Stopping aged care neglect can’t wait until the May Budget

Article published 1 March 2021

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“Disagreement among the Aged Care Royal Commissioners about which agency should implement the obvious and urgent reforms in their final report should be ignored: it’s the nursing home residents and people receiving or waiting for home care that matter”, said CPSA Policy Manager Paul Versteege.

“For more than two years, waiting for the Aged Care Royal Commission has been the perfect excuse for the Australian Government to sit on its hands while nursing home residents suffered neglect and abuse and thousands died waiting for home care. Today’s public release of the Aged Care Royal Commission’s final report ends that excuse and immediate action must follow.

“The Australian Government must immediately increase staffing in nursing homes, even if it’s on an interim basis while the Department of Health finalises the new system it is working on.

“The Australian Government must immediately provide home care to the 100,000 people still languishing on its waiting list. The argument that not enough staff can be found at short notice doesn’t wash: the waiting list has been there for years and years.

“The Australian Government does not need more time to study the Aged Care Royal Commission’s findings and recommendations. The last thing aged care recipients and people waiting for aged care need right now is further delays, further inquiries and preliminaries.

“The Aged Care Royal Commissioners agree on the vast majority of the reforms that flow logically from their impressive interim report Neglect.

“The recommendation for adequate staffing of nursing homes and the acquittal of Government subsidies can’t wait for Budget night in May.

“Immediate clearing of the waiting list for Home Care Packages and ensuring everyone gets the help for which they have been assessed after one month following assessment is a measure that implements the change from an eligibility (or waiting list) system to an entitlement system like the NDIS: when you need care, you get care.

“The replacement of the Aged Care Act 1997 is long overdue. It is about time Australia’s aged care legislation puts ensuring the safety, health and wellbeing of people receiving aged care first. That may sound trite, obvious and superfluous, but it isn’t. The current Act explicitly restricts supply and is obsessed with how Government subsidies are doled out.

“Aged care standards should be reviewed by 31 December 2021 and from then on every three years. A recommendation to develop a fulsome suite of aged care indicators about such things as falls, nutrition and hydration and pressure sores is designed to discover and publish the relative performance of aged care providers.

“The Aged Care Royal Commission’s final report is brimming with recommendations that are sound and make common sense. Most have been made before this Royal Commission started and most have been made multiple times. It is now time to stop the neglect of older people receiving or waiting for aged care and act.

“The Australian Government’s initial response to the Aged Care Royal Commission’s final report indicates it is not taking the problems in aged care seriously”, said CPSA Policy Manager, Paul Versteege.

CPSA’s responses to the Government’s comments on the Aged Care Royal Commission’s final report are listed below 1 – 6.

1. The Australian Government said: The Australian Government will immediately invest more than $18 million to enhance the oversight of the Government’s Home Care Packages Program, to deliver better value for senior Australians and the Australian taxpayer.

CPSA response: This money will stretch existing money for actual Home Care Packages as far as it will go, which is good, but as a response it is a total rejection of the Royal Commission’s recommendation to clear the Home Care Packages waiting list immediately and then keep it clear.

2. The Australian Government said: In response to the Royal Commission, the Government will immediately invest $92 million to create over 18,000 places for [personal care] workers [in home care] between now and mid-2023. The total value of measures to grow the skilled and professional aged care workforce is almost $92 million over four years.

CPSA response: 18,000 new, additional workers to deliver Home Care Packages (HCPs) over four years will have no effect on the HCP program capacity,. This is a rejection of the Royal Commissioners’ recommendations for the HCP program.

3. The Government said: Funding worth $32 million will immediately be allocated to enhancing the capacity of the Aged Care Quality and Safety Commission and greater regulation around the use of restraints in care.

CPSA response: The over-use of physical and chemical restraints is down to lack of staff to manage residents with challenging behaviors. Increased policing is going to have limited to no positive effect and will not reduce the use of restraints materially.

4. The Government said: In response to the Royal Commission report, the Australian Government will immediately invest an additional $189.9 million for residential care providers to provide stability and maintain services while the Government considers the recommendations of the Royal Commission’s Final Report. This support equates to around $760 per resident in metropolitan residential aged care, and $1,145 for those in rural, regional and remote areas.

CPSA response: It’s not clear over what sort of period this assistance will be made available, but it equates to about 30 hours of care per metro resident and 46 hours of care for rural/regional/remote residents. Even if this is bridging funding until the May Budget, it is woefully inadequate.

5. The Government said:  “Along with the measures to further develop residential aged care governance, our Government is also strengthening the arm of the Aged Care Quality and Safety Commission, by appointing an Assistant Commissioner for Sector Capability with responsibility for leading a transformative change program.In response to the Royal Commission, the Government will immediately invest $30.1 million to strengthen the governance of aged care providers and legislative governance obligations on the sector.

CPSA response: Both Royal Commissioners have recommended the end of the Aged Care Quality and Safety Commission, both having concerns about the ACQSC’s independence. This is a rejection of not just one set of recommendations but two. However, the ACQSC is underfunded, like the aged care sector as a whole, so $30 million extra will not go astray.

6. The Government said: Minister Hunt also confirmed that work will immediately commence to replace the Aged Care Act 1997, providing a strong, fresh foundation to enable the reforms to be implemented and drive a cultural change with the focus on responding to the needs of senior Australians.

CPSA response: Replacement of the Aged Care 1997 is the first recommendation, supported by both Commissioners. We welcome the Government’s response that it will start immediately on getting rid of the Aged Care Act by replacing it with legislation where people, not money and profits, come first.

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