Ministerial Address to Congress by Minister for Aged Care
Download as a PDF
Good afternoon,
Thank you for the invitation to speak to you this afternoon on “Super Sunday” of your National Congress.
First I want to respectfully acknowledge the traditional custodians of the land where we are meeting this afternoon, and to pay my respects to Elders past, present and future. I would also like to acknowledge the Aboriginal and Torres Strait Islander people here today.
I would like to thank the LASA Board for inviting me to speak today, in particular, I’d like to acknowledge Sean Rooney and the LASA board.
I often say that mine is the best job in the Commonwealth. Just about everybody in Australia will have some contact with the health system every year, and as we all know, just about everyone has an opinion about it.
I welcome that. It’s a privilege to be the Minister for a portfolio that elicits such a strong sense of personal investment from so many Australians.
Every single Australian is a stakeholder in the health and aged care portfolio.
And that places a lot of responsibility on those who are the current stewards of the system – to build on the legacies of the past and to prepare ourselves, and the system, for the future.
Sustainable, equitable, integrated – this is the goal for aged care and for the health system more broadly.
Consumer-centred. People-centred.
That’s what I want for our health system.
And it’s also what I want for the aged care system.
Ageing has never been a more active, empowered experience – with older people making wonderful contributions to their communities for many years after retirement.
And this change in expectations of ageing – makes it a particular privilege to also be the senior Minister responsible for aged care.
It was almost exactly a year ago when aged care came back to Health. I said that I’d put my hand up for it and that was a great decision.
We have a really exciting agenda in train to provide increased control and choice for older people. I will come to that shortly, but first let me emphasise that I also understand that aged care has to be there for people when they need it.
Aged care is there for people at one of the most vulnerable times of their lives. A time of potentially great stress for elderly people and their families.
Now I know that aged care is built on the skill, the commitment, the innovation and the determination of all the people who work in the sector – the providers, the workforce, the support staff, the facilities managers, the medical staff, the allied health professionals, the community organisations – and the families.
You all do an amazing job, and it’s a privilege to work with you.
This doesn’t mean, of course, that it is always an easy job to be the senior Minister responsible for aged care in Australia.
It is my responsibility, as Minister for Health and Minister for Aged Care, to implement reforms to the system that will preserve its strengths, while ensuring that it is sustainable, and that it meets the needs of individuals and communities in the future as their needs and expectations change.
But if there’s one thing I want to emphasise this afternoon – it’s that I have every confidence in the process of reform because of the way we work together.
Having worked with aged care for a year, I understand that you are as committed to the reform journey as we are.
As you all recognise in the theme of the congress – “No borders, no boundaries” – the sector must be offering choices, being smarter and more responsive – so care resources are available for those in need.
When we talk about new business models, and varying funding models – it means we are also looking at our responsibilities to address the distinct pockets of disadvantage and special need – the rural and remote communities, Indigenous communities, migrant communities, people who are poor, indeed women who have been impacted by a lifetime of caring and have limited accumulation of funds for retirement.
We can also be creating room for innovation and clever, new approaches for care and support.
It means changing the interface between primary care, the management of chronic conditions, and aged care so that there is better integration and more individuals are in control of their care choices.
We are achieving this together, and I want to say thank you – and to galvanise you so we can successfully continue our work together.
I think it’s useful to put our work in an historical context.
Once, aged care, as it was, was the domain of families, churches and charities. It was in the early 1800’s that the Benevolent Society of Australia, working with the poorest older people, started to advocated for a pension for the elderly who had nothing.
Later the Government assumed more control – aged care was a health service, and it was a system managed by government.
The industry grew, there were new players, the face of ageing changed.
Now fundamentally, the essence of our reforms is that the government’s role is changing – we don’t ‘own’ or ‘control’ the system.
Government will always have a role, for example, through My Aged Care which is bringing clients and services together to work closely together to make sure care is there when it is most needed.
The challenge for us all is how we respond to the changing face of ageing.
The 2015 Intergenerational Report estimates that in 2054-55, nearly 2 million Australians will be aged 85 and over.
We also recognise that with these rising numbers we are likely to have a cohort of older people with different expectations.
People want greater independence.
Most people will want to stay in their own homes connected into their community, living as independently as they can for as long as possible.
As you know, these types of considerations led to the Productivity Commission review of aged care, which we committed to in opposition.
But it is up to us now to jointly take further reform forward.
I am proud of our achievements to date and they create a great baseline for our next stage of reform.
We’ve delivered an integrated entry level program to support people in their own homes in the Commonwealth Home Support Program.
We’ve bedded down pricing and means testing changes to ensure that those who have the capacity to pay do so.
And in February next year we will fundamentally change the dynamics in Home Care between consumers and providers by allowing consumers the simple benefit of being able to move their package between providers.
However, there is more to be done.
I acknowledge that providers have been very agile and have been supportive of changing technologies. You have had to retrain your workforce and establish new ways of working within your organisation.
And there are other reforms happening in other parts of the health sector that interface with aged care that we must be conscious of. This in turn creates opportunities and competition for your high functioning workforce.
The Government’s signature primary care initiative, Health Care Homes, for example, is a revolutionary change to the way chronic and complex conditions are managed.
Through Pharmacy Trials we are looking at how the role of community pharmacists can be extended and adapted to make health care more accessible and integrated.
The devolution of mental health and suicide prevention services out to the Primary Health Networks will ensure communities are addressing their own needs in their own ways.
We are streamlining the PBS, reviewing and reforming private health.
Across the whole portfolio we are working on different parts of the health system so they are better aligned, more integrated, more able to flexibly adapt to change, and have a patient-focus.
Congratulations on your achievements to date and your willingness to participate in the reform journey.
There has been a very consultative, considered and constructive process between us in this area for a number of years. My experience has certainly been that Aged Care is the model for this.
Stepping back, I want to record how much I value the contribution of LASA. I appreciate the fact that representatives of your association have been so willing to work with us in partnership and to represent your interests in the development of aged care in Australia.
I want to touch on a few specifics this afternoon – the issues that we will all be focussing on as we look ahead.
Some are more challenging, but they are all issues we have to grapple with and are all part of the conversation that we are going to continue to have.
A conversation between government, industry, our workforce and older people, that is the individual consumers of our care, and their families, who use the system.
First, let me assure you that the Aged Care Roadmap is very much on my radar.
The Aged Care Sector Committee worked very hard to develop the Roadmap and I thank all who have contributed to it.
The Roadmap provides a very positive vision for aged care in Australia.
It provides a framework for us to consider our future reform – providing us with the basis for effective policy discussions as we move forward toward a system, less regulated, more consumer-focussed with a stronger presence in the community.
It sets out – in one coherent framework – the Sector Committee’s views on short, medium and long-term goals and needs for the sector.
I can assure you that I will be actively engaging with the vision as we consider the next tranche of reforms for aged care.
We are also working on preparing for the Legislated Review – required by legislation under aged care changes announced in 2012.
The Review is an important step in assessing how the reforms have shaped the aged care system, and where we could make further changes.
Continuous improvement is important. That we are learning, developing the strengths in the system, making adjustments, and being accountable.
We need to check that consumers are indeed being given more choice, and that costs are being managed and distributed equitably.
I am pleased to say David Tune, Chair of the Aged Care Sector Committee, will lead the Review – someone well known to all and very experienced. David will be speaking at this conference on Tuesday morning. There will be more information in coming weeks about consultation with the sector on the review.
I look forward to your contribution to this process.
On a different track, I can tell you that I am very encouraged with the progress of our roll-out of My Aged Care – and with the demand for My Aged Care Service increasing as people learn about My Aged Care and the range of support it can provide.
However, our ultimate aims for My Aged Care are not simply a national well-functioning booking, assessment and referral system.
We want people to feel comfortable engaging with the aged care system, investigating information – for themselves, in their own time, well before they suddenly need urgent care in a crisis.
We want people to use it to understand the kinds of services they may be eligible for, the ways in which we can help them stay in their own homes.
Consumers should be able to access the assessment process easily and efficiently.
The idea of a central, recognisable, user-friendly, client-focussed, market-based mechanism for people to access aged care is the essence of what we want for My Aged Care. As many of you will know these ideas are also key themes in the Government’s broader health reform agenda.
Across the Portfolio, I want services streamlined, integrated, simple, and accessible. The health system should help people to feel empowered by the tailored and individualised services.
I acknowledge that we had some initial challenges in terms of stabilising the IT platform for My Aged Care and the capacity of the contact centre to handle the higher than anticipated demand in both call volume and incoming correspondence.
We are also aware of some confusion, both in the contact centre and the sector, around some of the business rules which we have worked together to clarify. Together we have come through the transition year of 2015-16 to be in a much better place.
Some of the statistics are impressive. Between July last year and June this year the contact centre answered approximately 691,000 calls and issued over 325,000 referrals for assessment.
We had over 3 million visits to the My Aged Care website, for example. We know that we now have the volumes of clients passing through My Aged Care, however, we now have to focus together on the quality of the end-to-end client journey.
Historically once people have accessed care there’s been an assumption that that will continue forever, gradually increasing. There’s now a greater appreciation that people at all ages/stages can benefit from re-ablement and restorative services aimed at keeping people genuinely independent.
The new Short Term Restorative Care program is a key step in this direction, and I note the first places for this are available in the Aged Care Approvals Round (ACAR) that is open at the moment. It assumes that older people experiencing some kind of decline can, with the right support, regain function and therefore retain greater independence.
This is I think the other essential element of reform – that we’re moving the system from a ‘set and forget’ approach to assessing eligibility and need.
A lot of progress has been achieved through collaboration.
And of course, in the spirit of collaboration we have some significant challenges that we have to continue to work on.
So this brings me to the changes to the Aged Care Funding Instrument – ACFI.
Let me be really frank with you here. We have simply got to fix the way the funding assessment process for Residential Aged Care is working.
I do not believe that anyone can say that the Government should simply ignore the fact that costs were projected to grow by some $ 3.8 billion more than expected over the forward estimates.
In the context of the demographic challenges facing the Government this had to be addressed.
For the Government to deal with the profound demographic change that I outlined earlier it has to have predictable costs.
The Budget measures laid out before the election are designed to manage the rising costs in a way that responds to issues with ACFI.
I am committed to funding reasonable growth in the sector. We have ensured that, even with the tough measures to bring growth back to trend, funding for residential aged care will continue to grow on average by 5.1% a year over the forward estimates.
I know LASA members are concerned about the measures.
I appreciate that the Aged Care Sector Committee, and the ACFI Expenditure Working Group, which includes representatives from LASA, have been working with the Department on potential alternative approaches to the Budget measure on ACFI.
I know this hasn’t been an easy conversation. I can assure you that we will consider the options presented carefully.
We are as keen as you are to ensure we have a system that provides stable funding arrangements
Looking forward, the next step in the reform process is to investigate options for redesigning the residential care assessment and funding framework and consideration of decoupling the assessment process from service delivery – which may involve independent external assessors determining older people’s care needs and appropriate funding.
Again, this is an area where working together to bring our shared expertise to the table will get the best results.
This is a complex process and will take some time. We want to make sure we get it right.
Before I end, I know that many of you will be interested to hear about the future home-based care reforms – beyond the Home Care reforms of February 2017.
As you know, the Government announced its intention to move towards a more integrated care at home system in the future.
What we want to do is to make the system easier to navigate for consumers, increase their choice and control, and ensure that the system is sustainable into the future.
We also want to encourage restorative care and re-ablement approaches in community based care settings and to make sure that consumers get the right level of service for their needs.
The Government is open to discussing with the sector what approaches best deal with these objectives.
I know the sector has a strong expectation that design and implementation arrangements will be informed by consultation and co-design.
I want to emphasise that this is my expectation as well.
I also want to assure you that existing funding agreements will remain in place until they expire.
No decisions have been made about specific funding models or the final scope of these next reforms. We will continue to work together to make the right decisions so that people get the care they need.
Depending on the outcomes of the consultations, it could be that the best reform path is not necessarily a single program. We may need multiple programs that work in an integrated way.
I am very aware of the enormous contribution of volunteers in looking after people at home – the meals that are delivered, the community transport, and the social capital created through these activities. It will be important to preserve this in the future.
You will hear from us soon about the consultation process and opportunities that will allow you to participate in this discussion over the next three to six months as we embark on this next wave of reform.
As I said at the beginning today – I genuinely value the work that the aged care sector does and your contribution to it.
I also believe that you share my goal of creating and maintaining a sustainable world-class aged care system – where people can live healthy independent lives for as long as they can, part of the community, supported by a world-class workforce – who feel valued and empowered to advocate for their clients, their patients, their customers.
And perhaps most fundamentally of all, where people are able to get access to the care they need – whether it is support to stay at home, nursing care, advice, medical care, hospital care, support to recover, or support to be independent.
This will only happen if we make the right decisions now about how best to resource, structure, and shape the industry.
And we will only make the right decisions if we are open and honest with each other and work in partnership.
Everywhere I go I meet people who are committed to making sure the aged care sector can respond to the needs of people as they age – and that the sick, the frail, the very elderly, and the vulnerable have access to health and aged care.
It is one of my great pleasures as the Minister for Health and Minister for Aged Care.
It is also the great pleasure of Assistant Minister Ken Wyatt who in this term of Government will have a key focus on aged care.
Together we look forward to having many conversations with you over the coming year on how we can address the challenges and opportunities that aged care faces.
Thank you.
The post Minister Ley’s speech to LASA National Congress appeared first on Leading Age Services Australia.