The exposure draft consultation is finally closed but with the ‘undoubtably tight’ deadline for the new Act only four months away, chapters remain ‘to be drafted’.
The new Aged Care Act should include a definition of palliative care, specify that care should be provided based on clinical assessment and should manage state and territory inconsistencies, says the Australian Healthcare and Hospitals Association.
Currently, an estimated 1.5 million elderly are supported by Australia’s subsidised aged care services, amounting to $28 billion in taxpayer dollar in 2022-2023.
The current Aged Care Act was passed in 1997 and has undergone a multitude of updates over the past two decades.
Today, the DoHAC closed the public consultation on the exposure draft of its new Aged Care Act, following an extension period from 16 February.
In its submission to the exposure draft consultation, AHHA said its response would focus on its blueprint for health reform which encouraged “outcomes-focused, value-based health care”.
Overall, the AHHA was onside with the changes proposed in the exposure draft, “including the rights-based approach, new duty of care, the system and provider governance arrangements, compensation pathway, and the inclusion of palliative care and end of life care in the Statement of Rights”.
But it highlighted three sticking points that it said would need amending to ensure the Act aligned with its objective to “focus on the safety, health and wellbeing of older people, and put their needs and preferences first”.
First, palliative care and end of life should be redefined, said the AHHA.
“It must be considered that people can receive palliative care for a long time before they die, with some people living comfortably and receiving palliative care for years,” said the submission.
“Therefore, the line ‘except where it is the individual’s choice to access palliative care and end-of-life care’ must be removed, as it is possible and desirable to maintain the individual’s physical, mental, cognitive and communication capabilities for palliative patients to the extent possible.”
The AHHA concurred with the recommendations of Palliative Care Australia that a separate statement of principle on palliative care and end of life should be issued with the Act, as should a definition of palliative care.
Second, the exposure draft of the Act did not adequately define high-quality care, according to the AHHA.
“In assuring high-quality care, there must be an expectation articulated for providers to also use clinical assessments or reviews or tools to inform care provision.
“Omitting the use of these evidence-based, clinical assessment tools in the definition of ‘high-quality care’ implies that high-quality care can be delivered without the use of these tools, and evidence suggests otherwise.”
In line with the recommendations of the Royal Commission, the Act should specify that care should “be provided on the basis of a clinical assessment, and regular clinical review, of the person’s health and wellbeing”, said the AHHA.
And finally, the new Act must address inconsistencies in the legislation of the states and territories.
“The introduction of ‘supporters and representatives’ within the Act has the potential to create integration and implementation problems due to existing roles identified in state and territory legislation and practices.”
The rewrite of the Aged Care Act was prompted in 2021 by the final report of the Royal Commission into Aged Care Quality and Safety.
The exposure draft included the parts of the Bill with the most significant changes to the aged care system.
Currently, the Act is due to come into effect on 1 July, a timeline DoHAC’s deputy secretary for ageing and aged care Michael Lye told senate estimates last month would be “undoubtably tight”.
Now that the consultation has closed, KPMG will complete and issue a report to DoHAC on the outcomes within three weeks.
Any formal redrafting of the Act, based on KPMG’s report, is therefore unlikely to start before 1 April.
The health minister will be advised on when the bill may be ready to introduce to Parliament following assessment of the consultation report.
Once introduced, the Bill will need to go through the following: three readings in the House of Representatives, a public inquiry and detailed consideration, three Senate readings and a Senate committee hearing, before it can be signed into an Act of Parliament by the Governer-General.
Given that Parliament only sits for four weeks before 1 July, it is unsurprising that the likelihood of meeting this deadline has been questioned.
Changes to pay arrangements within aged care, included in the fourth chapter of the exposure draft of the Act, remain on the government’s to-do list.
The chapter was left as “to de drafted” in the exposure draft.
The government was presented with a final report by the Aged Care Taskforce in December which reviewed current funding arrangements, but has yet to release the report to the public.