The Australian
April 9, 2022

Aged-care funding is still $5bn a year short of what is needed to support older Australians, and some of the shortfall should be paid by well-off users rather than left entirely to the taxpayer, a leading aged-care provider says.

With aged-care policy dominating the early days of the unofficial election campaign, BUPA Asia Pacific chief executive Hisham El-Ansary said even after the budget response to the aged-care royal commission, the funding for nursing homes “doesn’t stack up”.

“The average funding for a resident per day is around $260,” Mr El-Ansary said. “That’s just over $10 per hour and with that, you’ve got to provide the accommodation, food, clinical services, entertainment, gardening, cooking, and cleaning. It just doesn’t stack up.

“This is a problem for all of us. It’s not just about government,” he told executive search firm Blenheim Partners’ No Limitations podcast this week. “Those of us who can afford to pay … should pay a bit more in terms of contributing to their care in the last stages of their lives.”

The Morrison government has committed about $18.8bn across two budgets to fix the beleaguered sector as its response to the damning findings of the aged-care royal commission. Key funding increases went to 80,000 additional home-care packages over two years, and to supporting nursing homes to deliver more and higher quality care including more nutritious food.

Anthony Albanese used his budget-in-reply speech last week to outline his party’s aged-care election platform, including a further $2.5bn – in part to ensure a nurse is rostered on 24/7 in aged-care facilities.

But Mr El-Ansary believes more funding is required than ­either of the parties is offering.

“I wouldn’t be surprised if the right number was (a further) $4bn to $5bn a year,” he said.

“Whether that’s all government funding, or whether that’s a combination of government and private funding, I think it’s in that order of magnitude.”

The Opposition Leader’s move to put aged care at the heart of his election pitch may have surprised political pundits, but a lot of voters have a deep personal interest.

More than 1.3 million Australians receive some form of publicly funded care, either at home or in a residential aged-care facility.

About 330,000 workers provide direct care and 100,000 have administrative and supporting roles. Add in the families who want the best care for their loved one, and the number of engaged voters quickly mounts up.

Plus, many know their day is coming. More than one million Australians are aged 80+, with 3.1 million more between 65 and 79, putting the over-65s at 16 per cent of the population. By 2060 it is projected to be 23 per cent, almost one in four people, the 2021 Intergenerational Report says.

Beyond the demography is the politics. Mr Albanese knows aged care has been a serious vulnerability for the Morrison government, especially since Covid-19 twice ripped through nursing homes across the nation, first in the early stages of the pandemic and then again in the Omicron wave, leading to the deaths of almost 2000 residents.

The Coalition was criticised as being too slow to act in protecting residents, providing vaccines, sourcing the necessary personal protective equipment for staff, and setting rules around staff and loved ones moving in and out of aged-care homes.

Aged care services minister Richard Colbeck was demoted from his position in the midst of the crisis. Some hapless performances in Senate committee hearings, including one in August 2020 where he didn’t know the number of aged-care Covid deaths, and a decision to attend the Hobart Ashes Test in January rather than front a Senate Covid-19 inquiry marked him as a liability for the government and an easy target for its opponents.

But there were problems with aged care well before the pandemic. “The flaws in the current system arise … to a significant extent from the decisions by successive governments to consider aged care as a form of welfare for the very needy, to be provided to the bare minimum extent required,” the royal commission concluded.

The Coalition heads into the 2022 election campaign relying on its $18.8bn response to the commission’s five-year reform plan, delivered mostly in the 2021 budget. In recognition that most older Australians want to remain in their own homes with services brought in, the new measures include 80,000 new home-care packages over two years at a cost of $6.5bn. It provided an additional $10 a day per nursing home resident for care and support, with a focus on food and ­nutrition, at a cost of $3.2bn.

And it committed $3.9bn for additional care hours, including nursing care, in residential aged care facilities.

The low pay of care workers and qualified nurses working in aged care was called out by the commission as a crucial area of ­reform. It recommended the government join with unions and providers to agree a fair pay rise for workers, who currently earn as little as $22 an hour, and where aged-care nurses are earning up to 40 per cent less than those in other areas of the health system.

The government chose not to do so, saying instead it would respect the outcome of an ongoing Fair Work Commission hearing into the wages of care workers, where unions are proposing a 25 per cent lift in wages. But it has been coy about whether it would pay for the entire increase.

Mr Albanese says Labor will support and fully fund the claim if elected into office.

The Labor leader pledged $2.5bn beyond the government’s planned spending, primarily to be spent on bringing nursing home care hours up and ensuring a registered nurse is on site 24 hours a day from July next year, a year ahead of the royal commission’s schedule.

Labor would ensure mandatory aged-care food standards were set and met, and promised to cap administration and management fees on home-care packages.

In the political back and forth, Labor says the Coalition never committed to the commission’s higher care hour recommendation, while Labor has. The Coalition denies this, accusing Labor of ignoring the commission’s time frame in its push for 24/7 nursing care in homes when a qualified workforce won’t yet be ready.

How our eldest citizens are cared for and treated is an emotional issue as much as an economic one. And perhaps more than any election in recent times, it is also now a critical political one.

Article by Stephen Lunn, Social Affairs Editor


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