A fairer more equitable system, say stakeholders

Sector reaction to the long-awaited and much-anticipated taskforce report is largely favourable.

Released today, the final report of the Aged Care Taskforce – made up of government-appointed industry experts – recommends that well-off older Australians pay more for the aged care services they receive.

“The unavoidable truth is that aged care needs far greater investment to deliver the services the royal commission challenged us to provide, and that the community expects,” said Tom Symondson – chief executive officer of the Aged & Community Care Providers Association and taskforce member.

“The hardest question is how to balance the fairness of asking older Australians with financial means to make greater financial contribution to their own care, against the fairness of asking a shrinking percentage of working-age Australians – who already fund the vast majority of the aged care system through their taxes – to shoulder an even greater burden.”

Importantly, the 64-page report recommends that government continues to be the primary funder of aged care – with a safety net remaining in place to ensure that nobody is left behind.

“Every Australian should have access to high-quality aged care, regardless of their location, income or financial means,” said Mr Symondson. “Crucially, the taskforce recommended that increased contributions should not be required for the care people receive, such as from personal care workers and nurses.”

However, the report recommends that people with means make contributions towards the costs of things they have typically paid for their whole lives – such as accommodation and living expenses.  

Such a requirement is necessary as the sector has – for too long – dodged the question of how to sustain the system into the future, said Mr Symondson. “As providers have struggled through one challenge after another, from bushfires to Covid-19, whilst losing millions of dollars per year, it has become crystal clear that we no longer have the luxury of kicking this issue into the long grass.”

He added: “Aged care in Australia cannot continue to muddle along with band-aid solutions while the system crumbles. We need a sector that’s set up to improve the lives of older Australians now and into the future … And the recommendations of the taskforce will help deliver that.”

It’s time now to make the hard decisions

Chris Mamarelis

Chris Mamarelis – CEO of New South Wales and Queensland regional and rural aged care provider Whiddon – told Community Care Review that, although a little late, overall, the report is encouraging. “It’s positive to see the government put all of those recommendations out in the public view. It’s also positive that it’s supported by such a diverse group of stakeholders – it’s got universal support for the recommendations and that’s a pretty unique position to be in, so that’s a big plus.”

Mr Mamarelis said he now hopes that all of the 23 recommendations get actioned quickly.

“What’s important is that the government is brave enough now to implement the recommendations and not cherry pick them. We’ve had recommendations similar to these before – through the royal commission, through the David Tune report – and we don’t want to be having this discussion again in another two or three years’ time. We’re well overdue, it’s time now to make the hard decisions and push forward with implementation.”

When it came to funding reform, Mr Mamarelis told CCR the taskforce only had two choices: “Increase tax or greater co-contributions – and they took the latter. I don’t think there’s a wrong pathway – there are political implications for both and that’s the pathway they took.”

Calling the report “another step in the right direction”, Mr Mamarelis would like, however, to see more support for regional and remote areas of Australia. “We need additional grants and capital funding strategies for those locations to meet demand.”

They’ve got the balance right

Cameron Holland

Ryman Healthcare CEO Cameron Holland told CCR the co-contribution model was popular among stakeholders. “In general, the taskforce recommendations were very much in line with what we’ve been advocating for – and I know that the wider sector has been advocating for – specifically around increasing co-contributions from residents with means on the hotel services side and keeping the care services completely government funded,” he said.

“We think [the recommendations] largely align with the work that needs to be done to underpin the sector to ensure financial sustainability for operators while at the same time improving the quality of care for residents. We think, in general, they’ve got the balance right to cover both of those outcomes.”

Mr Holland told CCR the only “but” is that the report is a recommendation only. “It still needs to go through government legislative review and actually become law. So while the recommendations are all lined up and make sense, the work really starts now to get the recommendations implemented.”

Taskforce member and StewartBrown senior partner Grant Corderoy told CCR that: “The Aged Care Taskforce report is predicated on the acknowledgement that the current funding envelope is insufficient to ensure the financial sustainability, future demand, workforce, standard of daily services, accommodation and innovation required for aged care service delivery.”

While the report makes recommendations focused on everyday living expenses and accommodation, Mr Grant told CCR: “The report also recommends that the accommodation supplement be reviewed, which will likely require an increase in that subsidy. The report recommends that home care recipients also pay a more equitable consumer contribution. It is important to note that the report does not recommend a levy and the government taxpayer subsidy remains the principal funding for residential direct care services.”

Mike Baird – chief executive officer of dementia care specialists HammondCare and taskforce member – said the reforms were required to ensure that the sector can meet the growing demand for aged care services in the years ahead.

“Increased co-contributions toward daily costs of care by those with capacity to pay would assist with making aged care more sustainable.”

Financial sustainability would also enable service improvements in areas such as palliative care and dementia care, said Mr Baird. “It would also offer capacity for innovation.”

Welcoming the report, Benetas CEO Sandra Hills said the suggested reforms would create a fairer and more equitable aged care system. “The recommendation to increase consumer co-contributions for those who can afford it, while ensuring appropriate protection for those who need assistance, is essential to supporting the long-term viability of the sector.”

Ms Hills said greater transparency of consumers’ assets – including superannuation savings – was also an important step. “Implementing a means test is a simpler and far less administratively burdensome way of increasing funding so that providers can concentrate on essential service delivery and caring for residents.”

Ms Hills said it was also good that the report acknowledged the impact financial instability has on the sector’s confidence and ability to invest in innovative care models. “We know the important role that technology can play as an enabler for Australians to remain in their homes for longer, so it’s pleasing to see consideration of this important measure in the report.”

Access will continue to be based on need, not ability to pay

Simon Miller

Anglicare Sydney CEO Simon Miller was pleased the report put a strong focus on a safety net for poorer Australians. This, he said, “means access will continue to be based on need, not ability to pay, while ensuring that those with greater means can make a bigger contribution.”

The peak body representing Catholic providers of health, community and aged care services Catholic Health Australia called on the federal government to implement the recommendations of the taskforce as quickly as possible.

“With most aged care providers running at a loss, these sensible and responsible reforms are urgently needed so they can continue to invest and provide quality care for all Australians – whether they be in a city, regional town or remote community,” said CHA CEO Jason Kara.

“We urge the government to swiftly adopt these recommendations and stand ready to assist their implementation in any way we can.”

With user contributions failing to adequately support the system and research showing people are willing to pay more for quality aged care, Mr Kara said the recommendations seemed reasonable. “The fairest way to deliver extra funding is to ask people who can afford it to contribute more for their accommodation and living expenses, costs they have covered over their adult lives.”

CEO of advocacy organisation Council on the Ageing Australia and taskforce member Patricia Sparrow said older people have told COTA over many years that they would be prepared to pay more for aged care “if the quality is improved; a clear safety net to protect those who can’t afford to pay is in place; there are strong consumer protections for all participants; and providers were accountable and transparent about where and how taxpayer funds and individual contributions are being spent.”

Ms Sparrow said there was no question that the sector needed to improve the quality of services that people were currently receiving – “and the taskforce report supports that this is what needs to happen.”

It is critically important we don’t create a two-tiered system

Samantha Edmonds

While the Older Persons Advocacy Network has also welcomed the report’s recommendations, Samantha Edmonds – director, policy and systemic advocacy – said the organisation wanted to explore the safety net provisions in more detail.

“We need to ensure our aged care system is sustainable and can meet the needs of our growing population. It is also critically important that we don’t create a two-tiered system where those who can afford to pay get a first-class service, and those who can’t afford to pay receive inadequate care.”

Ms Edmonds said throughout the consultation process OPAN’s message was clear: “We must ensure equitable access to aged care services, especially for our most vulnerable people regardless of the capacity to pay.”

Follow Community Care Review on Facebook and LinkedIn and sign up to our newsletter.