Leading Age Services Australia
So said one of the federal ministers responsible, Senator Mitch Fifield. But to Leading Age Services Australia (LASA), the changes do not signify good news. Rather the reverse, according to LASA’s Chief Executive, Patrick Reid.
If Patrick (who was formerly a leader of the Pharmacy Guild of Australia) appears to be severely critical of Canberra, it is non-partisan. Instead, he contemplates the inevitability of government shortcomings of whatever party holds power in view of the fact that aged care and its future are by definition long-term aims and ambitions and politics is equally definitively short-term. The two are largely incompatible, Patrick agrees, and consequently it is up to all of us to just get on with the business of ensuring a future for any of us who wants to live beyond three score and ten.
LASA was formed in 2012 as a combined organisation “to provide a single voice for the industry”, for users and providers of aged care whether in the private or charity-funded sector – residential or home care, respite care and dementia included. There is no sense of competition against other bodies that also seek to portray themselves as ‘peak bodies’, says Patrick, and he sees unity of purpose as an important aspect of the approach to the challenge of meeting the needs of the ageing population of Australia in years to come. “Our stated aim on behalf of our members is to have a unified voice,” he says.
“The sun still rose today,” Patrick told us on 1 July. “Reform was required but [these changes] don’t go far enough to improve the sustainability of the industry. They also have not pulled some of the major policy levers which are required to enable the industry to meet demand,” which is increasing daily. We need some 70,000 extra beds over the next eight to ten years at a cost, says Patrick, of some $21 billion, while total market capitalisation is only around $29 billion. “So we need to virtually double in the next few years the capacity it has taken a hundred years to get to.” Numbers hardly tell the whole story in any budget category, but bear in mind for comparison that the country’s F35 JSF fighter aircraft programme will cost around $24 billion ($12 billion for the jets and the same again for their upkeep).
“It’s a start,” he says, of the July reforms. “But it can’t be the end. A lot of ‘heavy lifting’ has to happen and there is concern about the ability of the market and the industry to meet the challenge of an ageing Australia. Our frustration is that we know it is coming and we can see it coming” – around 1,500 people turn 65 every week – “and those of us who are working with governments are getting a little frustrated that the pace of change and reform that is required to be sustainable is not actually occurring.”
Patrick believes the whole subject of ageing is one with which society in Australia has not yet begun to feel comfortable. It remains something that is addressed only when the immediate requirement – help for an aged relative – is acute. “The social compact needs to change too, in order that Australians can have that conversation about ageing,” believes Patrick. “It may happen with the baby boomers and they may change the social context.” But it hardly helps the cause that the dementia supplement was recently removed as a result of the federal budget, losing the industry some $653 million “at a time when we should be investing in aged care. That in itself is also a challenge.”
Patrick states that, “While economic prudence is the order of the day, ill-considered polices and funding trajectories often end up costing the taxpayer considerably more. With the cost of hospital care six times more than the most subsidised aged care, the threat is very real indeed. Industry is committed to quality, consumer-centric care; in exchange, government must acknowledge the real and unrelenting pressures of delivering care and services, with policy responses that assert a positive and forward thinking approach.”
On behalf of members, Patrick sounds a warning that big-business operators might be Canberra’s preferred option or even a hidden agenda. “One must question the government’s motives. What chance of viability is there for a small operator with a single standalone facility of 60 to 100 beds? Is the end game plan an industry of a small number of very large providers holding 90 per cent of beds?”
He also worries about the business climate for providers. The government is investing a lot of taxpayers’ money and “has a duty to ensure efficiency and effective care delivery; without a clear vision and forward planning, government will fail our most vulnerable. In order to redevelop and build, our industry must be confident that it can operate. Minister Fifield’s piece [quoted above] coupled with other actions from government does not instil confidence.”
Not all is bleak on the aged care horizon, though. Patrick mentions a number of areas where change is not only happening, but taking place with commendable speed, to aid the process of eking out the funds available. More preventive medicine, for example, reduces the cost of hospitalisation; emerging robotics can transform elderly mobility and enable many older people to remain independent – as most want – for longer. If the cost of the robotics is high, over a period of several years it may already be no more than the alternative cost of more conventional treatment and care. Even something as basic as the shift now underway toward better dietary habits – as Australians grudgingly start to heed the warnings about morbid obesity – is likely to show up in a couple of decades as a positive trend in terms of pure funding requirements.
These are factors, says Patrick, that cannot be costed into forecasts. “But despite warnings that the current changes would be a train wreck, the sun still shone this morning and the birds still sang. Innovation and change management are speeding up. The ‘fast fashion’ trend may move into aged care and people may take more responsibility for their own health. I am bullish,” he says, about the way innovation will pick up and fulfil part of the need for services and funding. There is a great opportunity for people from outside the industry to come and look at it with new eyes and bring a different dimension to the thinking about aged care’s future.
Despite the current federal axe-wielding, Patrick sees a good future for the aged care industry. He agrees that it is simply unthinkable that our future aged population might not have the care it needs and deserves. Any gap is likely to be taken up by the people and it is not a good idea to rely on the pollies to come up with the right solutions – if we want a fair go, we’ll have to provide it ourselves and human ingenuity and resourcefulness will always trump bean-counting bureaucrats. “If we rely on government alone to see us through we are in trouble. I think it is up to us as Australians – certainly as providers – to elevate the discussion and show the political leadership just how we can improve people’s living and having a good, healthy and valued life.”