AUSTRALIA’S aged care sector has this week united under one banner to demand that big-picture reform follow the recommendations of the Royal Commission into Aged Care Quality and Safety later this month.

Launching the ‘It’s Time to Care About Aged Care’ campaign, the new Australian Aged Care Collaboration (AACC) alliance is targeting key marginal electorates where more than 750,000 older Australians live, in an attempt to encourage the national Parliament to address the sector’s many challenges.

The AACC believes an overhaul of the design, objectives, regulation and resourcing of aged care is urgently required if Australia is to deliver the care and services older people need and deserve now and into the future.

Successive federal governments over the past two decades have failed to act on more than 20 independent reports highlighting the need for major reform.

The problem is clear. Australia devotes less than half of what comparable countries do to aged care (1.2% vs 2.5% of GDP). Denmark and Sweden allocate more than 4% of GDP.

The AACC represents more than 1,000 organisations who deliver 70% of government-subsidised aged care services to 1.3 million Australians, either in their own homes or in communal residential settings.

It includes not-for-profit providers, primarily church and other charity organisations, and a number of private operators, as a new single industry voice delivering quality care for older Australians.

The problem

• Australia’s aged care system is in urgent need of transformation, with 16,000 vulnerable Australians dying in 2017-18 while waiting for a government-subsidised support package in their own home.
• An additional 100,000 people are waiting for home support at their approved level – with those in need of the highest-level packages typically waiting at least 12 months.
• Separately, a further 88,000 places will be required in communal Residential Aged Care over the next 10 years, at a cost of $55 billion.

• As a result, under-resourced aged care homes were described as in an ‘impossible situation’ by Counsel Assisting the Royal Commission – and are struggling to maintain standards and staffing, whilst fighting to keep their doors open.

AACC representatives Sean Rooney and Patricia Sparrow said more than 20 government aged-care reviews in 20 years had failed to fix the inadequate system.

“After 20 years of missed opportunities, Australia cannot let the release of the final Royal Commission

report later this month pass without taking real action,” Ms Sparrow said.

“Australia currently spends about half of what other comparable countries do on looking after their

most vulnerable older citizens.

“Enough is enough – Australia should no longer accept the drip-feed of piecemeal rescue packages and ad-hoc changes.”

Mr Rooney said the residential aged care sector was in crisis with 64% of homes operating at a loss in 2020, almost double the medium-term average of 33%.

“Under-resourcing of the aged care system has been growing for a long time, and is not the fault of any one government or Parliament,” he said.

“But it is the responsibility of all Parliamentarians to recognise the injustice and inequity of maintaining a system the Royal Commission described as ‘a shocking tale of neglect’.”

The campaign

An ‘It’s Time to Care About Aged Care’ campaign advertisement helps explain the challenges of the current system.

An additional ‘It’s Time to Care About Aged Care’ report identifies for the first time the 30 members of the 151-member Federal Parliament who represent the ‘oldest’ Australian communities by age, and who have the greatest obligation to fix the system.

Of these seats, 14 are marginal, and in some cases are held by only a few hundred votes. They contain 755,045 voters aged over 55, an extraordinarily concentrated voting block.

Critical decision makers on both sides of politics represent these older communities. For example, the current Minister for Aged Care Greg Hunt holds Australia’s eighth ‘oldest’ electorate, Flinders, in Melbourne, with 50.7% of voters aged over 55.

Similarly, the Opposition’s former Minister for Aged Care Justine Elliott holds the sixth ‘oldest’ electorate in Australia, Richmond, on the NSW north coast, with 51.4% of voters aged over 55 years old.

“The 30 Members of Parliament who represent Australia’s ‘oldest’ electorates have the greatest opportunity to represent the needs of their communities, so that older Australians are finally given the respect, resources and support they deserve,” Mr Rooney said.

“The Australian community looks to these elected officials to stand up for them in the national debate and to help influence positive outcomes on behalf of their constituents.

“These MPs have the opportunity to truly achieve something great – and avoid the mistakes of the past

– by creating a sustainable and equitable aged care system that will stand the test of time.”

The Australian Electoral Commission defines a seat as marginal if it would change hands with a swing under 6%. Given the increasing volatility in the electorate, demonstrated by seats changing hands in recent elections with double digit swings, any seat with less than a 10% margin could now be considered vulnerable.

Table 1: 14 marginal seats among the 30 ‘oldest’ electorates in the Australian Parliament

Rank of oldest	Electorate	Total over 55	Total voters	% over age 55	Party	MP	AEC margin		State
2	Gilmore	67,487	124,104	54.4%	Labor	Fiona Phillips	2.6%	Marginal	NSW- regional
5	Cowper	65,019	125,827	51.7%	National	Pat Conaghan	6.8%	Marginal	NSW- regional
6	Richmond	60,099	116,862	51.4%	Labor	Justine Elliot	4.1%	Marginal	NSW- regional
7	Page	61,371	119,791	51.2%	National	Kevin Hogan	9.5%	Marginal	NSW- regional
8	Flinders	57,240	112,895	50.7%	Liberal	Greg Hunt	5.6%	Marginal	VIC- metro
9	Mayo	61,987	123,841	50.1%	Centre Alliance	Rebekha Sharkie	5.1%	Marginal	SA- regional
14	Monash	56,963	116,933	48.7%	Liberal	Russell Broadbent	7.4%	Marginal	VIC- regional
15	Indi	55,623	114,247	48.7%	Independe nt	Helen Haines	1.4%	Marginal	VIC- regional
16	Braddon	38,707	80,472	48.1%	Liberal	Gavin Pearce	3.1%	Marginal	TAS- regional
18	Lyons	39,229	82,101	47.8%	Labor	Brian Mitchell	5.2%	Marginal	TAS-regional
23	Robertson	52,038	111,827	46.5%	Liberal	Lucy Wicks	4.2%	Marginal	NSW- regional
28	Bass	35,358	77,431	45.7%	Liberal	Bridget Archer	0.4%	Marginal	TAS- regional
29	Eden- Monaro	52,198	114,468	45.6%	Labor	Kristy McBain	0.9%	Marginal	NSW- regional
30	Shortland	51,726	114,320	45.2%	Labor	Pat Conroy	4.5%	Marginal	NSW- regional

Table 2: Number of marginal seats in Australia’s 30 ‘oldest’ electorates

PARTY	NUMBER OF MARGINAL SEATS IN AUSTRALIA’S 30 OLDEST ELECTORATES
Liberal Party of Australia	5
Australian Labor Party	5
The Nationals	2
Independent/minor party	2
TOTAL	14

Table 3: Breakdown of top five ‘oldest’ seats in each state

	Electorate	55+	Total voters	% over age 55	Party	MP	AEC margin	Status	State
NSW
1	Lyne	67,807	119,739	56.6%	National	David Gillespie	15.2%	Safe	Regional
2	Gilmore	67,487	124,104	54.4%	Labor	Fiona Phillips	2.6%	Marginal	Regional
5	Cowper	65,019	125,827	51.7%	National	Pat Conaghan	6.8%	Marginal	Regional
6	Richmond	60,099	116,862	51.4%	Labor	Justine Elliot	4.1%	Marginal	Regional
7	Page	61,371	119,791	51.2%	National	Kevin Hogan	9.5%	Marginal	Regional
VIC
8	Flinders	57,240	112,895	50.7%	Liberal	Greg Hunt	5.6%	Marginal	Metro
12	Mallee	56,331	114,049	49.4%	National	Anne Webster	16.2%	Safe	Regional
13	Gippsland	55,359	112,457	49.2%	National	Darren Chester	16.7%	Safe	Regional
14	Monash	56,963	116,933	48.7%	Liberal	Russell Broadbent	7.4%	Marginal	Regional
15	Indi	55,623	114,247	48.7%	Independent	Helen Haines	1.4%	Marginal	Regional
QLD
3	Hinkler	60,182	111,223	54.1%	Lib/National	Keith Pitt	14.5%	Safe	Regional
4	Wide Bay	59,186	111,115	53.3%	Lib/National	Llew O’Brien	13.2%	Safe	Regional
22	Maranoa	49,529	106,260	46.6%	Lib/National	David Littleproud	22.5%	Safe	Regional
26	Fisher	54,161	118,296	45.8%	Lib/National	Andrew Wallace	12.7%	Safe	Metro
32	Fairfax	52,948	117,985	44.9%	Lib/National	Ted O’Brien	13.4%	Safe	Regional
WA
24	O’Connor	47,152	102,346	46.1%	Liberal	Rick Wilson	14.5%	Safe	Regional
27	Canning	50,840	111,074	45.8%	Liberal	Andrew Hastie	11.6%	Safe	Metro
36	Tangney	42,237	95,223	44.4%	Liberal	Ben Morton	11.5%	Safe	Metro
38	Forrest	47,834	108,193	44.2%	Liberal	Nola Marino	14.6%	Safe	Regional
60	Moore	42,569	102,731	41.4%	Liberal	Ian Goodenough	11.7%	Safe	Metro
SA
9	Mayo	61,987	123,841	50.1%	Centre Alliance	Rebekha Sharkie	5.1%	Marginal	Regional
10	Barker	59,069	118,877	49.7%	Liberal	Tony Pasin	18.9%	Safe	Regional
11	Grey	59,905	120,566	49.7%	Liberal	Rowan Ramsey	13.3%	Safe	Regional
33	Boothby	56,156	125,286	44.8%	Liberal	Nicolle Flint	1.4%	Marginal	Metro
37	Sturt	55,484	125,362	44.3%	Liberal	James Stevens	6.9%	Marginal	Metro

Table 3: Breakdown of top five ‘oldest’ seats in each state (cont)

	Electorate	55+	Total voters	% over age 55	Party	MP	AEC margin	Status	State
TAS
16	Braddon	38,707	80,472	48.1%	Liberal	Gavin Pearce	3.1%	Marginal	Regional
18	Lyons	39,229	82,101	47.8%	Labor	Brian Mitchell	5.2%	Marginal	Regional
25	Franklin	35,582	77,298	46.0%	Labor	Julie Collins	12.2%	Safe	Metro
28	Bass	35,358	77,431	45.7%	Liberal	Bridget Archer	0.4%	Marginal	Regional
48	Clark	31,427	73,315	42.9%	Independent	Andrew Wilkie	22.1%	Safe	Metro

The future

More than 4.1 million Australians, or almost 16% of the population, are currently aged over 65. By 2057, that will rise to 8.8 million, or 22% of the population, and by 2097 it will reach 12.8 million people, or one in four Australians.

“The challenges for aged care are only going to grow in coming years, as the large Baby Boomer generation requires more support,” Ms Sparrow said.

Types of government-subsidised aged care

Broadly speaking, Australians access government-subsidised aged care services in three different settings:

1. Own home – for people with low care needs (Commonwealth Home Support Program CHSP) –

840,000 people.

• Own home – for people with greater care needs (Home Care Package Program) – 174,000 people.
• Communal care homes – where residents generally receive nursing and personal care 24 hours per day, either on a permanent basis or as short-term respite stays (Residential Aged Care Homes) – 244,000 people.

Spending on aged care

• Total expenditure on aged care in Australia in 2019-20 reached about $26 billion.
• The Australian Government spent $21 billion, with most of the remainder paid directly by consumers.

Own home

• About 16,000 Australians have died while waiting for a home care support package.
• An additional 100,000 people are waiting for home support at their approved level – with people in need of the highest-level packages typically waiting at least 12 months.

Communal residential aged care

• Australia’s financing of aged care is highly skewed towards residential aged care, with 6.4% of over 65s in Australia living in these communal homes, compared with an OECD average of 3.6%.
• Approximately 63% of all government aged care funding, or $13.5 billion, is spent on communal residential aged care.
• A further 88,000 places will be required in communal Residential Aged Care over the next 10 years, at a cost of $55 billion.

Staffing

• 78,000 extra workers are needed in the next 10 years to deal with the country’s ageing population.

These figures may explain why the Royal Commission into Aged Care Quality and Safety found that Australians strongly support increased funding to ensure access to high-quality care in the future.

  www.CareAboutAgedCare.org.au      

image: Vlada Karpovich from pexels