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Aged care is in transition. It is evolving into a system that better supports the wellbeing of older people and the delivery of care in ways that respect their dignity and support their independence. There is an increased focus on consumer choice and control. At the same time, Australia’s population is ageing, and both the proportion and number of people needing care are increasing. Planning for this growth is one of the main challenges of aged care policy.
Over the last decade aged care has undergone several reviews. These reviews have catalysed changes in the system, particularly in 2012–14, when the government implemented reforms in response to recommendations made by the Productivity Commission (the Commission) in its 2011 report, Caring for older Australians. Those changes, referred to as the Living Longer Living Better (LLLB) reforms, included:
• additional support and care to help older people remain living at home
• additional help for carers to have access to respite and other support
• establishing a gateway to services to assist older Australians to find information and to navigate the aged care system
• changes to means testing in home and residential aged care
• changes to improve services for people with dementia
• additional funding for the aged care workforce.
Since the reforms were initiated, there have been significant further changes in aged care policy. These have included:
• major changes to the original LLLB measures, in the areas of dementia care and the aged care workforce
• increased consumer control through transfer of the funding for home care packages from aged care providers directly to consumers.
Several important recommendations from the Commission were not implemented but remain at the centre of aged care policy discussion, particularly the issue of ‘uncapping supply’: the removal of regulatory restrictions on the number of aged care places and packages made available to the community.
The LLLB reforms were significant reforms but also a step along a path that would bring further change. When the changes were announced, the government stated that a ‘five year review will assess progress of the first phase of reform and the pathway ahead.’ This report is the product of that review. Its scope is confined to aspects of the LLLB reforms rather than the aged care system more generally. For this reason, there are several important aspects of aged care that are not reviewed in depth, including quality and safety issues, the Aged Care Funding Instrument, the Commonwealth Home Support Programme and palliative care.