A BENDIGO business is prompting community discussion about the ever-growing demand for human services.  Care Beyond Measure is preparing for the worst – the day when demand out-numbers funding and workforce – and wants everyone to start thinking about the future. The in-home care provider is busy training a workforce of personal carers but is also taking the time to plan a community forum to be held in August. Care Beyond Measure senior manager Kevin Pittman paints a bleak view of the future and has prepared a presentation to highlight the “train wreck” that is edging closer and closer.  “There is a situation developing in our community that we need to start thinking about,” Mr Pittman said. “We really needed to start thinking about it 10 years ago but hey, any time is better than none.

“We need to start thinking about how we’re going to prepare for this situation.” Mr Pittman described the “situation” as a trifecta – staggering increases in demand, shortages of government funding and a shrinking workforce. “Who the heck is planning how to face a situation where we have much more demand, much more complex demand, much less money and much fewer staff all at the same time?” he asked. Bendigo Advertiser, 28 May 2012 

This is an interesting story – the aged care system in Australia has been under pressure for some time. There is 2011 report by the Productivity Commission that led to the current 2012 Government response, Living Longer Living Better, which is akin to moving the deck chairs around the Titanic. Their effort to switcheroo funding without biting the bullet of real reform means that most of the promised funding increases were moved to the end of the 5 year period (2016-17). Given the current (un) popularity of the Government, they are unlikely to be in power when these increases fall due. The Productivity Commission Report suggested opening up a very regulated industry to competition and moving the costs of aged care onto the consumer. This makes economic sense in the face of shrinking Government revenue and growing numbers of ageing Australians needing care over the next 20 years. It makes no political sense when the people facing the loss of their nest eggs all vote.

Over five years, the net cost of the package to the government is some $580 million and only $285m over the next four years – the period of the forward estimates. There is very little new spending over the next two financial years, with most of the new spending due from 2016-17.

There is little new money, with significant clawbacks in terms of means testing and reduced payments to providers. Greater consumer choice will be achieved only if providers are given appropriate incentives to invest and innovate. The package fails to achieve this balance – the pieces will be left for the next government to pick up. (The Australian)

When asked, most people state that they would prefer to aged in their own home, with control over who looks after them. This is most striking in the baby boomer generations who are currently engaged with the aged care system for their parents, unfortunately they may not have the means to pay for the level of care they will be expecting.

While no new reforms are embraced, the operators are all still facing the trifecta of reduced Govt funding, a shrinking workforce and spiralling demand. The complexity of care requirements is increasing and the likelihood is that many ageing Australians won’t be able to afford the type of care they, and their families, expect. So what are the future ramifications of this? Will care professions become better paid, with the commensurate de-feminization that usually accompanies this? What does this mean? What is role for robots and technology in providing care if the workforce is unavailable? Will care become an individual issue, leaving women to continue to bear most of the burden? Will Australia become more like Asia in our care of the ageing section of our population as suggested by Joe Hockey, the Opposition Treasurer, when we was addressing entitlement as an approach to welfare in Australia.

”The concept of filial piety, from the Confucian classic Xiao Jing, is thriving today right across Asia. It is also the very best and most enduring guide for community and social infrastructure … The sense of government entitlement in these countries is low. You get what you work for. Your tax payments are not excessive … By Western standards this highly constrained public safety net may, at times, seem brutal. But it works and it is financially sustainable.” Read more: http://www.theage.com.au/opinion/politics/a-strange-sense-of-entitlement-20120419-1x9yz.html#ixzz1wJM3NVeu

Responses to his speech were along the lines of the paragraph below:

Filial piety essentially boils down to families looking after their own, without government assistance. This means that women do most of the heavy lifting. A married woman is responsible, first and foremost, for the care of her husband’s parents, secondly for her children, and finally, her own parents. The eldest son provides the financial means for his parents. His wife gives up time, whether out of love, duty or the knowledge that options are limited…Hockey noted that the concept of entitlement is virtually non-existent in a Confucian welfare state. He neglected to mention that there is a strong sense of entitlement to women’s unpaid labour. The Drum

So, something is going to give and the question for thinkers using foresight is what, and how will this change the present situation?