DR ANNE WEBSTER MP

SHADOW MINISTER FOR REGIONAL HEALTH
SHADOW MINISTER FOR REGIONAL COMMUNICATIONS
FEDERAL MEMBER FOR MALLEE

TRANSCRIPT

TOPICS: Local power outage, insurance, Victorian government responsibility, Tri-State Regional Aged Care Forum in Mildura, care waiting times, telephone assessments, aged care algorithm, interaction with hospital and bed-block, investment in aged care beds

Marshall

Today in Mildura, the federal member for the Mali Dr Anne Webster is hosting the Tri-State Regional Aged Care Forum alongside facilitator Dr Nick Coatsworth. He's a physician and public health policy expert. They're in the studio with me now. Good morning.

Webster

Good Morning

Marshall

Firstly, Dr Webster, I know we're here to talk about aged care, but just quickly, what can be done federally for people in Mildura that are experiencing this power outage and the cost of food and equipment as well?

Webster

It's so huge, and to hear John say that this is the first time in the state - is really quite confronting. The federal government steps in when it comes to insurance. So, if anyone has difficulty accessing their insurance or having their insurance companies they're dealing with to move along with claims and even assessment, that can take quite a bit of time, by all means contact me I  can assist you with all of that. With regard to the Powercor - I know that my state colleague Jade Benham is talking with the Minister at the moment to see what can be done. You know, it's difficult not to to feel just a teensy tiny bit cynical that if this was the Premier's suburb would all this be actioned a little quicker and they've got a lot more people in a, constrained area in Melbourne if that actually occurred. So I would certainly like to see the state government step up and move this along.

Marshall

We are awaiting a response from the Minister for Energy, Jaclyn Symes, and I will provide that to our audience when that comes through. Now, Dr Webster, last month, the Four Corners investigation by the ABC exposed significant delays in accessing aged care. It did examine the new Support from Home system that is used government-funded support they receive. We do know people, if they are currently navigating the aged care system in the Mallee... will know the difficulties faced and the practicalities of actually receiving the care that they or their family needs. Now, today in Mildura, you are running the Tri-State Aged Care Forum here alongside facilitator Dr Nick Coatsworth. Why Mildura, and what has prompted this?

Webster

Mildura is set in a tri-state area, obviously. We have people who are having services delivered from Mildura across the River. The aged care system has members up in Broken Hill that are connected to Irymple, like it's all, there are moving parts that work together, hopefully! The issue that I'm trying to address with this Forum, and we have 150 people coming to the Forum, two-thirds of which are people trying to navigate the system. It's a mess. The Commonwealth Home Support Package, which is that elementary first step with a bit of gardening or home care, that has been operating for quite some period of time, doesn't have out-of-pocket costs, et cetera.  The Government has introduced Support at Home on November 1, 2025 - it has had nothing but troubles. I have a deaf gentleman here in Mildura who was assessed on the phone, can you believe? - over the phone! Awarded level 2 out of 8 ...

Marshall

Is 2 the highest? or is 2 the lowest? 

Webster

... No, lowest. I've got other people who have now gone into palliative care because they've taken 9 months to finally get the assessment done. The Coalition has challenged the government on the fact that it's an algorithm that determines that assessment, on the basis 80 per cent of that phone call, so whatever answers you give over the phone which ... in my view should be an occupational therapist in Mildura seeing people in their home, that actually assesses them appropriately. A phone call is nowhere near enough in my view. There are a lot of problems. The algorithm we now find cannot be over-ridden by human over-ride - humans cannot say that was incorrect, needs to be done again. Sam Rae has not been up front about that. This forum I am very glad to have Doctor Nick Coatsworth here - he's facilitated two other forums for me in the last few years, Regional Health Forum and the other Aged Care Summit and its great to have him back.

Marshall

Dr Nick, what are you hoping to facilitate in today's conversations and get out of today's forum?

Coatsworth

Grace, I think what makes this unique is just the number of people who are coming who are not from the industry, who are not providers, of course we will have providers there - but I understand two thirds will be people who are actually engaging with the system at the moment. I think that's unique - I think hearing from them about those challenges, validating what Anne's just said, about particularly this algorithm and hearing what the experience is for aged care consumers in the regions. We've experienced this in our family it was in an urban setting with my mum in Sydney - under the new home care support package she did wait for 6 months between getting approved for what used to be a level 3 and now would be a level 6 out of 8 - for a package for advanced dementia, and she couldn't access it. So, there was no funding for 6 months. So, between my brother and I we self-funded someone coming out and checking on her every day because that's what she needed with the advanced dementia - and when it did kick in we only got 60 per cent of the funding. That's exactly what's happening, that's what the ABC revealed on Four Corners, there are significant structural issues and I'm really keen on hearing from people living in this region on just how much its impacting them as I'm imagining its significantly more than it impacted us.

Marshall

What are some of the biggest impacts you're hearing, Dr Webster, I know that you've commented you have been inundated with calls to your office, what have been the biggest concerns to your office in Mildura?

Webster

Oh look the wait times - people can't get an assessment, when the assessment comes and it's clearly inadequate or its the 60 per cent funding that Nick's just spoken about, then it goes through to the Aged Care Commissioner - we facilitate and help people do that all the way through but it is phenomenally frustrating and incredibly sad when you know that we have 5,000 people who have died while waiting for an assessment outcome.

Marshall

5,000 in Mildura?

Webster

No in the nation over this period of time. 230,000 are waiting - they are on wait lists - its incredibly ... it's unacceptable when they are already at that vulnerable stage. People don't put their hand and say oh I really need aged care unless they do - and they are vulnerable and they become more vulnerable as services are not provided. I could fill your morning Grace with story after story about how our respected elderly are not being nurtured and cared for in the way they need to be.

Marshall

What's impacting wait times, is it staffing, or is it what we are seeing at the Hospital at the moment ? We know a lot of news coming out of the Hospital, the CEO has stepped down, there is an interim CEO, at the moment we also know 150 referrals not to do with aged care necessarily, 150 referrals that were missed - is what's happening at Mildura Base Public Hospital impacting this at well?

Webster

I would suggest that its chicken and egg really, for people who have not been able to access the care they need at home, they deteriorate in their personal status, often they will end up at ED. Then they are assessed as needing to go and have a bed, if they cannot get a bed in aged care, which is where they may need to go, then they're what the bureaucrats call 'bed blocking' I find really quite insulting as a term, they are lying in a bed waiting to get to aged care. I did hear a story this week that somebody's been in that situation for 12 months. 12 months!

Marshall

12 months in a hospital bed at Mildura Base?

Webster

... at, is it $6,000 a day for a bed in a hospital, maybe 3?

Coatsworth

Oh yeah, it's certainly several thousand ...

Webster

... a day! 

Coatsworth

... and thats happening in hospitals both in Mildura, we have that in Canberra, it's happening in New South Wales ...

Marshall

... and it's also the mental health toll for anyone that spends that amount of time in hospital, 12 months is debilitating ....

Webster

Yep - there is a statement Nick can correct me on it, if you spend a day in hospital it takes a week to rehabilitate

Coatsworth

That's probably more or less true. The transition when you are sort of, effectively we might use the term institutionalised ...

Webster

That's right...

Coatsworth

... within a hospital system. It's not as though people aren't trying to prioritise getting someone in that situation out into an aged care facility it's simply that the beds and the investment's not there. I suppose that brings me to something that I'm very passionate about, home care is the key there - the former Inspector-General Natalie Segel-Brown said that at the Natinoal Press Club a couple weeks ago, that would have been on Four Corners, we want to keep people at home. We do know that the end of that journey is often in aged care facilities and we are not constructing an environment where that sort of investment can happen. The number of new aged care beds being built is sorely insufficient for the needs. That relates to funding, that relates to providers being able to make a margin on their investment which really doesn't exist. Really importantly its about how its structured, the innovation piece, if you are focusing all your time on providing nurse-led care minutes which is what the Royal Commission told us to do, then you can't innovate, and those care minutes can't even be counted Grace towards allied health, which is such an important part, beyond nursing, nursing is important, but allied health is critically important in aged care facilities, and the system doesn't allow us to count those as care minutes. So I think, with all the best intent of the Royal Commission and it was was absolutely necessary, we have narrowed things down to this cookie cutter approach which has stifled innovation, which has stifled investment. What I'm hoping to hear today is... what effect that's actually having in the regional areas, how we might advocate for a bit more of a relaxed approach and an innovative approach to increase the number of beds.

Marshall

You're hearing this morning from Dr Nick Coatsworth, he's a facilitator at the Tri-State Aged Care Forum today in Mildura, also Dr Anne Webster, federal member for the Mallee. Dr Webster, what policies are you hoping come out of today's conversations, what are you pushing for?

Webster

Well I'm not pushing, I mean the whole idea of doing research and Nick's doing his PhD - at the tail end, he hopes - and having done it myself - you want the grassroots, what's coming up from the research that you're finding. So, this to me is research. It's obviously personal when it's constituents that I have a responsibility for as well. But I want to hear people's story because that should undergird good policy. What we have found over the last four and a half years is that we get policy or legislation developed and dumped on the desk and goes through the Houses of Parliament and then Labor decide to do stakeholder engagement. That is absolutely upside down. All the stakeholder engagement should go first, which then develops good policy. I am really looking at this piece, as Nick said, about the fact is people want to age well at home. They want that. We know that now, we need to be able to facilitate that. That is not happening. And when you have, you know, a couple of hundred thousand plus, we don't really know the numbers. They're opaque. These are old numbers, 230,000 who are waiting. I think that's a really bad outcome.

Marshall

And for today's forum if there are people listening that want to come down and want to share their stories is that still open for people to attend?

Webster

Unfortunately we are overbooked now but what we can do is send people the list of questions and they can answer them and send them back to us and it will be incorporated in the summary of today so they can still engage.

Marshall

And they'll get in touch with your office for those questions?

Webster

Yes

Marshall

Who has been invited today - it's a tri-state forum, who is coming from South Australia and New South Wales?

Webster

With South Australia, we are waiting to hear whether somebody is going to pop across. We've got my Chief of Staff who happens to live in South Australia, so you know, legitimately I could say South Australia, but not really. Tony Pasin was invited, one of my colleagues, and for him to invite his aged care providers and send out the invite. So - largely we have New South Wales, Broken Hill, Balranald, Wentworth, that whole area plus obviously a large contingent from the Mildura region. There are many providers who are coming, the National Rural Health Alliance CEO Susi Tegen is going to be here, we have Ageing Australia, we have a number of providers.

Marshall

Well, thank you so much for your time this morning and for coming into the studio. Welcome. Thank you. That's Dr Anne Webster there, federal member for the Mallee, Dr Nick Coatsworth there, Forum is on today. If you are unable to make it, is overbooked. As you heard, get in touch with Dr Anne Webster's office and you can receive those questions and provide your feedback.

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