SENATOR THE HONOURABLE CONCETTA FIERRAVANTI-WELLS

Transcript

Breakfast with Melinda James

ABC Illawarra

Aged Care Royal Commission

5th August 2020

 

SUBJECTS: Aged Care, Royal Commission, Shadow Minister for Ageing

 

E&OE …

 

Melinda James:  

Senator good morning.

Senator Concetta Fierravanti-Wells:  

Oh, good morning Melinda.

Melinda James: 

Look, first of all why don’t you just explain to us why Aged Care in particular is so close to your heart in terms of policy?

Senator Concetta Fierravanti-Wells: 

Well, it’s very close to my heart, at age 23 I was a founding board director of a nursing home in the Illawarra, and of course in the ensuing 40 years or so I’ve continued my engagement with the sector which of course included 4 years as Shadow Minister for Ageing and years when I also represented Health and Ageing in the Senate. So, part of that work, but also subsequently my own personal experiences.

My father had dementia and ultimately passed away after a long battle with dementia, and of course my mum died earlier this year, herself having gone into aged care. But of course, I’ve also looked at this from the cultural diversity perspective and particularly the needs of our – the special needs – of many in our community, so it’s something that is dear to my heart. I have a unique perspective and so as a consequence of this, given that this was a public process, an important public discourse at a very, very critical time, I thought it was appropriate for me to share those thoughts with the Royal Commission as they now look forward to see what we are going to do into the future.

And coming back to the point that you made, the issue here is – and the Interim Report of the Royal Commission has made it very, very clear - there are serious issues. But those issues have been continuing, there have been reviews upon reviews, and indeed even some of the reviews are being restated in subsequent enquiries.

So, let me put it into perspective if I can for listeners. In 2011 the productivity commission did a very, very good report called Caring for Older Australians with a whole series of recommendations. And that report basically was the roadmap that the Coalition was intending to use as part of its major reform before the 2013 election.  It was a very important reference point then, and it continues to be an important reference point for the Royal Commission, because in the end…

Melinda James:

[interjection] …Because all that work was done, you’re saying, in 2011, this work of looking at the system, looking at the need for reform and rethinking aged care now that we live longer, have more complex health needs at the end of our life, and increasing rates of dementia…

Senator Concetta Fierravanti-Wells:

Precisely Melinda, and indeed the point that the Interim Royal Commission is making is that - and it makes the very strong point that it’s very difficult not to be critical of successive governments, and I say successive governments because this has not just been failures of one particular government one as opposed to another – to fix the system.

And sadly of course, the Royal Commission Interim Report says that it’s impossible to escape the melancholy conclusion – and I’m quoting now – ‘that Aged Care services and the people who receive them have simply not being seen as a priority for successive Australian governments.’

Melinda James: 

And you include your own government in this as well, just to be clear, you’ve been very frank in your criticism of successive governments over several terms on both sides of the political divide.

Senator Concetta Fierravanti-Wells: 

Absolutely, and this is really, it’s a systemic problem and this is the whole issue, and this is what the Interim Royal Commission report is saying, it is identifying those systemic problems that have existed over a long period of time and you’ve got people who have been involved in the sector who are still involved in the sector. So, the bottom line is, if you keep doing the same things, and you know that there are problems, systemic problems in the system, therefore you will end up having a system that is now on the brink of collapse - and of course Coronavirus has made it even more so. So, this is why it is a very critical time now for the Royal Commission in the work that it’s doing.

Melinda James: 

It’s a very com – sorry for interrupting, I just want to make sure that we also get on to what some of your ideas about the way forward – ideas that you’ve had for some time now, and that have been put to governments previously. But what do we do to change this – I think one of the issues that a lot of people have been concerned about is the disproportionate effect on people who lived in private nursing homes in Victoria, and there’s even a story in the Daily Telegraph of today about aged care multimillionaire moguls and that those days need to be over for people making a lot of money out of aged care. The funding of aged care is going to be a perennial issue given, as I mentioned, more complex health needs. We’ve all acknowledged the need for better staffing – what are your views on funding and how it should work?

Senator Concetta Fierravanti-Wells: 

Well the funding is very important and it’s very important when you do look at funding in aged care to understand that Australians will have to pay more for the care of older Australians simply because our population is ageing. The important thing here is to find that right balance between the public funding and private funding. It is a very sensitive issue, it’s a very complex issue, but it has to be done in a way that’s efficient in its application.

There are a number of things that also have to be considered and the productivity commission when it did it’s work in 2011, made the finding and concluded that it was important that yes we do have a tax finance system, it has to be one that’s pay-as-you-go, supplemented by co-contributions. We are facing two things – and I think it’s very important that we do understand this –  one is that now our baby boomers are ageing, and of course they are in a financially more capable situation, and in terms of contribution of care, and of course for them choice will be very, very important as it is now.

But also, we have to look at the dependency ratio, the people who are of working age for every person aged 65 and over. Now, in 1978 that was 7 people, today it’s 4.2 people, by 2058 that’s going to go down to 3.1 people. So therefore, when you do look at what people want – so what do people want? What do our older Australians need? They need care, but they need it when they need it and wherever they need it.

And we have to understand that not every person has the same typical aged care profile – people need a mix of services in both health and ageing as their health waxes and wanes – and this is what the Royal Commission is saying. So, when you do design a system, it has to be very, very tailored, it has to be individual and it has to be one that responds to what Australians want.  

And let’s not forget, Australians want to stay in their own home – that’s predominantly the case.  That’s the thing that I have seen from my almost 40 years involvement in this space.  People want to stay at home, so therefore your system has to be designed to help people to stay healthy, to stay healthy in their homes if that’s what they want, and then at a particular point in time when they do need residential care, to access that care in a way that is fitting for their own needs. So, what I’ve done is set out what I think are some ideas, put together a blueprint of where I address the fundamental concerns that the Royal Commission have and offer some solutions in terms of how we can go and a way forward…

Melinda James: 

Including aged care being funded through Medicare, partly, and through co-contributions and possibly even quarantined super, that sort of thing.  People needing to save for their aged care needs…

Senator Concetta Fierravanti-Wells: 

Look I think that there are a number of key points here. The centrepiece of our policy back in 2013 was a 5-year agreement between the Government and the Aged Care Sector, and as you can appreciate Melinda, if work is done in partnership (and we do this with other processes, like we have a pharmacy agreement that is in place) this does afford certainty and flexibility, but it also puts the onus and responsibilities on the providers to come to the table and meet the responsibilities that they’re asked of them. The other thing is too, politics in Aged Care has been a real issue, because of course every time one talks about reform, there’s always a political issue and there’s always a scare factor in terms of one side as opposed to the other side. Therefore, the process of a 5-year agreement...

Melinda James: 

Takes that out, takes the politics out of it to a degree …

Senator Concetta Fierravanti-Wells: 

Of course, it takes the politics out, because you can do reform, it goes over 5-years, it goes potentially over different political cycles, but also it straddles different governments. And so, we’ve seen that it’s a very successful model in other places. But also, one of the things that’s very important is staying in your local area.

One of the sad things that I’ve seen is that people do want to stay in their local area which is why I think the concept of turning aged care facilities into aged care hubs – so effectively one-stop shops where people can get the services that they are assessed as needing – in their local areas those hubs can cater, under a Medicare umbrella, to those needs. If you expand the services that are available at your local aged care facility and you do so under a Medicare umbrella, it becomes a very different system.  And of course, Australians do understand what Medicare is all about, they live with it every day…

Melinda James: 

[interjection] And support it wholeheartedly – I’m so sorry to cut you off, we will have to leave it there, but so many interesting issues have been raised in your submission, and of the course the Aged Care Royal Commission having delivered its Interim Report, we have yet to see its final report and we’ll see what they do in fact recommend. But thank you so much for your time this morning.

Senator Concetta Fierravanti-Wells: 

Thank you very much Melinda.

 

[ends]