‘Market forces failing aged care’

Government aged-care policy is too reliant on ‘market forces’ and ‘consumer choice’, the aged care royal commission has warned.

Government aged-care policy is too reliant on “market forces” and “consumer choice” which aren’t delivering equitable ­improvements to older Australians’ lives, the aged care royal commission has warned.

In a new consultation paper proposing a completely remodelled aged-care system, the commission said older Australians felt dehumanised by being ­labelled “consumers”, and called on the federal government to ­intervene in the market to support older people in need.

“It is clear that the aged-care system is in desperate need of redesign — not mere patching up,” the paper said. “The direction of current reforms puts too much faith in market forces and consumer choice as the primary driver of improvement in the aged-care system … Market forces have an important role to play but are not delivering equitable outcomes in all parts of the country or for all groups.”

The paper said “framing the policy discussion around ‘markets’ and describing older people needing aged-care services as ‘consumers’ also reduces the issue to one of transactions rather than relationships or care”.

“The commonwealth has key responsibility for aged care (and) needs to do much more in guiding the system to deliver better outcomes for older people,” it said.

The commission’s draft redesign offers a three-tiered ­approach: an entry level support stream offering low-intensity services to help millions of older Australians retain acuity and ­independence; an investment stream for more intensive services to help restore a person’s functioning or slow their progression towards higher need; and a care stream for people needing personal support such as showering or feeding in their home or residential aged care.

It released its paper, which is open for public comment, before a new week of sittings focused on the links between healthcare services and aged care.

Senior counsel assisting the commission Peter Gray on Monday said people living in residential aged care did not have the same access to the universal healthcare system as others in the community.

“The evidence is clear that while Australia prides itself on having a universal healthcare scheme, aged-care recipients are often denied practical access to this healthcare,’’ Mr Gray said.

He said all people in residential aged care should have access to state and territory hospital network and outreach services.

“These services, we suggest, should reach into residential aged-care facilities or people’s homes and provide services in situ wherever possible,” Mr Gray said. “This will require regular, reliable funding, which as I have indicated earlier could be achieved by expanding the National Health Reform Agreement to ­include aged-care outreach services as an additional activity stream.”

He also called for a change to the fee-for-service model of funding primary care.

“While many general practitioners are providing excellent care under this regime, and some specialist aged-care general practice models are emerging, fee-for-service does not encourage holistic care or continuity of care,” he said.

He proposed consideration of a blended payment model, in which a GP enrolling an aged-care recipient would receive an annual payment based on the person’s health needs and care provided.