A tangled web tangles further – some doctors advise seniors to head to already strained hospitals to speed up referral

The tussle between state health ministers and their federal counterpart has been not so quietly simmering since its last flair up in September. While the specific number of aged care patients stuck in hospitals with nowhere to go has fluctuated, the growing frustration and disgruntled ping pong of accusations, of shirking promises or “responsibility”, has only increased. The latest update in the tangled web of healthcare, aged care and funding is what some doctors have been advising, suggesting elderly patients admit themselves to hospital to speed up referral to RAC or in-home care. The move has flabbergasted many, and yet at the same time, many advocates understand the move to try and support seniors in the seemingly perpetual rock and a hard place.

Deal or no deal

The 20-billion-dollar deal offered to the states by Canberra, to assist with the ever-strained healthcare system, has been ubiquitously rejected. And as is the case with Australia’s health and aged care issues, the layered and interconnected nature of problems means there’s another viewpoint to examine. Compounding issues of hospital capacity is the reported backlog of 3,000 seniors waiting for RAC and in-home packages. And into this setting has come concerning new reports.

At the very same time hospitals are struggling with discharging those that do not need to be there, seemingly endless wait times for aged care assessment, Support at Home packages and RAC placement has spurred a new apparent work-around. Some doctors have been telling senior patients to seek hospital admission to bring about a speedier referral process to RAC or in-home services.

Expediting

Chief executive of Older Persons Advocacy Network, Craig Gear, shared with the Guardian that, “we have heard of cases where people are told if they want to expedite the situation and their assessment, they really need to go to hospital”.

The perception that the processing time in the hospital setting is far quicker for an aged care assessment, than the 53-day waiting list, has reportedly caused some physicians to advise this route.

Gear notes, “We are of the position that there should be reduced wait times for assessments in the community. It should be three to four weeks, so people don’t need to go to hospital.”

He affirms what many experts and advocates have highlighted is equally of importance, the availability of options for RAC of best fit and the need to update approval times and full funding for in-home packages, “we’re also more concerned about people awaiting discharge from hospital, and that is really about the availability of options in residential care or in-home support.”

Providers and advocates align

The ability for high-performing providers, of all sizes, not just the big players, to heavily invest in bed build rates has come up against significant obstacles.

From ballooning land costs, interest rates the nation has all been reminded could one day soon be increased again, and construction costs, mean that numerous providers, treasured by seniors and loved ones, are on the back foot to foot the bill for more beds.

Provider heads have reminded Canberra that consistently changing policy, liquidity rules and risk of loan exposure are all significant obstacles to doing what is sincerely wished, to pour efforts and vision into a reality to meet the nation’s growing need.

Particularly for small to medium providers that seek to grow the net bed figures, outside of the ever-popular strategic growth of mergers and acquisitions, the opportunity to bed-build is hampered by the pricing models of care. With supplementary pricing vs RAD meaning balancing the desire to support seniors without means and needing to cover daily operational costs, provider leadership remains frustrated at Canberra’s ignorance of pricing model consequence. 

For many, profit or surplus is not in abundance. It is to these providers of quality, where waitlists have stretched due to word of mouth, that Canberra must turn policy to support and uphold a vision for bed build, quickly.

Overcrowded hospitals

Across the nation advocates are warning that shortages in RAC facilities are placing seniors in abysmal situations in hospital and overcrowding them in consequence, a situation of impact for all demographics across the nation.

Greens senator Allman-Payne has called for immediate action, citing the latest health department data that showed October to have 266,352 seniors on waitlists for aged care services.

While many of these seniors are not yet in hospital, advocates and experts across the nation have drawn the line between delayed care at home and early admission into hospital, further exacerbating the strain on hospital, and seniors not where they want or should be.

Allman-Payne noted, “if you’re an older person who needs care in Australia, first you wait for months just to get assessed for care, and then you wait for a year or more to actually get it. Labor’s aged care reforms are broken from top to bottom”.

“We’ve known that doctors are telling older people that the wait times for an aged care assessment are so long that the only way to get assessed quickly is to go to hospital. This data now proves it.

“Our parents and grandparents deserve better.”

Multi-faceted solves for multi-faceted problems

While health ministers continue to lobby for more funding for state healthcare systems, providers and advocates alike remain adamant that there is a wider picture that needs to be seen, and then to drive focused reform.

If hospitals are to move past seniors stuck within their walls, the most important reform strategy is to ensure they don’t end up admitted, or certainly not admitted early. Provider leadership and loved ones alike across the country have been calling for reform to wait times for assessments, to Support at Home packages, for fully funded packages, and to the supporting of bed builds by all shapes and sizes of providers.

While data is unclear, many of the seniors remaining in hospital are likely to need supplementary pricing care. The future of aged care demands a dynamic approach by government, in close partnership with providers who have a track record of substantiating quality care, for all Australians. Government and the sector must share the care of those who are able to provide RAD payments and those needing supplementary pricing.

However it is in preventative measures, for seniors to age at home, this being what Australians seniors have been adamant about, that future funding for healthcare and aged care must have as a centralising marker. From this vision-point, multi-faceted funding improvements can yield what seniors and the nation need, seniors aging at home, being healthier at home, out of hospitals and out of early admission to RAC.