Just 1.7% of aged care and home care providers make submissions in response to Royal Commission’s aged care redesign paper

Just 32 of the almost 170 submissions – published this week on the Royal Commission’s website – are from providers who deliver residential care and home care services. With the latest data showing Australia has 873 registered aged care providers and 928 home care operators, that is just 1.7% of the sector who have ‘had their say’ on the future of the system. The comments by Commissioner Lynelle Briggs at the end of the final workshop session on transitioning to a new system on Tuesday about preparing for change – and needing to raise the discussion up to the next level – now make more sense. The Commissioners are not getting the level of engagement from the sector that they are seeking. To recap, the Consultation Paper had asked for feedback – due by 24 January – on their new model which put forward several new ideas, including:

• A care finder to help older people link to services and coordinate their care.
• A support stream for basic home support services.
• An investment stream to fund reablement and respite care.
• A care stream for higher-level personal and nursing care or allied health to be provided at home or in residential care.

These are major changes – practically inverting the current model of care. An analysis of the submissions – which come from peak bodies, the Commonwealth and providers as well as doctors, geriatricians, nurse practitioners, academic researchers, lawyers, aged care technology providers, allied health professionals and the public – also shows there is little ‘new thinking’ for the Commissioners. Just a few have advanced a model of care that is significantly different from the streams put forward by the Commissioners. Only ACSA and COTA Australia promise to deliver future submissions on an alternative model. ACSA says its vision will be made available to the Commission “as soon as it is available”, while COTA says its “transformational aged care model” could be handed to the Commissioners as early as late February or early March. Most of the submissions – like the witnesses at this week’s workshops – accept the three streams with a few caveats. Some do offer a variation on the Commissioner’s model. Baptist Care Australia has put forward an alternative model based on four streams, while Dementia Australia says it would like to see just two broad streams for services – mainstream and specialist dementia services. Interestingly, Professor Kathy Eagar – who led the Royal Commission’s first research paper into residential staffing levels in Australia and how they compare to the rest of the world – says the model doesn’t “represent the vision of the fundamental reform” that she believes is required – and puts forward her own four streams. However, there is not much new here. A few aged care providers voice concerns about the move away from a focus on residential care – Lifeview says the paper “severely underplays the role residential aged care plays in the lives of many Australians” and “assumes all residential aged care providers do not meet the needs or preferences of their residential population and gives no credit to those who do this.” But only one provider Anglicare Australia says it does not agree with many of the propositions in the paper.

“While the paper offers a lot of clarity in relation to problems in the current system, some of its core suggestions may have the potential to create as many bureaucratic silos and unnecessary administrative complexity as we have now,” they conclude.

In short, the Commissioners are not hearing a lot of opposition – but they aren’t hearing many alternatives either. Is it any wonder then that the Commissioners and Senior Counsel see their model as the best way forward? You can read the submissions here.