CREATING AN AGE-FRIENDLY NATION
CREATING AN AGE-FRIENDLY NATION
NATIONAL AGED CARE ALLIANCE MEETING - MELBOURNE
***CHECK AGAINST DELIVERY***
I acknowledge the traditional owners of the land on which we meet – the Wurundjeri people of the Kulin nation - and pay my respects to their elders past and present.
Thank you for your welcome. It is good to be back with you. I recall my first ever attendance at a NACA meeting, early in 2014. Looking around the room this morning I am pleased to see familiar faces of people I have met and collaborated with over the past.
One of the few benefits of being in Opposition is having greater opportunities to get out and meet so many people, visit different locations and listen to what you have to say.
With me today is Senator Helen Polley. She is our Shadow Parliamentary Secretary for Aged Care.
I have gained a far greater understanding of the role of the Senate as a result of being in Opposition and of working so closely with Helen.
Helen and I have held the Government to account during Senate Estimates, through the Parliamentary processes and in the media.
Politically, Helen and I have been the two constants in Ageing and Aged Care.
Unlike the Government which has had three senior Ministers – four if you include Christian Porter who thought he had the portfolio for about a day. In addition they have had two or three junior Ministers. We are still unsure about what Fiona Nash and Ken Wyatt’s roles were in this space.
The roles Helen and I inhabit have had broader remits than our counterparts in the Abbott-Turnbull government, to deal with the wider policy area of ageing and longevity more generally.
The Government has had no one for us to directly counter in this space.
It’s not only poor strategy but it highlights the clear divide between the Coalition and Labor.
This morning I want to outline Labor’s plans – plans that we believe can lead Australia to become an age-friendly nation.
That includes addressing the future of aged care. But I want to make it clear: Labor is looking more broadly than simply aged care services in our policies.
In contrast to the ubiquitous billboards and advertisements promoting “anti-ageing” products, services and lifestyles; at this election, Labor is unashamedly “pro-ageing.”
What is the issue?
I do not need to tell you that the cohort of older Australians is getting proportionally larger as we see people living much longer.
The very fact that people are living much longer lives is one of the greatest achievements of the 20th century.
This longevity will define the 21st century.
Not just in Australia. This dramatic demographic shift is occurring across the world and has profound implications for our social and economic policies.
We often call this the Asian century. I think we could call it the older person’s century.
I do not use the word old or older dismissively or in a derogatory manner either.
I was quite inspired by the Age Discrimination Commission 2014 campaign – led by the formidable Susan Ryan - called The Power of Oldness.
It took back the negativity of the word “old” and made it powerful.
Power is not something we associate with age, necessarily.
But power is what older Australians have, particularly when they make up a quarter of the population as they will by the middle of the century.
It is our ambition to ensure that all Australians are able to live the best lives possible:-
Physically, cognitively, mentally, and spiritually.
All Australians deserve the opportunity to live meaningful lives:-
To be positively engaged in their community, with other people, and with their family:-
To live with dignity, security, and autonomy.
This is what the World Health Organisation calls “active ageing”.
It’s more than ensuring we have care for the elderly; it’s about ensuring we age well.
This is at the forefront of our policy and budgetary discussions.
But it cannot be policy in isolation.
Ageing policies that focus purely on aged care and pensions and health alone portray ageing as a fiscal burden.
So while we need solid policies on health, aged care, pensions and retirement income, there is so much more to ageing than retirement and aged care services.
Ageing impacts employment policy, education and training policy, immigration policy, innovation and communications policies, housing, regional development and infrastructure policies.
Labor recognises that ageing is more than a story of our illnesses and diseases. We want to celebrate age or oldness or longevity as a blessing not a burden.
A National Strategy
That is why a Shorten Labor Government will develop a national strategy to harness the economic and social potential of older Australians, with a view to becoming an age-friendly nation.
Labor will build on the work we began when we were in Government, through the former Treasurer’s Advisory Panel for Positive Ageing, made up of eminent older Australians:-
Work that was cut short when then Treasurer Joe Hockey unceremoniously sacked the panel in November 2013, six months short of completing its blueprint.
Thankfully, the tenacious Everald Compton and the panel continued their work and produced the Blueprint for an Ageing Australia in September 2014, with support from Per Capita.
It is a wide-ranging document that takes into account the economic and social potential of older Australians, overcoming barriers to working, encouraging inter-generational partnerships, the need for infrastructure planning and housing.
Labor’s strategy will address the important issues of elder abuse and discrimination – particularly found in the workplace.
We have already announced our policy to reinstate a stand-alone Disability Discrimination Commissioner, following the short-sighted move by Attorney-General George Brandis to sack the previous Commissioner and dump disability onto the Age Discrimination Commissioner.
In doing so, Labor is committing to a stand-alone Age Discrimination Commissioner.
We will work with the Commissioner to tackle the specific issues and barriers to work identified in the Australian Human Rights Commission’s Willing to Work Inquiry.
Labor has recognised that it is simply unsustainable to stick with the previous paradigms. We are an ageing population that is becoming more service-oriented.
That is why Labor will develop an overarching National Strategy for an Ageing Australia, coordinating Federal, State and Local Government, along with the sector and consumer responses, under Commonwealth leadership.
That work will be undertaken by a Minister for Ageing. Not a Minister for Social Services; nor a Minister for Aged Care.
But by a dedicated Minister who will coordinate cross-jurisdictional planning, policy development and implementation. Someone who can work with Departmental officials.
Our strategy will be built upon the World Health Organisation’s Active Ageing principles and age-friendly communities.
I have spoken to a number of local Governments around the nation. I am heartened by the work being undertaken by local Councils around the nation.
I was in the City of Swan, to the north east of Perth, last year.
They have developed an age-friendly policy that embeds ageing needs and issues into every level of work the Council is involved with.
Labor’s plan will support more Councils to take charge of developing age-friendly communities that meet the unique needs of their communities:-
Planning and development, public transport, age-friendly parks – with facilities for older people to enjoy, suitably located toilets, adequate seating and access suitable for wheelchairs and mobility aids.
It will cross portfolios. For instance I have been collaborating with Shadow Minister for Employment and Workplace Relations, Brendan O’Connor to address mature age employment issues and find innovative ways to maximise the opportunities this presents.
I am confident that a number of you here will be part of the development of our age-friendly nation strategy.
Labor has a strong record for collaboration and consultation with you.
Labor is supportive of the age-friendly communities concept and we will support communities and organisations to become more age-friendly.
That is why a Shorten Labor Government’s Active Ageing Fund will provide support to communities for innovative programs that enable older Australians to age well in their own communities, at home and at work.
We will refocus the grants program, known by a range of names: originally the Aged Care Service Improvement Services and Healthy Ageing Grants – fondly known as ACSIHAG; now known by the vague but much shorter title of Dementia and Aged Care Services grants – or DACS.
We will continue the funding allocated, honouring the commitments already made, and build in indexation increases from 2019.
While there are some great programs funded through this discretionary grant program at the moment, it often does feel as though the programs have lost focus, and simply become the bucket of money to fund projects that don’t fit anywhere else.
Under a Shorten Labor Government, the Active Ageing Fund will support programs to reduce the risk of dementia, falls prevention, improving physical activities and healthy lifestyles.
We believe in utilising community-specific approaches to active ageing, including diverse and unique communities such as Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse and LGBTI communities, as well as remote and rural communities, while not neglecting those at risk of homelessness.
As you are aware, there is a well-documented connection and relationship between the rate of physical and cognitive decline and lifestyle, social, economic and environmental factors.
Active Ageing affords older people with dignity, quality of life, greater opportunities.
At this time, when there are heated discussions about the growth in aged care funding, surely it makes sense to invest in Active Ageing now, before the bulk of our ageing Baby Boomers need complex aged care services?
The future of Aged Care Services in an age-friendly nation
Active Ageing does not get the attention that aged care funding does. And I know some of you just want me to get to the aged care policies.
In fact, there has been considerable pressure on Helen and me to make a definitive response and commitment to the Aged Care Roadmap proposals.
Firstly let me state at the outset that a Shorten Labor Government is committed to the ongoing aged care reform process to ensure all older Australians have access to the care they need.
The Living Longer Living Better reforms are a ten-year plan.
There is an appetite from some within the sector, to see the reforms brought forward.
In reality we have not yet reached the mid-point in that process.
The aged care system has come a long way in four years and we have learned a great deal.
It has been challenging: for consumers, for aged care providers, for our workers, for primary health providers and the community generally.
Personally, I think the reform process has been marred by poor implementation and lack of leadership and interest by the Abbott-Turnbull Government:-
- Two Machinery of Government changes
- Overspends and underspends
- Over $3 billion worth of cuts to the sector
- And My Aged Care (or MAC as it is commonly called)
The 2011 Productivity Commission report “Caring for Older Australians,” recognised that the aged care system was difficult to navigate and recommended a single gateway.
The gateway would provide consistency, improved information so consumers could compare services, and a single point where consumers only needed to tell their story once.
What we have at the moment is a website and a call centre.
The MAC system assumes most consumers have access to a computer and the internet, have the IT literacy to navigate the system.
It assumes most consumers have a general idea of what they want.
I do note the Government has budgeted for additional call centre operators to deal with a greater demand than previously anticipated.
Consumers and their loved ones want to chat to someone.
What we have heard in electorate offices around this nation is they really want to talk to someone face-to-face:-
To a real person who understands them and their community.
MAC is not yet a one stop shop. The quality of the information can depend on the individual operator you get on the phone at any particular moment.
More than that, MAC has not provided the support and convenience for the aged care sector that was promised.
Combine that with provider portal issues, significant payment problems with Medicare and means testing errors and delays from Centrelink, and we have a system that is not consumer-friendly let alone as age-friendly as it should be.
A Shorten Labor Government will begin addressing the problems in MAC within the first 100 days in Government.
We will work consultatively with the aged care sector, consumers – including those who are not computer-savvy, workers, primary health and allied health providers.
Of course, there have been some bright spots over the past three years.
Some aged care providers have found the new funding arrangements to be much more effective than originally thought. In fact, by all accounts, it has led to increased profitability for a number of providers.
We have been pleased to support the natural progression of the reforms through the introduction of an independent Aged Care Complaints Commission.
We have supported red-tape reduction measures.
And the more recent legislative changes to increase consumer choice and control of home care packages.
I understand there is some frustration with the number of stocktakes, audits, reviews, etc. They have delivered very little of late.
It took 547 days just to undertake a stocktake of federally funded workforce development activities.
A stocktake that was instigated under the proviso it would inform the development of an aged care workforce strategy.
In the end, it was not about workforce development at all. It was about cost-cutting.
The release of the stocktake report neatly coincided with the 2015 MYEFO, which savagely cut aged care workforce development funding, after a devastating 15 per cent cut in the 2015 Budget.
So I understand your hesitation and fear of reviews, audits and stocktakes.
As you understand, however, the Living Longer Living Better legislation mandates that a review of the LLLB reforms takes place at the five year mark.
According to that legislation the review report has to be tabled in Parliament in a little over a year’s time.
A Shorten Labor Government will conduct an independent, transparent and thorough review of the Living Longer Living Better reforms with a view to moving towards improved quality, better coverage, and greater flexibility, choice and consumer control.
In addition, this review will incorporate an examination of the Aged Care Funding Instrument, which many in the sector have called for.
By 2022, at the ten year mark, it is our vision that Australia’s aged care services system will:
- Be sustainable and affordable, well into the future
- Provide diverse and rewarding career options
- Encourage aged care services and businesses to invest, grow and innovate
- Offer increased quality care and services that support wellness, re-ablement and quality of life
- Offer greater choices for all consumers and place more control into their hands
- Support people to stay at home, part of their communities, for as long as possible.
I may be stating the obvious, but I believe it is important to have a clear vision for the future.
I imagine this is one of the reasons the Government tasked the Aged Care Sector Committee with development of the Roadmap to advise on future directions for aged care.
According to the Committee’s website, the intent of the Roadmap was to “generate discussion across the aged care sector and government regarding future reforms to aged care.”
I want to thank the Aged Care Sector Committee Chair, David Tune, who came out to the Blair electorate office in Ipswich to personally guide me through the Roadmap and answer my questions.
The Roadmap focuses on how we achieve a sustainable, consumer-led aged care market, where consumers have increased choice and control of what care and support they receive, as well as where and how and when they receive.
The Roadmap is a good starting point for discussions and assists in focusing the review.
What the Roadmap is not is a replacement for a transparent and independent review.
While the Roadmap is meant to be a discussion starter, I do note there are some who insist we make a commitment to the Roadmap’s progression and to a deadline for its implementation.
It would be irresponsible for Labor to commit to what was supposed to be a discussion starter, without the benefit of thorough analysis of the financial implications and what it will take to ensure consumers are equipped and prepared to take control.
What I can say is that I believe the Roadmap provides an important starting point and directions to consider within the review:-
A review that needs to be transparent, under the leadership of an independent reviewer or reviewers.
The review will be undertaken in close consultation with the Department, with you in this room, with those who are specialists and experts from related fields.
The legislated review provides a timely opportunity to address immediate issues and concerns. In particular the way we fund aged care.
This is something the Roadmap addresses but does not provide any real detail.
In this context, a Shorten Labor Government will include ACFI in the legislated review.
Helpfully, the sector has undertaken a number of independent analyses of ACFI, certainly in terms of the Abbott-Turnbull Budget cuts.
As an immediate priority, we must get to the bottom of the actual impact of the Budget cuts, especially those cuts to the Aged Care Funding Instrument:-
Over $1.6 billion, if we combine the previous cuts in the 2015 MYEFO.
The first tranche of those cuts begins on 1 July 2016 – a day before the election.
Like you, I was disappointed by the depth of those cuts, introduced days before we went into caretaker mode.
Not by legislation, but by a Determination lodged quietly in the in the final moments before going into Caretaker mode.
I will not sugar-coat it: Labor is not in a position to reverse those cuts.
But it does not mean we do nothing.
In the first instance I am calling on the Turnbull Government to release the modelling used to determine the accuracy of those cuts.
According to analysis undertaken by some of you in this room, the impact of those cuts is much higher than the Budget papers indicate.
We need to be in a position to understand more than just the impact on the bottom-line:-
What will be the impact on the quality of care?
How many jobs will be lost?
Who will provide care for those residents, and future residents, with complex health care needs?
How much will consumers be forced to pay for complex care?
What impact will these cuts have on efforts to efforts to improve services to those who are marginalised or have few options already?
These cuts apply to all providers. Not just the ones supposedly “gaming” the system.
A review of ACFI is a priority.
I believe it is time to address the unintended consequences of the funding instrument:-
What some of you here have told me are “perversely incentivising” keeping residents dependent, bed-bound, medicated:-
When what we want is for residents to become more independent, mobile, better.
The way we fund aged care needs to support wellness and quality care and services.
Which is why aged care services in Australia must reflect our lofty ambition to become an age-friendly nation:-
A nation that values older people and provides opportunities and support to live the best lives possible.
That includes quality end of life care, which my colleagues Catherine King and Tony Zappia outlined earlier this week.
Of course, we need to address the second leading cause of death in this nation: dementia.
I am pleased that the Roadmap addresses dementia.
Dementia is more than an aged care issue. Given the sheer numbers and the cost to the nation, to communities, to families, and to individuals, we cannot look at dementia in isolation.
In this regard, Labor will have more to say about this throughout the election campaign.
Finally, I want to outline Labor’s vision for the workforce.
Within our first 100 days, a Shorten Labor Government will begin work on the development of a strategy to develop the aged care services workforce.
We will undertake the strategy in consultation and collaboration with workers, unions, aged care providers and employers, with consumers, carers and other interest groups and ageing experts.
I can assure you that a Shorten Labor Government does not intend to tell employers how to run their businesses.
Rather, we recognise that the Commonwealth Government does in fact have a significant leadership role to play.
The Commonwealth Government is the prime funding source, controls the supply of services and regulates services. In addition, the Commonwealth Government is largely responsible for funding tertiary education.
It is important for someone to take leadership; to bring the parties to the table; to ensure a constructive and collaborative approach to developing this important sector.
Aged care services are people oriented. Personnel are the largest segment of aged care budgets. Quality care relies on a quality workforce, well-paid workforce.
This sector is one of the fastest growing segments in this nation. By the middle of this century one in 20 workers needs to work in aged care just to meet demand.
We know there are critical shortages of appropriately skilled, suitably qualified and motivated workers.
The sector historically has had a disappointing reputation for low wages, low retention and poor conditions.
We need a strategy to reframe aged care and related services as careers of choice.
That will require us to address some significant issues.
First of all, our strategy needs to address the training and qualifications needed within the workforce.
I have been overwhelmed at the stories I have heard about the inconsistencies in quality of the training in Certificate III and IV provided by registered training organisations.
Recently I was told that new graduates of one Certificate course could not even make a bed.
I am told that some employers have “black lists” of training providers whose qualifications do not equip graduates appropriately.
When Helen has asked the Government about these issues in Senate Estimates she has been fobbed off saying “that is not our department.”
I assure you that a Minister for Ageing in a Shorten Labor Government will work with colleagues in education and vocational education to ensure that the qualifications students receive adequately prepare them to work in this industry.
In addition, training programs need to equip and prepare future workers for the increasing complexity of care and new innovations.
They need to become more dementia aware, need to identify and understand elder abuse. They need to be equipped to provide good quality end of life care.
Any strategy has to address the issues of pay and conditions and career pathways.
We know that aged care nurses receive less pay than those working in hospitals for instance. That pay difference ignores the increased complexity of care in specialised areas of gerontology, chronic illnesses, dementia, and palliative care.
As we expect more of our workers, we need to ensure they are remunerated appropriately.
In developing this strategy, Labor will work collaboratively with aged care providers, unions, workers, training providers, consumers and specialists.
The strategy needs to address the unique issues facing remote, rural and regional communities; people from culturally and linguistically diverse (or CALD) backgrounds; those who identify as LGBTI; as well as Aboriginal and Torres Strait Islander peoples – those in remote communities, along with those who live in urban and metropolitan areas.
The strategy needs to address the needs of the workers, most of whom are women, getting older themselves, and require greater flexibility and support to allow them to continue working.
In addition, we need strategies to promote innovation; that focus on quality outcomes; that ensure we have the right mix of people.
Some of these issues were identified in submissions made to the Senate Inquiry, which Helen was involved with, and was truncated by this election.
Regardless, there are some quality submissions from a wide range of interested individuals and organisations. This work will not be lost, will not need to be duplicated and will be part of the development of this strategy.
In my many discussions and in public utterances, I know many of you in this room agree the development a Workforce Strategy is a necessity for this nation.
I want to wrap up and allow you time to ask us questions.
I remind you that aged care services are a significant part of our vision to develop an age-friendly nation. But it is not the whole story.
What Labor has is a clear vision that sees Australia not just coping with an ageing population; but maximising the opportunities the changing nature of our population presents.
It is our vision to see Australia transition to an age-friendly nation.
More than this, to be a world leader in developing age-friendly communities and the provision and development of suitable age services and products.
We are well placed in this region to be a leader in the provision of high quality, flexible services and products to meet the ageing populations across Asia.
As an age-friendly nation we will:
- Have a whole-of-Government approach, under the direction of a dedicated Minister for Ageing
- Promote and support Active Ageing
- Undertake an independent, transparent and thorough review of the aged care reforms, taking into account the Aged Care Roadmap and ACFI
- Continue to progress the LLLB reforms, and
- Develop an aged care workforce strategy.
Thank you for your attention and this opportunity to share Labor’s vision.
And thank you for contributions each of you make for older Australians.
 The Aged Care Sector Committee web site, www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reform/aged-care-sector-committee, last updated on 19 April 2016 and accessed 24 May 2016.