Put care back into aged care

Australian Medical Association/AusMed

Elderly Australians and their families cannot wait another year for the Government to fix aged care.

Declaring aged care to be in crisis, the AMA has called on the Government to act urgently to address the aged care crisis in Australia and not wait until the Royal Commission into the sector runs its course.

Jointly with the Australian Nursing and Midwifery Federation (ANMF), the AMA has urged the Government to immediately guarantee quality and safety in aged care, appropriately fund and staff residential aged care facilities (RACFs), and increase funding for home care packages.

AMA President Dr Tony Bartone said Australians should not have to wait for the findings of the Royal Commission before the Government starts investing properly in aged care.

"We can't wait for that Commission to hand down its findings while older Australians are suffering and being denied access to quality of life - even in the community through the necessary aged care packages," Dr Bartone said.

The Royal Commission into Aged Care Quality and Safety delivers its final recommendations to the Government in November 2020. It has already identified serious and dangerous shortcomings in the system, and more concerns will surface before the Commission reports.

The AMA and the ANMF fully support the work of the Royal Commission, but older Australians in aged care, and their families and loved ones, cannot wait another year for Government action to fix aged care.

Dr Bartone said care can't wait.

"We have to put care back into aged care," he said.

"Older Australians deserve to have the same opportunity to have the best quality of life as everyone else, and the same access to high quality medical and nursing care they have enjoyed throughout their long and productive lives.

"Standards of care for our elderly should not be compromised through restriction of resources or the budget bottom line. The Government cannot stand by and watch aged care providers continue to provide poor quality care because they are deemed 'too big to fail'.

"Ignoring the health and care needs of older Australians will lead to an increase in avoidable hospitalisations and excessive costs to the health system. The aged care system urgently needs a safe and quality skills mix of medical, nursing, and care staff. The increased presence of doctors as part of the care team is vital. The Government must act now."

ANMF Federal Secretary Annie Butler said older Australians deserve affordable, high-quality aged care services, with timely access to a range of appropriate health professionals, and in residential facilities, with care delivered by the right numbers of professionally trained nurses and care staff.

"They do not deserve the pain and suffering too many are currently experiencing nor do they deserve to continue to be ignored by their country's Government, which is meant to ensure their safety," Ms Butler said.

"We can't wait for the Morrison Government to act on recommendations of the Royal Commission to stop the suffering of our elderly; we simply cannot allow the Government to continue to sit idly on the sidelines and watch the extent of this suffering unfold.

"There is no need to wait, the Government can start taking action now. We need more nurses and more doctors in aged care. Legislated minimum staff ratios in nursing homes are needed urgently.

"Registered nurses must be available 24 hours a day, and there must be enough well-trained care workers to support the delivery of quality care. General practitioners must be supported to attend nursing homes to ensure quality medical care for elderly Australians."

The AMA and the ANMF said the Government could immediately provide:

  • mandatory minimum staff-to-resident ratios, including ensuring sufficient skilled nurses in RACFs;
  • increased GP aged care Medicare rebates for patients to facilitate enhanced medical practitioner care of aged care residents; and
  • expanded home care investment to allow more older people stay longer in their own homes and relieve pressure on residential aged care services.

Dr Bartone said older Australians have the right to live in dignity and have safe and appropriate aged care services provided to them.

Reforms proposed by the AMA and the ANMF

General funding increase

An increase in funding for aged care and increased transparency in the use of funding. Insufficient funding is the reason behind qualified staff shortages. A lack of registered nurses means that medication mistakes are made. Insufficient funding is why the food is terrible. Insufficient funding is why facilities aren't purpose-built.

Staff-to-resident ratios

Minimum mandatory staff-to-resident ratios, which reflect the level of care need of older people, should be introduced in RACFs. Registered nurses should be available on-site, 24 hours a day in RACFs to ensure older peoples' medical needs are adequately met, including the appropriate administration of medicines. That way unnecessary hospitalisations, unnecessary transfers and extended hospital stays would be avoided.

GP Medicare rebates

Increase the number of GPs working in aged care. The number of GPs willing to work in the aged care space has been reducing due to low Medicare rebates and the declining proportion of registered nurses in aged care. Medicare rebates need to increase in excess of 50 per cent to begin to adequately compensate for the additional time and complexity involved in comparison to a GP attendance in their own consulting rooms.

Home care packages

Government needs to increase the funding for home care packages, most importantly for Level 4 packages. Many older people prefer to age in their own homes or community. For this reason, ensuring access to primary, home and community care should be a priority.

As of June 2019, there were 119,524 older people waiting for their assessed home care package. The Royal Commission reported that 16,000 people died waiting for a home care package. Waiting times are more than 12 months. A greater availability of home care packages will defer and prevent the need for more complex care in RACFs and hospitals.

The AMA submission to the Royal Commission into Aged Care Safety and Quality is available at https://ama.com.au/submission/ama-submission-royal-commission-aged-care-quality-and-safety

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