Australian Approaches to National Issues and Local Action: Improving the Quality of Life of Older People 1 Simon Biggs (1), Lindy Clemson (2), and Hal.

Australian Approaches to National Issues and Local Action: Improving the Quality of Life of Older People

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Simon Biggs (1), Lindy Clemson (2), and Hal Kendig (2)

1. University of Melbourne and Brotherhood of St Laurence2. University of Sydney and ARC Centre of Excellence in

Population Ageing Research (CEPAR)

Symposium ‘Developing Collaborations between central and local government to improve elders’ quality of life’

Convenors: Aaron Azulai, Ministry of Senior Citizens, Israel and Ariela Lowenstein. Haifa University, Israel

International Federation on Ageing, Global Conference on Ageing, 28 May-1 June, 2012, Prague Czech Republic

OverviewAustralian Context and Health & Care

Initiatives (Kendig)

Falls Prevention: A National and State Priority (Clemson)

Not for Profits: Brotherhood of St Laurence (Simon Biggs)

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Australian Society in ContextModest population ageing so far (now 13%

65+)Highly urbanised with vast rural hinterlandsa third born overseas (Europe early & Asia recently)Babyboom cohort entering later life

Strong economy (s0 far) & high incomes (for most)Concern for fiscal costs of an ageing population

(Intergenerational Reports)The financial crisis & ‘return to surplus’

Weak Labor coalition national governmentand Conservative state governments

3Kendig

Australia in Context (Government) Financial hegemony of national government

Income taxes, income support, and grants to states

State government delivery of health & welfareLocal government weak (property services etc)Strong voluntary tradition in aged careLabor minority national government

Conservative Coalition state governmentsCouncil of Australian Government (to ‘resolve’

tensions)Election due next year

4Kendig

The ‘Local’ in the Health Policy ReformLong term State government responsibility for

co-funding and delivery of hospital and health services

National government responsibility for Medicare (compulsory health insurance)

Health System reform underway (we think)?Local Health Networks (co-funded)Medicare locals? How can we better integrate national and state in

region?And what if the government changes?

5Kendig

The Local in Aged Care Policy ReformNational responsible for all residential care and

(recently) home and community careState governments (with their regions and health and

community care responsibilities) vacating the field?Government has now accepted the Living Longer,

Living Better aged care reformsTipping the balance towards community careMore equitable user paysProposed ‘Gateway’ for regional integration

Can national government deliver at a regional, integrated level?

6Kendig

Focus on restorative programsGovernment policy and funding initiatives

2006-7 Self management2008 Prevention an outcome of national

summit2011 Productivity Commission Caring for Older

Australians. Restorative programs as part of community care

2012 Living Longer-Living Better aged care reform package. Gateway to include ‘re-ablement’ and wellness programs

7Clemson

Falls prevention: a national and state priorityFalls are a major cause of expensive

hospitalizationNational implementation plans for falls

prevention emerged in 2001 – not legislated, success depends on cooperation

States – varied leadership, organization and support

Committed ground-up fall prevention activities at local levels

8Clemson

Example of uptake of evidence-based programStepping On program supported in US

centrally, some states Australia at a state levelTranslation into practice- issues of

sustainability and lessons learnt Different models of delivery, partnershipsDeveloping network of supportPlanning for sustainabilityService provision across

traditional boundariesEducation, capacity building

9Clemson

Not For Profits in AustraliaA bridge between civil society, State and

federal Government.Religious, charitable and community groups84% of Community care packages provided

by not-for-profitsThe not-for-profit sector provides

approximately 65% of the county‘s residential aged care services

Simon Biggs University of Melbourne

Brotherhood of St Laurence

Simon Biggs University of Melbourne

Mission StatementOur vision: an Australia free of povertyWe work with others to create an Australia free

of poverty for this and future generations: a fair, compassionate and just society where all can fully participate in social and economic life, create and share prosperity and treat each other with dignity and respect.

Our mission is to research, develop and deliver innovative and high quality services, practices and policies to drive change that benefits all Australians.

Simon Biggs University of Melbourne

Simon Biggs University of Melbourne

Tensions around Power, Knowledge and Legitimation

Research and Policy AnalysisCampaigning and ‘Influencing’ AgendasFinancial dependence on GovernmentGovernment dependence on SupplyGovernment regulation of numbers of

licensed placesLegitimation through Consultations

Simon Biggs University of Melbourne