04/03/2026
Aged Care- An Opinion
I work as a GP and have some interest in aged care.
Much of the accommodation in the aged care sector is driven by real estate development in a corporate model. You sell your house. We sell you a broom cupboard for roughly the same price and promise a dodgy nursing home thereafter and some of the money going to your offspring when you die.
Now there is huge amount of ‘bed block’ in public hospitals because the families who will inherit the houses do not want this deal, so the house is not sold and the oldie in hospital has nowhere to go- hence the bed block. A geriatrician told me about this problem, which of course leads on to ambulance ramping at the other end. It is also a Federal-State issue as the services outside hospitals are mostly Federally funded, while the public hospitals are State funded.
The latest problem is the Federal government’s effort to shift costs back to the patients. It is part of the major problem in the whole health system in Australia, each player, Federal govt, State Govts, Insurers and patients try to shift the costs to someone else, without caring about the total cost.
Clearly home help is needed with a lot of different levels of needs and services. Corporates have moved in and the services tend to be very expensive. Some years ago I knew a man down the street, now deceased, who wanted a couple of hours cleaning a week. The company told him he had to have a minimum of 4hrs per week at $60 an hour. The lady who actually did it was paid $21 per hour.
In 2000, Kevin Rudd asked for submissions for a thing called ‘Vision 2020’,which was an ‘ideas workshop’. I wrote a submission saying that a government registration and insurance system was needed so that individuals could find other individuals to offer services without the middleman. I never even got a reply from Rudd.
Andrew Leigh is Minister for Competition, but it seems that the government is following the Howard line of opening up the disability sector to ‘for profit’ providers. AirTasker seems one of the few groups trying to link service providers with those who need services. Obviously there needs to be websites where people are rated, as happens for restaurants or accommodation.
If the government were pushed to have a registration website where people could put the services that they offer and their CVs, and pay a registration and insurance fee, it would be the basis for service delivery. Naturally there would be some crooks exploiting it, who would have to be identified when they were rated and then excluded by some sort of regulatory body, but overall most people would do the right thing, and the huge margins that some providers are charging would be non-competitive and would cease. The corporate providers say that they are needed for quality control, rostering etc, but their costs are often profiteering. ‘The market’ will fill any gap, but this is really a welfare issue that needs a cooperative approach, which tends to be lacking in Australian health planning.
