More than 100,000 Australians on wait list to be assessed for an aged care package | 7.30
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The Albanese government has introduced a huge revamp of the aged care system. One of its goals is to enable older Australians to stay at home and avoid institutional care. The success or failure of the system depends on getting a prompt test of what someone needs to remain in their home.
The Albanese government has introduced a huge revamp of the aged care system. One of its goals is to enable older Australians to stay at home and avoid institutional care. The success or failure of the system depends on getting a prompt test of what someone needs to remain in their home.
Some say they've been left waiting for that assessment for months. Anne Connolly reports. And Sarah Ferguson interviews Sam Rae, Minister for Aged Care.
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====
Transcript
You happy with tears. Why would you do
that?
It's hard for Eloise and her mom Carmel
to look back on this family celebration.
I think this is a fairy tale wedding of
two perfect people.
Within a year, their father and husband
Peter was seriously ill.
I'd like to propose a toast.
Dad was diagnosed with throat cancer. He
was quite advanced at the time of
diagnosis.
When Peter returned home after surgery
in January, the 74 year old was assessed
and approved for aged care support
services at home.
What wasn't clear to us that then there
was an additional 7 to9month wait for
the funding.
When the 74 year old was diagnosed as
terminal, the family was advised to get
an urgent reassessment.
Dad's needs were increasing by the
moment. You know, we needed personal
care assistance. We needed nursing.
The reassessment was to be done by a
company that had a government contract
to do the work called Aspire for Life.
So, it was put to Aspire for Life that
we needed a really urgent reassessment.
Aspire for Life gave mom and dad a
reassessment date of 8 weeks into the
future, and that was the most urgent
time they could get there.
The support Peter needed never came. He
died four weeks before his urgent
reassessment with Aspire for Life.
My mom spent those last few weeks
absolutely burnt out and exhausted
caring for someone on her own with no
support despite hours and days and weeks
of us just on the phone to these people.
For the past 40 years, clinicians from
state public health called aged care
assessment teams or AATs decided what
level of support elderly Australians
received, whether it be at home or in
residential care. Last year, the federal
government decided to partially
privatize the system, awarding contracts
worth more than $1.2 billion to more
than a dozen companies to do the job.
The waiting list for assessments now
sits at 116,000.
That's almost equal to the number of
Australians who are actually waiting for
a home care package, which is now at
120,000.
Aspire for Life was responsible for an
assessment for support services for
Peter, not his medical care.
In a statement, the not forprofit said
it couldn't comment on his case, but
said the high demand for assessment
services is universally acknowledged and
it was investing to meet demand.
The pressure on the system is evident
around the country, including here in
Canes.
Things are just not happening, and I
just don't know where to go. Coral
Wilkinson, a former AAT assessor, now
helps people navigate the system and
deals with a range of assessors in
Queensland.
Mari, I've got your back.
She's been overwhelmed by calls from
clients.
Some people are waiting 9 and 10 months
and their cases are urgent and they
don't know when they're going to be
assessed and their families are at
breaking point. Through her podcast,
people in the sector tell Coral the new
system is failing because some
organizations don't have skilled staff
to do assessments. I think there was
some uh naivity on the part of the
department and perhaps some of the newer
assessing organizations who didn't
really understand the level of of
knowledge and expertise that was is
required to assess older people who
particularly have higher and more
complex needs.
The 2021 Age Care Royal Commission
called for changes to simplify the
assessment system, but it didn't
recommend privatization.
It recommended that assessments be done
by people independent from approved
providers to avoid a potential conflict
of interest. If an assessment
organization is also an approved or
registered provider of inhome services,
there's that, you know, potential
conflict of interest or risk that the
assessment organization can then uh
channel people into their to their
provider.
The ABC has found that more than half
the companies awarded contracts are also
home care providers or have a connection
with one.
A spokesperson for the aged care
minister Sam Ray said the government had
robust arrangements to prevent conflicts
and the department can take action
including terminating contracts if a
conflict was identified.
Former clinical assessor Janine Mason
quit after 3 months with another
assessment company because she says she
wasn't given enough time to properly
assess people.
Many assessors feel this pressure to get
these assessments done. it it's coming
from
uh
departmental decisions that are pushing
down onto then companies that must
remain viable and keep their contracts.
Even more disturbing for her was a
practice that she says saw elderly
people dropped off the waiting list if
they didn't answer phone calls in time.
We were advised three calls were to be
given. If they don't respond to those
calls, then that referral would be
rejected. Um, there are many reasons
why, you know, three calls is not an
appropriate way to then reject people
out of a system who've been waiting
months and may not realize they've been
rejected out of the system.
Janine's former employer said there had
been a department guideline to this
effect, but that their organization had
not adopted this policy.
The government has strict KPIs for the
new assessors, including that 90% of
urgent assessments be done within 10
days.
At Senate estimates last month, the
department denied reports that KPIs had
been abandoned. Is it true that the
departments abandon KPIs for weight
times for assessment agencies?
No. So, we haven't abandoned um
have they changed?
They haven't changed. Uh
but the department acknowledged the KPIs
will temporarily not be enforced.
Have they been temporarily waved?
We have indicated that during the
initial transition to the single
assessment system workforce uh we won't
be enforcing those KPIs for
approximately the first 12 months of the
system.
The government says the median wait time
for an assessment is 23 days but
providers and families say people are
waiting months.
I've been working in this space for a
long time. I would go so far as saying
it's the worst I've ever seen it. I
haven't seen such a delay for people to
get their age care assessment.
I I really despair for the amount of
vulnerable elderly Australians. Probably
it's too hard to sit on the phone and
navigate the bureaucracy that is the
system.
So brave.
Yeah. I think this process shows we had
to speak for him and we still got
nowhere.
At the weekend, the government
introduced a new payment system as part
of its age care reforms where older
Australians will make a contribution to
their home care packages with hardship
assistance if they can't afford it. Sam
Ray is the Minister for Age Care. I
spoke to him earlier.
Sam Ray, welcome to 7:30.
Sarah, thanks for having me. Australia,
like many countries, faces an aging
population. Is this suite of reforms
that the government has devised enough
to meet that oncoming demand?
You're very right, Sarah. We do face an
aging population. It's one of the great
public policy challenges of our time and
we want every single older person across
Australia to be able to access safe,
dignified, and high quality aged care
services. And that has been the guiding
principle since uh really since the
Royal Commission handed down its
findings under the Morrison government.
Prime Minister Anthony Albanes made a
range of commitments ahead of the 2022
election and we've worked tirelessly
since we were elected to government to
pursue that ambition, safe, dignified,
and highquality aged care for every
older Australian. Now, in terms of
assessments, because this is the the
system that's been in place now,
privatized assessments that's been in
place um since the end of last year,
what happens in the most urgent cases
like the one that we referred to in our
story? Should you have a priority system
for those most urgent cases to make sure
that people get uh assessed immediately?
The assessment process has historically
been very complex, Sarah, and you're
right. At the end of last year, we put
in place uh the single assessment
system. This was a key recommendation of
the Royal Commission. uh and that has
gone through a period of maturing over
the last 11 months and we're now
starting to see the benefits of that new
single assessment system both in terms
of uh the experience of older people and
their families that are interacting with
the system and of course in terms of the
measurement that we do at a government
end. Uh the median assessment weight
times at the moment is uh 23 days and
just in the last quarter we saw that
improve by eight days. So, we are seeing
rapid improvements, but of course, I
want to see older people and the people
that love them being able to access an
assessment and care system that is agile
and able to respond to their needs. So,
we'll keep working to make sure that
that assessment system is part of a
broader ecosystem that is responsive to
the needs of older people in our
community.
Look, you know, obviously medians can be
very misleading, but just stay with this
issue of priority because it's obviously
at the sharp end of people's
experiences. Um, why don't you have a
priority system when someone who has a
whole series of red flags around their
situation like the gentleman in our
story that their case doesn't get pushed
up the system? Why should someone in a
priority setting like his wait so many
weeks, in fact, in his case too many
weeks before getting reassessed?
Well, we don't want anyone in a
situation where they are waiting for
such a long period of time. Sarah, it's
why these reforms have been so critical.
As I said, that medium assessment wait
time for the last quarter is down to 23
days. And you fairly make the point that
there is some variability around that.
And we'll continue to invest in the
assessment system so that no matter
where people live in Australia, they can
continue to access those assessment
services. Uh in terms of the way that
our national priority system works after
the assessment, we like to make sure
that everybody who gets a clinical
assessment of high priority receives
their care packages within a single
month. And that's part of the way that
we prioritize the distribution of care.
So it's both equitable as well as
responsive to the needs of older people.
And if you're able to just give me a yes
or no answer on this one, Sam Ray, are
people waiting longer for assessments
than they were under the old system?
No. Assessment weight times are
considerably improving. As I said, just
in the last quarter, we saw that
improvement uh in terms of the median
time coming down by 8 days. Uh we'll
continue to drive that assessment weight
time down. But
what about a priority system for the
most for the people in the most urgent
need of care?
We want a system that provides
efficiency on an equitable basis. Sarah,
roughly 40% of uh assessments that occur
across Australia are conducted within
the state and territory health systems
and often that is the space where people
who have uh high or complex needs are
assessed and the wait times there are
are very low indeed sometimes less than
a day. So there are systems in place to
make sure the people who have the most
acute needs do receive both assessments
and care as quickly as possible. on
co-ayments. Obviously, co-ayments are
anathema to the Labor government in
Medicare. Why do they belong in aged
care?
Well, we want to ensure that uh with
that aging population and the dynamics
that that brings that we have a
sustainable system and as I said before
that that system is equitable in term in
terms of its access. Meansested
co-ayments and that's very important.
Meansested co-ayments are a critical
component of ensuring both the
sustainability and the equitability of
the system. The federal government will
continue to pay for 100% of all clinical
care for inhome care recipients. And
then there are some means tested
co-ayments where people have the means
to make a co-ayment uh for their care.
They are being asked to do so.
Importantly here Sarah uh that has to be
uh done and implemented with a robust
system of protections in place for
people uh who are of lower means or who
have particular vulnerabilities. Uh we
have uh systems in place to ensure that
if people aren't in a position to make a
co-contribution or their circumstances
evolve that there's not an interruption
to the continuity of their care. So, how
do you prevent the poorest Australians
from foregoing the care that they need
because they determine they cannot
afford even the modest co-ayment that
you're asking?
Well, again, uh 100% of all clinical
care costs are met by the government. Uh
and then we have very robust hardship
provisions in place. So if a person's
circumstances evolve and they are unable
to make a co-contribution uh the
hardship provisions provide such that
their uh care is continuous and there's
no interruption uh and that their
co-ayment doesn't become a hindrance to
them accessing the care that they need
and do you accept that it will be a
threshold succeed or fail for you if
those weight times can't be brought down
wait times for assessments for elderly
people
as I said Sarah We've been working on
this ambitious, this is a generational
reform process and it has many aspects.
This is a complex system, the aged care
system, and we would like to reduce some
of the complexity through these reforms.
But I also want to be uh very
straightforward with people that we
won't be able to reduce all of that
complexity. We've already seen
significant improvements in outcomes for
older people. Uh over the last couple of
years, uh we've seen uh an additional
7.1 million minutes of care delivered to
older people every single day. We now
have 247 registered nurses in
residential aged care facilities. And
we've invested $17 billion in wages for
aged care workers so that we can uh
retain and attract the very best human
beings to provide this very special care
to the people that we love. Uh Saturday
was a big day. It marked the the
beginning of the new aged care act and
with that the statement of rights for
older people as well as the support at
home program. Assessments are an are a
critically important part of the work
that we're doing and I will remain uh as
I am focused on all of the reform
program. uh I will remain focused on the
assessment part to make sure we get that
right along with the rest of the
ecosystem that ultimately delivers the
best care outcomes and ideally uh joyful
quality of life for older people across
our country.
I'll just note that you didn't answer
yes or no whether it would be a
threshold success or failure for you,
but you've given us a uh an expansive
description of the new system. Sam Ray,
thank you very much indeed for joining
us.
Thank you, Sarah.
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Transcript
You happy with tears. Why would you do
that?
It's hard for Eloise and her mom Carmel
to look back on this family celebration.
I think this is a fairy tale wedding of
two perfect people.
Within a year, their father and husband
Peter was seriously ill.
I'd like to propose a toast.
Dad was diagnosed with throat cancer. He
was quite advanced at the time of
diagnosis.
When Peter returned home after surgery
in January, the 74 year old was assessed
and approved for aged care support
services at home.
What wasn't clear to us that then there
was an additional 7 to9month wait for
the funding.
When the 74 year old was diagnosed as
terminal, the family was advised to get
an urgent reassessment.
Dad's needs were increasing by the
moment. You know, we needed personal
care assistance. We needed nursing.
The reassessment was to be done by a
company that had a government contract
to do the work called Aspire for Life.
So, it was put to Aspire for Life that
we needed a really urgent reassessment.
Aspire for Life gave mom and dad a
reassessment date of 8 weeks into the
future, and that was the most urgent
time they could get there.
The support Peter needed never came. He
died four weeks before his urgent
reassessment with Aspire for Life.
My mom spent those last few weeks
absolutely burnt out and exhausted
caring for someone on her own with no
support despite hours and days and weeks
of us just on the phone to these people.
For the past 40 years, clinicians from
state public health called aged care
assessment teams or AATs decided what
level of support elderly Australians
received, whether it be at home or in
residential care. Last year, the federal
government decided to partially
privatize the system, awarding contracts
worth more than $1.2 billion to more
than a dozen companies to do the job.
The waiting list for assessments now
sits at 116,000.
That's almost equal to the number of
Australians who are actually waiting for
a home care package, which is now at
120,000.
Aspire for Life was responsible for an
assessment for support services for
Peter, not his medical care.
In a statement, the not forprofit said
it couldn't comment on his case, but
said the high demand for assessment
services is universally acknowledged and
it was investing to meet demand.
The pressure on the system is evident
around the country, including here in
Canes.
Things are just not happening, and I
just don't know where to go. Coral
Wilkinson, a former AAT assessor, now
helps people navigate the system and
deals with a range of assessors in
Queensland.
Mari, I've got your back.
She's been overwhelmed by calls from
clients.
Some people are waiting 9 and 10 months
and their cases are urgent and they
don't know when they're going to be
assessed and their families are at
breaking point. Through her podcast,
people in the sector tell Coral the new
system is failing because some
organizations don't have skilled staff
to do assessments. I think there was
some uh naivity on the part of the
department and perhaps some of the newer
assessing organizations who didn't
really understand the level of of
knowledge and expertise that was is
required to assess older people who
particularly have higher and more
complex needs.
The 2021 Age Care Royal Commission
called for changes to simplify the
assessment system, but it didn't
recommend privatization.
It recommended that assessments be done
by people independent from approved
providers to avoid a potential conflict
of interest. If an assessment
organization is also an approved or
registered provider of inhome services,
there's that, you know, potential
conflict of interest or risk that the
assessment organization can then uh
channel people into their to their
provider.
The ABC has found that more than half
the companies awarded contracts are also
home care providers or have a connection
with one.
A spokesperson for the aged care
minister Sam Ray said the government had
robust arrangements to prevent conflicts
and the department can take action
including terminating contracts if a
conflict was identified.
Former clinical assessor Janine Mason
quit after 3 months with another
assessment company because she says she
wasn't given enough time to properly
assess people.
Many assessors feel this pressure to get
these assessments done. it it's coming
from
uh
departmental decisions that are pushing
down onto then companies that must
remain viable and keep their contracts.
Even more disturbing for her was a
practice that she says saw elderly
people dropped off the waiting list if
they didn't answer phone calls in time.
We were advised three calls were to be
given. If they don't respond to those
calls, then that referral would be
rejected. Um, there are many reasons
why, you know, three calls is not an
appropriate way to then reject people
out of a system who've been waiting
months and may not realize they've been
rejected out of the system.
Janine's former employer said there had
been a department guideline to this
effect, but that their organization had
not adopted this policy.
The government has strict KPIs for the
new assessors, including that 90% of
urgent assessments be done within 10
days.
At Senate estimates last month, the
department denied reports that KPIs had
been abandoned. Is it true that the
departments abandon KPIs for weight
times for assessment agencies?
No. So, we haven't abandoned um
have they changed?
They haven't changed. Uh
but the department acknowledged the KPIs
will temporarily not be enforced.
Have they been temporarily waved?
We have indicated that during the
initial transition to the single
assessment system workforce uh we won't
be enforcing those KPIs for
approximately the first 12 months of the
system.
The government says the median wait time
for an assessment is 23 days but
providers and families say people are
waiting months.
I've been working in this space for a
long time. I would go so far as saying
it's the worst I've ever seen it. I
haven't seen such a delay for people to
get their age care assessment.
I I really despair for the amount of
vulnerable elderly Australians. Probably
it's too hard to sit on the phone and
navigate the bureaucracy that is the
system.
So brave.
Yeah. I think this process shows we had
to speak for him and we still got
nowhere.
At the weekend, the government
introduced a new payment system as part
of its age care reforms where older
Australians will make a contribution to
their home care packages with hardship
assistance if they can't afford it. Sam
Ray is the Minister for Age Care. I
spoke to him earlier.
Sam Ray, welcome to 7:30.
Sarah, thanks for having me. Australia,
like many countries, faces an aging
population. Is this suite of reforms
that the government has devised enough
to meet that oncoming demand?
You're very right, Sarah. We do face an
aging population. It's one of the great
public policy challenges of our time and
we want every single older person across
Australia to be able to access safe,
dignified, and high quality aged care
services. And that has been the guiding
principle since uh really since the
Royal Commission handed down its
findings under the Morrison government.
Prime Minister Anthony Albanes made a
range of commitments ahead of the 2022
election and we've worked tirelessly
since we were elected to government to
pursue that ambition, safe, dignified,
and highquality aged care for every
older Australian. Now, in terms of
assessments, because this is the the
system that's been in place now,
privatized assessments that's been in
place um since the end of last year,
what happens in the most urgent cases
like the one that we referred to in our
story? Should you have a priority system
for those most urgent cases to make sure
that people get uh assessed immediately?
The assessment process has historically
been very complex, Sarah, and you're
right. At the end of last year, we put
in place uh the single assessment
system. This was a key recommendation of
the Royal Commission. uh and that has
gone through a period of maturing over
the last 11 months and we're now
starting to see the benefits of that new
single assessment system both in terms
of uh the experience of older people and
their families that are interacting with
the system and of course in terms of the
measurement that we do at a government
end. Uh the median assessment weight
times at the moment is uh 23 days and
just in the last quarter we saw that
improve by eight days. So, we are seeing
rapid improvements, but of course, I
want to see older people and the people
that love them being able to access an
assessment and care system that is agile
and able to respond to their needs. So,
we'll keep working to make sure that
that assessment system is part of a
broader ecosystem that is responsive to
the needs of older people in our
community.
Look, you know, obviously medians can be
very misleading, but just stay with this
issue of priority because it's obviously
at the sharp end of people's
experiences. Um, why don't you have a
priority system when someone who has a
whole series of red flags around their
situation like the gentleman in our
story that their case doesn't get pushed
up the system? Why should someone in a
priority setting like his wait so many
weeks, in fact, in his case too many
weeks before getting reassessed?
Well, we don't want anyone in a
situation where they are waiting for
such a long period of time. Sarah, it's
why these reforms have been so critical.
As I said, that medium assessment wait
time for the last quarter is down to 23
days. And you fairly make the point that
there is some variability around that.
And we'll continue to invest in the
assessment system so that no matter
where people live in Australia, they can
continue to access those assessment
services. Uh in terms of the way that
our national priority system works after
the assessment, we like to make sure
that everybody who gets a clinical
assessment of high priority receives
their care packages within a single
month. And that's part of the way that
we prioritize the distribution of care.
So it's both equitable as well as
responsive to the needs of older people.
And if you're able to just give me a yes
or no answer on this one, Sam Ray, are
people waiting longer for assessments
than they were under the old system?
No. Assessment weight times are
considerably improving. As I said, just
in the last quarter, we saw that
improvement uh in terms of the median
time coming down by 8 days. Uh we'll
continue to drive that assessment weight
time down. But
what about a priority system for the
most for the people in the most urgent
need of care?
We want a system that provides
efficiency on an equitable basis. Sarah,
roughly 40% of uh assessments that occur
across Australia are conducted within
the state and territory health systems
and often that is the space where people
who have uh high or complex needs are
assessed and the wait times there are
are very low indeed sometimes less than
a day. So there are systems in place to
make sure the people who have the most
acute needs do receive both assessments
and care as quickly as possible. on
co-ayments. Obviously, co-ayments are
anathema to the Labor government in
Medicare. Why do they belong in aged
care?
Well, we want to ensure that uh with
that aging population and the dynamics
that that brings that we have a
sustainable system and as I said before
that that system is equitable in term in
terms of its access. Meansested
co-ayments and that's very important.
Meansested co-ayments are a critical
component of ensuring both the
sustainability and the equitability of
the system. The federal government will
continue to pay for 100% of all clinical
care for inhome care recipients. And
then there are some means tested
co-ayments where people have the means
to make a co-ayment uh for their care.
They are being asked to do so.
Importantly here Sarah uh that has to be
uh done and implemented with a robust
system of protections in place for
people uh who are of lower means or who
have particular vulnerabilities. Uh we
have uh systems in place to ensure that
if people aren't in a position to make a
co-contribution or their circumstances
evolve that there's not an interruption
to the continuity of their care. So, how
do you prevent the poorest Australians
from foregoing the care that they need
because they determine they cannot
afford even the modest co-ayment that
you're asking?
Well, again, uh 100% of all clinical
care costs are met by the government. Uh
and then we have very robust hardship
provisions in place. So if a person's
circumstances evolve and they are unable
to make a co-contribution uh the
hardship provisions provide such that
their uh care is continuous and there's
no interruption uh and that their
co-ayment doesn't become a hindrance to
them accessing the care that they need
and do you accept that it will be a
threshold succeed or fail for you if
those weight times can't be brought down
wait times for assessments for elderly
people
as I said Sarah We've been working on
this ambitious, this is a generational
reform process and it has many aspects.
This is a complex system, the aged care
system, and we would like to reduce some
of the complexity through these reforms.
But I also want to be uh very
straightforward with people that we
won't be able to reduce all of that
complexity. We've already seen
significant improvements in outcomes for
older people. Uh over the last couple of
years, uh we've seen uh an additional
7.1 million minutes of care delivered to
older people every single day. We now
have 247 registered nurses in
residential aged care facilities. And
we've invested $17 billion in wages for
aged care workers so that we can uh
retain and attract the very best human
beings to provide this very special care
to the people that we love. Uh Saturday
was a big day. It marked the the
beginning of the new aged care act and
with that the statement of rights for
older people as well as the support at
home program. Assessments are an are a
critically important part of the work
that we're doing and I will remain uh as
I am focused on all of the reform
program. uh I will remain focused on the
assessment part to make sure we get that
right along with the rest of the
ecosystem that ultimately delivers the
best care outcomes and ideally uh joyful
quality of life for older people across
our country.
I'll just note that you didn't answer
yes or no whether it would be a
threshold success or failure for you,
but you've given us a uh an expansive
description of the new system. Sam Ray,
thank you very much indeed for joining
us.
Thank you, Sarah.
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