Submission to the 2016 Aged Care Legislated Review

COTA Australia welcomes the opportunity to provide comment on the 2016 Aged Care Legislated Review. We note our appreciation to the numerous staff across the COTA Federation who have contributed to this submission. Additionally, throughout our submission we have included quotes from consumers who participated in our Consumer Engagement in Aged Care project in 2016.

COTA Australia has been at the forefront of advocating for an improved aged care system for older Australians prior to and throughout the reform processes that are currently being reviewed. In our initial submission to the Productivity Commission’s inquiry ‘Caring for Older Australians’, COTA Australia noted its support for reform based on a shared vision by the aged care sector. COTA’s support for this vision, along with the various recommendations we outlined in our submission, were developed based on the feedback provided to COTA Australia by older Australians. Our response to the draft report, along with the subsequent public hearings on the draft report, indicated our satisfaction that many of the issues we addressed and recommendations we proposed were adopted by the Commission in its final report.

In particular, we were pleased to see the Productivity Commission place the consumer of aged care at the centre of the reforms, proposing funding should be attached to the consumer rather than allocated to the aged care service provider. This is fundamental to the current reform process and achieving it across the aged care system is essential for the achievement of a consumer focused, market based, high quality and financially sustainable aged care for all across coming decades.

We continue to be supportive of consumers contributing towards the cost of their care according to their means, in this submission we discuss a number of concerns about the way greater user pays has been implemented.

We strongly supported the introduction of the “Gateway” which we recommended to the Productivity Commission. However, we also discuss in this submission concerns around the efficacy of its implementation and the elements that we envisaged that remain unimplemented and are contributing to unintended consequences.

Following the release of the Productivity Commission’s Final Report COTA Australia coordinated thirty-two ‘Conversations on Ageing’ across the country between the then Minister for Ageing the Hon. Mark Butler MP and over 3,400 older Australians. At each forum held between August 2011 and February 2012, the Minister presented an overview of the reforms proposed by the Productivity Commission followed by over an hour and a half of conversations with older Australians directly expressing their opinions, questions and concerns about the proposed reforms to the Minister. The conversations identified a number of key views of older Australians that helped to shape the Government’s response in the form of the Living Longer, Living Better reforms to aged care.

As a key Sponsor member of the National Aged Care Alliance (the Alliance) COTA Australia has wide ranging and effective stakeholder relationships across the aged care sector. COTA Australia was a founding member of the Alliance. It led the development of the “NACA Vision”, the first articulation of the directions of the current reforms process. COTA contributed significantly to the Alliance’s first Aged Care Blueprint in February 2012 (following the Productivity Commission Report) and subsequently to its second Blueprint in June 2015, including the Position Statement for the 2016 Federal Election which includes specific actions for implementing Blueprint 2. COTA Australia has also been an active member of the Aged Care Sector Committee, contributing to the development of its Aged Care Roadmap.

COTA Australia is strongly of the view that participation in such sector dialogue is critical to ensuring sustainable, quality outcomes for older Australians. We also note our support for the comments made to the Legislated Review by the Alliance, including the need for the Review to be conducted with an eye to future reforms, both those already announced by Government as well as those envisaged through the Blueprint and Roadmap documents.

Nevertheless, as we embark on a review of the reforms over the past five years, we need to reflect on the impact of these reforms for older Australians. During engagement with members, issues around costs of aged care constantly remain one of the top three issues raised with COTA Australia – be it the inequity of neighbours or friends paying a different rate for the same service (because of their different programs, or that one provider charges the full basic daily fee, while the other does not), or that consumers are asked to contribute the same amount of client contributions despite receiving very different quantum of services.

Far too many consumers continue to report to COTA Australia that they are unable to exercise significant choice and control of their aged care services, with many expressing the view that they feel unsupported or uninformed to navigate what remains a complex system of care and services. It is for this reason, as discussed in this paper, that COTA Australia strongly advocates the need for initiatives to better inform consumers about the choice and control of their aged care services.

The reforms to aged care have been a series of steps towards delivering an aged care system that delivers outcomes based on the needs of older Australians. While the first five years of reform have seen improvements in this regard, a number of critical reforms remain to be adopted and implemented to ensure the system as a whole delivers aged care and support that is responsive to the individual needs of consumers and their carers and families. Accordingly, we would like to see the implementation of the Aged Care Roadmap and NACA’s Blueprint 2 in the shortest possible timeframe.

COTA Australia notes its strong support for the 20 recommendations made to the review by the National Aged Care Alliance and does not propose to repeat these items in our submission. In particular, we draw the Review’s attention to:

  • recommendation 3 (publication of quarterly data on unmet demand);
  • recommendation5 (assessment of how empowered consumers feel to exercise choice and control),
  • recommendation 8 (the need for greater promotion of consumer protection laws);
  • recommendation 10 (development of a diversity framework);
  • recommendation 18 (that the review publish a draft report for consultation); and
  • recommendation 19 (effectiveness of the reforms regarding reablement and restorative care).