Pay per shower: fully-funded aged care turns market-driven aged support

The new Home Support Program for older people introduces a ‘free market’ transactional aged care system. This is a step backwards Sarah Russel reports.

Forty years ago the Hawke Government launched a major aged care initiative consistent with traditional Labor values. The Home and Community Care (HACC) program provided state-supported home and community-based support services. These services, such as meals on wheels, public transportation, and nursing care, have allowed seniors to live independently in their own homes.

Compare this with the Home Support Program that the Albanian Government introduced on 1 November. Unlike Hawke’s HACC program (which later became the Commonwealth Home Support Scheme), the Home Support Scheme is a transactional aged care system in which users pay a share based on services received and the financial situation of the participant.

Even basic services such as showering require financial contributions from retirees.

Is this further evidence that the current federal Labor government is the least Labor-like in the history of Labor governments?

Historic aged care reforms raise concerns

Promises of aged care reform

In the 2022 federal election campaign, Albanese campaigned for aged care reform. But soon after Labor was elected, a number of red flags came up. The first was Albanese’s decision to keep the aged care and sports portfolios under the same minister who was not in the Cabinet (changed after the 2025 election).

Another red flag was raised when Labor tabled the Aged Care and Other Legislation Amendment (Royal Commission Response) Bill 2022. This was the exact same bill the Liberal Party introduced in 2021.

When I realized that the Ninth Schedule had been included in Labour’s bill, I thought it was a mistake. This gave providers and their employees immunity from using restrictive practices such as chemical restraints (drugging residents). The aged care royal commissioners had not recommended this, so why did the Labor government include this scheme in the bill?

After raising my concerns about the Ninth Schedule to aged care minister Anika Wells, I received a response from the Department of Health. This response contained similar language to the response I received from the previous Coalition minister a year ago.

In its early terms, the Labor government claimed to have “reformed the Australian aged care system through several key initiatives”. Having a registered nurse on duty 24 hours a day in all elderly care homes was an important initiative. So does the increase in wages for personal care workers.

Star ratings and special deals

After the Minister for Aged Care and Sport won some elections to the board, the Labor government introduced a bill. star rating system It initially assessed that 91% of aged care homes provided “acceptable” quality of care. This star rating system was revealed to be more fabricated than substance, after horrifying accounts of widespread neglect and abuse in aged care homes were heard during the royal commission.

The Labor government then did what even the Coalition chose not to do and what the Aged Care Royal Commission had warned against. Almost disbanded $1.5 billion Private operators to carry out aged care assessments under the Single Assessment System.

This was another stop on the aged care free market train.

Our taxes are now given to large private companies to undertake special assessments and to private companies to provide the services.

Privatization is a complete fiasco.

Unsurprisingly, the privatization of regional aged care assessments has led to poorly educated people undertaking these assessments. In some cases, aged care assessments are conducted over the phone or online. How is it possible to accurately assess the needs of an elderly person without meeting him/her in person and observing him/her in his/her home?

Perhaps the most mind-boggling initiative was for the Labor government to convene another task force in 2023. This task force recommended that older people contribute to the cost of care based on their ability to pay.

Co-payments are contrary to the recommendations of the Royal Commission.

It called for guaranteed access to aged care based on assessed need.

Co-contributions depend on whether the services are clinical or not. Clinical services (nurse care, wound management, physiotherapy and medication assistance) will be fully funded by the Home Support Programme. However, non-clinical services (home and gardening assistance and lifestyle activities) require joint contributions.

Pay or skip your shower

Some bean counters in Canberra have decided that showering is a non-clinical service. As a result, seniors who need help taking a shower must pay for this service. For example, retirees will be asked to contribute 5 percent of the cost. If an elderly person cannot afford the co-pay for a shower, they may need to skip it.

Did the bean counter think that not showering could turn into a clinical problem very quickly?

Aging Australian Chief Executive Tom Symondson spoke out when he said, without citing any evidence: “My strong feeling(italics mine) means that retirees “will not seek support for showers because of the five percent fee.”

My strong feeling is shock. It is shocking that the Labor government has introduced a scheme to charge pensioners for a support worker to help them shower. I can only imagine what Hawke would say when he saw his beloved Labor Party go so far down the neoliberal rabbit hole.

Aged care ‘free market’ where home care package deal masks crisis