PATRICIA KARVELAS, RADIO NATIONAL: After a breakthrough deal with the coalition, the Federal Government will help older Australians live at home for longer and improve conditions and protections for people living in aged care facilities. Prime Minister Anthony Albanese says the $5.6 billion package marks a historic moment.
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ANTHONY ALBANESE, PRIME MINISTER: This is about caring for the generation that cared for us. Older Australians built this country, they shaped our economy, they did the hard yards. Reforms like this don't happen every day. They are once in a generation and this is very significant.
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KARVELAS: Now, a bit of an explainer. Under the reforms, new entrants into the aged care system will have to make larger means tested contributions. There'll also be stronger powers to investigate bad behaviour and civil penalties, not criminal ones, for breaching standards of care in the sector. The new contributions and accommodation arrangements will be limited to older Australians who enter the residential aged care system from 1 July next year. Joining us now is the Minister for Aged Care, Anika Wells. Welcome.
ANIKA WELLS, MINISTER FOR AGED CARE AND MINISTER FOR SPORT: Good morning.
KARVELAS: Did we need a millennial to get a deal done which will effectively impact baby boomers?
WELLS: We needed the entire sector to buy in, and this has been a huge grand bargain from all corners of the sector. It would not have been possible without everybody in the sector giving up something that they wanted to do in order to get something that was more important, which was a viable and hopefully thriving aged care sector, which, as you and I have talked about before, has been on its knees for years.
KARVELAS: Under the reforms, 30 per cent of full pensioners and 75 per cent of part pensioners entering residential care will actually be required to pay more. How much more, Minister?
WELLS: What you are required to contribute will really depend on your clinically assessed need, and then that mix of services that helps you stay at home for longer. So there's three different streams for that clinical care, independence and every day. And the clinical care will always be picked up by the taxpayer. So we never want anyone at home to not get their wound dressed or have an OT come and see them in their home because they can't afford it. The taxpayer will always pick up clinical care, so you never have to sacrifice that if you can't afford it.
Independence and everyday living - everyday living in particular - those are the kinds of things that you've paid for all your life. Maybe the guttering or the gardening or the cleaning. We're asking for you to make a co-contribution towards that again according to your means. But I think for your listeners, a point of reassurance should be that for every dollar that we do ask you to co-contribute towards your new support at home package, the taxpayers will still be contributing $7.80 towards your package.
KARVELAS: So what's the maximum extra people will have to pay?
WELLS: In Support at Home or resi?
KARVELAS: Let's go with both. Support at home.
WELLS: Well, in Support at Home, it really depends on what mix of services you need. One of the benefits of this is that people do have more complex care needs. Their needs haven't been necessarily getting met because the current system only has four levels of packages. In the new support at home regime, there's eight levels of packages specifically to address those people that want to stay at home, but have more complex needs that ordinarily would have had to go into residential aged care. So under the new support at home regime, rather than $61,000, which is the current limit, they'll now be up to $78,000 in your package to keep you at home.
KARVELAS: Okay, self-funded retirees could pay an extra $13,000 a year for residential aged care. Do you think that's fair?
WELLS: What I'm hoping is that when that person arrives at residential aged care - and let's be honest, it's not something that people look forward to. In fact, over the past few years, people have been dreading it after all the horror stories that we've heard in the Royal Commission. What I hope is when that moment comes, and I'm sorry if it's not something that they want to do, that they arrive to an aged care facility that has a new wing being built and that the room that they have has an en-suite. They're not sharing a room with somebody else. And I hope that they can smell the food cooking in the kitchen because there's a chef there cooking it for them, and it's not just being heated up like what exists so frequently over the country at the moment.
So, people have told me- and I've been doing mobile offices on this as the minister for two and a half years, and for three years as a backbencher before that, is that they want a higher standard of aged care. Lots of people have said to me, I'd be happy to pay a little bit more if I could get a higher standard of aged care, but that standard just has not been there because since COVID, those new beds have not been being built, those new renovations have not been being done because this sector has been on its knees. And yesterday was a really important day to try and make this sector sustainable.
KARVELAS: So some people though, at the higher end would be paying, what, $13,000 extra a year?
WELLS: It will depend upon your income and your assets, similar to the assessment that people would be familiar with the pension. There are fact sheets and case studies on the health.gov.au website today if your listeners want to have a look at case studies of people with similar circumstances to them. But we also have a cap of up to $130,000 that exists across the aged care system. So from the moment you start making co-contributions towards your support at home package, that is going towards your lifetime cap of $130,000.
KARVELAS: So that's the most individually you'll have to pay regardless of how many assets you have?
WELLS: Whatever your means, whatever your duration of care.
KARVELAS: Okay, but that has increased the cap, hasn't it, under these arrangements?
WELLS: That's one of the measures we've had to do to make this sector sustainable. And when I say we, I again want to acknowledge the work of the taskforce. This was something that we brought together, all different corners of the sector. Those taskforce deliberations that went on for six months, they were really good faith. Like I said, a bunch of people really putting skin in the game from their own part of the world, be it provider or consumer advocate, to try and get something workable that everyone could live with. And then I took those recommendations and we negotiated with the opposition, and we've ended up with something that everyone can live with. And at the end of the day, it's one of the most transformational reforms, the biggest reform to aged care in 30 years.
KARVELAS: I want to read you a text from one listener who is concerned, and I'm sure you'll hear some concerns - it'll be a mixed response like with anything: I'm a self-funded retiree who has worked more than ten years past the date when I could have claimed the aged pension, so far, so good, having saved the government more than ten years of pension payments, I might be able to work for another ten. So why should I have to be penalised by paying more when I get some care? Is it time for me to squander my hard earned savings in order to receive a publicly funded pension? For many older people like me, the prospect of being penalised for working, for continuing to work is ageism at its worst. Is it- is that the unintended consequence for people?
WELLS: Well, I'm sorry that person feels that way, but I guess from my position, I'm worried that person is not going to have a bed to go to. I'm worried that person, when they reach a point where they need a home care package, is going to have to sit on a waitlist for too long and not get the care that they need, and if they don't get the care that they need at home, you know what happens? People have falls, people fall sick, they go into hospital. You know, people are in beds in hospital that we need for other people that need primary and emergency care in hospital. They then enter residential aged care and they're not happy. They're sharing a room. There's no en-suite, there's no balcony. They don't like the food. All of these things we can't do unless we make this system sustainable.
When I sort of fired the starting gun on this at the National Press Club more than a year ago, I said, we're trying to answer the question how to get more money into a system that is desperate for more money. And we don't want people to be afraid of going into aged care. And too many people have told me that they are. So yesterday we really did something transformational about it.
KARVELAS: Yeah. That's interesting. You talk about the fear. Is doing a deal with the coalition on this part of reducing that fear so there are no scare campaigns and that there's no anxiety for older people?
WELLS: It was about the anxiety of investors. It was about making sure that the rules weren't going to change when the Government does. This is a sector that has that investability gap. You said that the horror stories, everyone can think of a horror story from the Royal Commission. People didn't want to work there. People don't want to invest in aged care. So the sector isn't viable. We have to make it viable. Yesterday, we introduced a bill to make it viable. That was why we took this through taskforce to make sure that the sector had bought in and that the sector was recommending what we do, and then we negotiated with the opposition for six months to land something that we could all live with. And then yesterday we introduced it to the Parliament.
KARVELAS: Right now, there are 68,000 Australians waiting for their home care package. And we know from the Royal Commission some older Australians have died while waiting for their package. How will the support at home program, which you are really expanding, be different?
WELLS: Well, not to bore your listeners with too much policy, but the system at the moment is really inefficient. There's lots of unspent funds that sit across the existing packages, and by re-gearing the whole system to what we're doing, where you make a contribution towards the services that you actually use yourself, we're going to be able to redirect all that money and create tens of thousands of new packages for people. One, there's people waiting, but two, there's more people entering the system. You know, there's more and more people that are going to need aged care in the decades to come. That's what the Intergenerational Report told us.
So yesterday, it was really important that we introduced this system and now we've got to try and negotiate it through the Parliament. But like you say, the fact that the Opposition were prepared to negotiate with us in good faith, Senator Ruston and the Shadow Aged Care Minister spent so many hours with us back and forth trying to make sure it was something that we could all live with, that gives people certainty. Your listeners listening today, certainty that this is- you know, it should be above politics. It's too important to fail. We've come to something that we can all live with, and hopefully we can get it through to start 1 July 2025.
KARVELAS: You want to increase the number of people who can get those in-home services. How will you get the extra workers? Because that's been an enormous- big problem with this sector.
WELLS: The number one problem, I reckon, is workforce shortages in aged care, sort of- what I inherited and what people still tell me. The biggest thing we did, as you’ll know - we've talked about it - is the $11.3 billion pay rise for aged care workers. That has been a game changer. People tell me that every single time I go to a nursing home or home care. I just had a provider who looks after rural and remote nursing home, so some of the hardest places to staff in the country, he said to me last week his staff turnover was 40 per cent before the pay rise and it's 20 per cent now. It's dropped to 20 per cent and we have more pay rises on the way.
KARVELAS: So you think that you'll have enough people working to be able to start that in July next year, when more of these services are rolled out for homes?
WELLS: I hope so, but that's always the challenge when you're dealing with such a big problem as workforce shortages. I know that I talked to Bill Shorten and Matt Keogh about this in NDIS and veterans as well. You know, it is a fact that we, Australia, are in a global race for nurses in particular and for care workers. And we're obviously going to keep pulling every lever we can to get as many workers as we need to try and look after people at home, in particular, and in residential aged care.
KARVELAS: Two of the points that you seem to have agreed to the coalition's demands, one of them that criminal penalties for aged care are no longer there. Why not?
WELLS: Like I said, in our negotiations, everyone had skin in the game. Everyone had to give up things that they wanted to see in there in order to find a grand bargain that everybody could live with. For us, I still think and like you already mentioned, there's really strong regulatory reform in the act. There's a new compensation pathway for people, and there are civil penalties to make sure that there's a cop on the beat and that people will be penalised for doing the wrong thing.
KARVELAS: And the other big change that was really delved with on AM a little earlier is that you have made significant changes, including the removal of provisions that would have- and I'm using coalition language here, they say forced unionism in every aged care home, but that essentially means that you won't have a worker's voice. Does that mean that workers won't be able to advocate for themselves?
WELLS: No, I don't think so. There are existing ways that our workers and worker representatives contribute to making sure that nursing homes are safe and operable and are operating as best that they can be, and we will continue to make sure that is a presence and look at what else we can do in that space. But at the end of the day, I don't want to go into the ins and outs of it. Everybody gave and took in this. And we had worker representation on the taskforce that contributed to the recommendations that I then took to negotiate with the Opposition.
KARVELAS: Is the deal done and dusted, or do you expect there'll be some shifts during the Senate process and maybe during a time where some people raise objections to the idea of paying more?
WELLS: Look, I think it's a huge- like you had with the Prime Minister at the top of this interview, this is a huge deal. This only happens once every 30 years. We welcome everybody who has worked with us so willingly to make it happen. It's because aged care is so important. I think that the Senate understands that. Certainly, parliamentarians have been engaging with me about what their constituents need for two years. And at the end of the day, if you want ambitious reform, you have to do it in a sincere and genuine way. We've had good faith negotiations all along the way, and I am confident we'll have a good faith outcome.
KARVELAS: Elon Musk says your misinformation and disinformation bill will- is fascist, is the language he's used. What do you make of that?
WELLS: That's news to me, PK. I've had my head in aged care and in sport, where we also introduced governance quotas this week so that there will be 50 per cent of women on sport boards and as sport chairs for our national sporting organisations in this country. So forgive me if I haven't been tracking Elon’s [indistinct] …
KARVELAS: [Interrupts] Incredible pivot. Incredible pivot …
WELLS: [Laughs] Thank you. I am the Sports Minister.
KARVELAS: … but I'm assuming you don't think that the Government are fascists?
WELLS: I have yet to meet one in the Government.
KARVELAS: Thank you so much for joining us.
WELLS: Have a good morning.
KARVELAS: Aged Care Minister Anika Wells, you're listening to ABC RN Breakfast.