward said: “Recruitment, training and retention of a quality aged care workforce is one of the biggest challenges facing the sector now and in the future.

“Therefore, we welcome the establishment of a taskforce to develop a national approach to workforce planning.”

ACN called on a workforce strategy to include a mandate that at least one registered nurse is on-site at all time in residential aged care facilities.

Funding aged care

The Aged Care Guild, representing the nine largest residential aged care for-profit providers in the industry, said the Government’s response to the review tabled needs to focus on a sustainable funding strategy for the long term aged care needs of Australians.

Guild chief executive Cameron O’Reilly said just as the Government has legislation before the parliament aimed at securing a long-term funding deal for the National Disability Insurance Scheme (NDIS) through a higher Medicare levy, it has to embrace Tune’s recommendations about how to fund the massive growth in aged care needs in a rapidly ageing society.

“How we sustainably fund the growth of care services and care workers with a mix of public and private funding is one of the key questions facing the country and Mr Tune’s sensible recommendations have put this issue firmly on the national agenda,” O’Reilly said.

COTA’s Yates said: “If politicians on all sides are going to rule out greater user contributions such as some of those recommended by Tune, they must tell Australians how they will fund aged care into the future; either government pays more or services will decline in quality and numbers.”

Overall, LASA said the review is an important reflection on the status of the aged care reforms process in Australia and provides useful recommendations to build on.

Yates said the government must now use the recommendations put forward in Tune’s report, supported by the sector through the National Aged Care Alliance, to deliver real, meaningful change to the sector that enhances the lives of older Australians.

Click here to view the report of the Legislated Review of Aged Care 2017.

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One comment

  1. Before I start, I would like to make it known, that I fully support Hospital and Home Care as being part of a necessary and valuable care system for those needing to access care of some kind. My comments below are thoughts based on what I see, in my small area of Adelaide day to day and are not meant to put down or offend anyone! however….

    It seems that Residential care is being treated with the usual contempt. Don’t get me wrong, I think that Home care should be the first choice in many cases, but it should be just that, a choice. We receive feedback from potential residents who want to enter aged care, but are being “pushed” into Home care. It is a lot cheaper to fund, after all!!

    We also have many residents admitted to our home who have been receiving home care, yet arrive with many issues which are symptomatic of “staying at home”. Socially isolated, lonely, scared at night, etc…, and having someone visit for a few hours a week can never come close to addressing this. What about families I hear you say? well in reality many families try their best to stay involved, but most have full time lives of their own, and that is where the gap in recognition from the Government and the many reports on Aged Care lay.

    Next, with the non-inclusion of the full value of the family home, I would agree that it should be taken into consideration, BUT, there would need to be some safeguards, perhaps a sliding scale, consideration of average house prices in each state and rural remote settings for instance. There is a big difference in the overall financial state of persons who own a “half million dollar” house. In many areas older persons who own relatively high value houses have never lived a “high value” life. Multi-Millionaires, though? Fair Game 🙂

    Finally, a thought.. (Generally) Public Hospitals are twice as expensive (at least) per day to fund than a High Care Residential Aged Care bed. Many patients in hospitals would be much better off in a “Home-Like” environment, so why not make the Residential Aged Care system more central to this debate by placing a sharper focus on transferring non-acute patients over the age of 65 to Residential Aged Care, either short or long-term (the introduction of STRC has helped, but needs much more focus) which would have a Three-fold benefit:

    1: The hospital system would have increased capability to manage more urgent cases
    2: Patients would be able to settle in a “Home-Like” setting
    3: Government would save billions in funding.

    *State vs Federal funding arguments would potentially put an end to this, so in that case politics would win out over care outcomes…

    Thanks for reading!

    Small not-for-profit Residential Aged Care Provider in Adelaide’s Northern suburbs