On 22 October, the final submission and 124 recommendations were presented to the Royal Commission by their Counsel Assisting, highlighting the need for huge reform changes for the sector, including the creation of an independent aged care commission, staff ratios and personal care worker registration, and a new Aged Care Act.
While some public figures and advocacy groups have expressed disappointment that the recommendations don't go far enough, most peak bodies are happy with the direction of the reform.
Industry peak body, Leading Age Services Australia (LASA), broadly supports the released reform roadmap for the future.
The organisation believes there were three main positive themes in the submission - better quality outcomes for people receiving care, more care services aligned to quality of life outcomes and practical timelines for implementation.
LASA Chief Executive Officer (CEO), Sean Rooney, believes that a number of key structural problems are being addressed by the recommendations that will allow older Australians to receive the level of care and support they deserve.
"It is not just more staff and more funding to provide care, it is a holistic approach including greater access to social inclusion, pharmacy, mental and dental health. There will be more supports for innovation in care design including telehealth and technology," explains Mr Rooney.
"Our preliminary view is that proposals for fundamental reform of aged care institutions – including the creation of an independent pricing authority, inspector general, and overarching commission with responsibility for funding and regulation – would help remove politics from the aged care system and ensure decisions are based on evidence, and the best interests of older Australians.
"We welcome the increased focus on the collection of quality indicators and the outcomes for older Australia to support choice and accountability at the system and provider level. Counsel Assisting has also proposed clear timeframes and transitional arrangements, which will be crucial to avoiding further delay in achieving the reforms that older Australians need."
While LASA is mostly positive about the approach, they do believe there are some areas Counsel Assisting need to further consider, such as excessive compliance as the result of these reform changes.
Once in a generation opportunity
The big picture reform from the Royal Commission has been described as a once in a generation opportunity by not-for-profit peak body, Aged & Community Services Australia (ACSA).
Patricia Sparrow, CEO of ACSA, is hoping that the Final Report, to be delivered early next year, will bring about real, lasting reform for the sector.
"The Royal Commission provides a significant opportunity for a reset of aged care so it meets our growing expectations for how older Australians live and are supported in the twenty-first century,” says Ms Sparrow.
"This is a once-in-a-generation opportunity to find solutions to support better health and quality of life outcomes for older Australians, now and in the future. ACSA welcomes the recommendations for new rights-based legislation and creating a demand-driven aged care system."
ACSA is happy that the workforce has been outlined as needing further support since the aged care workforce already needs more people as the ageing population grows and it makes the sector look attractive as a career option.
Ms Sparrow explains that the reform will assist in retaining good workers, provide them with better training and attract people who can begin making a valuable contribution in the sector.
She adds that the financial pressures aged care providers have been experiencing were recognised by Counsel Assisting in their proposed reforms, and that public financing of such a system is critical to delivering on the promise of these recommendations.
"While further consideration of the full suite of the Royal Commission’s recommendations and reform is needed, the Counsel Assisting’s final submission puts the Royal Commission on track to better set up Australia for our ageing population and the decades to come," says Ms Sparrow.
Peak body for non-government providers, Catholic Health Australia (CHA) supports many of the propositions put forward, including the focus on the workforce.
Pat Garcia, CEO of CHA, says, "We agree with the focus on providing seniors with better access to the wider health system, including primary care, palliative care, and other specialists, along with acute care, mental health, allied health and oral health services.
"We are pleased to see the recommendation to abandon the current rationing of services which has 100,000 older Australians on a waiting list for home care. We also support giving people greater choice over how their aged care needs are to be met, including a choice of provider and a level of engagement in managing their care.
"The establishment of an Aged Care Pricing Authority is positive, as is the move to a case-mix classification system in residential care, such as the Australian National Aged Care Classification (AN-ACC) model.
"We know however that these reforms to residential funding will take time, which is why CHA has been strongly advocating for immediate measures to address the critical financial pressures facing residential providers."
CHA is glad to see that the reform proposed by Counsel Assisting includes time frames for implementation.
Preparing the sector for the Final Report
For-profit peak body, Aged Care Guild, believes the recommendations mark an important step for the Royal Commission process and is an indicator of what will be delivered in the Final Report in February 2021.
While the Aged Care Guild is still assessing the recommendations in detail, it applauds the proposal for a rights-based system of aged care as well as the complete rewrite of the current aged care legislation.
Nicolas Brown, Acting CEO for the Guild, is insistent that the Aged Care Guild and its members do not want this report to sit on the desk of Government like the many other reports have before it.
"This time we need real change and the aged care sector is committed to the necessary reform,” says Mr Brown.
"Counsel Assisting’s recommendations only reinforce the extent of change needed and we look forward to working with Government, workers, consumers and other stakeholders to make this happen."
Palliative care recognised in reforms
Palliative Care Australia (PCA) has welcomed the proposed recommendations, specifically the compulsory palliative care training for workers, palliative and end of life care funding, and a review of the Aged Care Quality Standards.
Minister for Aged Care and Senior Australians, Senator Richard Colbeck, says the Australian Government has put more of an emphasis on the importance of palliative care in the sector through recent funding, which also seems to be reflected in the recommendations put to the Commission.
Board Chair of PCA, Professor Meera Agar, is excited to see palliative care has been included in the potential aged care reforms.
"It is extremely pleasing to see that palliative care has not been overlooked. PCA and the sector more broadly has advocated strongly for many years, and again in recent weeks, for a much greater investment in palliative care, together with palliative care training for every health and aged care worker," says Professor Agar.
PCA is encouraging the Commission to include palliative care within the new Aged Care Quality Standards and a call for data governance including an aged care minimum data set.
Rohan Greenland, CEO of PCA, says, "We can’t improve what we don’t measure. There’s too much about palliative care service delivery in aged care that we simply don’t know.
"Accepting the recommendation to the Commission for the development of a national minimum dataset to be overseen by the newly established Aged Care Commission would plug those gaps."
Minister for Aged Care and Senior Australians, Senator Richard Colbeck, was contacted for comment about the proposed reforms, he did not provide his response prior to publication.
The Royal Commission is requesting feedback from the public about the final submission and proposed recommendations from Counsel Assisting. Send your feedback to ACRCfinalsubmissions@royalcommission.gov.au by 4.00 pm (AEDT), 12 November.
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