As the term of the federal parliament draws to a close, the Aged Care Bill 2024 has finally passed. The new Aged Care Act will start from 1 July 2025.
It is worth remembering that aged care reform was a central plank of the Albanese government’s election pitch in 2022 with new aged care legislation promised by 1 July 2023. Providers, industry groups and advocates alike have all been critical of the government’s slow progress.
The Royal Commission into Aged Care Quality and Safety’s first recommendation was a new rights-based Aged Care Act, which delivered its final report on 26 February 2021. Minister for Aged Care Anika Wells claimed in parliament this week that the bill before parliament implemented this key recommendation.
Following the introduction of the bill into parliament in early September, there then followed a period of consultation/inquiry and debate. Key initial concerns focussed on the enforceability of the statement of rights. The need to introduce additional rights-based protections, including civil penalties for providers, was also key. Government amendments purport to have addressed these concerns. Ultimately the challenge will be whether these commitments result in practical improvements on the ground.
The Royal Commission recommended a right to access care. Funding mechanisms in the new Act – principally the raising of the Refundable Accommodation Deposits (‘RAD’) – have already been met with significant opposition from those older Australians worried about affordability and equity. The Greens issued a dissenting report, which, in addition to concerns over the strength of the rights-based framework in the initial version of the bill, was also critical of the lack of safeguards for financial hardship. Regarding quality of care, it remains unclear whether a provider will be obliged to offer detailed terms of service and accommodation standards.
Certainly, the high-quality care objective recommended by the Royal Commission is not expressed as an objective in the new Act. Much has been said about the aged care workforce challenges with the sector having been plagued by low wages and high turnover for years. Whilst there have been some reforms during the life of this government including some workforce development, the introduction of a requirement for increased higher level nursing care and a 15 per cent wage increase across the sector, the systemic issues of training, recruitment and retention are harder to overcome.
The government insists that its $11.3 billion investment in pay rises will create a sustainable and innovative sector. Yet critics question whether the combination of chronic long-term underfunding and increased demand on services can be realistically addressed by a one-off capital injection.
The Support at Home program is a key element of the reforms and has been pitched as another transformative initiative. The government has committed to a $4.3 billion investment over the next decade which it states will address home care wait times, funding classifications and services like cleaning and gardening. Minister Wells claims that “the new Support at Home program will enable all of us to live independently in our own homes for as long as possible as we age”. Clearly, workforce shortages and greater demand year on year will test such an ambitious goal.
Regulation has long been another reform issue. The reforms claim to offer stronger mechanisms for handling complaints, stricter accountability provisions, and the introduction of strengthened Aged Care Quality Standards. It is noteworthy that the recently established (2023) Office of the Inspector General of Aged Care does not have the power to investigate individual complaints.
One of the more controversial aspects – immunity from prosecution from the use of restrictive practices without lawful consent – remains, but one of the government amendments is to sunset the immunity provisions.
A transition taskforce has been announced and will shortly be established to bring all stakeholders together in the leadup to the enactment of the legislation on 1 July. It remains to be seen what effect the reforms will have on a sector that has been in a state of neglect and crisis for decades.
Catherine Henry is a local health and aged care lawyer and advocate, and principal of Catherine Henry Lawyers.
This opinion piece appeared in the Newcastle Herald on 30 November 2024.
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