Coalition’s $17.7bn aged care budget pledge ‘falls well short’ of what is needed, experts warn
Aged care experts are warning the Morrison government’s budget commitment of $17.7bn for the sector “falls well short” of what is needed for generational reform and to avoid workforce and transparency “vulnerabilities”.
Aged care workers and Labor have also slammed the government’s response to the aged care royal commission outlined in Tuesday’s budget, accusing the Coalition of not addressing low wages and overstretched carers.
In its $17.7bn five-year plan, the government pledged to clear the home care package waiting list within two years, mandate minimum care time requirements for residents living in aged care facilities, and boost the sector’s workforce.
The government will adopt key elements of the 148 recommendations made by the royal commissioners, including structural changes to how aged care is governed, a new Aged Care Act, and an increase to providers of $10 per resident a day.
However, it has not accepted six recommendations, including a levy to raise money for the sector and suggestions for reforming how much older Australians pay in contributions. The government is considering 12 further recommendations.
Stephen Duckett, the health program director at the Grattan Institute and a former secretary of the federal health department, is concerned the government’s spending increase of $17.7bn over five years “is about half” what the Grattan Institute and other economic modellers predicted would be needed to address the royal commission recommendations.
Duckett believes the government’s key pledge to clear the roughly 100,000strong waiting list for home care packages cannot be achieved with the $6.5bn over five years allocated in the budget. The backlog is so pronounced the royal commission heard Australians were routinely dying while on the waiting list.
“The royal commission said you’ve got to clear the waiting list and make sure new people who are approved for a package don’t wait for more than 30 days – and the government has met neither of those,” he said.
Duckett said when the government’s spending on aged care “fully ramps up” in coming years it will be “about half of what was needed”.
The increase of $10 a day for each resident for providers and the star rating system to score providers on key performance measures so they can be easily compared are “significant improvements”, the economist said.
However, Duckett was disappointed at the government’s decision to continue funding staff upgrades for the existing aged care regulator, the Aged Care Quality and Safety Commission, instead of abolishing the body for a new regulator to create “a total change in attitude and structure”.
He said the decision not to accept recommendations for changes to means-testing to determine what aged care residents pay “is another signal it’s an election budget”. The government didn’t want to “antagonise” anyone in the system by increasing their contributions, he argued.
The opposition’s aged care spokesperson, Clare O’Neil, said the $17.7bn plan did “nothing to improve wages for overstretched, undervalued aged care workers”. “How do we attract the needed 700,000 workers to the sector when these workers remain some of the lowest paid in our economy?” she said.
O’Neil warned the government’s allocation for home care packages was not enough to clear the wait list.
Jude Clarke has worked as a carer for 48 years and said her wages were still about $25 an hour.
The 63-year-old was in Canberra on Wednesday with the United Workers Union which says more needs to be done in terms of wages and conditions or the workforce won’t grow.
“We are grateful for the money they’re bringing in, but it’s just not going to the right places, we need more staff on the floor,” Clarke said.
“None of us feel valued at the moment. If we had a decent wage and career path, you could see more people choosing this for work. But right now we don’t even have time to ask residents how they’re feeling, or what clothes they want to wear. My biggest fear that is when I get to aged care, it’s going to be even worse, and carers’ tasks will become more robotic.”
Ian Yates, the chief executive of the Council on the Ageing, called the government’s aged care package “a solid step”.
He suggested it was billions of dollars short of what analysts had said was needed but Yates was more confident than Duckett that the plan could clear the waiting list for home care packages. In part, that was because he expected future funding increases to be announced.
Yates warned of “vulnerabilities” that would emerge in the workforce due to border closures assumed in the budget.
“So much of the workforce has traditionally come from overseas, both visa and migrant workers. It’s not clear where a lot of the workers for the extra care the government has planned for will come from in the short term,” he said, noting the local skills and training measures would not address the labour required.
Prof Joseph Ibrahim, head of the health law and ageing research unit at Monash University’s forensic medicine department, criticised the government for not initially agreeing to the recommendation to impose civil penalties for a breach of the duty of care, and compensation payments in the event of a breach – something the government is still considering as it prepares the new Aged Care Act.
Ibrahim said the decision not to signal its support for civil penalties, combined with the decision to adopt a government leadership model within the Department of Health as opposed to a new commission independent of the government, will hamper transparency in the sector and foster a continuation of poor performance and decision making influenced by politics.
Ibrahim was also critical of continuing with the quality and safety commission.
“We can’t get fooled by the pile of gold, because a lot of it is just going towards meeting existing requirements,” he said. “The industry really requires a culture change, and I don’t believe this has been set with the budget, because the key elements remain within the government.”