Aged-care lobby to be front and centre of next election

The aged-care crunch has been coming for decades. As Simon Benson reports on Monday, a coalition of 1000 aged-care organisations — operated by churches, charities and private providers — is set to unleash a campaign across 30 federal electorates, demanding that the government spend an extra $20bn a year to bring the sector into line with world standards. The target electorates include the 15 most marginal in Australia and 15 with the highest proportion of voters over 55. The timing is masterful, with an election to be held early next year, at the latest. More immediately, the campaign coincides with the final report of the royal commission into the aged-care sector, due to be handed to the Morrison government late next week. It is likely to be highly critical of long-term funding shortfalls and other serious problems that have denied older Australians the quality of care they deserve. The commission’s interim report in October 2019 highlighted incidences of staff shortages, neglect and unconscionable examples of abuse at aged-care homes.

The lobby group, calling itself the Australian Aged Care Collaboration, is spearheaded by the main church-backed providers — Catholic Health Care, Anglicare, Baptist Health Care, UnitingCare Australia — as well as not-for-profit, charity and private operators. Some of its players will be adroit campaigners on the ground, eager to follow in the footsteps of the push by the Catholic and independent school sectors against the Turnbull government in 2018. This alliance, however, will be targeting all parties. One electorate in the firing line is Flinders, held by Health Minister Greg Hunt. Mr Hunt holds it by 2.8 per cent and more than half its voters are aged 55 or over.

The group is highlighting clear shortfalls in the system. In 2016-17, for example, 16,000 people died while awaiting government-subsidised support in their own homes. About 100,000 people are currently waiting for home support, with those in need of the highest level packages typically waiting at least 12 months. A further 88,000 places will be needed in communal residential aged care over the next decade, at a cost of $55bn. According to the alliance, Australia devotes 1.2 per cent of GDP to aged care, compared with the OECD average of 2.5 per cent of GDP.

The lessons that emerge from the alliance’s manifesto, It’s Time to Care About Aged Care,reinforce the warnings Treasury has issued in its Intergenerational Reports since 2002. That year, when the Howard government released the first report, it warned that the nation needed to prepare for an “aged care resourcing crisis’’. In 2010, the Gillard government’s Intergenerational Report noted that the number of Australians aged 65 to 84 would more than double over the next 40 years, and the number aged 85 years and over would quadruple. As the population aged, the proportion of working people to support them was set to fall sharply, from five working people per aged person in 2010 to about 2.7 working people for every older Australian by 2050. Market forces, that report predicted, would eventually boost wages for aged-care workers as demand for their services increased. Recruitment of suitable staff from overseas could be necessary if the needs of older Australians were to be met, Treasury noted 11 years ago. An updated intergenerational report will be released in the middle of this year.

Home-care packages, which allow older people to stay in their homes and communities, are increasingly popular. The government has funded an extra 10,000 packages a year over the past three years. The lobby group’s effort will ensure the issue is front and centre in the May budget. While the treatment of older, vulnerable people is a hallmark of a civilised society, the demand for a doubling of taxpayer spending and the royal commission findings to date underline several points.

First, as Australia emerges from the COVID-19 pandemic facing net debt of $1.4 trillion by 2023-24, spending in other spheres, including welfare, must be contained if the aged-care sector is to receive a significant increase to meet the needs of the ageing population. Second, the looming cost of aged care is a prime reason to prioritise growth and productivity to boost government revenue. Third, with about 78,000 extra staff needed now, as the commission estimates, immigration could have a role to play. And fourth, extra money will not solve all problems. Too many older Australians have suffered unkindness and incompetence from those supposed to be caring for them. Those lobbying for more money need to look hard at themselves.

Nor can the issue of retirees with the means to pay for more of their own care be ignored. In December, Adam Creighton opened a Pandora’s box when he raised the issue of tighter means tests and argued that “the massive increase in public spending on the horizon is not inevitable if we can shift more of the cost on to the recipients of the services’’. In its interim report, the royal commission said the system was “a shocking tale of neglect … that diminishes Australia as a nation”. Cabinet’s expenditure review committee met last week to discuss the issue. This will be a “barbecue stopper’’ political issue in the months ahead.