DAVID BEVAN, HOST: Federal Minister for Health and Aged Care. Good morning, Minister.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning, David.
BEVAN: Minister, is Hannah (caller) right that elderly people under these measures will end up living in squalor? Specifically, she referred to gardening services for My Aged Care recipients, being capped at 18 hours per year and cleaning at just one hour per week?
BUTLER: I very strongly disagree with Hannah's description of what the new support at home program is going to mean for older Australians. It's going to be very good for older Australians. It's a very substantial investment, Billions of additional dollars into allowing people to stay at home for as long as they possibly can. Hopefully for the remainder of their life. There'll be hundreds of thousands of additional packages, because we know that demand for home care is outstripping the supply of packages right now. They'll be much more tailored packages particularly, at the high end of need, there'll be much greater levels of support for people who might have a higher level of need for personal care and even nursing care in home. We’ll be giving much more support in areas like assistive technology and ultimately at the end of life, palliative care as well.
One of the issues Hannah raises, though, is this question of how much gardening and cleaning support will be provided in these new packages, and that has been something that's been dealt with quite a bit in a Senate Inquiry that's been underway over the last several weeks. We have an Aged Care Bill before the Parliament, which overhauls the aged care system, long overdue reform that was recommended by the Royal Commission into Aged Care. It particularly focuses on the support at home question to keep people living at home as long as possible. And there's been quite a bit of discussion about caps or limits on cleaning and gardening services. The Senate Inquiry Report dealt with that, and we're currently having a pretty close look at that as well.
BEVAN: So what does all that mean? Does that mean that Hannah is right that gardening will be capped at 18 hours a year?
BUTLER: There is a cap in the original Bill that was put into Parliament. We want to make sure that taxpayer support as far as possible is focused on people's personal care and nursing care needs so that they are able to stay at home as long as possible while also providing some support for cleaning and gardening.
BEVAN: So Hannah’s right?
BUTLER: No, let me finish David. This question of caps was raised in the Senate Inquiry. The Report from the Senate Committee that inquired into the Bill is currently being considered by the government. And one of the things that we're looking at very closely is the community response to this question of caps. The Bill is still going through the Parliament, it's not finalised yet.
BEVAN: And as the Bill currently stands on the 11th of November at 9:15 Adelaide time, does it involve a cap of 18 hours per year on gardening?
BUTLER: I can't tell you whether it's 18 particularly, but there is a cap around that level for gardening and cleaning services.
BEVAN: So she's right?
BUTLER: Yes but as I said the Bill is not finalised through the Parliament. It is still being considered. That is one of the issues that was raised by the Senate Committee. We're looking at it, as we're hoping the Bill will go through the Parliament over the next couple of weeks. There will be a debate in the Senate, and we're looking at what came out of the Senate Committee Report, while we move into the Senate fortnight.
BEVAN: Do you plan to lift the cap?
BUTLER: I can't tell you that right now, David. All I can say is that this is one of the issues that was raised with us, and it's under deep consideration by the government. We want to get this right. That's the purpose of having these Senate inquiries so the community is able to point out issues that they are concerned about. The process is then that government will consider that as the Bill goes through the final stages of debate, which will happen and I hope, over the next fortnight.
BEVAN: And the cap for cleaning is as it currently sits in the Bill at one hour per week?
BUTLER: Look, I think that's right. I haven't got the Bill in front of me.
BEVAN: It sounds like Hannah is pretty much on the money so far.
BUTLER: Hannah's obviously read the Bill or read some material in relation to the Bill, and that's a good thing. We wanted the community to look at this really important reform. But I want to be clear with people, we are massively expanding the support, the new support at home program for older Australians. This builds on a program I introduced when I was last the Minister, 12 or 13 years ago, the home care package program. Because we recognised then as we recognise now, the old system used to be overwhelmingly focused on building nursing homes, funding nursing homes, when increasingly we hear from older Australians, yes, they want a good nursing home system in place if they need it, but really what they want is support to stay in their own home for as long as possible. There will be Billions of dollars additional money invested into this program hundreds of thousands of additional packages. But we want to get the design of the packages right.
BEVAN: Will the packages be grandfathered? That is whatever you're getting right now you will continue to get? These new arrangements will only apply to new entrants into the scheme?
BUTLER: That's right. I listened carefully to what Hannah said in your recording. I'm going to take that away. I don't have that level of detail at my fingertips. But we were very clear as we negotiated arrangements with the Opposition through Anne Ruston, the Shadow Minister for Health, who is also a South Australian, as you know, David. We had really constructive negotiations because we wanted to reach an agreement with the alternative government of the day that gave older Australians and providers of aged care certainty that whatever we land, finally, as a Parliament is going to endure, everyone has certainty about what the new arrangements would be. And one of the aspects of that agreement was what Hannah called grandfathering, which is if you're in the aged care system now, then you will stay on your existing arrangements. Now, I will take away the particular point that Hannah raised in her discussion about the application of the cap. I don't have that detail in my fingertips, but we were very clear that there would be essentially no change for people who are currently in the system when the new system takes effect on the 1st of July next year.
BEVAN: So Hannah's gardening and her cleaning and her contributions, they shouldn't change?
BUTLER: The broad principle was that people stay on their existing arrangements. I'm going to take away that question, I can come back to you if you'd like, David, because I haven't got that detail at my fingertips about the application of the cap. But I've also said that this Bill -
BEVAN: But it’s either grandfathered or it's not. I mean, some people might be worried that Hannah seems to know more about the Bill than the Aged Care Minister?
BUTLER: It is a 500-page Bill, David. We negotiated grandparenting arrangements that gave people confidence that their existing arrangements would remain in place. It's an issue that is still under consideration by the government, because it was a matter dealt with by the Senate Committee. And as I said, the Bill is not finalised yet it's still being debated by the Parliament. And the sort of feedback from Hannah is exactly what we want through having a Senate Committee.
BEVAN: You don't want people ringing up saying, I'm afraid that elderly people will be living in squalor. I mean, that wasn't your intention when you put this out for consultation?
BUTLER: As I said, I strongly disagree with that description. This is going to be a dramatic improvement on support for people, older Australians living at home. I'm interested in the particular, detail that Hannah picked up on. But her editorial commentary I entirely disagree with. This is a huge reform to the benefit of older Australians that builds on the very substantial reform we last made when we were last in government, and there's really been nothing changed in the intervening ten years.
BEVAN: Well, a lot of people want to talk to you about this. Catherine's called. Good morning, Catherine. What would you like to say to the Minister?
CALLER: My mother was on a Home Care Package and living at home and her home care providers were unable to change the smoke alarm batteries in her house. So there's not much point in keeping elderly people at home if their homes are not safe?
BEVAN: Minister, what do you say to Catherine?
BUTLER: There are support arrangements in place, I didn't entirely hear what that was. Something about batteries not being able to change smoke alarms, was it?
CALLER: Smoke alarm batteries. The home care providers were not able to climb up on ladders in order to change the batteries, and they seemed unable to arrange for someone to come in and change the batteries. My sisters and I live interstate, my mother was living in Adelaide. We were not able to arrange anything either until my sister organised for Hire a Hubby to come in. Mum was 90. She didn't want to have to deal with tradies and so forth. She had to have people she didn't know coming in and out of the house. It would have been a lot better for her had the home care providers been able to do things like provide maintenance or arrange for maintenance and supervise the maintenance.
BUTLER: There are maintenance services that are funded by the government. We're actually expanding those right now. Not just maintenance, but also home modifications, providers that can go in and put shower rails in, for example, those sorts of things. Home maintenance and modifications is a really important part of our program and they are available through the My Aged Care site as well. I don't know the specifics of the home care provider. I can imagine that some home care providers would not necessarily want their carers going up ladders, depending on the height of the ceiling. That’s a matter I'm not, particularly across. But to be clear, we know that sort of home maintenance is a critical service for older Australians, not just smoke alarms, but a range of other things as well that go beyond cleaning and sometimes do require people with specific skills. There is a program for that. We're expanding funding for it right now because we know that that's a really important service for older Australians. I can't comment on that individual case, though.
BEVAN: Catherine, thank you for your call. Let's go to Mick. Good morning, Mick. Mick, what are your thoughts?
CALLER: If the cap of one hour cleaning a house for a week is true, I'd like to ask Mr. Butler how he gets away with having one hour a week on his house?
BUTLER: All I'd say is that question of a cap of cleaning and gardening is a matter that went through the debate of the Senate Inquiry. We've heard the recommendations out of that and we we're considering it right now.
BEVAN: But that one hour a week that didn't fall out of the sky. Somebody put that in the legislation. It's your legislation. You wear that, don't you?
BUTLER: As I said, the demand for aged care at home is huge and it's growing enormously fast right now as particularly the large baby boomer generation hits the age of needing aged care.
BEVAN: But that was your idea.
BUTLER: Let me finish, David. We're trying to maximise the support we can give with limited resources, limited workers, to personal care and nursing care services that really make a difference for a person's ability to stay at home and not have to go into an aged care facility. We're now looking at whether we've got that balance, right. Yes, a cap was put in place. It's been the subject of debate through the Senate Committee. The Bill is not finalised yet, as I've said now on several occasions. That is obviously an area that we'll be considering over the coming few weeks as the debate around this Bill goes through the Senate and the terms of the Bill are finalised.
BEVAN: Rebekha Sharkie is the Member for Mayo, she's an independent MP. Good morning, Rebekha Sharkie.
MEMBER FOR MAYO, REBEKHA SHARKIE: Good morning, David. Good to be with you.
BEVAN: What's your message?
SHARKIE: Well look I posed maybe about six pages of questions to Minister Anika Wells, during consideration in detail, which is an opportunity to put these questions to. And every single time the Minister just said no response. I share Hannah's concerns. My understanding is that while people's contribution will be capped, if you're already in the home care system, not that you will have changes with respect to what you can do with the funds that are allocated to you. I'm also really concerned about people that are on the CHSP, the Commonwealth Home Support Program and that has, you know, a couple of hundred thousand Australians and that sits at that lower level that is that, you know, light touch care. My understanding is, that those people will not be part of the grandfathered system. And when they move into needing higher level home care support, um, they will then be subjected to the new fees.
BEVAN: You're saying at least 200,000 people are going to have their services cut?
SHARKIE: Well, that they will go from when they go from CHSP and they would currently see themselves as part of the Home Care Package. My understanding is, and I posed the question to the Minister and she didn't respond, is that those people, as they move into needing a bit more care, will be under the new system.
BEVAN: Which is a reduced service?
SHARKIE: Look, it's a highly prescriptive system. What I don't understand about, you know, what's been proposed by government, and I do appreciate this now, palliative care levels, which I think are really needed, is that we have a system in NDIS that's all about choice and control. We move into aged care and we say we're going to dole out to you exactly what you are allowed to have under this new system, and that's not going to suit everyone. Some people, particularly those in regional areas, are on half an acre, but that's their home, you know, that's they were used to a quarter acre block, half acre block, whereas their gardening needs are going to be very different to someone that's living in an inner-city unit. So they're my concerns. I'm also really concerned about the fact that we have 76,000 Australians right now waiting for a Home Care Package. It's taking up to 15 months. And when I pose those questions to the Minister about, what's your plan to get these people support, um, again, there was no response.
BEVAN: Alright. Rebekha Sharkie there, thank you very much for your time. Let's go back to your calls. Catherine's called from Vale Park. Hello, Catherine.
CALLER: Oh, good morning everyone. My biggest problem is the garden. I've got multiple sclerosis and I think 18 hours of gardening a year is absolutely useless to me. And when you have one of these gardeners, often you say, could you please help weed that? And they say, oh, we can't pull up weeds. Now, what is the point of having a gardener if they can't pull up weeds. Yet, some of them are fantastic and are really helpful, others aren't. They just don't have any control. And it seems to me the provider has all the control and the patient or client has very little control and that’s not a proper Home Care Package.
BEVAN: Thank you for your call, Catherine. Let's go to Gary. Good morning, Gary. What's your story?
CALLER: Well, I've got an 84 year old mother in law, and she was interviewed last week to get a Home Care Package. She's partly blind with immaculate degeneration, and she can't hear. She looks after her 88-year-old husband, which has been with dementia, and she suffers a bit of depression. And they said, no, you're not eligible for any home care packages, you can look after yourself. And when they said, oh, who mows the lawn? She said, oh, you know, I'll mow the lawn because my husband can't mow the lawn. And they said can you pull that? I said, oh, it's hard to pull, but I can do it. And she said, well, tell you what, go to Bunnings and by an electric mower they're very good. Minister, what do you say to Gary?
BUTLER: There’s an assessment system in place that's been in place for years for people about their aged care needs. I have to say, listening to Gary there, I can't understand why someone in that position would not be eligible for aged care, but I don't have all the facts in front of me.
BEVAN: Can Gary get in touch with your office?
BUTLER: Gary can get in touch with my office. There's no problem with that at all.
BEVAN: Alright, if you can, leave a number, Minister, that Gary can call.
BUTLER: It’s (08) 8241 0190. But can I respond to a couple of things that Rebekha Sharkie said, because I don't want people to take away from what Rebekha said, some of the things you said as well, David. There is no suggestion people are going to have their services cut who are in the home support program I don't know where you or Rebekha got that.
BEVAN: I didn't get it from anywhere. She just said it.
BUTLER: I can't remember who said it, but we're expanding funding for home support. That system is staying in place until 2027, that is very light touch services as she described, like Meals on Wheels, like community transport, if you need to get on one of the community buses and things like that. Again, demand for those services is expanding very fast, which is why we're putting additional supplementary funding into that program for providers who are struggling a bit to keep up with demand in the system-
BEVAN: And to be clear, because there's a lot of bureaucracy here. What is that scheme? The one that Rebekha Sharkie referred to is about 200,000 people. What's it called?
BUTLER: It's called the Home Support Program, and there's probably more like 800,000 people on it. It's not really home care, it's more a light touch services like having your meals delivered, community transport, some light touch cleaning and other services.
BEVAN: And you're saying that's not changing at all?
BUTLER: Home Care Packages were really designed for people who needed personal care assistance with showering, getting up, and going to bed, basic nursing care or allied health services. It's a higher level of care than home support.
BEVAN: And you're saying that Commonwealth Home Support Program have I got the term right, that's not being altered at all?
BUTLER: No, that's going to remain in place as it currently is for the next couple of years.
BEVAN: For everybody?
BUTLER: For those people, we're putting extra funds into it because demand for those services is growing fast. And what we're focused on now is building a new home care program for people who have those higher level needs. And also, we haven't really talked about this today, David, but a very big very change to residential aged care because we again know we need more aged care facilities built, there's no building going on right now. Every aged care facility I visit in Adelaide, and I've probably visited ten over the last few months, they're all full, completely full. We need new nursing homes being built as well. I mean, the point is really that we need a lot more service in the system because we are a population right now that is ageing very fast. Demand for these services is growing very fast. That means a lot more taxpayer funding means a lot more workers into the system. And we're working really, hard to build the sort of aged care system that older Australians after having worked and paid taxes all their life, frankly, deserve.
BEVAN: Can you stay for a couple more calls?
BUTLER: Sure.
BEVAN: Jan has called from Kensington. Hello, Jan.
CALLER: Hello. I approached earlier in the year for an assessment because I need some things done in the house and I've been told now that there'll be at least a year's wait for an occupational therapist to come to assess me before I can have anything done. Because in the eastern and southern suburbs, there are no therapists available?
BEVAN: So you've applied for the services now, but you'll be told it'll be at least another year before you get assessed. And then you'll have to wait for whether or not your application is approved?
CALLER: Yes.
BEVAN: Minister, can you do anything for Jan?
BUTLER: Again, that seems an extraordinary period of time to be waiting. And we are struggling getting occupational therapists in particular, because so many of them have been sort of pulled into the NDIS system. I know the state health systems as well as aged care are really struggling to get occupational therapists, but that seems an inordinate amount of time to wait. If Jan would like to contact my office, you now have my office phone number.
BEVAN: That’s 0841 0190. Jan, thank you very much for your call. And, Minister, thank you very much for your time.
BUTLER: Thank you, David.
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