Why is 8 mins of allied health for older people not enough, and then the government says 2 secs is?

Updated: Sep 24, 2021

Older people need movement and allied health. That doesn't seem to be under dispute. Also not under dispute is that older people need MUCH MORE allied health than they are getting now.

The Royal Commission into Ageing Quality and Safety found up to 30% of residents received sub-standard care. Over two years, through more than 10,500 submissions and 600 witnesses, the two commissioners heard extensive evidence of a system in crisis.

The commissioners heard evidence many times that allied health provision in Residential Aged Care was inadequate. They heard that on average older residents in aged care received only 8 minutes per resident per a day and that this clearly wasn't enough.

'Mobility is closely linked with people’s health and their quality of life. However, we heard numerous examples of aged care providers not supporting people to maintain and improve their mobility—including limited access to allied health professionals critical to promoting mobility, such as physiotherapists. Poor mobility increases the risk of falls and fall-related injuries due to deconditioning and reduced muscle strength.' p79 Final Report

The Commissioners heard that there was little focus on reablement and reconditioning currently with the way allied health is provided. The inquiry found that allied health professionals in their 8 minutes per a resident per a day were being forced to spend their time on non-evidence based interventions like massage rather than more proven strategies like exercise.

Reablement and rehabilitation need to be a central focus of aged care. We recommend

that care at home should include the allied health care that an older person needs to

restore their physical and mental health to the highest level possible—and to maintain

it at that level for as long as possible—to maximise their independence and autonomy.

Throughout our inquiry, many witnesses described the crucial role of allied health in

maintaining mobility and functionality and providing restorative care in response to acute

events. We also learned that many people receiving aged care services do not have

sufficient access to allied health services.

In the Royal Commission recommendation 38 both commissioners called for more access to allied health than the current 8 minutes per a resident per a day. One of the commissioners even gave specifics of which allied health professionals should be employed by nursing homes. Both agreed there needed to be funding for allied health through a blended funding model. The government accepted this recommendation i.e. they agreed that older people weren't getting enough allied health now and that a blended funding model was needed to make sure that older people got more allied health than they receive now.

You might notice though that the government in their response to this recommendation didn't say how MUCH allied health older people should get.

This stands out quite clearly when you see the governments response to the recommendation that nursing hours were also inadequate. The governments response to this recommendation was VERY detailed - 200 minutes of care time and having a registered nurse on site for 16 hours a day.

Why would the government feel the need to mandate the number of minutes of nursing care, and NOT allied health unless they had no intention of actually improving allied health services for older people?

Well the answer became clear in the budget released. Allied health was the BIG loser. This was even said by the Royal Commissioner Lynelle Briggs and the author of the new funding model the An-ACC Kathy Eagers.

There was $17.7 billion announced for aged care funding. Of this $3.9 billion (22%) related directly to Recommendation 38 to increase the amount of front line care (care minutes) delivered to residents of aged care and respite services, mandated at 200 minutes per day, including 40 minutes with a registered nurse.

How much would be spent on allied health? Good question!

$27.9 million out of $17.7 billion. 0.16% of the total amount.

Professor Kathy Eagar said the $27.9 million allocation over four years for allied health in aged care was insufficient.

“That’s only $7 million a year across 2,700 homes, which is very short sighted and just not enough,” Professor Eagar said.

She said allied health was the “real loser” in the budget because the royal commission had made “naïve” recommendations about allied health.

“We recommended 22 minutes of allied health per day be built into the funding model. And that be the mandated minimum and it be publicly reported up from the current average, which is eight minutes per resident per day,” she said.

How many minutes of care does this actually lead to?

Well as Kathy said $7 million a year across 2700 homes = $2592 per a nursing home for allied health.

There are 189,954 people using residential aged care resident in 2020 according to Australian Government

That means every nursing home resident in Australia will get a measly $36.71 per a YEAR of allied health.

A 20 minute care plan session with an allied health professional the government rebates through medicare for those eligible $55. So every older resident would receive 13.33 minutes of allied health PER A YEAR.

This equates to 2.18 seconds of allied health per a resident per a day. Less time than an allied health professional would take to say "Hi I'm here to...."

How can 2.18 seconds of allied health be enough when 8 minutes of allied health wasn't enough? Its clearly not.

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