RAF EPSTEIN, HOST: Sam Rae joins you. He's the Aged Care Minister and the MP for the western suburb seat of Hawke. Good morning.
SAM RAE, MINISTER FOR AGED CARE AND SENIORS: Good morning, Raf. Thanks for having me.
HOST: Some older Australians right now are paying for showers. Did you get that wrong?
RAE: Well, as we said from the beginning of this generational reform program, Raf, we would listen to older people and we'd respond to their experiences. And of course, this new Support at Home program began just in November. And I have been listening to older people, I've been listening to their families as well as the amazing carers who look after them, and what's clear is that we need to make a change. We need to ensure that showering, dressing and continence care are considered clinical care, and that's what we'll be doing from October
HOST: Why didn't you do that first up?
RAE: The original program was designed based on expert advice, but we need to be really clear about this, Raf, and you alluded to this in your introduction. Our aged care system costs the taxpayer about $40 billion a year, and demand for aged care is growing very, very fast as we see baby boomers entering the aged care system. So we need to make sure that the aged care system is sustainable so that it can serve generations of Australians to come. That's what these means-tested co-payments were about when we introduced the new Support at Home program – matters that were considered clinical care are not subject to these co-payments, and thus the government pays the full cost of them. We're now making this change to ensure that these items, showering, dressing and continence care are considered clinical care.
HOST: When do you listen to the experts and when do you listen to people's experiences?
RAE: Well, I think you've got to balance both, Raf. I think people play different roles in terms of policy shaping.
HOST: I'm going to interrupt – when you say balance both, I started the interview by asking you if you got it wrong. Did you?
RAE: I think this is about listening to people. There have always been people with differing views about this issue. And so we balanced the decision making and the policy design based on what we were being told and the advice that we were being given. But again, I have been really clear, this is a huge reform program. It is going to require refinement ongoing. And this is one such example where we've had advice from older people based on their experiences of the program to date, and we're making the changes that they say they need.
HOST: Will there be more refinements? I mean, are you open to other changes about other co-payments?
RAE: We are open to any refinements. I am actively having conversations all the time with older people and their families and carers, as well as with the policy makers across Government, to understand how we can get the best possible outcomes for older people. Minister Butler is going to stand up at the National Press Club today, and he's going to make some announcements in regards to aged care amongst other things. And we'll have more to say ahead of the budget in May.
HOST: Okay, the obvious thing to ask you as Aged Care Minister, especially on Drive but across the ABC, this conversation about the algorithm that determines a person's eligibility for in-home care. If you're always open to refinements, are you going to change the way the algorithm works? Are assessors going to be able to override the algorithm?
RAE: Well, again, what you're referring to there, Raf, is the Integrated Assessment Tool. And that which is referred to as you have is actually the automated component, which is the application of the aged care rules. Let me just explain how the system works really clearly. The assessment is a clinical assessment. It's always done by a person. Every single assessment is done by a person. The data from that clinical assessment is then entered into the Integrated Assessment Tool, and there's an automated application of the aged care rules so that they are fairly applied to everybody. But I am absolutely looking at the Integrated Assessment Tool and giving consideration to any improvements that we can find to make sure that we do have a dignified and sustainable aged care system here in Australia.
HOST: The person who does the assessment can't override the algorithm, but let's put that to the side because that's about how the system works. I'm more interested in the government's intentions. I read your comments as, yes, we are open to changes. Is that the right way to think about the way that algorithm interacts with the assessor? You are open to change?
RAE: Yes, Raf, it’s the right way to read everything that I’m doing in this space. I’m open to any refinements that get a better system for older people. Now, as I’ve said, the system has to be sustainable. A $40 billion system has to be sustainable for Australians, but at the same time we need to make sure that we’re getting high quality, dignified care for older people as well.
HOST: Is the Government listening, or is the government only listening when people are screaming?
RAE: Well, I think the government is listening all the time, and I certainly commit myself to that as I have since I took on this role. Again, there are different views across the community…
HOST: You understand my question, right? Everyone wants governments and politicians to be responsive. Some people might feel they only get a response if they make an inordinately large amount of noise. Is that a fair way to characterise the way your Government responds?
RAE: No. Raf, if you go to any pub in Australia, you'll have six different views put by seven different people around the bar. The reality is there are different views about the best approaches that the Government can take. And so our responsibility is to listen to people, to take the best advice, to consider the circumstances and the trade-offs before us, and to always act in the national interest. That's what this Prime Minister does, and that's what we, as representatives of the Government, always have to focus on.
HOST: Sam Rae’s the Aged Care Minister. 1300 222 774 is the phone number. Are older Australians effectively paying more? Because more broadly, the co-payments are still there. Are older Australians paying more because you failed to rein in costs on things like the NDIS?
RAE: Well, we've seen growth in terms of the cost of the NDIS grow very rapidly. Let's be really clear. The NDIS was created by Labor. We will always fight to protect it, Raf. But the stewardship of the NDIS under the previous Liberal government was very, very poor. We saw cost growth under that government get out to about 22 per cent. Our Government has reigned that cost growth into 10 per cent in the four odd years that we've been in government. And Minister Butler's made clear that he's ambitious about further cost growth reductions, and he's going to outline that in more detail in his address today at the National Press Club.
HOST: You could fund it by taxing gas more.
RAE: There are always a range of options for government to consider and they all have trade-offs, Raf There are no easy decisions. All the easy decisions have been made. So it's just difficult ones that we've got left and we've got to make those trade-off decisions along the way.
HOST: This text from Barbara: Spare us, Raf. We do nothing about the money in gas, but we send elderly and disabled people on a guilt trip along with their carers about the basics like showering, what a disgrace. That's from Barbara. What would you say to her?
RAE: I'm sorry, Barbara, it feels that way. As I said, when it comes to the aged care system, we've got a $40 billion system. It's a very extensive system and it serves a lot of people. We've got roughly well over a million people across the whole system, 830,000 people receiving services under CHSP, the Commonwealth Home Support Program. We've got 200,000 people in residential aged care and our new Support at Home program is designed to meet the needs of people moving forward. We've got about 370,000 people receiving packages under the current Support at Home program. But these systems need to be sustainable and they need to balance that sustainability while ensuring that we provide older people with dignity in those latter years.
HOST: Do you think Australia taxes our gas exports enough?
RAE: Raf, I think you probably know this, that when you take on a role like I've taken on, it comes with great privileges in terms of being part of these public policy conversations, but it also bears with it some responsibility. The Government will go through the Budget decision and the Treasurer will lead that alongside the Prime Minister. I'll leave it for the Treasurer to make our Budget announcements ahead of time.
HOST: Okay, let me end on this maybe. You've talked a lot about listening. What's the Government learned from older people having these experiences with showering and the co-payments?
RAE: Raf, I learn every single day and I spend a lot of time with older people and with their families and of course with the workers that work in this space who are extraordinary people. It's one of the great privileges of my job to get so much time with those people. There are different views about a whole range of matters from policy development through to football prospects but I listen and I learn. I continue to do that. As I said, it's a great privilege as part of this role.
HOST: Thank you for your time this morning.
RAE: Thank you, Raf.