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Federal Government drops plans to ‘privatise’ ACATs – will the Royal Commission be left to decide the fate of the assessment teams?

4 min read

Health Minister Greg Hunt has confirmed the Commonwealth will not be proceeding with its planned tender process for aged care assessment services following widespread backlash from the Opposition, the States and Territories, unions and sector peaks over the decision.

At a meeting of the Council of Australian Governments (COAG) Health Council last Friday, Mr Hunt (pictured centre above) announced it had agreed to work together with the States and Territories on how to “have a consistent, uniform, efficient and integrated aged care assessment process that meets the needs of senior Australians and their families.”

“The Commonwealth has confirmed that it is not proceeding with the current tender process,” the communiqué from the meeting states. “Over the longer term the Commonwealth will take advice from States and Territories and from the Royal Commission about what the exact delivery mix should be.”

As reported in our 21 January 2020, 224th edition, the Government had planned to put its streamlined Regional Assessment Service (RAS) and Aged Care Assessment Teams (ACAT) service – recommended by David Tune in his 2017 Aged Care Legislated Review – up for public tender this year with the new teams to be in place by April 2021 – 13 months away.

Aged Care Minister Senator Richard Colbeck responded to criticism of the ‘outsourcing’ in late December by stating that the Royal Commissioners supported the plans to streamline the service (which was outlined in the Interim Report).

Commissioner weighs in on ACAT privatisation

However, this earned a stinging rejection in a press release from Commissioner Tony Pagone QC that they “did not endorse the Government’s stated position” of ‘privatising’ the service – a first for a Royal Commission.

The decision also earned the ire of the States and Territories – which run the ACAT teams of nurses, geriatricians and social workers out of the state hospital system – with the support of federal funding.

NSW and WA had planned to present a joint paper outlining concerns with the plan and asking the Government to delay its plans until after the Royal Commission’s Interim Report is presented in November, while Victoria had already declared that it would not take up the new model.

We had approached the Department of Health about exactly when the decision to tender for the teams was made in between the initial consultation for the streamlining process in December 2018 and news of the tender process in December 2019.

Their spokesperson would not confirm a date, but emphasised that the States and Territories would be able to tender to provide the integrated assessment services.

“The Commonwealth does not directly provide assessments – it has always managed assessments through various forms of contracts or agreements with either the States and Territories or community based organisations,” they said.

“The new measures will ensure all assessments fall under one contract.”

That argument didn’t fly with Labor, the Australian Nursing & Midwifery Federation (ANMF) or Victoria which all launched separate petitions against the move.

So, why the move to ‘privatise’ if it wasn’t part of the original recommendation?

Saturday Paper says Government looking to tighten home care requirements

The Saturday Paper’s Senior Reporter (and former Social Affairs Editor at The Australian) Rick Morton had offered one possible answer.

He spoke to ‘experts’ who speculated the Government’s takeover of the teams would give the Commonwealth the power to make eligibility requirements for home care harder – and reduce one of its major problems: the home care waiting list.

Is the Government so devious in its thinking though?

Shifting the teams under the Federal Government fits with aged care’s position as a national system.

The Government had also reportedly been looking at a model that limited a single provider – including the States – from being able to have more than 50% of the assessment work in any one region, setting up a system with multiple teams.

This throws up some challenges – but also increases competition and cuts costs and red tape – which would explain the Government’s preference for such a model.

Interestingly, Morton also reported that the issue of the ACATs would be the subject of a Royal Commission hearing later this year.

Given Commissioner Pagone’s statement in January – and the Interim Report’s firm stance that aged care services should not be left to “market forces” – how likely is it however that the Commissioners will side with the Government on this issue?