Our vision of better care for older Australians is at risk

With many Baby Boomers entering retirement, Bupa’s Global Chief Nurse Jan Adams asks, is Australia ready?

The time has come for Australia to start having important community discussions about aged care.

The number of Australians aged 65 and over is projected to be around 7 million by 2054-55, double today’s estimated 3.5 million, according to the AIHW Intergenerational Report 2015.

It will drastically change the shape of our country and economy, we need to talk about it as a nation and plan for it now because it will affect us all.

Consider this: did you know that there is a 45% chance you will need residential aged care if you make it to your 65th birthday?

A significant portion of Baby Boomers will eventually need aged care.

The latest Aged Care Financing Authority report estimates there will need to be an additional 83,500 care home places over the next decade to meet growing demand.

This is almost triple the amount of new places created over the previous decade and will need to be supported by around 614,000 new care workers by 2050, as estimated by the ‘Future of Australia's aged care sector workforce’ report.

How do we prepare for this as a country? Australians expect and deserve high-quality health and aged care.

These questions are especially timely with the Government’s current inquiries into aged care quality and David Tune’s upcoming Report.

Bupa’s submission to Nick Xenophon’s Senate Inquiry on Aged Care Quality Assessment calls for urgent funding reform to ensure Australians can continue to access high-quality aged care. Much like the Living Longer, Living Better reforms, the next wave of aged care reforms need to be developed in a bi-partisan way.

Jan Adams, Bupa’s Global Chief Nurse and Acting Managing Director of Bupa Aged Care Australia
As a nation, we need to have a serious discussion on how we plan for an ageing population, as well as how we help each Australian plan to age.
Jan Adams, Bupa’s Global Chief Nurse and Acting Managing Director of Bupa Aged Care Australia

It is understandably complex with no easy solution, but it will shape our country and should not be a short-term issue nor should it be politicised.

The recent changes to residential aged care funding – particularly the indexation freeze and changes to the Aged Care Funding Instrument (ACFI) complex health care (CHC) domain – are making it increasingly difficult to provide the high level of care required for residents with complex care needs, within the aged care home.

This follows sustained cuts since 2013, including the loss of bond retentions, removal of payroll tax exemptions for some providers, and the removal of dementia supplements.

These cuts have impacted our most vulnerable community members, those with complex care needs such as severe dementia or other chronic conditions.

Where care cannot be delivered in the aged care home, due to inadequate funding, people will increasingly need to be transferred to the more-costly hospital setting.

This is a very poor outcome for the resident, their family and the health and care system.

More broadly, it is more costly and places unnecessary strain on a system already under stress. The average revenue available to provide care in the residential aged care sector is approximately $260 per day, significantly less than the private ($1,239) and public ($1,400) hospital sector. (1)

Australian Government aged care expenditure is expected to be $17.5 billion in 2016-17 and, according to ACFA, increase to $20.8 billion by 2019-20. Bupa recognises it is not realistic to expect the government to significantly increase funding to the industry in the current budgetary environment.

At the same time, we need to avoid a situation like that of the United Kingdom, where ongoing reductions to aged care funding have resulted in approximately 25% of acute care beds in hospitals being occupied by people with dementia and aged care facilities continue to close.

Sustainable funding is key to providing quality aged care and attracting a strong workforce. Without reform to the existing funding model, it is inevitable that the quality of aged care delivered in Australia will diminish over time – regardless of the effectiveness of the aged care accreditation, monitoring, review, investigation, complaints and compliance processes.

The current Government focus on aged care reform is welcome and presents a great opportunity to look at innovative ways to help Australians plan for retirement and better meet the demands that will come from our ageing population.

While it is a sensitive topic, Bupa believes we need to reconsider the Productivity Commission recommendation in 2011 to move to market-driven aged care funding, where people who can afford it contribute more to the cost of their personal care, and those who cannot afford it continue to be heavily subsidised. This would be consistent with research by the Council of the Ageing (COTA) which found that consumers don’t mind if people are being asked to pay more if they can afford it – so long as they also get better choice and a better quality system.

At Bupa, we are committed to delivering high quality health and care for our nearly 7,000 residents, as well as advocating for a more sustainable system.

We will continue to work with the Government to prepare for the huge challenges associated with an ageing population so that we can deliver the best care outcomes for our oldest Australians. They need it and deserve it.

Jan Adams is Bupa’s Global Chief Nurse and Acting Managing Director of Bupa Aged Care Australia.

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(1) NSW Auditor-General’s Report to Parliament, Managing length of stay and unplanned readmissions in NSW public hospitals, 2012-13