Australia’s home care system is “chaotic” according to the lead author of a major new report from the Grattan Institute.
Although the vast majority of Australians want home care in their old age, home care is hard to come by, confusing and expensive.
“More money and better design could give Australians more dignity and better care in their old age,” says Stephen Duckett, director of the Grattan Institute’s health and aged care program, adding that the care system to the elderly is failing many older Australians.
“A new home care program is being introduced from mid-2023. The number of home care packages is increased by almost 50%, care seekers are employed to help people find services and Small regional offices are being created, but despite committing more than $2.44 billion in additional funding each year for home care spaces, the government’s response leaves unfinished business.
The Institute would like to see the government bring the system to the people, establishing dozens of regional offices across Australia to develop local, personalized services for people who need aged care and want them are delivered to their homes.
According to the report, Australia’s home care system is inefficient and home care programs provide relatively low levels of uncomplicated care at high cost.
play the system
“Administrative costs and hourly rates for services are high. The four-tier classification system for home care packages is only loosely linked to the actual costs of providing care. This allows providers to increase their costs and game the system.
Despite committing more than $2.44 billion in additional funding each year for home care spaces, the government’s response leaves unfinished business.
Report of the Grattan Institute
“Average hourly rates for personal care, cleaning, and gardening are nearly $60, and $100 for nursing, plus overhead. Administration and management costs are about a quarter of the total allocated for a package ($13,000 per year for a Tier 4 package), regardless of the level of service provided.
“Providers have discretion whether or not to charge recipients a basic daily fee as co-payment. As a result, it is difficult for care recipients to compare the value for money provided by individual providers. There are also large differences in the costs of care between high-cost and low-cost providers.”
The report says the extra money provided by the government will be spent on a poorly regulated and difficult to navigate system where consumers get a bad deal.
“Despite the reforms proposed by the federal government, the management of the home care market will not be strengthened enough to protect the interests of the elderly. Only small regional offices with limited scope and authority are proposed.
“The introduction of face-to-face support and 500 care seekers to help older people at risk is a big improvement to My Aged Care. But their role is too limited. They don’t have the ability to negotiate , to monitor and manage service agreements with providers on behalf of consumers.”
Administration costs and hourly rates for services are high. The four-tier classification system for home care packages is only loosely related to the actual costs of providing care. This allows vendors to cut costs and play with the system.
Report of the Grattan Institute
The government also has no plan to increase the number, salaries and conditions of home care staff who have precarious work with high levels of precariousness, poor working conditions and are underpaid for what they do. that they do.
The report explains: “There are labor shortages and high levels of dissatisfaction among workers. Vacancy rates are above 10% for most categories of staff, and staff turnover, between a quarter and a third each year, is high.
“Home and community care has been devalued as ‘women’s work’. Unpaid overtime, split shifts and highly variable hours are generally expected of workers in the ‘caregiver ‘ traditionally associated with women,” the report said.
He estimates that around 46% more staff – or around 58,000 carers – will be needed just to meet the projected increase in home care places and better pay and conditions will be needed to attract and retain care workers at home. residence.
The report is highly critical of the online and telephone service My Aged Care which it says is “transactional, impersonal and insufficiently informative. The website is difficult to use.
“There is no systematic, personalized route to information, assessment and home care services. Government proposals do not adequately address these issues.”
A better home care system would cost taxpayers more, the report says.
At least an additional $400 million needed
The costs of creating additional places could be partly offset by reduced administrative costs and reduced demand for residential care. But improving the necessary regulations and shipping support would cost at least $400 million a year more than the government promises to spend.”
The report’s recommendations include: Improving Home Care Market Stewardship, Eliminating the Home Care Waiting List, and Expanding and Developing the Home Care Workforce.
“The government has done a lot in response to the Royal Commission’s 2021 final report, but our report shows it needs to do a lot more,” says Dr Duckett.