The aged care system is bogged down from years of rules and regulations piling on top of each other to the point where it is now grossly inefficient and failing to deliver optimum care equally across the country.
We need to step outside the aged care system to design a real, long term fix. Plan T: Transformation is required.
As ex-IRT CEO, Patrick Reid told SATURDAY: “Something is broken when 40-50% of a skilled health professional’s time is devoted to administrative tasks.”
We can’t afford this inefficiency. And we can’t afford the rigidity, says Sasha Andrews, CEO of NSW Mid North Coast stand-alone provider Woolgoolga & District Retirement Village (WDRV).
“Regionally, it’s extremely difficult to find enough staff to meet the mandated care minutes. In some cases, the CEO is providing direct care, but that care doesn’t count under the current framework. It’s happening, but it’s not recognised.”
The aged care system is inflexible. This is just one of hundreds of similar points made by the 17 CEOs who responded to our Election Wishlist.
They have moved beyond the money challenge to the system that stymies them operating a functioning business, let alone an efficient business delivering quality care.
A system operationally on its knees is not ready for the first Baby Boomers who hit 82 and home care in 2027, and residential care at the age of 84 in 2029.
No new hospital beds, no new aged care beds, no new workforce. Care workers already account for 16% of the total Australian working population – do we expect we can employ more?
Our figures at DCM (and others) show that by 2028, 128,000 people are virtually assured to die at home after three to four years of living in increasingly life-threatening frailty and fear.
Each year, the funnel will fill with more, and the chilling fact is that those people will know there is no substantial help available.
Plan T: Transformation required
We cannot allow this to happen on our watch. It requires a wartime approach where all parties come togther to create the resources required, and untie all the regulatory knots.
Ian Yates says a vision is required of where we want to go. “We need to set out a set of standards with the industry which are better than the minimum standards, and which also has excellence at the top. If you actually want to argue for less regulation, you need an industry that is in itself better and has (earnt) confidence in the community.”
But the aged care system is a behemoth with a turnover of $40-plus billion per year. It can’t be significantly changed overnight, if at all.
The Government also does not have the cash to throw at change, and nobody could argue that would be a good strategy.
So, how do we support 40+% more customers with less, and less red tape?
The only solution is to have an infomed working group outside the system tasked to identify the operational tangles, and put forward sensible fixes.
Coalition of the Willing
We envisage a Coalition of the Willing of say 20 operators that each release one competent executive for one month to forensically investigate one oppportunity each, and then build a book of recommendations to review with the Department and Government in partnership.
Once done, a second group of 20 step up.
What is an example of what can be achieved? Patrick Reid and Sasha Andrews’ tangles above can be solved.
Another is Duncan McKimm, CEO at retirement living and residential aged care operator Clarence Village in regional Grafton (NSW), who wrote to us concerning the issue that applies to all operators with residents paying for accommodation via a percentage on RADs.
“If aged care moves to a rental-only model, what will prevent capital from moving out of regional areas into metropolitan areas where capital appreciation (and rent) is greater?” he asked.
The system is the same across the country, but regional areas can’t charge the high RADs equal to their metro cousins. No capital, no new beds.
The Shared Care initiative where retirement village residents share portions of their Home Care Packages to fund services, like a village nurse, for the benefit of all residents, has been given the green light by the Department to stage a three-year trial.
The transformational approach would say that the findings will be clear within 12 months and if positive, it can be rolled out within 18 months across the sector, not three-plus years.
Pace of change
There is a second factor in why transformaton is required: the pace of change.
An operating system that grew out of the 1997 Aged Care Act and the 1997’ish health care system is not match fit for tomorrow’s world.
An open and entrepreneurial mind is required to be creative and proactive.
In last weekend’s SATURDAY, we feature Amplar Health, which is delivering hospital transition care for SA Health by taking 24 rooms in the Adelaide Pullman Hotel. CEO Robert Read tells us Amplar Health’s Hospital in the Home model has already supported over 20,000 patients, with the complication rate one-third of a hospital. The program has delivered an extraordinary NPS score of 90.
Willingness of Government to partner
Today is a unique opportunity to engage with the Federal Government. Health and Ageing Minister Butler has a 14-year deep understanding of the aged care portfolio and the rapidly increasing load the ageing Baby Boomer is building.
For the first time in recent history, aged care has a dedicated Minister with an expanded brief to include ‘ageing’.
Plan T – Transformation
The logical conclusion is that the time is now to be proactive as a sector; invoke Plan T.
What is required is a Coalition of the Willing, made up of the first 20 operators.
Should peak bodies be involved? Of course, but not in the actual work, because this should be done by executives on the ground, and the peaks have a significant workload supporting members in the current system.
We at DCM are not operators. We can be a vehicle to promote the sector and to the broader community (we talk to 125,000 buyers of ageing services every month).
We are aware of many leaders who recognise the challenge and the opportunity. It is time to stand up and act.
As Mahatma Gandhi said: “You must be the change you wish to see in the world.”
