After the solemn start to the day, the COTA CEO brought a pragmatic account (and a very small touch of humour) to the court proceedings.
Asked to define safety in aged care, Mr Yates said it is about avoiding harm – later adding the aged care system along with prisons is the only institution we have left in our community.
Mr Yates (pictured) told the Commissioners that if Australia wants an aged care system that is fit for purpose, we have to fund it differently like the National Disability Insurance Scheme (NDIS).
He argued funding should be allocated so good providers can expand and poor providers would have the regulatory plus the financial pressures to exist – and the Senior Counsel Assisting Peter Gray QC was swayed by his argument.
“That is a very important point you make,” Mr Gray conceded. “You mean we are missing out on competition?” – to which he COTA CEO replied ‘yes’.
Mr Yates cited research by Professor Michael Woods from the University of Technology Sydney (UTS) and aged care accountant StewartBrown commissioned by the Government to investigate the current bed allocation model and finances.
They are due to report mid-year but Mr Yates added it would be impractical to switch models overnight because they would need to analyse how to supply beds in “thin markets” where there is no competition.
“The Government could look at reverse options where people would bid for what they are prepared to pay to build beds in that area.”
He added that we – and the Government – still don’t know the total amount of funding required to properly fund the system. That said, while the funding model may cause financial restraints, he was firm that funding is no excuse for poor care.
“We need a coherent system – one passes the pub test about what’s fair.”
He emphasised that COTA are not proposing a deregulated market – rather a differently regulated one. “There would be some market testing of what would constitute a price.”
COTA’s submission also re-confirmed its call for a maximum three-month waiting time for Home Care Packages (HCPs), but Mr Yates says that would involve pushing more packages into the system – and more funding.
“The challenge for Government is how do you get this many packages into the system when you want a (budget) surplus as well?”
He also referenced the need for higher wages, estimating a 15% gap between similar jobs in other sectors. “You can do the training but if you’re not offering the money you’re’ not going to attract people… We can attract the people but are you going to ask them to do it at a discount?”
In one of only two questions Commissioner Ms Lynelle Briggs AM stopped Mr Yates and asked about nurses and staff ratios.
Mr Yates acknowledged there are challenges in recruiting nurses including:
- difficulty in recruiting nurses to aged care
- changes in practices that reduce the need for qualified nurses
- (“this will get me in trouble”) the time strong command and control nature (of nurses) could be less consumer focused anticompetitive to the hospitality industry
Ms Briggs did not follow-up the subject.
Mr Yates returned several times to the need of a fundamental attitudinal change in Australia to get rid of the idea that “we have a best by date” as we get older.
The statement prompted a cheeky response from Commissioner Richard Tracey – “You’re not past your best before date. We will be seeing more of you.”
That may just be an invitation to reappear.