Paul Murray: Warning signs have been in our face for years over aged care but nothing was done about it

This is a column about why people are losing faith in governments to fix the things they really care about. If a few politicians read it – and take notice – it will be worthwhile. Australian taxpayers forked out more than half a billion dollars for the 2021 Census. One of the key purposes of the five-yearly snapshot of the nation is to provide governments – and businesses – with data about demographic changes. Census data combined with the intergenerational reports which former coalition Treasurer Peter Costello started in 2002 – and there have been five more since – provide the Federal Government with detailed information about the long-term sustainability of policies over a 40-year horizon. So how did Canberra fail to head off the aged care crisis which is now hurting so many Australian families and threatens to harm many more in the future? Costello’s first report more than 20 years ago found that the number of Australians over age 65 would double between then and 2042. Too little was done for two decades to halt what has now become a crisis. Tellingly, the 2002 report warned for the first time that the ageing population would increase demand for aged care services while shrinking the working-age tax base, creating a structural budget deficit over time. The most recent intergenerational report ordered by Treasurer Jim Chalmers two years ago found the number of people over age 85 would treble by 2063. So what did he do? Chalmers’ response in the 2024 Federal Budget was to provide a bandaid of $531 million for 24,000 additional home care packages, designed to reduce the wait time to six months. To put that into context, it’s about the same amount of money the government is prepared to spend to host the next United Nations climate change conference. Think of it as Albo’s Burswood racetrack. While that extra home care cash appeared good news, in effect it underlined the ominous shift away from funding aged care beds for those who can’t stay in their homes. That Budget also provided $190m for 12 weeks of transitional care to get aged care patients out of hospitals, but there was nothing to attack the chronic shortage of institutional beds to accommodate the transfers WA Aged Care Minister Simone McGurk told her fledgling Federal counterpart Sam Rae to his face this week that WA was way short of what was needed after he came here grandstanding about $30m in funding for one small residential facility for 30 homeless people. “(It is) very, very welcome,” McGuirk said, ironically. “That means we’ve got 27 more facilities to go.” How long will it take to build the 27 urgently-needed aged care homes? And what will the new wait list be by the time they are completed? McGurk also reminded Rae that WA has a backlog of 8000 Federal home care packages. He countered with a boast about “the biggest aged care investment by any Australian government.” So what? When demand is doubling, does he think the required spend would shrink? The 2021 intergenerational report done for coalition Treasurer Josh Frydenberg – just before Labor came to power – warned the aged care sector was financially unsustainable. It called for new arrangements to ensure fairness, innovation, and long-term viability. Without reform, the sector would struggle to meet demand, improve quality, or attract investment. Which is just where we have landed. There are very few places available for people seeking concessional care in WA. So what is the point of spending hundreds of millions of dollars on all these censuses and reports if the politicians don’t take the necessary steps to fix the system? My eyes have been opened to this crisis by a family member entering the residential aged care system in recent months and another who consequently needs in-home services. If it looks bad from the outside, it’s far worse for those trying to navigate a confusing and opaque bureaucracy unable to meet urgent and incessant demand because of a lack of resources. The stress this is placing on both families trying to negotiate the system and workers having to resort to stop-gap measures to paper over the shortages is immense. There are waiting lists to get onto a waiting list. The Albanese Government is just the latest in a long line of administrations which have done too little to ensure that this crisis did not arrive. But it is handling it badly. The neglect of the aged care system was revealed in the royal commission called by the Morrison Government in 2018, which reported in March, 2021. While what led to the inquiry were reports of abuse and neglect in aged care, what it found was a system described as fragmented, underfunded, and poorly regulated and failing to meet the needs of vulnerable people. But the initial response from union-dominated Labor when it came to power in May 2022 was heavily skewed to the wages and conditions of the workers in the sector, which increased the cost-burden on providers. While the labour issues needed fixing, it exposed Labor’s priorities. Labor’s culpability was exposed in the Senate two weeks ago when the non-government parties ganged up to force the immediate release of 20,000 promised and budgeted home care packages which had been delayed from July to November. It was a humiliating defeat for a government with a massive majority in the House of Representatives to be overpowered 35-20 in the Senate and to see the distribution of the packages taken out of its hands. Having refused during the debate to accept the amendment — and then voting against it — Labor compounded its intransigence with an egregious stunt. Minutes after the vote, Health Minister Mark Butler and Rae called a press conference to portray the 20,000 rescheduled places – part of their election promise to provide 83,000 – as the government’s initiative. Shameless. The Senate rebuff was informed by a meeting of its community affairs references committee the previous Friday which was specifically investigating the home care program delays. The very first testimony by Samantha Edmonds from the Older Persons Advocacy Network set the tone, with a case study of man called John: “The biggest gap in the new rights-based Aged Care Act is that older people only have the right to an assessment of their needs, not the right to receive the type and amount of aged-care services relevant to those needs in a timely way. However, even the right to an assessment is not fulfilled. “John’s original referral for reassessment was lodged in August 2024. Since that time, he and his carer have been directed to three different assessment services and were informed that the referral was sitting with one, then the next, and a third. “Despite nearly 12 months of follow-up, including numerous emails and phone calls, John has still not received the triage call, let alone the actual assessment that is essential for his access to suitable care. “John’s condition has significantly deteriorated over the past year. His mobility has declined, and his care needs have increased dramatically. He has made a conscious choice to remain living in the community, yet the system has failed to support this choice. “The delay in assessment has placed a severe burden on him and his family, who are now paying $700 per week out of their own pocket to try and cover the shortfall in care being provided. “His family is exhausted and at breaking point, with no capacity to meet the increasing care gaps. They genuinely fear for his safety and wellbeing. “They emailed the assessor in May this year, requesting urgent action and left multiple phone messages with no reply. They highlighted the financial and emotional impact caused by the delay. “The current home-care provider has also contacted the assessment service and was informed that they did not have a referral for John. The provider had submitted a referral. As of 15 July, this year, John is still waiting for his pre-assessment triage call.” The committee was told nearly 5000 people died while waiting for an aged care package in the last financial year. Some 90,000 people who had been assessed were still waiting to receive care, while more than 120,000 were waiting for an assessment. Combined, the evidence showed more than 200,000 elderly Australians were in the queue for home care, so the 20,000 the Senate bludgeoned from the government is a drop in the bucket. Then there’s people waiting an average 140 days for increasingly scarce residential care placements as the demand soars, with WA’s list the longest of all the States. No wonder people have lost faith