“I want to begin this hearing with a basic proposition. People living in rural, regional and remote communities of Australia ought to have the same levels of access to aged care as people living in metropolitan areas, and the aged care they receive must be safe and of high quality,” said counsel assisting Peter Gray in his opening remarks to the royal commission in Mudgee.
Basic yes, but more often than not it does not seem to be the case. Overall, rural and regional communities face many unique challenges when it comes to healthcare. Access is a key barrier to good health, with people in rural areas more likely to report not having a regular GP (20 per cent compared with 3 per cent for people in major cities).
People living in rural and remote areas have 1.3 times the mortality rates of their city dwelling counterparts, as well as higher rates of disease and likelihood of serious injury. Couple this with a forecasted shortfall in the nursing profession – estimates suggest a projected deficit of 85,000 by 2025 – and the communities in rural and remote areas can often feel left behind.
Gray told the commission that due to these shortfalls the Aged Care Act classes people who live in “rural or remote” areas as “special needs”.
However, there are fewer residential aged care places per 1000 people in these areas compared to their urban counterparts, fewer people using community aged services per 1000 people, fewer facilities able to deal with complex care needs and longer waits for home care packages, if they are available at all.
These issues came to life with the story of the Dunlops, Sue and Phil, who appeared on Tuesday.
Sue, 72, lives on a farm outside a country town and has received aged care services form three home care providers since 2017.
Starting on a level two package and eventually progressing to level four after reassessment, in 2018 Sue's level of care started to decline. After nine months of home care, the second provider then suspended Sue's services due to apparent issues accessing the Dunlop property.
The Dunlops then noticed that they had been charged for visits that did not take place.
“They suspended services on that day, on 17 January, we got the bill for January. Then when we got a bill for February, there was three additions for services that were never provided. And then in March there were also three additions for services that were never provided. And I initially started trying to find out why they had been added on, because from 17 January there was no visits at all to our property,” said Phil.
“They still continued to charge us all of the interface fees, which add up to about $1000 a month, for talking and what have you. But the only things that appeared on those bills were the additional visits that never occurred. And we never got a final account for – services were completely suspended on 20 March. We did get a bill for March which had the additional three charges on it. We never got a final statement in April showing any credits back for those additional charges that had been made.”
Sue told the commission that her troubles with accessing aged care almost ruined her idyllic retirement home and it was important for her and Phil to appear to highlight the issues people in country communities face with the aged care sector.
“We lived for 42 years in the Blue Mountains and our house burnt down in 2013,” she said.
“So, when I found this farm I absolutely loved it. It’s got a beautiful view over hills. It’s just got that feel. I knew I should be there when I saw it, even though it was run down. I do love it. I don’t want to move. I love having animals around me. But it is so, so hard when you can’t get any help out there.”
The commission is in Hobart this week and will examine the operations of Bupa and Southern Cross Care facilities to unpack ways to improve the governance of aged care providers.Do you have an idea for a story?
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