16,000 died waiting for a Home Care Package: Royal Commission

Article published 23 April 2019

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THE Aged Care Royal Commission has finished its second hearing. This hearing was about aged care at home, which means Home Care Packages (HCPs) and the Commonwealth Home Support Programme (CHSP).

The Commission examined My Aged Care, the HCP waiting list, HCP fees and charges and the home care workforce.

Senior Counsel assisting the Commission did a summing up at the end of the second hearing. This summing up gives an indication of what findings the Commission may come up with in its interim report in October this year.

Senior Counsel criticised My Aged Care, the first point of contact for anyone wanting aged care: “A broad range of older Australians experience difficulties using these channels, creating barriers to the effective use of My Aged Care”.

Also: “…, the quality of the information provided by My Aged Care is perceived as falling short of community expectations in that the prevalence of the call centre providing information regarded by users as unreliable or unsuitable is significant, and the website does not support older people to exercise choice and control”.

Then: “…, the services provided by My Aged Care are not accessible for people with hearing or visual impairments, people with communication difficulties, including those brought on through dementia or people from culturally and linguistically diverse backgrounds”.

Senior Counsel noted evidence about the HCP waiting list and that the Department of Health had said “… that home care packages are not effective at this time” and “…that there was an unprecedented increase in demand;  moving from potential 64,000 packages in June 2016 to 92,000 services in June 2018”.

The Department estimated “… that if home care packages were provided to all people on the waiting list at the level of their assessed need, the annual cost would be approximately $2 to $2.5 billion dollars”.

In 2017-2018, “a total of 212,857 people appeared in the national prioritisation system for at least some part of the year. Of these people, more than 16,000 died, waiting for a package that they never received”.

Senior Counsel noted that “the evidence at this hearing indicates that in 2017-2018, the average wait time was, for level 1 packages, seven months;  for level 2 packages, 13 months;  for level 3 packages, 16 months;  and for level 4 packages, 22 months”.

“On any measure”, Senior Counsel commented, “delays of this magnitude to access the care and support that is actually needed is unacceptable and raises real safety risks.  There are more people waiting for care and support from a home care package at their assessed level than there are people receiving a home care package”.

“Evidence is building that delay in accessing care and support in your own home leads to earlier entry into residential aged care facilities and increased hospitalisation.  Delay in providing services goes to the very heart of quality and safety in aged care.  It pushes people into an institutional setting which is not where older Australians want to be, at significantly higher cost to the community”.

“The availability of aged care services in the home must meet the existing and future needs of older Australians to live with dignity, with their needs met, in their homes”.

On HCP fees, Senior Counsel noted a concern about high fees and administration costs charged by providers, lack of transparency about what fees actually cover and the possible inadequacy of the current oversight of fee-setting arrangements.

About the home care workforce, Senior Counsel said that “there is a lack of mandatory minimum qualifications and training requirements for workers”.

Also, there is “a lack of guaranteed working hours and low levels of remuneration are of key concern to personal care workers”.

The Royal Commission’s third hearing will be in Sydney from 6 May to 8 May and 13 May to 17 May. This hearing will be about residential aged care, with a focus on care for people living with dementia.


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