The incoming Government, whatever their political stripe, must move swiftly to address growing concerns amongst older Australians, their families, and the aged care sector itself about the incoming Support at Home reforms, said the man at the helm of the leading dementia carer.
"Let’s stage implementation of these well-intentioned reforms," Andrew Thorburn, CEO of Not For Profit HammondCare, told The SOURCE for our series in which we ask aged care leaders what they would like to see from the next elected Government.
Andrew listed several aspects of Support at Home that are causing unease:
- consumers need more time to understand how the new co-contribution framework affects them individually,
- providers are still determining the implications of the 10% cap on care management fees,
- more time is needed to prepare existing Home Care Package recipients for the transition, including preparing new service agreements, new pricing, and establishing new client contribution frameworks, and
- managing continuity of service for clients who do not want to accept new pricing arrangements.

Support at Home Manual
is not expected to be released
until June.
Release more home care packages
Andrew also said "there should be universal entitlement" for home care, and he would like to see a complete removal of the waiting list.
The 83,000 new packages in the first year of Support at Home "will not be enough" to meet the current Government's stated aim to reduce wait times for home care to three months by July 2027, he said.
'Small house model' for dementia care
Andrew would like to see more 'small household model' homes in Australia for people living with dementia, with HammondCare a specialist in dementia care.
These are "proven to provide the best quality of life when the time comes for residential aged care," he said.
With the number of people living with dementia forecasts to more than double to 800,000 within 30 years, Andrew also said better dementia care training is needed - for aged care staff, carers at home, first responders, and health professionals.
The 1.7 million people who care for people living with dementia also need better support and more respite options, he said.
Factor dementia cohorts into quality measures
Andrew is concerned the introduction of quality measures - specifically Star Ratings and Quality Indicators - could be resulting in people living with dementia refused entry into residential aged care.
"Quality Indicators analytics and Star Ratings need adjustment to reflect the circumstances of the different cohorts within aged care homes to avoid circumstances where people living with complex dementia are turned away from services," he said.
Current policy settings are leaving people with dementia "trapped in our public hospital system", he said.
Sector must work with Government on workforce
On workforce, Andrew, "We need a long-term plan developed by both the sector and the Federal Government, implemented together with clear objectives for the next five years."
It's estimated the need for aged care workers will double in the next 15 years, with an additional 400,000 workers needed by 2040.
Changes Andrew is proposing are:
- better career pathways for aged care workers,
- leadership training,
- use of AI and technology where possible to reduce administrative tasks,
- refund university fees for Registered Nurses who go into aged care,
- offer paid study placements,
- introduce paid traineeships for students studying Certificate III fees for TAFE courses in aged care,
- allow flexibility for training on the job,
- allow retirees to work in the sector without pension and superannuation penalties,
- promote aged care careers in schools with opportunity for paid placements, and
- create a wider availability of Certificate III VET courses for Year 11 and 12.
Immigration
Immigration settings must also be carefully calibrated so as not to prevent the flow of workers from overseas.
"Reductions in present immigration numbers must not restrict the current flow of migrants arriving on student or temporary visas from countries like Nepal who are making a valuable contribution to the sector," Andrew said.
Read previous articles in our 'political wishlist' series:
Level the playing field on payroll tax: Homestyle Aged Care CEO Tim Humphries’ political wishlist
Seven years since a workforce strategy: Juniper CEO Russell Bricknell’s ‘political wishlist’
“Whining for more money won’t cut it”: IRT CEO Patrick Reid’s political wishlist
Anne McCormack CEO of mecwacare wants to see greater recognition of palliative care in aged care