The Royal Commission has wrapped up its first formal hearings in four months with a clear message – mental health, allied health and oral health services must be made a priority for people for receiving aged care services – but there are many barriers to achieving this goal.
As with previous hearings, the Department of Health was grilled by the Senior Counsel over its role in facilitating services, in particular the Government’s Better Access initiative introduced on 1 January 2019 to provide mental health services into aged care homes.
Their evidence revealed just 2% or 3,605 residents had officially accessed the program in the last 18 months – a dismal figure given the high numbers of residents with a diagnosis of depression.
There were also vast disparities in the spending by the 31 Primary Health Networks (PHNs) on the $82.5 million four-year program with two PHNs outlaying around $1 million each – one to provide 5,700 services and the other providing just five.
The Department defended the numbers, blaming its “progressive” roll out and residents not being obligated to participate, but both the Counsel Assisting and Commissioner Lynelle Briggs shot down these arguments.
“Can I just ask the obvious question that follows from that?” Commissioner Briggs asked. “Given that the average time in residential aged care is under a couple of years, many of these people will be dead before they get access to these entitlements, and that really is something that I would hope the Department is concerned about and looking to address, and as soon as possible in terms of the next stage of policy development.”
The accountability – or lack of it – for providing these services was also centre stage, with witnesses calling for mental health and oral health screening to become part of the Aged Care Quality Standards and ACATs respectively.
There were also a number of references to providers ‘gaming’ the system, with some witnesses warning that providers should not hold any increased funding for health services until they have ‘proven’ themselves.
The Counsel Assisting team also put forward its own proposal for a specific requirement for providers to maintain the mental health of their residents – a seemingly impossible challenge that would be difficult to mandate.
The proposition to deliver outreach mental health services into aged care and the community by the state health system was dismissed by representatives from the NSW and SA State Governments because of understaffing.
Again however, it was Commissioner Briggs who had the last say on the matter, noting that aged care homes often find “the cheapest option” or none at all when it comes to providing these services.
“The system as a whole lacks accountability,” she said.
The Commissioner also returned to her pet subject: providing ‘joy’ to older people, asking several witnesses to provide suggestions on how this can be achieved.
“The opportunities to do good in this area are enormous, and I think we’ve just started to unpack that today,” she said. “We’re especially interested in ways that the wider community can engage with and support older people so that those issues of identity, well-being, and so on, are embraced by all.”
You must get in quick however – submissions on the topics raised in this hearing will close on 31 July, 2020, less than two weeks from now.
