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ROYAL COMMISSION: Need-based care and funding to reflect actual cost of care

The Royal Commission into Aged Care Quality and Safety held a brief hearing in Adelaide on Wednesday to hear all of the submissions about aged care program redesign proposed by the Counsel Assisting team and the Royal Commission staff.

​Senior Counsel Assisting, Peter Gray QC lead most of the hearing and presented all of the current proposals to the Commissioners to help further inform their decisions. [Source: Shuttertstock]
​Senior Counsel Assisting, Peter Gray QC lead most of the hearing and presented all of the current proposals to the Commissioners to help further inform their decisions. [Source: Shuttertstock]

Senior Counsel Assisting, Peter Gray QC lead most of the hearing and presented all of the current proposals to the Commissioners to help further inform their decisions for the Final Report due in November.

The aim of this hearing was to outline all of the Commission's proposals for an aged care redesign and to prompt responses from aged care organisations and the Government.

Mr Gray highlighted that reforms would need to be coupled with a continuity of care over the implementation and would not be done overnight.

He believes a transition strategy would be required for a successful move to a new aged care system.

The current proposal includes a need-based entitlement to aged care; a change in the system towards wellbeing and independence; an increased focus on preventative and early interventions in maintaining and restoring functions; a change in access to aged care, care finding and case management; funding changes; innovative accommodation options; improved data collection and analytics; and local strategies to provide equitable access to aged care for all, no matter their lives or background.

Mr Gray says, "Support and care in accordance with the assessed needs of each older Australian should become an entitlement based on need. People assessed as having needs justifying higher level of care at home should not have to wait until a rationed package becomes available.

"People receiving care whether at home or in a residential facility should have confidence that their provider is funded to provide the care that is necessary to meet their assessed needs."

He explains that funding levels should reflect the cost of necessary care and suggested that the rationing of aged care funding should be removed.

"The first way in which care in accordance with assessed needs should become an entitlement is that for the first time funding must reflect the actual cost of providing the necessary care," says Mr Gray.

"Funding would be set by an independent authority on the basis of efficient standardised costs ascertained at regular intervals."

A common trend throughout Mr Gray's submission was the need for the Australian Government to support the aged care sector through investment and funding changes and reform changes.

Mr Gray touched on the current aged care sectors reactive approach to care, suggesting that preventative and early interventions, which sustain independence and enhance wellbeing in each person, should be the goal.

"Care planning should reflect a person’s choices, goals and strengths, not just their traditionally defined objective care needs. Care planning should prioritise quality of life from the outset all the way through to palliative care," says Mr Gray.

"It should encompass psychosocial supports, happiness, and should integrate with existing supports in the community including from family, friends and support groups. Funding for supports to enable social connection should be available at all stages of aged care."

Case finding was another topic touched on, including a proposal that My Aged Care needs to be different.

My Aged Care would require a new workforce of care-finders, properly trained, to help older Australians find care that suits them.

Commissioner Pagone thanked Mr Gray for his submission, saying, "The Commissioners have heard and seen over many months some deeply concerning neglect, whether institutional or governmental, clinical, emotional or personal, and our focus has moved now squarely upon what to recommend to give Australians the aged care that we deserve and that will do our country proud. 

"We have heard anecdotally that some of the participants in the sector have been reluctant to engage fully with the Commission, and we urge that any that may feel reluctant overcome their reluctance and engage fully."

To access all of the suggested submission made by Counsel Assisting to the Commissioners, head to the Royal Commission website

The next Royal Commission workshop is on 16-17 March in Adelaide with a focus on Research, Innovation and Technology.

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