Collaboration across all sectors and levels of government is needed to solve the crisis in aged care.
It is likely more than 1,000 elderly people will be stranded in Western Australian hospitals by year’s end, according to advisory firm ACIL Allen.
Too healthy to stay in hospital, too frail to go home, unable to access a home care package or a bed in a nursing home.
Not only is a hospital setting deeply inappropriate for anything but a short-term stay, it is expensive for the state government, with a stay in a general hospital bed costing about $2,000 a day.
What’s more, ACIL Allen has estimated that the cost to the state of providing this care will rise from $10 million per month in June 2021 to up to $71 million per month by December 2022 (and that is before Omicron impacts are considered).
ACIL Allen estimates the cumulative direct impact on the government of inpatient care for elderly people who should not be in hospital will be up to $790 million for the period June 2021 to December 2022 (again, before Omicron impacts are considered).
And yet, if there was a bed in a nursing home or a home care package available for each of these 1,000 people, the federal (not state) government would be up for $280 a day and $70/day, respectively.
This leaves the state government with the best part of a billion dollars to address the chronic shortage of beds in a hospital system never meant to be an aged care facility.
So, why are there no beds or packages available for these 1,000 elderly people? The predominant cause here is the aged care sector’s workforce, or rather the lack of it.
WA’s rate of population ageing means the demand for aged care services is increasing exponentially and, for many reasons (including low pay, low status, an inadequate funding model, immigration hurdles), the aged care workforce is not keeping up.
Given that dynamic, providers do the only thing they can do: close or slow admissions to focus on the workforce they have to provide care for existing residents.
The healthcare, aged care, seniors living, disability and mental health sectors are deeply interconnected and interdependent with each other and the broader community.
So, while it would be easy to start pointing fingers, there is a deeper challenge here.
The state government, federal government, providers and every other stakeholder must adopt a ‘systems lens’ in engaging and collaborating on solutions that focus on the real issues as opposed to organisational mandates, political agendas and KPIs.
Blame and linear thinking, with its cause-and-effect focus, will simply create a raft of inherently ineffective ‘whack-a-mole’ solutions.
If we are to make sure those 1,000 elderly people are not left stranded in the hospital system at great cost to taxpayers, and that they get the care they need, then there are two short-and medium-term priorities that require genuine engagement by all stakeholders, including government.
Firstly, the aged care sector must be an integral part of the planning and implementation of the WA government’s COVID-19 Safe Transition Plan.
As Amana Living CEO Stephanie Buckland said recently:
“We’re caught in a Commonwealth/state divide. Aged care is a Commonwealth responsibility, no-one is arguing that, but the Commonwealth doesn’t have the operational might in the health system that the state government does; it simply can’t respond in the way that is needed within the time required.”
Irrespective of the fact that aged care is federally funded, the state government has the logistical power to ensure that elderly Western Australians don’t pay the price for an open border.
Likewise, it is the state government’s hospital system that will bear the brunt when aged care homes go into lockdown and stop admissions.
Secondly, we need workforce plans that apply a ‘systems lens’ across the whole of the tertiary healthcare, primary health care, aged care, disability and mental health sectors in WA, and then again federally across aged care and disability.
While they might have different state and federal masters, the same people use these services and, importantly, the same nurses and carers work in them.
There is no piecemeal solution here.
Collaboration by all parties is key, as is leadership from the state and federal governments and a recognition that, at the end of it all, are people who need and deserve our care.
Amber Crosthwaite is a commercial lawyer specialising in seniors living, aged care and disability.
