Two West Aussies in their 80s explained problems with the new Support at Home program to Hon Sam Rae, Minister for Ageing and Seniors at Melbourne last month in a meeting arranged by OPAN the Older Persons Advocacy Network.
Lesley Forster (pictured above), of Donnybrook, presented the consumer perspective on co-payments.
“This model links access to care with income and asset levels. While this may appear fair on paper, in practice, it risks pricing out the very people it claims to serve,” she said.
“These are people who are already making impossible choices between food, medication and care. What’s being proposed is a system that expects them to shoulder more of the cost without clear information, without adequate protections, and without any guarantee of value in return.
“The more services you use, the more you will have to pay, so the neediest people on the highest level packages will be expected to pay more than they can afford.
“The three tier system is un-workable. It is not possible to describe any services as non-clinical because cleaning, gardening, social support and transport are crucial elements of maintaining mental health.
“They are the foundation of mental wellbeing, safety, and staying home out of hospital and nursing homes.
“Aged care should never be a luxury or a gamble. It is a basic right. As the royal commission made clear — older Australians deserve care that is rights-based, not profit-driven, she said.
Frank Smith raised problems with expense inclusions and exclusions.
“The rules that limit how aged care package funds are spent are ageist. Older people are treated as incompetent to make their own choices. No other welfare payment is so restricted.
“The 2025 Stewart-Brown report found unspent home care funds are in excess of $4.3 billion. That means many people are not getting the care they were assessed for.
“With a few exceptions exclusions are common sense. The devil is in the details for inclusions. Providers vary in the way they interpret them.
“Most hassles appear to be around home maintenance. Providers seem to think minor electrical and plumbing repairs are limited to changing a light bulb or unblocking a toilet.
“Providers and the Department of Health and Aged Care have a fear of misuse, although actual misuse of package funds is very low. A sample audit found incorrect items cost only 1.2 per cent of care recipients package funds.
“I am not proposing open slaver, but flexibility to better fit our needs. We oldies know what we need better than a Canberra bureaucrat.
“My suggestion is that a proportion of package funds should be available to be spent at the discretion of the recipient on any item not specifically excluded and provider’s fees should be based on a percentage of package funds actually spent on care, not on the total package,” he said.
This would give older people improved choice and control about their home support while still preventing misuse of government funds.
Minister Rae said forums like this are a great opportunity for honest dialogue between older people, their advocates and government.
“The feedback I heard today reinforces the urgency of the Australian Government’s aged care reform agenda.
“Our new Aged Care Act represents a significant step forward in transforming aged care to create a system that has older people and their rights and dignity at its core,” he said.
CEO of OPAN, Craig Gear said the new Act was a marked improvement on the current legislation.
“It’s not the end of the journey but a starting point for the cultural change that has to happen in aged care. Reform will be ongoing.
“The Aged Care and Other Legislation Amendment Bill 2025, recognises the need for such a large and ambitious piece of legislation to continue to evolve.
“It gives the Minister the power to make necessary adjustments to the rules, with the requisite parliamentary scrutiny.”
“Let’s get this right, together,” said Ms Forster.
