RAFAEL EPSTEIN, HOST: Sam Rae, good morning.
SAM RAE, MINISTER FOR AGED CARE AND SENIORS: Good morning, Raf. How are you?
EPSTEIN: Why don’t we start with who’s paying extra? What sort of assets or income do you need to be assessed as paying more?
RAE: Raf, as of Saturday, two days away, as you know, we are heralding the most substantial reforms, these are generational reforms to Australia's aged care sector. And as you rightly point out, they are a long time coming. They include a statement of rights, which will come into effect for the first time in our country. Older people will have a set of rights legally enshrined under which their care must be delivered. But we know, and you and I have discussed this previously, that we have a significant challenge in that we have an ageing population and so demand for aged care services has been growing.
As well as that, we had the harrowing stories that came out of the Royal Commission that led all of us to the conclusion that generational reform was absolutely necessary in order to make sure that every older person across our country could get safe, dignified and high quality aged care. In order for that to happen, our aged care services must be sustainable.
In the home care space - and as of Saturday, there's substantial reforms there because we begin our Support at Home program - we have seen costs for home care grow by 800 per cent over the last decade. And so you're right, as of this weekend, there will be changes because under Support at Home, for those people who are new coming into the program since September 2024 - people previous to that will have their financial arrangements grandfathered, but people newer to the program where they are able to make a contribution, they will be asked to do so.
EPSTEIN: I read that the threshold is essentially a pensioner with an income above $34,000 and also assets, which I assume is bank account, of more than $60,000. Is that roughly it? You start paying more if you're a pensioner with an income above $34,000, and you've got more than $60,000 in the bank. Is that roughly the point above which you begin to pay more?
RAE: Well, every single individual has a means test that is personalised to them. So it's not particularly helpful to generalise it in those terms. And there's a very sophisticated process between the aged care system and the Services Australia systems to means test every person who is receiving these services. We want everyone to be able to access the very best aged care services. The Government continues to pay 100 per cent of clinical care costs. We will always do that. And that's in both the home care space as well as the residential care space.
EPSTEIN: Why don't we focus on that word then? Look, I think there are fee estimators on Government websites so I'll send people there, and Richelle Hunt's going to go through of that in detail after 11. But let's focus on clinical and not clinical. Is showering clinical or not clinical?
RAE: Well, there are three categories that the expert process for determining the service list has put together. Clinical care is care that is delivered by a nurse or a practitioner with university qualifications. It either has to be delivered or overseen by that. That's the definition of clinical care. So clinical care, as I said, is still met 100 per cent by the federal Government. No one's asked to make- nobody, absolutely nobody is asked to make a co-contribution on the basis of clinical care. Showering sits in the independence category, which is the next category. And for a full pensioner who enters the home care system after September 2024, they will be asked to make a 5 per cent co-contribution to the independence category of services. However, we have some very strict safeguards in place, including very robust hardship provisions. So if people are unable to make their co-contributions, it won't interrupt their care. They will continue to receive their care and those hardship provisions will come into place to ensure that they are no worse off.
EPSTEIN: But getting help to wash, that's essential. It might not be clinical, but it's essential. What is your- and I get it, right, you're saying this is all supposed to make the whole system sustainable. So what do you say to the person who doesn't have much but is paying more to get help with something that is essential, like just help to wash each day?
RAE: I agree. It's incredibly important. There is no doubt about that. And we'll be monitoring very closely the clinical outcomes as we enter this new system. But the experts tell us that this is an appropriate service list and that these are appropriate co-contribution rates to get the very best outcomes for older people.
EPSTEIN: Are you saying there- I love a bit of Government flexibility, but are you saying that it's possible people might not have to pay for showering in the future if the system looks like showing a whole lot of people have an adverse income?
RAE: I'm not going to go into the maybes and the possibilities of the future. I think that's unhelpful. What we're doing at the moment is introducing the most sophisticated home care system for the most people that we've ever been able to provide care for, Raf. This is about making sure that every older person across our country can access these very quality services that has to be done sustainably. And I think the important language here that everyone needs to understand is that where people have the means to make a contribution, we are asking them to do so. And obviously, where they don't have the means to do that, they will still receive care.
EPSTEIN: I do want to leave time to get into the pretty long waiting list for aged care in the home. Sam Rae is with us, the Aged Care Minister. Sant has a question calling from Mount Waverley. Go for it, Sant. The Minister's listening. What's your query?
CALLER: Good morning and thank you for taking the question. I have been providing services to Home Care Package clients. Previously for a service, the client sometimes pays nothing. With Support at Home, as you said, the client has to pay something. Now, the system's made so complicated that [the] client has to make his contribution to the provider. And every dollar that goes through the provider, provider charges a commission. So client has less to spend. And secondly, the new contracts coming through are 60 pages long. And the provider wants direct debit sets with the client and with me. How come an 80-year-old people with pension only can first- you know…
EPSTEIN: I'm going to cut you off there, Sant, because I want to get an answer on the 60 pages and on the commission as well. But Sant, you're raising great points. Let's start with the complexity, Minister. 60 pages? That's tough for anyone, isn't it?
RAE: I think there is probably some interest at play here. Most home care services are currently delivered under a contractual basis between the older person or their representative and a service provider. They are predominantly provided under contractual arrangements already. And the contract is there between the two parties to protect the interests of the older person. And as I said, as of Saturday, there will be additional obligations on the providers.
EPSTEIN: Is it too complex, though?
RAE: Well, hang on a second. There will be additional obligations on the providers in order to fulfil their responsibilities to the rights of older people. Now, business owners will tell us across any sectors of the economy, Raf, that their administrative obligations are too high. We went through a Royal Commission where we heard the most harrowing stories of the way that people were being treated in care because of lack of regulatory oversight or lack of response from providers. So with the greatest respect to all providers, and I believe that we have a sector that is significantly improved and indeed working very hard to deliver the best care that they can. But I am unsympathetic when it comes to providers who want to deregulate a sector when that regulation is in place to make older people safer.
EPSTEIN: What about the commissions? I want to get to another call, Minister, but with the commission, a lot of people saying more money in the system, the people providing the services aren't getting more money and people are getting less services.
RAE: Well, I respectfully disagree. Although I do agree that it is a complex system and through this reform process, Raf, we have tried to reduce some of that complexity. Some of the things that we've done is that we have put caps on the administration costs that providers can charge. And there are concerns across providers about this, but we are capping the administration costs because too much of people's care packages was being deployed for administration.
Now, we have published, or rather the independent pricing authority has published a pricing list for services that both providers and older people can access to understand what appropriate prices look like. Providers are now required to publish their prices as well publicly. And from July next year, the independent pricing authority will put in place price caps on services that are delivered to make sure that older people are paying the right price for the services they're getting.
EPSTEIN: Aged Care Minister Sam Rae is taking your questions. I want to get onto that queue. Sarah's calling from Clifton Hill. What do you want to ask, Sarah?
CALLER: Just intrigued to know if you've got elderly parents who refuse to go onto a plan, but suddenly have both had a crisis, both had a stroke. Are they triaged in the system over other people who've been waiting a long time if they’re in a more acute situation?
EPSTEIN: Great question. Sam Rae?
RAE: It is a great question, and Sarah, it sounds like as if you’re facing some significant challenges and my heart goes out to you in that regard. There is a process through the assessment of older people. Every person who comes into the aged care system goes through a clinical assessment process.
EPSTEIN: It was taking too long all year. Has that improved?
RAE: It’s down well under a month for clinical assessments at the moment on average, Raf. And under our new single assessment system which has only been in place for the last six months, we’ve seen continuing reductions in wait times for assessments.
EPSTEIN: I reckon I can fill an hour or two hours with people who are waiting longer than a month.
RAE: Well, I can tell you that the official audited data shows that the average wait time is under a month for a clinical assessment. And anyone who is assessed as high priority, and those circumstances to which Sarah refers, might fall under those circumstances. That’s a clinical process, so I’m not going to pre-judge what the clinicians might determine. But anyone who was assessed as high priority receives a home care package within a month. Every single person across the country. They receive their home care package within a month. It is the medium priority assessments where we’ve seen the longer wait times, which have been a great frustration for people, and great frustration for me personally. While I do want high priority people to get their packages quickly, I do want to see those medium priority, they’re still important. They are very, very important...
EPSTEIN: I have to leave it there, Minister, because of the news, but thank you for joining us.
RAE: Thank you very much, Raf.
EPSTEIN: Sam Rae, the Aged Care Minister.