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Aged care sector unites to demand big picture reform

Elderly couple standing together smiling

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 oldestElectorateTotal over 55Total voters% over age 55PartyMPAEC margin State
2Gilmore67,487124,10454.4%LaborFiona Phillips2.6%MarginalNSW- regional
5Cowper65,019125,82751.7%NationalPat Conaghan6.8%MarginalNSW- regional
6Richmond60,099116,86251.4%LaborJustine Elliot4.1%MarginalNSW- regional
7Page61,371119,79151.2%NationalKevin Hogan9.5%MarginalNSW- regional
8Flinders57,240112,89550.7%LiberalGreg Hunt5.6%MarginalVIC- metro
9Mayo61,987123,84150.1%Centre AllianceRebekha Sharkie5.1%MarginalSA- regional
14Monash56,963116,93348.7%LiberalRussell Broadbent7.4%MarginalVIC- regional
15Indi55,623114,24748.7%Independe ntHelen Haines1.4%MarginalVIC- regional
16Braddon38,70780,47248.1%LiberalGavin Pearce3.1%MarginalTAS- regional
18Lyons39,22982,10147.8%LaborBrian Mitchell5.2%MarginalTAS-regional
23Robertson52,038111,82746.5%LiberalLucy Wicks4.2%MarginalNSW- regional
28Bass35,35877,43145.7%LiberalBridget Archer0.4%MarginalTAS- regional
29Eden- Monaro52,198114,46845.6%LaborKristy McBain0.9%MarginalNSW- regional
30Shortland51,726114,32045.2%LaborPat Conroy4.5%MarginalNSW- regional

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

PARTYNUMBER OF MARGINAL SEATS IN AUSTRALIA’S 30 OLDEST ELECTORATES
Liberal Party of Australia5
Australian Labor Party5
The Nationals2
Independent/minor party2
TOTAL14

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         
1Lyne67,807119,73956.6%NationalDavid Gillespie15.2%SafeRegional
2Gilmore67,487124,10454.4%LaborFiona Phillips2.6%MarginalRegional
5Cowper65,019125,82751.7%NationalPat Conaghan6.8%MarginalRegional
6Richmond60,099116,86251.4%LaborJustine Elliot4.1%MarginalRegional
7Page61,371119,79151.2%NationalKevin Hogan9.5%MarginalRegional
VIC         
8Flinders57,240112,89550.7%LiberalGreg Hunt5.6%MarginalMetro
12Mallee56,331114,04949.4%NationalAnne Webster16.2%SafeRegional
13Gippsland55,359112,45749.2%NationalDarren Chester16.7%SafeRegional
  14  Monash  56,963  116,933  48.7%  LiberalRussell Broadbent  7.4%  Marginal  Regional
15Indi55,623114,24748.7%IndependentHelen Haines1.4%MarginalRegional
QLD         
3Hinkler60,182111,22354.1%Lib/NationalKeith Pitt14.5%SafeRegional
4Wide Bay59,186111,11553.3%Lib/NationalLlew O’Brien13.2%SafeRegional
  22  Maranoa  49,529  106,260  46.6%  Lib/NationalDavid Littleproud  22.5%  Safe  Regional
26Fisher54,161118,29645.8%Lib/NationalAndrew Wallace12.7%SafeMetro
32Fairfax52,948117,98544.9%Lib/NationalTed O’Brien13.4%SafeRegional
WA         
24O’Connor47,152102,34646.1%LiberalRick Wilson14.5%SafeRegional
27Canning50,840111,07445.8%LiberalAndrew Hastie11.6%SafeMetro
36Tangney42,23795,22344.4%LiberalBen Morton11.5%SafeMetro
38Forrest47,834108,19344.2%LiberalNola Marino14.6%SafeRegional
60Moore42,569102,73141.4%LiberalIan Goodenough11.7%SafeMetro
SA         
  9  Mayo  61,987  123,841  50.1%Centre Alliance  Rebekha Sharkie  5.1%  Marginal  Regional
10Barker59,069118,87749.7%LiberalTony Pasin18.9%SafeRegional
11Grey59,905120,56649.7%LiberalRowan Ramsey13.3%SafeRegional
33Boothby56,156125,28644.8%LiberalNicolle Flint1.4%MarginalMetro
37Sturt55,484125,36244.3%LiberalJames Stevens6.9%MarginalMetro

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

   Electorate  55+Total voters% over age 55  Party  MPAEC margin  Status  State
TAS         
16Braddon38,70780,47248.1%LiberalGavin Pearce3.1%MarginalRegional
18Lyons39,22982,10147.8%LaborBrian Mitchell5.2%MarginalRegional
25Franklin35,58277,29846.0%LaborJulie Collins12.2%SafeMetro
28Bass35,35877,43145.7%LiberalBridget Archer0.4%MarginalRegional
48Clark31,42773,31542.9%IndependentAndrew Wilkie22.1%SafeMetro

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

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