Initial personal responses (ten questions) to the draft report of the Productivity
Commission’s inquiry into Caring for Older Australians:
1. What are your first impressions? How would you describe the report? How well has
it considered and addressed the myriad perspectives and concerns raised in the
many submissions? Any surprises?
Comprehensive. Considered. Careful. Commonsense. Caring. Costings
The report appears to capture, explore and express the content, complexities and
concerns of the myriad perspectives and discussions on the aged care sector; its
policy and program parameters and the provision and delivery of aged and
community care services to older people.
The Report also reflects a hopeful mood and generous spirit of deliberations about
the needs in the aged care sector. It is timely to improve the provision of aged care
services for the well being of older Australians. There is an expectation that reforms
are possible.
Yes the positive and hopeful mood for reform was a refreshing surprise.
Difficulties in costing and implementing the reforms could easily sour the mood and
underlying cynicism re-surface.
Encouraging to note that non-English speaking background/Cultural and linguistically
diverse aged and community care issues are canvassed as integrated elements for
the sector not as exotica or an afterthought.
2. How does it compare/contrast with previous reports eg PC report 2008, Hogan
Report etc?
The report builds on the previous reports and specific aspects (for example:
inconsistencies in costs; increasing diversity of needs and changing access to
residential care) are articulated so that the PC Inquiry Report provides evidence
that its accumulated knowledge and perspectives and most of the views expressed
and the objectives are substantiated and underpinned by previous works and in
2010 re-evaluated, re-stated and reinforced by the recent Inquiry. The
recommendations, therefore, are authentic and valued because they recognise
and respect what has gone before and build onto rather than simply pull apart the
system.
The Inquiry Report is a more comprehensive; coordinated and targeted approach
to the aged care framework, system and sector. The suggested recommendations
better capture an integrated sector, rather than sections, as did some of the other
reports. This is the Report some in the aged care sector having been waiting for….
Encouraging to note that non-English speaking background/Cultural and linguistically
diverse aged and community care issues are canvassed as integrated elements for
the sector not as exotica or an afterthought.
3. What are the strengths of the report? What delights or impresses you? Why?
The Inquiry Report captures the past, grounds the aged care sector in the present
and proposes reforms for the future.
The Inquiry Report is comprehensive and coordinated and targets the aged care
framework, system and sector. It is a timely stock take of the current situation and
suggests recommendations and reforms which can improve the provision and
delivery of aged care services so that older people can better access services of their
choice.
The report is comprehensive and detailed yet the summaries are concise and
coordinated and the recommendations and reforms practical and possible.
Navigating aged care has been a nightmare and this report puts much into
perspective: access; information; consumer-centred care; carers; workforce; costs;
affordability…and recommends practical, targeted reforms.
Encouraging to note that non-English speaking background/Cultural and linguistically
diverse aged and community care issues are canvassed as integrated elements for
the sector not as exotica or an afterthought.
4. What are the report’s weaknesses? What has been left out, ill-considered or done
poorly?
The gaps include lack of clarity and integration with the disability sector and the
forthcoming Productivity Commission Report; lack of clarity on the implementation
process for the HACC program transition: two states not participating, will the
coordination and delivery of aged care programs be compromised?. There is lack of
clarity and overlap with some aspects of Disability; Health; HACC , and carers.
Significantly, costings for most suggested reforms are in principle and ball park
figures rather than specific and formulaic. It is understandable but costings can
provide a valued rationale for escape clauses for governments and others. And
costings can be an unsurmountable challenge for consumers. Costings will be the
devil in the detail.
For older people from diverse cultural and linguistic backgrounds the report
canvasses several priority issues but does not address them as specific reforms, for
example: How will the report and information about the reforms be provided to
older people from diverse cultural and linguistic backgrounds? How will they provide
feedback and responses? How will they access the Gateway? Will the objectives and
outcomes to be achieved by the Gateway identify and aim to address the special and
specific information needs of older people from diverse cultural and linguistic
backgrounds? Will the Gateway be able to refer Dutch older people to Dutch
speaking service providers?
5. What areas or ideas need further development or discussion?
There is lack of clarity and overlap with some aspects of Disability; Health; HACC ,
and carers. Significantly, costings for most suggested reforms are in principle and
ball park figures rather than specific and formulaic. The development of costings for
priority reforms need further discussion through elaboration and exploration.
For older people from diverse cultural and linguistic backgrounds the report targets
several priority issues but does not explore them as specific reforms, for example:
How will the report and information about the reforms be provided to older people
from diverse cultural and linguistic backgrounds? How will they provide feedback
and responses? How will they access the Gateway? Will the objectives and
outcomes to be achieved by the Gateway identify and aim to address the special and
specific information needs of older people from diverse cultural and linguistic
backgrounds? How will interpreters be used? Will there be CALD community
capacity building so that older people from diverse cultural and linguistic
backgrounds can receive cultural appropriate care from their own community
should they so choose?
How will service providers receive information and training on culturally competent
service delivery? Who will fund the training? Who will provide the training?
6. What is your particular area of interest – the ‘barrow’ you push? How well has it
been addressed in the draft report?
MAC has two particular areas of interest: CaLD older people accessing and receiving
responsive and targeted culturally appropriate care information and services and
service providers assisted (through education and training) to deliver culturally
appropriate care. Both areas are raised as issues to be addressed but particular
reforms are not canvassed or detailed with any specifics. For example: it is noted in
the report that older CaLD people become less proficient in English as they age and
therefore need targeted information about aged care services yet it is stated that
the Gateway will provide access to information to all and it is desirable that CaLD
older people will access the Gateway and that interpreters will assist in the
communication process.
The specifics about whether and how the Gateway will be required to be reflective
of and responsive to the information needs of CaLD older people; whether there will
be bilingual workers; how family members and informal carers can participate;
whether the post war, hard earned, family heritage assets will be able to be passed
on; how interpreters will be used and whether the Gateway will be user friendly for
significant numbers of CaLD older people…all these specific areas of interest are not
really explored in any detail nor canvassed let alone reforms suggested or issues
addressed effectively.
7.
How should the sector respond from here? What are the opportunities?
The sector needs to respond to the report in a sector based, constructive and
coordinated way. The response from the sector should be with a wide angled lens,
not with a rear view mirror, self serving; entrepreneurial or silo based. The report
succeeds in bringing together various threads of aged care; on first reading it is a
snapshot which identifies the aims and objectives and proposes a shared view of
those aims, objectives and challenges. The report is an opportunity to progress
that shared view into a shared vision for the future of the aged and community
care sector. Sector focussed opportunities include: to be consumer directed; to
improve and simplify pathways to information and access to services; to improve
education and training, to develop a dynamic workforce and to be inclusive of
various elements. The opportunity beyond reviewing and reflecting but now to
respect and respond.
8. What key challenges lie ahead? What issues or obstacles should we watch for?
There is still much to do in a timely manner: respond to the report to emphasise
currency and validity; continue advocating on the main aims and objectives;
reinforce the shared views and build on them by providing details and costings
which embrace the spirit but are practical, inclusive and responsive in their
implementation.
9. What are the priorities coming out of the report?
Older people having access to choices; current information; simplified pathways;
consumer directed care; continuity of care; family, carers and volunteers
supported and being able to contribute to costs as their means permit.
Meanwhile service providers coping with competition; more flexible approach to
providing services and accommodation needs and supported with education and
training of the workforce; carers and volunteers
10. How should the Government respond?
Provide a timely response which accepts the principles and premises; identifies
the gaps and develops a planned, costed, integrated implementation model.