Presentation on the Aged Care Taskforce report

Transcript

Department of Health and Aged Care
Aged Care Taskforce Report

Tuesday, 12 March 2024

Presented by:

Moderator:

Michael Lye – Deputy Secretary, Department of Health and Aged Care 

Speakers:
Nigel Ray – Deputy Chair, Aged Care Taskforce

Tom Symondson – CEO, Aged and Community Care Providers Association

Grant Corderoy – Partner, StewartBrown

[The visuals during this webinar are of each speaker presenting in turn via video]

Michael Lye:

Hello and welcome to our webinar this afternoon which is covering the release of the Aged Care Taskforce Report. My name’s Michael Lye. I’m the Deputy Secretary for Ageing and Aged Care at the Department of Health and Aged Care.

I’d like to start the proceedings today by acknowledging the traditional owners on the lands on which we are meeting. For me in Canberra that is the Ngunnawal people. And I pay my respects to Elders past and present. And I extend that acknowledgment and respect to any Aboriginal and Torres Strait Islander peoples who are joining us on the webinar this afternoon.

It’s my pleasure to be here today and welcome you to this presentation by members of the Aged Care Taskforce on the report they provided to Government. We’re taking this opportunity to talk to aged care providers and the wider community following the release of the Aged Care Taskforce Report. At this point I will note that this is a report to Government rather than Government policy and the Government will respond to the report once it has stakeholder feedback and time to consider.

The Taskforce was established as a time limited body to assess and provide Government with advice on aged care funding options that are sustainable, fair and equitable and help create a more vibrant and innovative sector now and into the future. So I’d like to take this opportunity first of all to introduce the Taskforce members and thank them for their efforts. Joining us today are Nigel Ray who’s the Deputy Chair of the Aged Care Taskforce, Tom Symondson from the Aged and Community Care Providers Association, and Grant Corderoy from StewartBrown.

Before I invite our first guest to speak, Nigel, I’d like to remind you all that this session will be recorded and will be available later on the Department’s website. You can ask questions by using Slido. You should see an icon on the right hand side of your screen. And we’ve allocated time for your questions after the presentations. So first of all I’d like to invite Nigel who’s going to provide a summary of the key themes from the Taskforce’s report. Thanks Nigel.

Nigel Ray:

Thank you Michael and good afternoon to everybody. And thank you for joining this webinar on what is an incredibly important topic particularly for older Australians. Let me just start by saying that the Taskforce Report outlines the key challenges for the sector starting with the simple fact that Australia needs more and better aged care. If we look at over the next 40 years Australia’s population aged 80 and over is projected to triple and within 20 years we expect an additional one million older Australians to be using aged care. And in-home care which is older Australians’ revealed preference for care is growing at a rate of 44,000 places a year at the moment.

So more funding is needed to improve accessing home care, to improve quality, to improve services that are provided and to support the long term viability of the sector, for without supporting the long term viability of the sector we will not be able to provide the sorts of care that everyone expects to be provided. And that’s sort of the basic point of the report.

So to get additional funding we expect that Government will remain the predominant funder as it is today with a focus in particular on providing care, and that where possible, that is where it’s affordable and fair, consumers could be asked to make larger co-contributions to things that they provide for throughout their adult lives such as everyday living and accommodation.

So the Taskforce has made 23 recommendations built around seven principles which we consulted on and received considerable input from the community. They fall into three groups. Supporting older people to age in place, which as I said is the strong preference of older people, equitable and sustainable funding models and ways to improve quality, innovation and transparency. Together these recommendations seek to create a sustainable, fair and equitable system now and into the future particularly in the face of increased demand.

I’m not going to go into the detail of the recommendations because my colleagues from the Taskforce will do that. But I think the main thing that I want to stress is that the Taskforce’s view is that the Government continues to be the main funder of care and an increased role for consumer contributions to fund the gap in sector viability.

The Taskforce agreed that it’s appropriate for older people to contribute to their aged care costs when they have the means to do so particularly around their everyday living and accommodation costs. There will be some markets in which mainstream funding may not be appropriate and the Taskforce recommended that in those markets continued block funding from Government would be necessary and appropriate and we also recommended that the remoteness classification should be reviewed in order to ensure that it’s appropriate. We also made a number of recommendations around innovation and transparency noting that in order to get innovation it’s important for providers to be financially viable. Without that we’re not going to see much innovation.

So I think that’s close to my five minutes of introduction and with that let me pass back to you Michael.

Tom Symondson:

I’m not sure that we can hear Michael. So I think I’m next so I might just - - -

Michael Lye:

Apologies Tom. Apologies Tom. I think it’s fixed. Sorry. I was going to say that we’ll throw to Tom and Grant respectively. Tom first. Thanks.

Tom Symondson:

Thank you. My name’s Tom Symondson. I’m the CEO of the Aged and Community Care Providers Association as Michael said and we represent about 1,100 providers of home‑based care services, residential care and retirement living. And I was a member of the Taskforce. The outline of what’s happened today is that we have for the first time in a very long time a report that grapples with some of those really tough issues around how to make aged care sustainable, not just now but into the future. We have a rapidly growing population. We know that there will be a doubling in the number of older Australians over the coming decades who need our services but we also know that we don’t have a sustainable way forward at this time to ensure that the services those people need will be there and that they can be confident that they will be there at the quantity and the level and in the location that older people need them to be.

So this Taskforce Report puts forward a blueprint for how you’re going to achieve that. It as Nigel has said is based on some very clear and strong principles, the most important of which is any changes have to be in the interests of older people ultimately. And a sustainable sector is in the interests of older people because it gives them that confidence that the system will be there able to respond to their needs when and where they have them, wherever they need them.

So there are a couple of things in the Taskforce Report, a couple of themes of the recommendations and Nigel’s kind of touched on these. Across both home care and residential aged care there is a set of recommendations which talk about the need to assess whether people have adequate means to potentially contribute more particularly towards those services that they have paid for for their whole lives. That’s things like food, cleaning, gardening, those kinds of things that whether you’re 40 or 75 you pay for yourself throughout your life. But at the moment in aged care we have a very different approach. What we have said, and it’s a very clear theme of the report, is that Government funding should be prioritised towards care needs. So by that we mean nursing care, supporting people to wash or to eat, helping people stay healthy and well in their home through home care services. Those things are services that we believe that any Australian of any age should be able to access either for free or very heavily subsidised by the taxpayer. You’d be able to access them as a 45 year old in a public hospital. Why should you not be able to access them as a 75 year old in aged care. And therefore the idea of these consumer co-contributions should be focused around those other areas of support that you require as an older person. As I’ve said, things like gardening, things like cleaning, things like activities and lifestyle. So that’s kind of the thrust of where the recommendations go.

The thing I would say is most important to note is that the whole purpose of the Taskforce and its report was to put aged care on a sustainable footing, not just now but in five, ten, or 20 years so that the ageing population can be confident that it will be there and capable to provide the high quality care that the Royal Commission challenged us to deliver. And I think taken as a whole picture those recommendations that have been put forward in that report do achieve that. Obviously as Michael said it’s not Government policy. It is a Government commissioned report by a taskforce of people like myself and Nigel and Grant and others from different perspectives. But it was a very well rounded group. You had people from the union movement, people from the provider movement and many representatives of consumers but also representatives of younger people. And that I think should give confidence that these recommendations are the best that we can put forward to resolve the issues of sustainability in our sector ultimately for the benefit of older people which is the whole point, otherwise there isn’t one.

I will stop there and I think I will hand back to Michael.

Michael Lye:

Thanks Tom. Thanks very much. All right. For a second perspective we’ve got Grant Corderoy from StewartBrown. I should say, because people have asked the question about not having a consumer rep on the panel today, we have sought that through asking Taskforce members to come on the webinar today. Unfortunately we couldn’t get one of the consumer reps. But as Tom indicated they were very much part of the discussion and part of the ownership of the final report. So Grant over to you.

Grant Corderoy:

Thank you Michael and good afternoon. And just to echo what Michael was just saying and what Tom said, I’d have to say that the 16 members of the Taskforce which came from diverse backgrounds representing different consumer groups, and with the great support of the Secretary of the Department providing advice or guidance where required, it was very much a uniform approach. It was a uniform approach because the Government with its reform agenda and its absolute desire to improve aged care generally in the sector and follow on the Royal Commission recommendations was wanting to get that broad support. And I think it’s that broad support that we can now lead into where we’re going forward.

I think the big thing going forward now is actually education. We’re hearing for example some of the early comments in the report might be that we’re taxing the elderly and this is further cost for the elderly. And I think we just have to break down what the Taskforce Report is about. It didn’t cover direct care, direct care being your assessed care needs for your residential and home care, and at the moment they come under the purview of the Pricing Authority which I think is a very good step to have this Independent Pricing Authority. So their charter of course is to make certain that the funding for direct care is adequately covered by the subsidy, and that includes innovation and changing care needs. And I think that the Pricing Authority will do this in a very professional and demonstrative manner.

I also would like to add that our direct care needs are very much paid for by the taxpayer to date. In fact over 94% of our direct care needs in residential and over 95% in home care is paid by the taxpayer. Which one of the argument we get is that ‘I paid taxes all my life. Why should I be paying more for my aged care?’ Well the reality is the taxpayer is very much covering that and that makes Australia really unique and strong when we’re looking at our place in the world of how other countries handle it. The Taskforce is very much charged with saying to improve the funding envelope how are we going to be doing that for our everyday living needs. So residential, this is our food, our catering, our cleaning, our laundry, utilities and our accommodation. Because that’s where the sector has become unsustainable. Through formerly ACFI and now AN-ACC we’ve always made a margin in our direct care. We’ve always got a subsidy greater than the direct costs including corporate costs of providing direct care services. We’ve lost in our everyday living and we’ve lost in our accommodation. And they’ve been running at a loss for ten or 15 years which we’ve highlighted in our reports and the Department’s now very much highlighting.

So what this is really saying is that why should consumers not pay what’s expected to pay for the cost of doing it. So if the everyday living costs are $80 a day at the moment we’re paying a basic daily fee of $61. So is that right that we should only be paying partially what the cost of providing that service is? And that same analogy can go to accommodation. So I think that we’ve set a really good blueprint for the future by saying that we not only should co-contribute to care but recognition of the fact that the Government through the taxpayer, via the taxpayer money is paying for our care needs. What we’re doing is we’re trying to get a proper recoupment of our everyday living services. So we’re not taxing anyone any more. We’re paying for those things that we paid for all of our lives and we should be paying for them whilst we’re receiving care and of course we should have a very strong safety net and we should also make certain that regional and rural areas and particular demographics are also covered within that safety net.

So I actually think that if the message comes across correctly I think the Taskforce work supported very much by the Government and by the Department and Secretary should be relatively uncontroversial. What we have to do is make certain that we keep a clear delineation that we’re not taxing people more for their care. What we’re doing is we’re wanting the consumers to contribute more for those daily services that they’re receiving be it in home care or residential care. So I think that now the shirt sleeves come up because we’ll now want to say what does it mean to the consumer or the participant, what does it mean to the provider, and what does it mean to the sector. And I’m very confident that we’ve got a quantum shift in how we’re going to approach our care in the future.

Michael Lye:

Thanks very much Grant. Well we’ve got a heap of questions in from participants which is great. And obviously with Slido we can work out which ones are the most voted for. And so we’ll start trying to answer some of those now in the time we’ve got available. And I might Nigel get you to answer the first one which is:

Q:        Are you suggesting it is common for people to be paying for cleaning and gardening throughout their life? I feel this is out of touch.

Nigel Ray:

No. Not at all are we suggesting that. Indeed the vast majority of people do it themselves throughout their lives. That’s what they do.

So we’re not suggesting that at all. What we are suggesting is that those sorts of services are those which it would be possible for people to make larger co-contributions towards. So we’re not saying pay the whole lot necessarily at all. We’re saying make a contribution towards provided that people have the means to do so. So there will be a strong safety net and it would be based around the capacity to pay. It’s not a blanket across the board thing. And it’s also not necessarily – we’re not recommending necessarily that it’s the full cost either. It would be a contribution to that element of the care package so that taxpayers’ money can focus on the care component.

Michael Lye:

Thanks Nigel. Fantastic. All right. The next question which I might ask Tom.

Q:        Will providers still be expected to be debt collectors and collect these client contributions? In the home care sector this is notoriously difficult and feels unfair when the provider is not making these decisions.

Tom Symondson:

It is a good question but it’s one of those ones that ultimately has to form a part of the design. Obviously in my day job as a representative of providers this is something we deal with all the time and it is very challenging to be kind of seen as a debt collector if you like. That has to be part of kind of the response to the recommendations. What we’ve focused on is should contributions exist, and we have said that they should and obviously as Nigel has outlined variably depending on your wealth but also on what you’re needing in terms of services.

The challenge is of course if we increase the amount of co-contribution that people are asked to make or the number of people who might contribute who at the moment might not, it will become an administratively complex system. It’s already administratively complex. So one of the things we said in the Taskforce Report and we repeat it again and again and again is that whatever comes out of these recommendations has to be simpler. It has to be less difficult to implement. It has to be less difficult for consumers to understand than the current system but it also has to be easier for providers to implement so that we’re not wasting time and effort on kind of administering the system when the whole point is it’s supposed to make care better and not distract people from delivering that care. 

So I think that’s a design and implementation question. Ideally yes I’d love it if providers weren’t the ones having those conversations because it is a very difficult conversation to have and a very difficult process to go through. But I think that’s probably a little bit down the line.

Michael Lye:

Thanks Tom. And look thanks for the perspective that sits behind that question. It’s obviously something that as Tom said we’ve got to take into account in thinking through next steps. Grant I’ll ask you this one.

Q:        Has there been any consideration re co-contributions to the numbers of women who use aged care services and tend to live longer and yet generally have lower superannuation and paid taxes?

Grant Corderoy:

Certainly one of the good things that we had on the Taskforce is an intergenerational economist which is the first time that I’ve come across such a person and he was very valuable. And obviously we’re very cognisant of the fact that superannuation balances for the males far exceed those for females. And this is built into what we call the safety net. So the principles enshrining before and certainly enshrining the Taskforce and the Government and the Department is that we have to make certain there’s a safety net for all. So obviously superannuation balances form part of your ability to pay contributions but clearly it will be structured in such a way that no one is going to be disadvantaged because their contributions for super are less. That’s when in a sense that safety net kicks in if that comes about. And remembering of course that we’ve always got the safety net for our direct care. So this is your everyday expenses and that safety net will certainly be there to ensure that women in particular who do live longer and would have smaller superannuation balances at this point in time and will be quite a while before they come to equity or parity certainly the Taskforce did consider the implications of that very strongly.

Michael Lye:

Thanks Grant. All right. The next question is – I might ask this to you Nigel.

Q:        Can you confirm that allied health services will be fully funded under the proposed recommendations and not incur consumer co-contributions?

Nigel Ray:

So I think that that decision hasn’t been taken. It’s a matter for Government. What we have recommended is that it’s very clear what is included and we would expect – I’m just not quite sure of the breadth of the definition of allied health services but we would expect most of them would be included somewhere on the list right. But for good reason we did not go through the service list which would be a long exercise and we did not go through it line by line. But in principle the sorts of allied health services that older Australians need in the home in particular I would expect to be included.

Michael Lye:

Thanks Nigel.

All right. Now I’m not avoiding the top question. I’m seeing if I can get an accurate answer for that.

Tom I might go to you on this one.

Q:        How do you see the Taskforce recommendations supporting older people to age at home? The risk of not adequately supporting holistic ageing needs, example cleaning, is that people may need to enter residential aged care before they need or want to.

Tom Symondson:

Yeah. It’s an excellent question and I kind of revert a little bit to what Nigel was saying. We don’t want to give the impression that we’re just saying cleaning, gardening, anything that’s not administered by a nurse is suddenly not paid for by the taxpayer. That is absolutely not what we’re saying. We’re saying two things. Firstly we have to assess people’s ability to pay before they should be asked to pay anything or any more than they already do. And if they do not have the means to pay then they should be supported. But we are also saying that we want as kind of a signal to encourage people to prioritise their health needs. I know this is something that is often said, that as long as I’m getting my gardening done and my cleaning done, actually that’s what I need in order to stay independently in my home, but we have $2.3 billion sitting in home care packages that is not being spent and we are often seeing people moving into residential aged care because they have not been able to adequately support their own health needs either because they couldn’t access the services or because they chose not to. 

Now that is something that is very concerning for us as a system and we want to make sure that where people have health needs they are encouraged to manage those and supported to do so, but that that’s the priority for taxpayer funding. Because it’s about safety and it’s about keeping you healthy. Does it mean we should not pay for those things or contribute at all to those other things that support you to be independent? Of course it doesn’t mean that. In fact one of the things that we were very clear on in the Taskforce Report is that supporting independence – that’s my language. I don’t think it’s how we describe it – but things that support you to be independent remain really important. Because if we don’t support people to be independent in that holistic sense that’s not just about health but is about making sure that your home is liveable and there aren’t trip hazards and that you’re able to get meals and have community transport, you will end up forcing people into residential aged care long before that’s the right place for them. And we do not want that. But we have to prioritise where the money goes and we have to prioritise where we’re asking people to make greater contributions if they can afford to. 

And the definition we’ve used is those things that you would if you needed them at other points in your life have been expected to pay for, not those things if you’d needed at other points in your life that would have been paid for by the taxpayer. You go to a hospital, it’s free if you’re 40 or 75. You need a gardener? If you’re 40 you have to pay for it. We’re not suggesting you have to pay for the whole amount, but that’s kind of the way we’ve cut it. And I get for some people that is going to seem like the wrong way to cut it, but it’s the best way we could come up to do so fairly and equitably.

Michael Lye:

Thanks Tom. The next question is probably one for me which is:

Q:        How or when will Government consult with older people about the amount of co‑contributions that they will be asked to pay?

I’d just like to point out – and I think Nigel referenced this – that the Taskforce as part of its work received I think 180 different submissions and had a number of round tables. One of the things that we did was that the Council of the Ageing and the Older Persons Advocacy Network hosted 12 in-person forums as well directly with consumers to gauge people’s views on the work of the Taskforce. 

I mean the other thing that’s happened is the Department did some focus group work with older Australians to gauge their views about means testing or co-contributions and one of the interesting things that we found was that people estimated that they thought under aged care, the existing system, that they contributed about half of the costs of their total care in the aged care system. And actually you’ll know from the Taskforce Report that those numbers are much, much lower than that. But what they did say was that they’d be prepared to pay between 30% and 40% of the total costs of their services if there was a quality system available. And so that’s part of the research that the Department conducted as part of this exercise. But obviously the reason that we’ve released the Taskforce Report and want to talk to community about that is because we want to gauge people’s attitudes towards some of the principles the Taskforce has put forward and then indeed more specific proposals if the Government considers to go down that path.

All right. I’ll have a go at – Grant maybe this question.

Q:        $2.3 billion unspent funds in the home care program. Doesn’t this need reviewing ASAP?

Grant Corderoy:

Absolutely. In fact it’s now $3.2 billion so it’s increased even further. This has been a constant area, but this is really more of a funding issue. What it really means is that at the moment in home care for every dollar of funding we’re actually only providing a service of just under 85% or 85 cents in the dollar. In other words that’s what the unspent funds throws up and that’s a consequence of how the four levels are designed at the moment and the way that the funding instrument is designed at the moment, that people aren’t using all of the funds in the majority of cases. And that unspent funds amount is continuing to increase and yes at the moment it’s idle money which is now more sitting with the Government, with Services Australia, not in the balance sheets of the bank accounts of providers through a change in their – I think that the support at home model that’s coming through which is due for July 2025, I think that is going to be really important because it’s going to really clearly design what’s the cost of providing the services and the hope that we’re using all the funds that are allocated to us to ensure that our care at home and all the needs we have are safely met. So it’s a question. Yes. It’s important but I think it’s a consequence of our current funding model.

Michael Lye:

Yep. Thanks. Thanks very much Grant. And just to that question that was asked about the 44,000 growth per annum, that is the average annual increase based on population projections. I understand it’s almost all in home care packages as we currently understand them in terms of the level of support but you could take that as being the increasing demand for care in the home. I hope that’s clear.

Q:        When can we expect the Government’s response to the recommendations?

Well I think the Minister has made it clear today publicly that this first step is about airing the result of the Taskforce’s report. I think she’s indicated that the Government has had an initial discussion and briefed the opposition on that. The Government is keen to get bipartisan support for some propositions here and that obviously there’s decision making processes in Government. And so we can’t give you an answer on how imminent that is but she’s indicated that this is the first step here in airing the report and gauging people’s reaction to the work of the Taskforce. We’ll certainly keep you updated.

Okay. I might ask this one to Grant. 

Q:        Why is someone required to sell their home when entering a Government owned aged care facility? A real burden financially for people with only a pension. In really remote areas the sale can take over 12 months. They might like to allow their family to live in it with the shortage of housing.

Do you want to have a go at that one? 

Grant Corderoy:

Yeah. It’s a very good question. So let’s just look at the term Government owned. Government owned homes are predominantly about 9% of all homes in Australia, the majority being in Victoria. And most of the Government owned homes using that term don’t actually require a large accommodation deposit or a RAD and many don’t require any at all. But if we look at the overall sector it’s a very good question. And this is the inequity at the moment, that if you can afford a RAD, like selling your home and forming a RAD, it’s actually a cheaper form of accommodation than if you can’t and you’ve got to pay a daily accommodation payment. And that’s something that we tried to address in the recommendations and address in the Taskforce work and particularly in regional areas. We just know that the housing – and that’s normally your only asset, in many areas your only major asset, not superannuation. To sell the home to move in we need to be looking at – one of the recommendations is that we need to expand the range of financial products that the sector can currently have so that you can – and I don’t use the term reverse mortgage, but that you can leverage off your home to pay for your daily accommodation payment, and knowing that you don’t have to sell the home or the family doesn’t have to sell the home. So it’s working closer with super funds and financial institutions to develop a much greater package of financial products that really overcome this significant obstacle that many people face.

Michael Lye:

Thanks Grant. The new top question here is:

Q:        Why is there so many disparities around NDIS and aged care funding methodologies and care deliverables?

Look that’s a great question. I’ll just say very quickly that the Government’s established a Care Economy Taskforce and our Department, DSS and the NDIA and Department of Veterans Affairs are all involved in a process to try and reduce those differences. So for example we’re doing a lot of work around trying to harmonise worker screening between the NDIS and aged care because we realise this is a significant barrier for workers and providers in those two sectors. Pricing is another area where the review of NDIS has suggested that we need to think about similarities between pricing in the aged care and disability sectors. And we know that in veterans affairs service delivery that differential prices mean that sometimes allied health professionals and other people delivering services are less likely to prioritise that care sector. And so for all those reasons the Care Economy Taskforce is working with our relevant departments to try and get greater harmony between these big systems to make sure that we don’t see those disparities which then mean that consumers don’t get a good quality service or affordable service. So that’s a big piece of work but it’s happening behind the scenes.

Nigel I might go to you on this one.

Q:        Will a clear, defined list of what can and can’t be charged as additional services finally be documented so it is crystal clear to both consumers and providers what is in the minimum and what is therefore additional?

Nigel Ray:

So I think this is related to residential care. The minimum will be crystal clear and the Taskforce has suggested that IHACPA help establish that and the price for it. The Taskforce for additional services – we would hope that each provider is crystal clear on what they are providing or offering but it’s not going to be a single package of additional services. That’s an area where providers will be able to offer bespoke things. What we have said very clearly in the Taskforce Report is that there needs to be strong protections for consumers around those additional services and that that is a condition on allowing providers to charge more for them. And one of the examples that’s often quoted is the capacity for an individual consumer to seek additional TV channels in their package, that sort of thing. That’s something that’s often the sort of example that we’re talking about.

Michael Lye:

Yep. Thanks Nigel. Look next question. This one’s for me. 

Q:        Did anyone consider the optics of four older white men delivering the information given the majority of consumers are women? It is a backwards step in terms of diversity in conversations and someone should have noticed this.

Look I do apologise for the make up of our panel today. As eminent as our Taskforce membership are here joining us not all of them were our first choice. We were seeking a diversity of views, obviously consumers and providers and men and women. We had a balanced Taskforce membership, half women, half men. We had representation. Tom Calma joined us from First Nations peoples and Mary Patetsos joined us from the culturally and linguistically diverse background network. And so diversity was really important to us. Just the sheer fact of trying to make this webinar available to give you information today at very short notice meant that we weren’t able to achieve that diverse panel that we would have liked. And I do acknowledge that for some of our audience today that’s a disappointment. And so that’s the reason. And on balance it was more important for us to get available people, people from the Taskforce with the expertise in front of you as quickly as possible, and we weren’t able to achieve the balance we would have liked. But thanks for the comment.

Okay. I’m going down to the next one. I think a couple of these ones that are close to the top of the list I think the panel has already answered. Tom I’ve got a difficult one for you.

Q:        Will there be a review of the huge salaries drawn by CEOs and others of aged care facilities?

Tom Symondson:

To be fair I get asked this one quite a lot. I generally get asked it in the media. I’m never afraid of a question like this. The reality is that most providers run one site or they run a small number of home care packages. The CEO does not earn a huge amount of money. But it is a very variable sector and we have some providers that run hundreds and hundreds of services, home care, residential, and often they are running other kinds of services as well and salaries vary enormously. I’m not going to defend any individual’s salary. That’s for them to do. 

The reality however – and I think it’s really important to remember – is the vast majority of providers of services to older people are small and more often than not running one or two sites, if it’s residential care or a small number of packages or CHSP services, and so the staff in that environment are not earning huge salaries. In fact this is something that we’ve had to look at as a sector because we didn’t believe that our workers were earning the right level of salaries, which is why we were so delighted last year that our care staff, nurses and personal care workers and a group of others, a huge number of largely female staff received a 15% pay rise and the Government was good enough to fund that as we were hopeful they would.

I think it’s really important to keep in context that we need to drive up salaries for people at the frontline. CEOs can defend their own salaries. They’re very capable of doing that. But the average CEO of a provider in this sector is not earning a huge salary. And I don’t want us to get distracted from the real problem which is that we need to make sure our workers are earning the best possible salaries that they can.

Michael Lye:

Thanks Tom. We’ve got time for a few more questions and we’re getting to the provocative ones.

Q:        Consumer pays is reasonable. It is ludicrous that older people expect the Government, taxpayers to pay for their meals, bathroom upgrades and garden maintenance. Client contributions should be mandatory and Services Australia financial hardship applications completed by those truly unable to pay.

I take that as a comment but Nigel did you want to talk about kind of the consideration that the Taskforce gave to this question about that people have differential needs?

Nigel Ray:

Absolutely. It’s a theme through the Taskforce Report that some people have considerable capacity to pay for services and some people have very little or no capacity. I notice some question come up talking about homeless for example and that was something that we specifically thought about in the Taskforce. And there are specialist services provided I know particularly in Victoria. The way that we thought about this was that if people do not have the capacity to pay then they should still be able to age with dignity and get the care that they need etcetera and that that’s a role for a strong safety net, and that people who have a capacity to contribute – and no one’s being asked to pay for everything but people who have the capacity to contribute should be asked to do a bit more where they can particularly as we have said for the sorts of services around everyday living and accommodation, with the taxpayers’ contribution focused on providing the care that everybody needs. And so that was the way we thought about it.

We haven’t made a specific recommendation on the means test. That’s a matter that the Government’s going to need to consider as it responds to this report. But we have suggested strongly it should be a lot simpler than the current arrangements which are very difficult for people to understand and navigate.

Michael Lye:

Great. Thanks. I’ll go to you Grant on this one and then I’ll deal with the top question.

Q:        Will there be high level home care packages than a Level 4 as this is insufficient as there is a big difference between Level 4 home care package and high level residential care?

I think it was will there be a higher level home care package. Do you want to talk about that briefly?

Grant Corderoy:

Just briefly. Certainly the Tune review back in 2017 recommended a Level 5 package equivalent to then the average ACFI. It’s certainly been on the cards. I just want to point out that the Level 4 packages now have got the highest level of unspent funds. But I think that with the removal of ACAR – getting a technical term – from 1 July a major impact on residential aged care is that once you’re assessed for aged care you’ve got the choice of where you want to receive that care, and that includes higher level of packages. If you’re at home or in a residential environment is applicable and appropriate. You have the choice of receiving high levels of care. So I think that will actually be the precursor to see that for certain people they can get a higher level – we’ll call it Level 5 today – a higher level of care and therefore receiving a lot more clinical care and not necessarily having to receive that in a residential aged care facility. So that will suit certain people and that option is very much available.

Michael Lye:

Thanks Grant. Someone’s asked:

Q:        Why was the release of this report delayed three months?

It hasn’t felt like a delay to me I will say. Obviously the work of the Taskforce was complex and they obviously drew on quite a lot of input from the community in formulating their views. And while Minister Wells was part of that process the broader Government was not. And so I think Minister Wells referenced this morning in her press conference that she’s part of a Cabinet Government and part of the job that she has had since the report was handed in was explaining to colleagues about how the Taskforce had come to their ways of thinking and understanding exactly what that meant. And that has produced this step which is to release the report and now consider community feedback on it. So I don’t consider it delayed. These are complex issues and obviously the Government is wrestling with the idea about an expanding ageing population and thinking about how we make sure that aged care’s sustainable into the future. And so these are large questions and as you’d expect they’re giving plenty of attention to it and giving it due consideration.

Look I know we’re just slightly over and I’m just having a quick look to see whether there’s any – maybe one last question and Nigel I’ll throw it to you if you don’t mind before we close out.

Q:        Page 9 of the report states that income from superannuation should be drawn down in retirement to cover health. Could you please expand on this particularly with reference to allied health in residential care and in home care?

Nigel Ray:

So I saw an earlier question where someone was asking about effectively the access to the Medicare system which is there for all including older Australians. So that’s obviously one point to make. The second is that it is the case that – so the majority of people who have superannuation balances when they retire use them for retirement spending and they tend to run those balances down over time which is an entirely appropriate thing to do. Some people don’t. And the question that the Taskforce – so the Taskforce is not saying what the superannuation asset should be used for but are saying holistically it’s about paying for things in your retirement phase. And as you know the Government provides considerable tax concessions in order to support that. And that’s really what it’s about rather than specific comments on what individuals should do with their retirement balances.

Michael Lye:

Thanks Nigel. I feel like I’ve thrown you some of the hard questions. But maybe not. All right. Look I’m just conscious of time. And can I finish by saying thank you all for your participation, for your questions today. Great questions. And the questions from today’s session as well as questions we haven’t been able to cover in the available time will be compiled in a question and answer document on the Department’s website along with the recording of today’s session. So you won’t miss out. I know we didn’t get to all of your questions.

I’d certainly like you to share your views about the Aged Care Taskforce and its report. The slide at the end of the presentation contains the contact email address. We’ll leave that up there for a few seconds. Obviously there’s a lot of material to digest from the Taskforce’s report. We’ve got a little way to go with this but as with all of the areas where we’re trying to reform aged care we’d really appreciate your view. We want to make sure that the changes that the Government considers in making the system a better one for older Australians is informed by your voice. So jot down those details or take a little photo of those details and please do contact us. 

Can I thank our panel members today for making their time available. Great to have had their insights on the Taskforce amongst the other voices in that membership. And thanks again for joining us. Goodbye for now.

[Closing visual of slide with text saying ‘Thank you for attending the presentation on the Aged Care Taskforce report’, ‘AgedCareTaskforce@health.gov.au’, ‘A recording of today’s presentation will be available soon’, image of QR code, ‘Final report of the Aged Care Taskforce’, ’12 March 2024’]

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