Steve Teulan: Same old aged care solutions risk locking in problems

Demographers have long been warning of the coming “care tsunami.” As the baby boomers age, a tidal wave of older Australians will reshape our population and the social contract underpinning how we share resources and fund services. The first waves are already breaking. Demand for care is rising faster than our capacity to deliver it, and the gap between what older Australians need and want and what the current system can provide is widening.

This imbalance is delaying access to both residential and home care, leaving hundreds of thousands of older Australians and their families in distress. The public hospital systems are struggling as the only alternative venue for care, and older people are waiting in hospital unnecessarily for up to months for a permanent place of care.

Against this backdrop, the new Aged Care Act, which takes effect on Saturday, represents an important step in improving the aged care system. It strengthens the rights of older people to high-quality, dignified support, reinforced by stronger protections when those rights are disregarded.

It places increased expectations on providers and makes them more accountable for the care they provide. The Act also offers the opportunity to achieve a more financially sustainable aged care system.

Provided that governments are willing to commit the required funding to home-based care, the Act empowers more people to live in their homes for longer, remain connected to their communities, and have clarity about what they can expect from the system.

The Act takes important steps towards recognition that funding should reflect the true cost of delivering care. There is also acknowledgement that aged care providers must be able to increase investment in services if they are to meet the higher standards and improved quality of care demanded by this reform. However, it is not clear whether funding and regulatory settings have reached the point of encouraging this investment.

The new Act represents the most significant reform of the Australian aged care system in three decades. But it will take more than legislation to meet the enormous challenges facing the sector.

Over the next four decades, the number of people over 80 years of age is expected to triple to more than 3.5 million. By 2042, the number of older people using home care is projected to increase to almost 2 million, up from about a million currently.

When there are already 200,000 older people waiting for a home care package, it’s clear the sector has little chance of meeting this demand without further reform.

The temptation in addressing crises like these is to look for simple fixes. Some might say providers should just build more residential aged care beds. Or the Government should just tip more money into the system and release enough home care packages to meet demand.

Of course, if providers or the Government could simply turn a dial to add more beds or fund more home care packages, the pressure would be solved overnight. But in the real world, both face hard constraints on funding and delivery capacity. And even if such solutions were possible, it’s worth asking: would they deliver the best achievable outcomes for older people? Would they be sustainable, and offer value for money in the long run?

There’s also the risk of locking in today’s problems. Pouring more resources only into existing models could fuel even greater demand, stifle innovation, and tie up funding that might otherwise support more flexible forms of care.

So what is to be done?

The sector and the Government must expand our thinking to tackle the challenges of the future. Increasing the flexibility of the system would enable older Australians to access different models of care that suit their specific needs. Solutions could include an expansion of targeted preventative and restorative programs, rolling out comprehensive centre-based and online support programs, where appropriate, for people living in the community, and providing funding at the residential aged care level in existing alternative accommodation settings. The broader Commonwealth Home Support Program must be utilised to its maximum, flexible potential.

Supporting providers to innovate in the types of services they offer would increase choice for older people and provide earlier access to care, by encouraging investment in the sector.

Wider use of new technology can support remote monitoring and communications to tackle isolation and help people continue to live safely in the community.

These are types of future reforms that can tackle the aged care system’s challenges over decades, rather than budget cycles. They will require strong, creative leadership and only succeed if they have bipartisan support and are shaped by genuine input from across the sector.

With this approach, we may one day look back on the current crisis as one that inspired us to act for future generations and the good of the nation.

Steve Teulan is the deputy chair of Catholic Health Australia. Alex Lynch is its aged and community care director