20,000 Home Care Packages released – but government siloed questioning and evasive answers doesn’t reach the bigger picture

Aged care has been a multi-faceted, dynamic, ever-evolving sector of challenge for countless past Governments, and aged care sector leadership alike. With the pointed ingredients of a significantly vulnerable part of the population, rising costs, labour retention issues, funding model break-downs, top-down compliance regulation, opaque legislation and rules, unintended consequences of said legislation, and now, a boomer cohort that is soon to bring hundreds of thousands more to the sector, there has never before been a time when bi-partisan collaboration is needed. While relentless questions surrounded the delayed home care packages, seeking to get at the heart of the delay’s impact was not. From straining hospital systems, increased ambulance ramping times, to lack of RAC places, providers struggling to be profitable, home care packages could help mitigate stressors on multiple sectors. Health and aged care need their situations fully addressed through impactful questioning and transparent answers.

Tying home care package delay to Nov 1 Act implementation

Tuesday started early for Mark Butler. On RN Breakfast, Minister Butler responded to questions about the withholding of home care packages noting that the aged care legislation delay is “relatively short.” Asked too, of how many senior Australians will die while waiting for assessments and packages in the next two months, a figure wasn’t forthcoming. A theme that played out through all of question time, until the umpteenth minute. However, the figure wasn’t as current as hoped.

Minister Butler noted, “[This is] a relatively short delay. Really, four months … we’ve pushed the new system down the road from the 1st of July to the 1st of November, as you say. The sector wanted it. They didn’t think they were ready to do this.”

Sector wide was the call as to the overwhelming change the legislation would bring, the opaqueness in rules to government compliance and the likelihood of unintentional contravention is understood.

However, in tying the refusal to release home care packages due to sector wide articulation of likely disaster in the Act is neither helpful nor reasoned. Many across the sector are calling for home care packages to be released. In providing support at home, prior to entering aged care, potential residents are likely to be able to maintain a higher level of health upon entering aged care, as well as being able to remain in their homes longer, consequently reducing strain on the aged care sector.

Breaking news: 20,000 Home Care Packages released before November 1

Greens Senator Penny Allman-Payne stated the Senate is prepared to act if the House isn’t, so as to mandate Labor to release more home care packages without delay. Senator David Pocock noted that 20,000 further packages were needed immediately, with Allman-Payne saying that would be the “bare minimum.” In breaking news the Labor government has announced they are releasing the 20,000 home care packages that were requested by the group of non-government senators. It is not clear however, when the exact date of these 20,000 will be released, just that it will be “before November 1.” A schedule has also been released by Government stating the release of an additional 20,000 by the end of December to help mitigate the inflating waitlist obstacle for older Australians. 

Allman-Payne stated, “Every day that the government delays is another day that somebody … [is] not getting the care that they need. So we have legislation before the parliament. The government could actually fix this today. They budgeted to release home care packages on the 1st of July. [Providers have] told us they are ready to go. There is no reason for this delay.”

It has taken significant pushing in parliament, and a concerted effort to get their position out through the media, that these senators have been able to force the government’s hand. 

“As one of the other witnesses at the inquiry said, eight weeks is a long time for an older person. Six months to two years is catastrophic.” The release of the 20,000 Home Care Packages is “welcome new for home and community care providers and a direct result of our sustained advocacy on behalf of our older peoples and our members” says Ageing Australia. 

Senator Allman-Payne, outside of question time, did start to comment on the wider ramifications being felt across sectors from current systems, “Months stuck on the aged care waitlist means going without help to shower, to feed yourself, to have a safe and clean home. It means worsening health, more time in hospital, and our parents and grandparents dying without proper care.” It is bringing these links to the chamber, and having a robust discussion on how significant the colliding crises are, and will be, that the likelihood of cross sector resolution can start to be inched towards with the collaboration of all parties. 

While a success in the short term, the focus also must remain on Government as a whole addressing the larger systemic collisions of issues and sectors. The lack of clarity on waiting to release the packages, the siloed questions on, while still valuable, topics does not inch resolution closer on the wider issues. The playing out of question on Tuesday is evident of much broader and deeper work still needed in this discourse. 

Criticisms and incomplete answers

The leader of the opposition, Minister Ley shared her assessment of Rae’s Monday answers in terms of the delay to home care packages, “First he blamed the sector. Then he blamed elderly Australians. By the end he seemingly blamed the now minister for communications and her legislation.” Rey sticking to his message of Monday, doubling down on Butler’s remarks, the additional 83,000 home care packages are intrinsically linked to the new Act still making its way through parliament ahead of Nov 1.

Rae states, “Older Australians waiting for in-home care, at present we’re releasing more than 2,000 packages a week, ensuring the support continues to flow to those who need it most. As I said, we will continue to ensure that those assessed with a clinical assessment process as high priority receive their home care packages within a month.”

As those tracking his comments on the matter, this provided no further insight on how many people exactly were still waiting, how many were passing away before an assessment and if 2,000 was a drop in the bucket consequently. However the bigger picture of hospital straining under what has been reported as seniors in beds unnecessarily, nor mitigating RAC numbers was included in any of Rae’s answers.

Liberal MP Zoe McKenzie brought forward the case of “Kevin” who’s been told to wait around a year for an assessment. Rae addresses the question by asking for Kevin’s details to follow up. He also notes the new system will minimize wait times, without clearly articulating how.

Ley followed up with question three trying to find out the number of those who have died waiting for packages. Rae mentions he’s saddened to hear of any older Australian passing away, and in the next breath refocussed to argue the opposition, under Senator Ruston ,was in support of “delay[ing] the start date for the new aged care reforms.”

Outdated stats and continued rhetoric

When asked by frontbencher Angie Bell about the number of those who have died waiting for home care packages, the chamber is told it is “4,812” yet this number is from the previous financial year, not since Rae became responsible for the aged care portfolio.

Pointedly Liberal Minister Thompson asks if Rae will respond to the families of “vulnerable elderly who have died waiting for you to do your job?”

Rae’s response is to elucidate on the delay of the act being welcomed widely and instances of mortality in the aged care system are “sad.” Finishing up with a, “I have canvassed these matters very extensively in the parliament over the last couple of days. I refer the member to my previous answers.”

“Nothing to do with the release of home care packages”

In a moment of clarity Senator Ruston responded to Rae’s mention of her statement of approval for the delay, “I did agree that the government wasn’t ready for the reforms to be in place by the first of July, and that was through their own fault. They had been warned, but nonetheless, we didn’t want to see older Australians adversely impacted by a change in system before it was ready.”

“This has got nothing to do with the release of home care packages. Home care packages have been released for many, many years, and the only thing standing in the way of the government releasing home care packages right now to older Australians … is the government’s refusal to release them.”

“So I think the minister’s being a little disingenuous today to try and suggest that the reform framework, in any way relates to providing care.”

The bigger picture must be addressed

Arguably Question Time highlights a profound problem within the Government discourse, and how it is limited. The siloed nature of questions, vague and dismissive answers is not getting to the heart of a sector that has interconnected issues of cause and effect.

Questions must be asked of sectors colliding, hospitals seeing inflated ambulance ramping rates that have been attributed to seniors without a place in RAC need to be discussed. The dwindling diminishing availability rates in RAC needs to be investigated and understood, particularly in how home care packages can mitigate the strain on RAC. The funding models for both RAC and home care need to be significantly discussed as to how to underpin a sustainable future of balanced payment from the tax-base, as well as private means.

Additionally, within the home care packages themselves, experts and advocates have started to raise the alarm surrounding the inequality pricing models of the scheme itself. While understanding when future packages will be released, it is vital that the government robustly and transparently discuss the feasibility, social and financial, of the scheme, to effectively support Australians, and be sustainable for the long-haul.

While the need for increased home care packages is largely understood across the sector, the bigger picture is also desperately in need of unified discussion, by government, with close partnership with provider leadership, across health and aged care. Macro solutions-based questioning and robust testing across all levels of government and sector leadership must occur for the deeply complex needs of health and aged care to be effectively addressed, not just for the incumbent government in 4 year blocks, but for all Australians in the decades ahead.