Don’t hold back on CDC reforms: report

The Government must fund a public information campaign to complete the rollout of consumer directed care, promote new online service options and revisit mandatory qualification requirements for care workers, according to a report published by the Centre for Independent.

In the report about consumer directed care reforms, released last week, Senior Research Fellow and Director of the Healthcare Innovations Program, Dr Jeremy Sammut, said the success of consumer directed care depends on the Government following through in all aspects of reforms to “unleash” the market.

“Ensuring consumers can exercise real choice also depends, in the first instance, on fostering greater awareness of the fact that consumers now have the right to choose,” Dr Sammut wrote.


“Consumers have a right to be informed about the full range of government-funded services available if they are to exercise real choice, and should not be denied knowledge of the innovative models that can deliver better value and quality.”

Dr Sammut outlines a ‘to do’ list of additional reforms needed to promote what he describes as “real choice and greater greater improvements in the efficiency and effectiveness of consumer-driven aged care in the new economy”.

These include:

  • establishing a minimum standards framework for home care services to ensure excessive regulation does not restrict provider competition — and therefore customer choice — in the new consumer-focused market, and doesn’t burden the sector with excessive cost.
  • Ensuring consumers do not face significant switching costs, by foreshadowing the application of Australian consumer law to the charging of hefty exit fees should traditional providers fail to cease a practice that is contrary to the spirit and intent of the CDC reforms.
  • Reviewing the duty of care provisions of the Aged Care Act to prevent traditional providers citing statutory obligations as an excuse to deny consumers the right to choose alternative providers. This will help stimulate the unbundling of one-size-fits-all care packages into separate services (spanning fund holding, administration, case management, care coordination, advocacy and service delivery) that can be purchased discretely from specialised organisations offering different parts of the bundle.
  • Revisiting mandatory qualification requirements for care workers to make it easier for those without industry experience to seek employment in the sector, while trusting consumers to judge workers’ suitability based on the quality of service received and assume a level of risk consistent with independent ageing and dignity of life.
  • Examining how employment laws might be applied to an individual engaging another individual to provide personal care and domestic service, to clarify the status of care workers as independent contractors hired directly by consumers. This will encourage the growth of innovative online marketplaces for care and support services that can offer better value and superior quality home care.
  • Undertaking a public information education campaign to foster awareness among ageing Australians and care recipients of their right to choose under the CDC system, and promote knowledge of the full range of options now available, including online platforms.

According to a survey by researchers at the University of SA, University of Adelaide and Torrens University, only 11 per cent of respondents had heard of CDC, and only 22 per cent of those who were aware of CDC (2 per cent of the population of older people) had a sound understanding of its entirety, the report notes.

“Education for consumers about the CDC changes should include information about how to switch providers, and personal stories of consumers making choices and achieving better outcomes by switching (as is the case with the NSW NDIS campaign).

“It should also include information about individualised budgets and provider charges, and about accessing impartial and independent advice.”

“The biggest service a government-funded public information campaign might render would be to challenge the established culture of the sector regarding the key issues of choice and risk.”

“Education of providers and consumers alike is needed around the concept of duty of care — which should be redefined to a more reasonable and balanced definition that encompasses people’s right to choose, as opposed to providers inhibiting choice on the basis that they have to manage risk.”

Dr Sammut also said consumers need to be made aware of new online options.

“Fostering greater awareness of innovative online options should also be a key objective, regardless of the objections of traditional providers whose interests are threatened by greater choice and transparency.”

“Fear of upsetting key stakeholders with vested interests (and ready access to media prepared to run “embarrassing” anti-private sector, pro-‘charity’ stories) may explain why the federal government is running relatively quietly on the full introduction of the CDC system — at the expense of leaving consumers in the dark about the new private sector care options now available, and thereby jeopardising the success of the key reforms,” he wrote.

The full report can be viewed here

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