Nursing homes run by private, for-profit providers are the worst performing in the country while aged care facilities with fewer than 30 beds run by state governments are the best quality, world-first research released by the royal commission has shown.
The Aged Care Quality and Safety Royal Commission today released a study it commissioned from the University of Queensland which analysed complaints, quality care indicators, compliance breaches and the prescription of high-risk medicines such as antipsychotics and opioids for every residential aged care facility in the country.
Researchers from UQ found that even if every aged care home was operating without any cost inefficiency at all, they still would have required an additional $621m to perform at the top quality level in the financial year 2018-19. If an even higher quality small-bed model was used, the additional funding needed in a single year is closer to $3.2 billion.
“These estimates are for the quality levels found among facilities within the current residential aged care system under current funding levels,” the researchers note.
“Funding levels might need to be much higher than the estimatesif the Australian community and the royal commission aspire to achieve a higher quality in the future than facilities have achieved historically.”
In its analysis, the UQ report shows private, for-profit nursing homes were the least represented in the top quality level — just 4 per cent of profit businesses made it into this category — and the biggest single group in the worst performing category.
Government-run facilities, smaller in number and often operated by state and territory governments, were the best performing with almost one-quarter of facilities in the top quality tier. The next highest were not-for-profit providers with 13 per cent.
Again, in the lowest quality tier government providers made up just 8 per cent of facilities. Not-for-profits accounted for 10 per cent and privates came in at 14 per cent.
The Royal Commission has already entertained a much bigger scope of reforms for the sector, estimating in a consultation paper that total funding may need to rise by as much as 50 to 100 per cent; between $13 billion and $26 billion from a range of sources.
In response to that financing consultation paper, also released yesterday by the inquiry, Queensland Health director-general Dr John Wakefield said “the predominantly market driven approach to the delivery of aged care fails to meet the needs of many in the system.”
Currently, taxpayers fund about 80 per cent of all residential agedcare costs and the vast majority of home care packages but the federal government, which funds the sector, does not run a single facility.
Not only does provider-type have a statistical link to the quality ofcare offered, so does the size of the home itself. In the UQ study, nota single nursing home with fewer than 15 beds registered in the lowest quality tier. But nursing homes with 61 to 120 beds, 121 to 200 beds and 200 or more beds accounted for 12, 17 and 21 per cent of all facilities in the worst performing tier.
The Prime Minister was again on his feet in parliament yesterday [[Wednesday]] defending the Coalition government’s decision while Scott Morrison was Treasurer to carve about $1.7 billion in funding from the direct nursing subsidy, the Aged Care Funding Instrument.
Those changes, in late 2015 and in the 2016 budget, reduced funding for the two most serious levels of care — severe behaviours and complex healthcare needs — so that they grew by less than realcosts or, in the case of complex needs, went backwards by an average of $400 per resident in a single year.
But yesterday, the Prime Minister said frailty and care needs are increasing.
“When we make those decisions we know, and the aged care sector knows, that they are having to deliver on a much higher level of acute care today than was the case 10 years ago or 20 years ago,” he said.
“And that means the demands are greater. And that means the actions need to be greater.”
The Royal Commission continues.
Rick Morton is the author of the bestselling One Hundred Years of Dirt. He has been a journalist for 15 years with a particular focus on social policy and national affairs. Rick is the senior reporter for The Saturday Paper.
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