HAMISH MACDONALD, HOST: The Federal Government is facing growing pressure over delays to 80,000 Home Care Packages promised to older Australians in the lead up to the federal election. The introduction of these packages has been pushed back to 1 November and it seems to have left some Sydneysiders waiting for vital supports and services. We've been covering this story in recent weeks, hearing some harrowing accounts from people left in desperate situations. A Senate inquiry will begin next week looking into the human cost of all of this, and we've been pursuing answers from the Federal Government for time.
Sam Rae
is the Minister for Aged Care. Very good morning to you.
SAM RAE,
MINISTER FOR AGED CARE AND SENIORS: Good morning Hamish, thanks for having me on.
MACDONALD: We'll get to all of these issues around the Home Care Packages.
Just want to ask you about the changes to the NDIS announced yesterday. A lot
of very concerned parents here in Sydney this morning. A lot of people with
kids in the system worried about what this might mean for them. Can you offer
an assurance? Can you tell them exactly how things will change when these
changes are brought in?
RAE: Well, this is a very important announcement, Hamish, and it's
about ensuring that the NDIS is sustainable into the future. It's obviously a
world-leading institution in terms of the support it provides for people living
in our community with disability, but we know that it has been put under
sustainability pressure. So the announcement yesterday was that the government
will work on the Thriving Kids program. This is a program designed to support
kids with mild and moderate level autism and it's about making sure that they
have the support in the community that they need so that they're not forced
into the NDIS system, that there are existing supports in the community that
can be delivered through existing health and support programs. We'll work
closely with the state and territory governments as well, and the school
setting is important as part of that discussion.
MACDONALD: Can people expect the same standard of support and service,
though?
RAE: I believe they will actually see a significant improvement,
Hamish, and I think for many families with lived experience of supporting their
own children with these mild and moderate level autism symptoms, actually
having a community-based approach to delivering supports is both better for
kids, and it's more equitable across the community as well. So I think there's
always value in finding, for example, school-based options for supporting kids
that are facing challenges rather than taking them out of that school
environment for their therapy.
MACDONALD: Sam Rae is the Aged Care Minister. Sam, we've been reporting on
the story of Kathy and Alan Whelan for some weeks now. This is Kathy when she
first called in to us a few weeks ago.
[Excerpt]
CALLER
KATHY: His situation is he's got a
progressive neurodegenerative disease, and I've been looking after him at home
for many years. I applied to get an assessment in 2023 for a Home Care Package.
It took 12 months for the assessment to ‘24. We're still waiting for a ramp.
He's in a wheelchair and it's just really, really hard.
[End of
excerpt]
MACDONALD: So Kathy's husband had that assessment November last year. They
were approved for a Level 4 medium priority Home Care Package. The implication
of that medium priority designation seems to be that they've been left without
things like the ramp. Do you think that's adequate? Is that acceptable in your
view?
RAE: Well, Hamish, first of all, let's just acknowledge, I mean,
these are really distressing stories, and they're distressing for everybody
across the community. I know you've got your own lived experience of this, and
I think we just need to firstly acknowledge that we don't want to hear of any
people, any families facing these sort of challenges. The Royal Commission into
Aged Care was named with just one word, which was neglect. We know that our
aged care system hasn't been meeting community expectations, and we know that
it needs a complete overhaul. And I was really distressed to hear of Kathy's
story and I've been following the case and discussing it with the department. I
understand there is now a pathway to resolution. I won't go into Kathy's- or rather
Alan's personal details around that, but I understand there's a pathway to
resolution and I would say that wherever ...
MACDONALD: But the question is whether that's adequate. Someone that
clearly needs to be able to get in and out of the home, needs a ramp to be able
to do so, receives a categorisation that means that this package is not
delivered urgently. Is that, in your view as the Minister, is that adequate?
RAE: Absolutely not, Hamish, and that's why we are overhauling the
way that we deliver in-home care. So the Home Care Packages program on 1
November will be changed substantially into the Support at Home program where
we get to- this is not a mild update. This is not a modest change, this is a
complete overhauling of the way that we deliver in-home care so that we can
deliver better care for people and more care for people. I think one of the
things that we have to understand about in-home care, it's critically
important. And older people across the country are telling us that they want to
stay in their homes for longer and they want to receive appropriate care. The
growth in in-home care has been very, very substantial. Ten years ago …
MACDONALD: [Talks over] So what would be a reasonable period of time for
someone waiting now to expect to have to wait for the Home Care Package to be
delivered once they've been assessed? Because I think, having covered this
story now for a few weeks, it seems like there's a lot of people here in Sydney
that are waiting. They've had their approval, they've had their assessment,
their approval. They don't really know when they're actually going to get
access to these services or supports.
RAE: Well, as I was just saying, what we've seen is really
significant growth. So in the last 10 years, we've gone from the Federal
Government spending a billion dollars on in-home care to $8 billion in in-home
care. And just in the last five years, we've gone from 150,000 people accessing
in-home care to over 300,000 people. So the growth in this program has been
very substantial. And in some ways, that's a good thing, in that older people
tell us they want this in-home care, and I think it's about creating a
sustainable set of options for aged care as people are ageing in our community.
But as you point out, the system hasn't been working. It really hasn't been
meeting community expectations and it hasn't necessarily been meeting people's
clinical care needs. So this is why we're completely overhauling it at the
moment …
MACDONALD:
OK. But will Alan and Kathy get a
ramp? Like this family needs to get in and out of the home. He's fallen into
the garden a bunch of times, we heard from Kathy. I mean, they're going to have
to wait until November to get a permanent ramp installed. At the moment, the
local men's shed's helping out. But are you going to provide that for
them?
RAE: Well, and I think that was a lovely offer from the local men's
shed, let me say. But there's been contact- again, I want to be respectful of
Alan and Kathy's privacy here.
MACDONALD:
Sure.
RAE: But there's been contact throughout the week. And I do the role
that you've played in highlighting some of these cases. And I've been following
up on them personally. So my understanding is that Alan is booked for an
assessment next week and the ramp has been approved for installation. So I
don't want to go into any greater detail than that about them specifically. But
the reality is we know that people are waiting for their home care. We're
releasing packages every single week at the moment. And as you allude to, what
I think is a really important point, anyone who is assessed as high priority is
receiving their package within a month. Now, when we get to 1 November we're
going to be injecting an additional 80,000 packages, in fact, more than 80,000 packages,
into system just in the first 12 months of Support at Home to try and meet this
rapidly increasing demand as our population ages.
MACDONALD:
So when you're talking about
those 80,000, the promise was that they would come into effect from 1 July.
It's now been delayed to 1 November because of the delay to the implementation
of the new Aged Care Act. But a lot of people in the sector particularly seem a
bit surprised that the Home Care Packages have been caught up in those delays.
Is it necessary for those Home Care Packages to wait until November, given that
those have effectively already been allocated in the sense that people have been
accepted as in need of a Home Care Package?
RAE: Well, respectfully, Hamish, the promise was that we would
implement a new Aged Care Act, an overhaul of the aged care system. And, in
fact, the last act was passed through the Parliament in 1997. In 1997, I was in
Year 5. So this is a really substantial overhaul, and the reality is it is
overdue. There is no doubt about that. Now, the Support at Home piece that
accompanies the Act has to come in with the implementation of the new Act. Now,
as soon as I became Minister a few months ago, I put my ear to the ground. I
spent a lot of time talking to older people in our community and their
families. I spoke to providers. I spoke to workers. I spoke to people all
across the sector about what the implementation timeline looked like and the
overwhelming response that I got, both through private conversations, and if
you look through the public commentary that organisations, advocates and people
made, was that there needed to be a brief deferral. It was a really hard
decision to make that deferral decision, but it was a really important one
because I didn't have confidence that we were going to have continuity of care
for older people if we brought it in on 1 July. So we've got this brief
deferral [indistinct] …
MACDONALD:
Respectfully, Minister, as I
understand it, related to the broader changes as part of the Aged Care Act, not
necessarily to do with the delivery of Home Care Packages. I want to play a bit
of Senator David Pocock, who we spoke to yesterday, talking about the impact of
these delays.
[Excerpt]
DAVID
POCOCK: This is not working for
older Australians and I just don't understand why they're leaving so many
people stranded like this. There's a real human cost. More people in our
hospitals, more people in residential care and more people dying.
[End of
excerpt]
MACDONALD:
That was Senator David Pocock.
How do you respond to that? Do you acknowledge there's a human cost to this
delay?
RAE: Can I just say a couple of things about this? Firstly,
politicians who are seeking to weaponise this for their own political purposes
are not helping older people in our community at all. And I find that approach
very disappointing. There is a legislative relationship. In the legislation,
the reforms are tied to Support at Home. And so the legislators in the
parliament, of which I am one and of which Senator Pocock is another, could
quite clearly see when we voted for the legislation that moved through the parliament
in the last term that the two were dependent on each other. So to try and
re-architect history is very unhelpful for older people in our community and
it's misleading …
MACDONALD: But- you seem to be suggesting that …
RAE: … the reality is we need a new age count, a rights-based act,
and that will herald the opportunity bring in the Support at Home changes and
the additional growth component that comes with it.
MACDONALD: We understand the practical realities of this, of course, but
you seem to be saying that it's older Australians and the sector that's saying
to you it needs to be delayed. We also heard from Margaret, a home care worker,
who told us this.
[Excerpt]
CALLER
MARGARET: We're a very small
provider in southwest Sydney. We can take on an extra 20, 25, 30 packages
tomorrow, but there's just not the assignment of packages that is coming
through the system.
[End of
excerpt]
MACDONALD: Do you acknowledge that actually more people could be being
helped right now if you were to release some of these 80,000 Home Care
Packages? I know there was a call for you to release 20,000 of them and you
said no.
RAE: These aren't the same systems, Hamish, and I acknowledge that in
some cases, in some places, there are greater need and what we're doing is
continuing to release packages every single week. I think this is an important
point. I just want to dwell on this for a second. We are releasing packages
every single week. Everyone …
MACDONALD:
How many are available to be
released before November 1? Could you be specific?
RAE: Well, the important thing from November 1 is there are 80,000
new packages …
MACDONALD:
Understood. How many can you
release between now and November 1, just to be honest and upfront with the
community?
RAE: Well, that depends on a range of factors. It's not as simple as
just putting a number up, but let me give you an example. So since the aged
care reforms were announced in September 2024, so that's effectively the period
that most people are talking about here. We announced that we're going to go
through the reform process. We announced the Support at Home changes. There’s
been a total of a hundred …
MACDONALD: Understood. Do you know how many packages you've got that you
can release between now and November 1, just to be upfront with the community?
RAE: I'm being very upfront, Hamish. We've released a total of
133,000 Home Care Packages since September 24, and we're releasing them at an
average of about 2700 a week. Now, that's ongoing at the moment. So I don't
want to put an exact number on it, but that's the average and I don't expect
the average to change over the period between now and November particularly. So
we're releasing above 2000 packages on a weekly basis and we're ensuring that
anyone that is assessed as high priority gets their package within a month.
I don't
want to be obtuse here, Hamish. I am not saying that this system is working the
way that I want it to work, and that's why we are doing these substantial
reforms. This is a really serious piece of reform. It is about making sure that
we have a system that is fit for purpose moving forward. It's not meeting
community expectations. It's not meeting my expectations. And I want us to get
to a point where we are delivering both home care and residential aged care
that meets the needs of our community. That's my focus every single day.
MACDONALD: Sam Rae, really appreciate you turning up to answer some
questions. Have a good day.
RAE: Thank you, Hamish.