Dhairya Bharatbhai Parekh(s2886628)Healthcare

8/12/2019 Dhairya Bharatbhai Parekh(s2886628)Healthcare

http://slidepdf.com/reader/full/dhairya-bharatbhai-parekhs2886628healthcare 1/14

Australia is a unique mixture of modern culture and old traditions. The country has its roots of the

modern culture from the British who established as settlers here. The original population,

Aboriginals and the Torres Strait Islanders, have been one of the oldest known civilizations known to

mankind. They have been living on this island continent approximately for around 60000 years. The

rest of the people are migrants and their descendants who came in here from more than 200

countries since Great Britain did the first settlement in Sydney Cove in 1788.

After the Second World War, the Federal Department of Immigration was established and several

schemes launched as the country was in need of immediate rise in population for the army.

After the Second World War, there was a sudden upsurge in the local population as well. It has been

well documented that a total population of 6.5 million people has migrated in the country since

1945. Since the famous population burst 55 years ago the country now faces a problem of the aging

population.

Australia offers one of the best healthcares around the world. Even though the GDP spending areless than other OECD countries the standards of the healthcare in the country are high and well

maintained. However the ageing population, sedentary lifestyle, rises in the people affected with

chronic diseases creates concern in the minds of the government. Sadly, a little can be done now to

change or alter the population dynamics. Hence the only alternative is to bring about a change in the

present healthcare approach. A change needs to be made to suit the needs of the population

requirements in the future.

After taking in confidence the State Government, the central government started taking into

considerations various perspective about addressing this problems. On August 2nd

2011 the National

Health Reform Agreement was announced in coordination with the state and the territory



government. The main aim of these reforms is to provide a better healthcare to the Australian

population and to get it equipped for the future changes and requirements.

The health reforms has decided to focus on 8 different streams

Hospitals Primary care

Age care

Mental health

Standards and performances

Workforce

Prevention

Ehealth

However out of the 8 streams one of the major concerns for the Australian government is the

constantly ageing population. Twenty years post the Second World War, there were a significant rise

in the birth rate owing to the prosperity .this was known as the baby-boomers. These baby boomers

are now ageing.

Other than that, the reduced fertility and the increased life expectancy also have played a significant

role in the rising of the ageing population. According to Department of Healthcare and Ageing, 7.2

million people will be over the age of 65years by 2051 from the current 2.5 million. This would

comprise of the 26.1 % of the total population. The proportion of the people aged over 85 years will

go as high as 6% from the current 1.4% by the year 2051.

Despite the population of Australia as a whole ageing, there is wide variation seen as far as theindividual territories are concerned. Tasmania is proposed to grow the state with the most aged



population surpassing the South Australia by the year 2021. By 2051, as compared to the rest of the

country, the province of Tasmania and South Australia will have 30% of population over 65 years of

age. The northern territory will be having the least of the aged population whereas the province of

Queensland and Western Australia will have a moderate variance in the age of the people.

Ageing will bring about a significant effect on the economy of the country. The increase population

of the aged over the employable population bounds to create a significant load on the budget

making it necessary to increase the tax burden on the working population. The ability to support the

aged will be also compromised due to labour shortage and increased population going for the early

retirement. Significant low labour class will be working to support an evidently large aged population

as the size of the dependable population rises.

According to the 13th biennial report, 44% of those aged 65-74 have disability of which 11% have a

severe activity performing issues that is to say they always require assistance in performing the day

to day activities including mobility and personal care.81% of people who are aged above 85 years

have disability issues with severe activity difficulties.49% of the Australian people between the age

of 65-74 are affected by the long term chronic diseases such as hypertension, diabetes, arthritis,



musculoskeletal issues etc.

It is in the best interest of the government that it starts taking steps to reform the strategies to deal

with age care issues

Since 1962 the older Australians have lived in the Commonwealth funded Aged care after an

amendment to the National Health Act 1953 was passed allowing the per-day nursing benefit for all

the residents in the government approved nursing home. Nursing homes were the main form of the

residential care until the Hostel sector took over which highlighted the need for the greater social

support along with the personal care requirements.

The nursing and the hostel sector were two different sectors in which the nursing sector was funded

by a complex system of payment linked to staffing for the care (Care Aggregated Module, StandardAggregated Module and Other Cost Reimbursed Expenditure). The residents in the nursing care paid

capped daily fees of 87.5 percent of combined pension and rent assistance with no entry

contributions regardless of his income and assets.

The residents in the hostel paid daily fees of 85 percent based on the providers initial assessment.

They also paid the negotiated capital entry contributions based on the assessment unlike the nursing

home. This system was incapable as far as the efficiency and the effectiveness was concerned. The

sustainability of the funding system, lack in quality and the rising demand were the major factors

that questioned the credentials of the system. This brought in the major reforms were brought

about by the Coalition Government in the year 1997.



The major reforms included unifying nursing homes and hostel under one system, single funding

tool, greater flexibility, greater care fees, and income tested fees, accommodation payments

(accommodation bonds, accommodation charges), extra service schemes, quality assurance,

certification etc

In the year 2008, considering the fact that a large no of people lived in their own home and thenmoving towards residential care was a clear signal in the rising demand of the aged care. A total

population of 1.9 million people aged 70 and above which was expected to double in a couple of

decades. Also, around 200000 people were known to suffer from the dreadful disease of dementia,

making it necessary for the government to take revolutionary steps. The sources tell that dementia is

the single greatest contributor to the burden of the disease and disability at the older ages. It solely

contributed the rise in the residential aged care. It was estimated that in 200 4, 171000 were over 65

years with dementia and by 2050 this would be around 730000 that is around 2.8% of the total

population. Perhaps the rate of dementia in the people of Western Australia was higher than the

people in the other part of the country.

Important changes in the age care system came about on 20th March 2008. There was change in the

accommodation fee and the government subsidies for the people who entered in the residential

aged care. Other than that, the inequities with respect to the income tested fees were also

addressed. These changes were passed in the parliament with bi-partisan support.

The resultant was that people who could afford more for their accommodation and caring were

asked to pay more. The people who couldn’t afford to pay were given subsidy provided by the

government. However no changes were made in the accommodation fees and age care fees for the

existing aged care residents. The income test for aged care residents became fairer, with self-funded

retired were considered as same as pensioner with respect to their income.

The maximum level of the resident’s income did not depend on the whether the resident is a

pensioner on the self paid retiree. The existing aged didn’t have to pay more at all and 45% of the

self paid retirees paid less for the age care under the new system. An asset test was carried out on

all the high care residents to decide how much accommodation charge the individual will pay and

how much will be subsidized by the government.

The changes brought about a significant revolution in the field of aged care. Nearly $1 billion was

raised as the additional funds with $860 million coming from the government and rest from the

residents. These huge funds gave them certainty, better future, investments in better propertybetter amenities and facilities for the needful.

According to the report of the National Health and Hospital Reform Commission released in June

2009, the reforms brought around included the provisions for the extensions of the aged care

subsidies by around $838 million, an increase in the flexibility of the community aged care by $437

million, medical arrangements with the residential aged care services and training the workforce for

delivering the advanced care. The accessibility of the people to the hospitals and the aged care

centers improved by the achievements of the National Access Targets. Rising number of the aged

care people led to the development of more responsive services. A few reforms were also made for

improving the allocative efficiency. The three reforms comprising of the increased sub-acuteservices, improved access to age care and advance care planning made a large number of bed



available in the hospital. There was also an increase in the number of the age care places looking

towards the rising demand predicted by the Australian Institute of Health and Welfare (AIHW)

The year 2010 was evident in own sense. The Commonwealth took over the full policy and funding

responsibility for the aged care services. The complete resourcing was transferred from the Home

and Community Care (HACC) program to the Commonwealth. Developments of the consistent

program took place including the basic aged care at home to the high level care in the aged home

care. The Commonwealth became the lead funder in the Australian health and the hospital system

and brought about an increased collaboration between the acute care, hospitals, GPs, primary

health care and essentially the aged care.

Coming to the monetary point of view, the Commonwealth invested $813 million in the dedicated

aged care with an additional funding of $533 million. Another $280 million was driven to the states

for aged people in the public hospital sector.

It was also decided that the Common wealth would invest more in the Zero Real Interest Loans for

the development of 2500 additional Aged care places. The Commonwealth also decided to provide

aged care in the 286 bed equivalent Multi Disciplinary services to provide integrated health and the



aged care service. It also decided to team up with the state government to release more land and

accelerate the process of planning approvals so that an increased number of aged care could be built

and made operational rapidly.

The Common wealth made an allocation of around $99 million for the increased accessibility of the

primary Healthcare services for people in the aged care homes and $10 million for upsurge in theviability of the community aged care providers.

For the patients who had a prolonged stay in the hospital, 2000 flexible aged care places were

started in the various states and territories. Other small things taken care by the Common wealth

included strengthen consumer rights for the aged people, controlling the costs of the tax payers, sub

acute beds to help the transition phase between the acute and the aged care.

More than $390 million were allotted for comprehensive and professional workforce to bring in

greater support.



In the year 2011, Aged and Community Service Australia acting CEO said the funding for the critical

age care service in the Federal Budget remained undisturbed in spite of the rising cost. A claim of

$330 million inclusive of 1.75 % subsidy for community aged care and a 10$ rise in the

accommodation charges for high care individuals was not considered in the Federal Budget. Theresultant was that that the service providers failed to provide an optimum service to the aged



people. Furthermore, the July decision of Fair Work Australia resulted into the increased salary of

the aged care workers, which undermined the workforce till an extent.

However there were a few positive outcomes also. There was an increase in availability of the

important components for age care until an amount of $16 million, the matter of age care being

identified as high priority under the Fair Work Australia initiatives to satisfy the rising demands

In April 2012, the government launched a complete package for a better, fairer, sustainable and

nationwide concentrated package for the aged care. The Living Longer Living Better as it was called

provided a huge amount of $3.7 billion over a time of next 5 years for a comprehensive age care. A

10 year plan was commenced that looked forward to provide the people with more choice, sense of

control and improved quality of care. It was launched with aim of dealing with the economic backlog

the ageing population will create. The purpose of providing a quality care right at the home was

taken care of in this package.

Special care was taken to strengthen the work force and better care for the people suffering fromgeriatric diseases such as dementia.

Recently it has been also decide that from July 201 the government will provide additional funding

through an AGED CARE FUNDING SUPPLEMENT for all the aged care providers to increase the

funding to the workforce, improvise the quality of the services, reduce the staff turnover, deliver

better work practices, boost the outcomes and better planning. A package of 268.4million had been

announced over the next 5 years to deal with the dreadful dementia.

Government made it easy for the assessment of the aged care by starting the Aged Care Assessment

Services which assist the aged people about the services that will best deal with their requirements.

They also help referral to the appropriate residential or community care options. The ACAT team can

also help provide subsidy from the government. The service has been funded by the Australian

Commonwealth and so free of cost to the aged.



A critical analysis of the reforms and the changes brought around in the last 5 years tells that the

government has taken the aged care and its implications quite seriously. However, the age care

system is underfunded, complex, and inconsistent. It lacks choices and the consumer feels trapped.

There is a little choice and one cannot quit once in the system one cannot quit.

The age care system is focused significantly on the aspect of maintenance rather than rehabilitation.It’s more dependent on what the government can or cannot do rather than on what the people

need.

The government needs to also look for the aboriginals and the people of the Torres Strait Island

with significant aged people and depleting health. Care must be taken to ensure the various funds

allocated are indeed reaching the targeted population at the peak time.

Apart from that, government needs to act on the rise in the geriatric diseases among the aged. This

includes dementia, Alzheimer’s, arthritis, impaired vision and hearing. The number of people living

with dementia is expected to rise to one million by 2050 from 257000 in the year 2010.

The government should also focus on the aspect of increasing the workforce. The pays should be

increased to lure more people towards the lucrative jobs. A significant amount of time is spent on

the paperwork by the staff rather than on the care.

In the best interest of the citizen a new aged care system with strong safety net with no limit on the

type and the quantity of the service must be designed. It should also be taken into consideration

that the need of the low-income Australians and the ones in the remote part be addressed. Care and

accommodation are two separate entities to be taken care of. New innovative ways should befigured out to address the aged care. The Productivity Commissions recommendation should also be

taken into consideration. The recommendation includes a single entry point for the aged care which

will simplify the complex process. It also recommends a government run equity scheme that enables

people to borrow against their houses that will allow the wealth tied to private houses being

unleashed without selling them. Flexibility should be allowed in the payment methods.

Aged care is a vital concern for the government in the current scenario. If properly taken care of, the

knowledge, experience and foresight from the aged people can be harnessed for the progress of thenations.

References

Age and Community Service Australia (2011). News 2011 — Aged & Community Services

Australia. Retrieved from http://www.agedcare.org.au/news/2011-news



Age and Community Service Australia (2013). Real People, Real Lives - Inside WA's aged

care system — Aged & Community Services Australia. Retrieved from

http://www.agedcare.org.au/news/2013-news/real-people-real-lives-inside-was-aged-

care-system/view

Aged & Community Services (2011). Budget leaves aged care in limbo.

Aged and Community Service Australia (2011). Aged Care Reform – It’s Time.

The Aged Care Assessment Service (ACAS) - Services: Aged Care in Victoria - Victorian

Government Health Information, Australia. (2013). Retrieved from

http://www.health.vic.gov.au/agedcare/services/assess.htm

Aged Care Assessment Team ACAT Aged Care Assessment Service ACAS List Contact . (n.d.).

Retrieved from

http://www.agedcareconnect.com.au/aged_care_assessment_team_service.php

Aged Care Reform - It's Time 8 Aug 2011 — Aged & Community Services Australia. (n.d.).

Retrieved from http://www.agedcare.org.au/news/2011-news/aged-care-reform-its-time-

8-aug-2011

All Books - OECD iLibrary. (n.d.). Retrieved from http://www.oecd-ilibrary.org/books

An indepth analysis of aged care reforms, covering community care, rural/regional concerns

and more | Croakey. (n.d.). Retrieved from

http://blogs.crikey.com.au/croakey/2012/05/02/an-indepth-analysis-of-aged-care-

reforms-covering-community-care-ruralregional-concerns-and-more/

Australian Government (2010). A National Health and Hospitals Network for Australia’s

Future Delivering the Reforms.

Australian Institute of Health and Welfare (2008). Australian Health 2008.

Australian Institute of Health and Welfare (2012). Australian Health 2012.



Australian population to top 23 million tonight - ABC News (Australian Broadcasting

Corporation). (n.d.). Retrieved from http://www.abc.net.au/news/2013-04-23/australia-

to-top-23-million-today/4644974

Council of Australian Governments (COAG). (n.d.). Retrieved from http://www.coag.gov.au/

Departmen tof Health and Ageing (2011). Department of Health and Ageing - Alzheimer’s

Australia report on feedback received from older Australians, their families and carers

through the national conversation on aged care reform. Retrieved from

http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-survey-un-

2011.htm

Department of Health Ageing (2013, May). Department of Health & Ageing - National

Health Reform Full Steam Ahead . Retrieved from

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr11-nr-

nr114.htm

Department of Health and Ageing - 2012 National Aged Care Workforce Census and Survey

– The Aged Care Workforce, 2012 – Final Report . (n.d.). Retrieved from

http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-nat-agedcare-

workforce-census-survey

Department of Health and Ageing (2008). Residential Age CareReforms.

Department of Health and Ageing (2012). The Age Care Workforce.

Department of Health and Ageing (n.d.). The Ageing Australian Population and Future

Health Costs: 1996- 2051.

Department of Health and Ageing (2012, April). Department of Health and Ageing - Living

Longer. Living Better . Retrieved from

http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-aged-care-

review-measures-living.htm



Department of Health and Ageing (2013, May 24). Living Longer. Living Better. - Tackling

Dementia. Retrieved from

http://www.livinglongerlivingbetter.gov.au/internet/living/publishing.nsf/Content/tacklin

g-dementia

Department of Health and Ageing (n.d.). yourHealth - About National Health Reform.

Retrieved from

http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/health-reform-

overview#.UaVp_rU3BNN

Department of Immigration and Multicultural Affairs (2001). IMMIGRATION

FEDERATION TO CENTURY’S END 1901– 2000.

Financing and Analysis Branch Commonwealth Department of Health and Aged Care

(2000).The Australian Health Care System.

Government of Western Australia (2003). MODEL OF CARE FOR THE OLDER PERSON

IN WESTERN AUSTRALIA.

Information about early signs and symptoms of dementia - find out if you are at risk of

developing Alzheimer's disease | Alzheimerâ�� s Australia. (n.d.). Retrieved from

http://www.fightdementia.org.au/understanding-dementia/am-i-at-risk.aspx

Len Gray (2001). Two Year Review of Age Care Reforms.

Lin Hatfield Dodds (2011, January). Aged Care In Need Of New Look . Retrieved from

http://www.theage.com.au/opinion/aged-care-needs-a-makeover-20110123-1a1bj.html

Melissa Sweet (2012, May 2). An indepth analysis of aged care reforms, covering community

care, rural/regional concerns and more | Croakey. Retrieved from

http://blogs.crikey.com.au/croakey/2012/05/02/an-indepth-analysis-of-aged-care-

reforms-covering-community-care-ruralregional-concerns-and-more/



National Health and Hospital Reform Commission (2009). A Healthier Future For All

Australians Final Report JUNE 2009.

National Seniors Australia (2010). The Future of Age Care in Australia.

NCOSS - Council of Social Service of New South Wales - Aged Care Reform. (2013, March

13). Retrieved from http://www.ncoss.org.au/content/view/6781/111/

One in five aged care residents malnourished: study - ABC News (Australian Broadcasting

Corporation). (n.d.). Retrieved from http://www.abc.net.au/news/2013-05-23/study-

finds-one-in-five-aged-care-residents-malnourished/4707806?section=act

Dhairya Bharatbhai Parekh(s2886628)Healthcare

Documents