SALLY SARA, HOST: Returning to federal politics, and the government is expected to announce changes to the Support at Home aged care program today. The Government has now decided to dump a controversial co-payment from October, which saw some people paying $50 an hour for basic support such as showering, dressing and continence care. Sam Rae is the Minister for Aged Care and Seniors, and joins me in our Parliament House studio. Minister, welcome back to Breakfast.
SAM RAE, MINISTER FOR AGED CARE AND SENIORS: Good morning, Sally. Thanks for having me.
HOST: Why is the government changing policy here?
RAE: Well, we’ve always said through this generational reform process that we’d listen to older people and we’d respond to their experiences. And since November when this was implemented, I’ve been listening to older people, I’ve been listening to their families, as well as the amazing people that provide the care. And what they’ve made clear is that they want showering and dressing, and continence management care, considered clinical care and therefore not subject to the means-tested co-payments, and that’s the change that we’re making.
HOST: There were very loud and well informed and persistent voices before this change was made. Why wasn't the Government listening adequately then?
RAE: Well, there have been different views on either side of this, and of course the Government took the advice of experts through the design process. We’ve got a..
HOST: Did the experts get it wrong?
RAE: We've got a $40 billion aged care system, Sally, and it needs to be sustainable for generations to come. And that's what this reform process has been about. It's why we have implemented means-tested co-payments for some forms of non-clinical care. But as I said, we've made clear that we'll continue to listen, particularly to older people and their carers. And in this case, we're making the change that older people have made clear they want.
HOST: You've said that showering, dressing and continence aren't optional extras, but are the basics of ageing with dignity. What was your view in November?
RAE: Well, as I said, we took the advice of the experts in the designing of the system. But I always said we needed to listen to older people and we needed to respond to their experiences. And that's what this is about, responding to people's experience of the system. They've made clear that the current settings aren't right, and so we're moving that showering, the dressing, the continence care into the clinical care part of the system.
HOST: So did the experts get it wrong here?
RAE: As I said, there were different views that were being put forward through the policy design process in the last parliament, and this is about responding to the advice that we're getting from older people.
HOST: These changes came into effect in October. Some older Australians have had to pay for showering and continence care since November. Will these people be reimbursed?
RAE: The changes came in on 1 November, of course, with the new Aged Care Act. The new Support at Home program began at that stage as well. The decision that we've made is that from October, these changes will be put into effect so that the co-payments will no longer apply to these types of care which we are now classing as clinical care.
HOST: So returning to the question, those people who have already paid some of these co-payments, will they be reimbursed?
RAE: As I said, this will be implemented from October forthcoming. So there's not a proposal around reimbursement. This is about making sure that the settings are right moving forward.
HOST: Why aren't they being reimbursed if the Government got it wrong?
RAE: As I said, this is about responding to the experiences of people. I’m not really going to get into the discussion around the commentary of this, of the rights and the wrongs.
HOST: But this isn't commentary, this is the people who have paid for things like showering and continence care. The Government's now realised or recognised that that wasn't right, that shouldn't have happened. So they're going to be left out of pocket, will they?
RAE: What the Government's recognised is that older people want to see these types of care classed as clinical care. That's the change that we're making. As I said, a $40 billion system needs to be sustainable, Sally. We can't be in a situation where we're making a promise to the people of Australia about the dignity that they'll receive through the aged care system. If we can't deliver on it and we can't keep it sustainable. That's what these changes are about.
HOST: So the Government got this wrong. People have had to go into their own pockets to pay for some of this care, but they won't be reimbursed.
RAE: Again, there are means-tested co-contributions associated with non-clinical care. That's what you're referring to here.
HOST: No, I'm referring to those who were paying for things like continence care, showering, dressing. They won't be reimbursed.
RAE: Well, up until now, they have not been considered clinical care. The change that we're making is that they will now be considered from October clinical care, and from that point, there won't be co-contributions associated with it. The Government will fund the full cost of those cares.
HOST: When did you start discussing this potential change to the policy?
RAE: Well, from the day that this this began, we have been taking advice from older people and from carers, and I have stayed in touch with people to understand what their experiences of this are. And through that process, obviously, kept an open mind about what changes needed to be made. I've made that very clear that we'll take whatever actions we deem necessary to get the best outcomes for older people.
HOST: Are the experts being thrown under the bus here?
RAE: There's no point in throwing anyone under the bus here, Sally, and certainly not the experts. There have been a group of people across the sector, the advocates in terms of consumer advocates, the workers and the workforce representatives, people who've been working extremely hard all the way through this generational reform process. We need to just take a step back. Under the last government, we had a Royal Commission into Aged Care that was damning in terms of its findings. And these reforms have responded to the recommendations of both the Royal Commission as well as the taskforce that was set up in order to get better outcomes for older people. This is a once in a generation reform. There will be further refinements that will need to happen ongoing. This is the priority now, which is why we're responding.
HOST: Was this the Prime Minister's decision to reverse this?
RAE: The Prime Minister is absolutely part of this decision. He leads a government where we make careful and considered decisions that are in the national interest, and so he has been a key driver of identifying this challenge and understanding older people's experiences and helping us to respond to it.
HOST: Did you take this back down to the Prime Minister, or did the Prime Minister tell you to change this?
RAE: As I said, this is a Cabinet-Government that the Prime Minister leads. We make these decisions together.
HOST: Did you submit to Cabinet that there should be a change here?
RAE: I don't want to go through the budget process. But yes, my role, along with Minister Butler who is the Cabinet Minister- I'm not a member of the Cabinet, but Minister Butler's role alongside me is to take submissions to the Budget process, and this was one of the submissions that we took to the Budget process.
HOST: You're still a relatively newly minted Minister. What have you learnt from this?
RAE: I learn new things every day Sally. But I can't enough – my focus is on getting the best outcomes for older people. That's what this decision is about. That's my focus every single day. We've received fantastic advice from older people, their advocates, their families and of course the workers that care for them. We'll continue to listen and we'll continue to make refinements wherever we can see opportunities for improvements to the experience of older people.
HOST: Sam Rae, thank you very much for joining me in the studio this morning.
RAE: Thank you, Sally.