ANDREW CLENNELL, HOST: Joining me now is the Aged Care Minister, Sam Rae. Sam Rae, thanks for your patience and your time. The Government's aged care reforms are in place, and they do everything from give a Statement of Rights to older people to promise to provide more home care places. But there is a sting – people will pay more for their home care and aged care providers will be able to deduct some of the refundable accommodation bond principal for the stay of those in aged care. Take us through these changes.
SAM RAE, MINISTER FOR AGED CARE AND SENIORS: Good morning, Andrew. Yesterday was a really important day for older people and for their families. Of course, the new Aged Care Act began. It's the first substantial update to the aged care legislation since 1997. I don't know what you were doing, I was in Year 5 at Fadden Primary School. So older people and the people that love them, such as us, have waited a long time for these changes. And you're right, we've seen demand growing very substantially for in-home care services. In fact, it's roughly doubled in the last five years. And we want every Australian to be able to access safe, dignified and high-quality aged care services, and that's what these changes are all about.
CLENNELL: But they're about charging people more too, aren't they?
RAE: Well, I think we need to look at the two major parts of care that is provided to older people. We've got in-home care, and yesterday our new Support at Home program began. And everybody who was receiving home care before September 2024 has their financial arrangements grandparented - that is, they won't be subject to any future co-payment arrangements. But people who have joined since September 2024, where they have the means to do so, are being asked to make a co-contribution, a modest co-contribution, with very strict guardrails in place so that there is no interruption to the continuity of care for older people.
CLENNELL: Can you give us an example of one those co-contributions?
RAE: Yeah, of course, so the Government will continue to pay 100 per cent of all clinical care costs, and that's very important. Every single piece of clinical care that's provided to an older person, the Government will pay 100 per cent of the costs. For a full pensioner, when it comes to independence care, that's the type of care that they traditionally have been able to provide for themselves or perhaps paid for themselves around the home, we will be asking full pensioners to make a contribution of 5 per cent to independence care. These are changes that are designed to make sure that the system is sustainable and accessible for every older person as our population ages.
CLENNELL: Now, you've come under real attack from state governments around the number of people that are stuck in hospital waiting for an aged care bed. In New South Wales there was a story recently – there was 1151 aged care and NDIS recipients in New South Wales public hospitals at the beginning of this month who had exceeded their expected rate of discharge – an increase, or should I say last month, an increase of more than 60 per cent in one year. So we have some concerns here, don't we?
RAE: Andrew, this is a long-standing and very complex public policy challenge. We're working really closely with the state and territory governments on this. We know that we've seen underinvestment in the residential aged care sector over the last decade as compared with that which our ageing population requires. And frankly, the significant cuts that the Scott Morrison government made in the aged care space have hampered the growth of the sector in order to respond to our growing ageing population's needs. So we are playing catch up here. That said, we're working closely with the state and territory governments. There are a range of options available to us to try and reduce the impact of this issue. People who are affected by this issue often have quite complex needs and multi-layered needs, so there's not a one size fits all here. We need to get the very best outcome for the people that we're talking about, the human beings, these wonderful older people who are being affected by this issue. We also need to make sure that we have an efficient hospital system so that everybody else in our community can get the care they need when they need it.
CLENNELL: All right. While you're talking about working with the states, can you confirm the Federal Government has added to its recent offer on the five years’ funding health agreement, $2 billion, to deal specifically with aged care bed block?
RAE: I'll leave it to Mark Butler to talk about the negotiations with the state and territory governments. He's the one that is leading those negotiations. But let me be really clear – we have a unity of focus with our state and territory counterparts in dealing with this issue, and we're leaving no stone unturned. We're working through all of the various policy options. And as I said, there's not a one size fits all here.
CLENNELL: Well Sam Rae, you're not denying that $2 billion has been put on the table here, are you?
RAE: Andrew, what I'm saying is that we'll leave no stone unturned. We'll continue to work with the state and territory governments. We'll work through all of the policy options to get the best possible outcomes for older people, but also to make sure that our tertiary hospital system is fit for purpose and working for every Australian.
CLENNELL: All right. Well, let's talk about that. There was a story in the Adelaide Advertiser on 3 October that spoke of a woman in her 70s who has spent 1052 days in hospital, referred to more than 60 residential care homes with no placement offers, and a man in his 70s who'd spent 357 days in hospital, referred to more than 30 homes with no placement offers. And South Australian Health was reported to now have 377 patients in care stuck waiting for federal care places. Are you familiar with these cases? How can this be? How can an elderly woman who should be in aged care spend a thousand days in hospital?
RAE: These are very distressing stories that we hear and they concern me deeply. I don't want to speak to the specifics of those cases out of respect to the individuals, but we have been working very closely with the South Australian Government. I've met personally with the South Australian Health Minister and we follow up on the individual cases that come to light along the way. But substantially we have to deal with the issue, which is that we're seeing older people and sometimes people affected by multiple issues, including mental health issues, being caught up in the hospital system when their care would be much better delivered in residential aged care or some variant thereof. That's our focus. As I said, we want every Australian to receive safe, dignified and high-quality aged care services when and where they need them.
CLENNELL: I mean, such is the issue around health funding, NDIS and the aged care backlog in hospitals. Last week, we had state disability ministers threatening to boycott a meeting with your Ministers, Mark Butler and Jenny McAllister. That's a bit of a concern, isn't it?
RAE: That’s a matter for the state ministers. Let's be really clear, we've made substantial investments since coming to government across the whole Health portfolio. I think you mentioned earlier, yesterday began the biggest investment in Medicare in Australia's history – $8.5 billion dollar investment to ensure that every single Australian can get bulk billed and see a GP when they need to. Australians know that no one will invest in Medicare like a Labor government. Ultimately, we've seen Medicare degraded under Scott Morrison and under the Liberals, and we're finally getting the investment needed and the work done to get it back into shape to meet the needs of Australian families.
CLENNELL: You promised 20,000 extra Home Care Packages by November. Said in a press release over the past couple of days you've delivered them. So just to be clear on this, Sam Rae, are all these new Home Care Packages not replacing Home Care Packages of people who've moved into residential care or passed away? They're all new?
RAE: Yes, that's right, Andrew. So over the last weeks we've delivered 20,000 additional Home Care Packages to the more than 300,000 that were already in the system. That's part of our commitment to deliver 83,000 additional packages of care to older people across our community this financial year, and we're well on track to do that.
CLENNELL: Even if you deliver those 83,000, which you say you're on track to do, Senate Estimates was given figures last month that show at the end of September there were 121,909 older Australians on the waiting list for home care, and 116,000 waiting for an assessment. So that's more than 200,000 in terms of a shortfall of care you're able to provide. Doesn't this show the Government needs to put even more funding and more effort into this issue?
RAE: Two points here, Andrew. Firstly, those two figures can't be conflated. The assessment waitlist is a much broader waitlist. It's an assessment of someone's broader health state. Some of those people may require home care. Some won't have needs that high yet. Some will have needs higher and will be entering the residential aged care. There's also significant duplication across the two systems where people who might already be receiving in-home care are perhaps waiting on a reassessment because their circumstances have evolved. So banging the two numbers together is a sharp bit of politics but it doesn't do anything for older people, and it doesn’t further the…
CLENNELL: What do you think the number is?
RAE: The September number was right in regards to the 121,000, nearly 122,000 people waiting on the National Priority System for Home Care Package allocation. It's why the additional 83,000 packages that we're delivering this financial year are incredibly important. And I also make this point – every single person, regardless of who they are or where they are, that receives a high priority clinical assessment, receives their package of care within a single month. But there is a broader conversation to be had here, Andrew. We have an ageing population. We've seen demand for in-home care grow by 100 per cent, double in the last five years. Australians tell us they want to stay in their homes for longer, in their communities, close to family. We want to support them to do that. is a substantial challenge. It's why these reforms are so very important.
CLENNELL: You promised to fully fund the aged care pay increases of 15 per cent. There are some in the sector who are saying the money that's been budgeted for that is not sufficient. What do you say to that?
RAE: Andrew, since coming to Government, we've made an $18 billion investment in aged care wages. We've seen retention of our very highly qualified, exceptional human beings that provide that care. We've seen the retention rates for those improved substantially. We're attracting new people to the sector, excellent people to the sector. We're investing in scholarships and training. These are the most substantial investments that have ever been made in the aged care workforce.
CLENNELL: So it’s enough? So you have enough money?
RAE: We are working together with these amazing people to professionalise the industry. We've finally got wages into the zone where they should be and we're seeing the results, and the results are better care and more consistent care for older people.
CLENNELL: So briefly, you have enough budgeted for the pay rises in your view?
RAE: The Federal Government has fully funded the pay rises that have come out of the Commission. That's an $18 billion investment, and we've finally got those wages where they need to be.
CLENNELL: All right, in a decade it's estimated there will be 2 million Australians over 80, almost double what it is now. Are these reforms enough to address that? Or does there need to be more user pays, and does there need to be more Commonwealth funding for aged care?
RAE: Well, what happened yesterday is neither the beginning of the reform process nor the end of the reform process. But the new Act sets us up for the future, Andrew. It sets us up for that ageing population and the challenges that those dynamics bring. We, of course, need to see ongoing investment in the aged care sector from Government and from the private sector as well. Investability in the residential care sector is one of the next challenges that we face because we substantially need to lift the supply of residential care. But the work that has gone into this over the last number of years and the new Act which came into effect yesterday is the basis upon which we can work together with the sector, with older people, to ensure that we have a world-class aged care system that is fit for the future and will meet the needs of our ageing population.
CLENNELL: Now, we had some shocking inflation numbers during the week, meaning Australians won't get an expected rate cut this week. Much of it is fuelled by energy prices. Why is your Government so convinced that you're taking the right steps when it comes to the energy transition?
RAE: Well, let me just touch on the inflation numbers for a second there, Andrew. When Australians voted Scott Morrison and the Liberals out just over three and a half years ago, inflation was running above 6 per cent. It’s now half that…
CLENNELL: Let's talk about now, Sam Rae. I know that's the talking point with respect, but let's talk about this figure and energy prices now.
RAE: Andrew, now is informed by the context of history. When we came to Government, inflation was running above 6 per cent. It's now half that. We've had three rate three cuts this year already. Of course, the Federal Government is absolutely focused, and Jim Chalmers is absolutely focused, on keeping inflation in the target band. He's made very clear that the large driver of this recent modest rise, relatively modest rise in inflation, was driven by those power incentives, essentially the rebates from the state governments coming off. And I think you'd agree that we can't use taxpayer money outside of an inflation crunch. We can't use taxpayer money inefficiently, so that always has to be a consideration. But the reality is here inflation is in a much better space than it was three years ago.
CLENNELL: And finally, it looks like the Opposition are headed towards abandoning a net zero target. Certainly the Nationals are today. What's your reaction to that?
RAE: Andrew, these guys have rendered themselves irrelevant to this debate. Australians expect governments to be able to walk and chew gum. We've got to be able to address the issues of climate change at the same time as driving down power prices for households and business. Renewable energy is the cheapest form of new energy. It needs to be backed by the parts of our grid that still have some sustainability left in the tank, as well as firming gas. But let's be really clear, these guys don't have a plan for the future. They ran through dozens of energy policies when they were in government. They're going to continue with their little microcosm of crazy policy discussion. But we're getting on with the job of making sure that Australia has an energy system that can deliver for households, deliver for businesses and address those climate change issues into the future.
CLENNELL: Sam Rae, thanks so much for your time.
RAE: Thanks, Andrew.