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Reforming aged care: a practical plan for a rights-based system

Aged care quality and safety Ageing in place Aged care Australia

Australia has let older Australians down – our aged care system is a mess and is not fit for purpose. The current system supported 1.3 million older Australians and cost government nearly $20 billion in 2018-19. But it is conceptually fraught and badly funded. Capped funding results in unacceptably long wait times for home care, and evidence of poor-quality residential care abounds.

Australia needs a new aged care system. This report identifies three key changes needed to create a rights-based system that would ensure older Australians can get the support they need to stay active, independent, and engaged in the community for as long as possible.

Firstly, older Australians who need support should have universal access to care. Rather than rationing care and classifying people into broad groups, a new funding model should require that reasonable and necessary funding matches a person’s individual care needs. This should be documented in individual support plans, which are portable between settings, and which then form a contract about what care they should receive.

Secondly, older Australians should have face-to-face help to obtain a range of diverse and high-quality service options. Rather than a poorly-regulated and fragmented system far away in Canberra, 30 regionally-based ‘system managers’ across the country should be made responsible for the care of older Australians in a defined geographic area. They should manage the local service system and only accredit providers dedicated to the rights of older Australians.

Thirdly, rather than viewing older Australians as passive recipients of care, regional system managers and their community representative committees should enhance the independence of older people through social participation programs, promoting healthy ageing, and better integrating the aged care system with health care.

Australia must learn the lessons from the Royal Commission into Aged Care Quality and Safety by building a new, high-quality aged care and support system that respects the rights of all older Australians.

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Grattan Institute Report No. 2020-17