MARY GEARIN, HOST: Sam Rae, the Minister for Aged Care and Seniors, also the member for Hawke joins us now. Thank you very much for joining us.
SAM RAE, MINISTER FOR AGED CARE AND SENIORS: Thank you for having me, Mary.
GEARIN: So yes, you're the new Minister. Congrats, they gave you an easy one to start off with, didn't they?
RAE: Let me say, it is an enormous privilege. This has been such an important conversation that you’ve been having today, and it’s an enormous privilege for me to serve in this role and to get to work with older people across our community – people who have served our community, who have contributed to our society and economy and who are now in another stage of their life. And of course, the people, the families, the carers, and indeed the workers that work so hard to afford these people dignity and safety, and dare I say it, a little bit of joy in those years. It's a great privilege for me to be in this role.
GEARIN: Yes, I think tomorrow marks your 7th week in the role. And as we've heard all day, it's such a complex area with so many interconnecting parts. We've talked about the confusion, emotional strain of navigating it, waiting times, the cost burdens, care exhaustion, all of it. Where do you start? Where did you start to tackle first in these past 7 weeks?
RAE: It is a very complex system and I would be lying if I didn't say that there have been moments where it has felt like I've been drinking from the fire hose in terms of my understanding of the system and building my awareness. I've been spending the last 7 weeks speaking to as many people across the sector as I possibly can. I've spoken to older people. I've spoken to their families. I've spoken to workers and workforce representatives. I've spoken to providers and people across the sector. I think some of the things that we can all acknowledge right at the front of this conversation is that every older Australian deserves access to high quality care and support as they age. That is whether they're remaining in their own home or they're moving into that residential aged care space. Older Australians deserve an aged care system that treats them with respect and indeed is sustainable over the long-term.
GEARIN: That's the principle, of course, but where do you start? What has started to emerge from that fire hose that you've been facing as the first thing you do, the first thing you concentrate on?
RAE: I don't think there can just be one thing at a time. There are many aspects to this complex system. But in terms of this conversation, I think one of the places to begin is understanding that we had the Royal Commission. And coming out of the Royal Commission were harrowing, distressing stories about people’s experience with the aged care system. Of course, through the last term of Government under my predecessor, Minister Wells, the Government already began a very large program of addressing these issues. I should be fair here and say that a lot of the work that's happening in this space, and has happened to date in this space, has been done on a bipartisan basis, or even a multi-partisan basis, where all the people across the Parliament regardless of their political leanings have been coming together to try and address these issues. I think that’s an important point to make, because not every issue has to be a political football. When it comes to aged care, we can all get together, we can all agree that the system should be better.
GEARIN: Wouldn't it be good to think that, yes, that will allow us some strength and some ability to get to this. Let's go to some of the specifics. Let's go to Kate, who talked about the assessments that are taking too long, that are occurring across states, the confusion that leads to. How do you address that?
RAE: Firstly, can I say thank you to Kate because she works in the sector and is one of those amazing people that I was speaking about who provides dignity and care for the people that our sector is designed to support. Thank you to Kate and to all the people like her. She's right. It's incredibly stressful to be waiting to find out what kind of care an elderly parent or relative, or indeed if you're an older person yourself and you're trying to work through this process, it's a stressful process to go through. It's often under intense pressure. Sometimes there has been illness or something that's happened to the person in question. And we know that wait times are too long and that has been an issue. We also know that there's been a great level of variability depending on whereabouts in Australia you are or which assessor you've been assigned to. There has traditionally been a lot of frustration in the assessment process. We've put in place the Single Assessment System, and I think there's been some conversation on your program today about that already. Indeed, the new reforms that are coming in on the 1st of November are designed to, again, cut down on the wait times for assessment and to ensure that there is greater consistency in assessments across all of Australia and the different people that require it.
GEARIN: You did mention there the blowout in assessment times. There's wait list blowout as well for the Home Care Packages that we have seen over the past year or so. How realistic is it that you can cut wait times for Home Care Packages with the degree of demand that's coming, and potentially also this rush before the 1st of November?
RAE: I think we have to go back to first principles here. The first principle of this system is to provide the right amount of care, and indeed as much care as is needed, to as many people as possible. Now, 5 years ago, we had less than 200,000 people in the home care system. As of now, we're approaching 306,000 people. There's been significant growth in the home care system. In fact, every single week, we're delivering record numbers of packages for people for home care. When Support at Home comes in with the new Act on the 1st of November, there will be an additional 80,000 packages that will be delivered in the first 12 months of that Support at Home system. There's really significant investments that have already been made. Therefore, we'll see more people on the wait list, realising the packages, realising the care that they require.
GEARIN: The fact that they've been delayed as well is its own problem. That's 83,000 packages that have been delayed and contribute to the problem?
RAE: Can I say a couple of things about this that are really important. First of all, we are assigning packages every single week, and we'll be doing that all the way through up to November. Every single week there are packages assigned. Now, when people go through their assessment, they receive a prioritisation, either high or medium prioritisation. We are ensuring that everyone who receives a high priority assessment still receives their package within a month. The people that are assigned or assessed as being high priority absolutely will continue to receive their care and the package that supports it within that month. Once we bring in Support at Home on the 1st of November, we'll be able to start to drive down the waiting list because we'll bring in those 83,000 additional packages and they'll be better tailored packages. They'll be designed so that they meet the needs of the older person in question in a more efficient way. It's a much more sustainable system.
GEARIN: There'll be many people listening. I can already see on text, Sam Rae, who will be keeping you to your word. And it's a devilish sector that you're in now. I mean, how realistic is it that you can actually deliver on what you're saying?
RAE: Again, I think older people have waited long enough.
GEARIN: That's true, but what's going to be done that will speed up those times? What can they be looking to that means that they can trust what you're saying is going to be right?
RAE: As I was about to say, older people have waited long enough. This is a rights-based framework that's enshrined within the new Act. The Support at Home changes mean that we'll have a more efficient system that better distributes public resources to the people that need it. Let's go back to the first principle. We're trying to get as much care as possible to as many people as possible. We know that we've got an ageing population. We know that the demand for services is growing very, very fast. We need to make sure that we can provide those services sustainably. That's why we're going to continue to release packages, we’re going to continue to assign packages in the lead up to 1 November. Then, over the 12 months from 1 November, we’ll have 83,000 additional packages that we’ll be able to use to make sure people are getting the care that they need.
GEARIN: You’re listening to Sam Rae, Minister for Aged Care and Seniors. Minister, on the panel this morning, Rachel Lane joined Raf. She's the principal of financial advice firm Aged Care Gurus. She was saying that the carers pension should not be means tested. Let's have a listen.
RACHEL LANE, CLIP: This idea that we pay people like Fleur a Carer Allowance of $200 a fortnight to pop some petrol in the car or something, it's really quite offensive. They really should make the carers pension not means tested. They should really say if you've given up your job in the workforce, which means you're giving up that income, you're also giving up the contributions to your superannuation that enables you to fund your future retirement and your future aged care.
GEARIN: Minister, will you remove the means testing for the carers pension?
RAE: Can I, first of all, give a massive shout out to the carers all across our community. Carers and family members are at the front lines of supporting older people as they go through this journey, be it support at home or into residential aged care. We should always acknowledge that they are making a significant contribution. I agree that they are often doing it at personal cost, whether it be financial cost, certainly a cost to their time.
GEARIN: Will you remove the means testing?
RAE: Let me get to that in a second. Let me just say we need to make sure that we have as much support in place to support carers, and that is about supporting them from an emotional perspective. We fund the Carer Gateway, which provides a range of services and support that's just for carers. They can access them in person or online or over the phone. You can call the gateway and speak to someone who understands what you're doing. It's a complex thing to give care to another person.
GEARIN: It is, but I guess we're talking about the monetary support. We’re talking about financial support. Can you say that you’ll consider removing the means testing for the carers pension?
RAE: My colleague Minister Plibersek has control of our welfare arrangements and I know that she's giving very deep consideration, as she always does, to the systems that are in place to support people. You're right, there is a Carer Payment that is available to people and it's usually available if you're providing constant care to someone for at least six months.
GEARIN: Will you go to Minister Plibersek and say that this needs to happen?
RAE: I'll be working very closely with Minister Plibersek and all of my colleagues across Government to make sure, within the boundaries of sustainability across Government, we have the best systems in place to support carers and older people and workers all across this system.
GEARIN: Another issue that we were hearing about, Minister, is the Star Rating for facilities. We had a striking comment saying it was like sticking a finger in the air to actually figure out the quality of these facilities. Is that something that you're concerned about?
RAE: Respectfully, I don't agree with that assessment. I think what we've seen since the Royal Commission are significant steps forward in terms of assessing the quality of services being provided. We've also, might I say, seen a significant lift in the quality of services being provided. There is the Star System. We're seeing the majority of residential facilities receiving 4 or 5 stars these days, which means they are either ‘good’ or ‘excellent’.
GEARIN: But if people are saying that the assessment isn't sound or valid, then it doesn't mean much, does it, if there's a rise in the number of stars?
RAE: That's not the advice that I've been getting. I think we have to acknowledge that subjective views will always mean that different people have different views about these things. But we have a system in place that assesses the quality of care being delivered, and it's based on a whole range of things from personal care through to the type of food that people are receiving. It's a dynamic system. It's one that has constant review. And, of course, we have people who are experiencing these things on a daily basis, the people who are in the care and, indeed, the carers and families that support them. We have a range of systems in place to ensure that we've got safety and quality across the system. There is the Star Rating system, which allows older people and their families to make informed decisions about their care. Where that care is not meeting community expectations, we’ve got the Aged Care Safety and Quality Commissioner who can always step in to try and support families where their expectations are not being met.
GEARIN: Sam Rae, thank you. We understand how difficult this sector is and we really appreciate you coming onto the show to talk through all of it. But I must reflect to you the nature of some of the texts coming through to me, that is saying that you're telling people what they already know, you're talking about the system and the benefits of it so far. But all day we've been hearing about that it's just not good enough. It's too onerous. It's not up to scratch. It is leaving people in distress. People will be wanting to hear from you that the system is a bit broken and want to hear some ideas about how you're going to reform it that comfort them beyond what they're trying to find out about the 1st of November. What can you tell them?
RAE: I apologise if I haven't been clear about that. I thought that I was at the front end of this conversation. I acknowledge that this system has not met community expectations over a period of time. I think, again, we saw the Royal Commission reveal a whole host of information and experiences that were very, very distressing at the worst end of the spectrum. Since that time, we have had a prolonged period of developing reform, which culminated, as I said, on that multi-partisan basis with the Aged Care Act and the adjustments for Support at Home. They'll come into effect on the 1st of November. We've already seen significant steps forward. I don't pretend for a second that this system is working to the standard that we would all like it to be. We're not there yet. We've seen improvements. We've seen that we've mandated 24/7 registered nursing. We now have registered nurses in our residential aged care homes 99 per cent of the time. We've funded more hands-on care for over 250,000 older people in aged care homes. We've delivered higher wages. The Federal Government has invested $17.7 billion in higher wages for aged care workers. We're starting to see the results of these things. We now know that 74 per cent of aged care homes have an overall Star Rating, to go to your Star Rating question, of 4 or 5 stars. That's a 36 per cent increase since Star Ratings began in 2022. We're seeing the effects of these investments. They won't happen overnight. And I don't want to be dishonest with our community about that. This is a long-term reform process.
GEARIN: I'm wanting to reflect again that the text messages, in the face of the emotional testimony that we've heard from so many – hundreds – of people today, that the statistics that you are saying may well be factual, but they're not landing with people. Can I just ask you one last question? These reforms that were put off from tomorrow now to the 1st of November were put off because providers weren't ready. If providers are saying again that it's not ready by November, will they be delayed again?
RAE: No, we will not be delaying the implementation of the Act again or the introduction of Support at Home.
GEARIN: No matter what?
RAE: No, we're going to stick to the 1 November timeline. As I said, I spent the first weeks doing a lot of listening, working with older people, working with their families, listening to workers. There are a range of reasons why delaying the Act was the right thing to do. It was a really difficult decision, particularly for a new Minister coming into the portfolio, but it was the right thing to do.
GEARIN: But you're ruling it out happening again?
RAE: We're working tirelessly to make sure that the implementation on the 1st of November is as smooth as possible, and we will be implementing the new Act and the Support at Home arrangements on the 1st of November.
GEARIN: Sam Rae, thank you very much for your time.