Penny Allman-Payne (Queensland, Australian Greens) | Link to this | Hansard source

I present the report of the Community Affairs References Committee, The transition of the Commonwealth Home Support Program to the Support at Home Program, together with accompanying documents, and I move:

That the Senate take note of the report.

This is a report that came out of the committee's previous aged-care service delivery report that was tabled in October 2025, and, as a result of that inquiry, the committee recommended that two further inquiries be put on foot, one of which was this inquiry, which looked at two things. First was the preparedness of the government to transition the Commonwealth Home Support Program into the Support at Home program, which is slated to happen no earlier than 1 July 2027. We also were tasked with looking at whether the provisions for home modifications in the end-of-life pathway under the Support at Home program were sufficient.

I begin by thanking older people, their carers, their families, advocates and providers who gave evidence to this inquiry. There are a number of aged-care inquiries on foot, and we know that the sector is experiencing change fatigue, and we know that older people and their families and carers are really struggling under the weight of a system that is not meeting their needs. The continued need to advocate for change is something that takes a lot of emotional labour. I want to thank everybody across the sector, both providers and, more importantly, older people and their families, for taking the time to continue to show up to our inquiries and to continue to provide submissions so that the government has the evidence that it needs to take into account what should be happening in this sector to really serve the needs of older people and the people who care for them.

This inquiry is happening in the context of an aged-care sector that is in crisis. The transition to the Support at Home program has left many people languishing on waiting lists, whether that be a waiting list for an assessment or a waiting list to actually receive care. It's also seeing older people struggling under the weight of a co-payment system in Support at Home that is forcing many older people to have to make decisions about the level of care that they can access.

It's in that context that the committee looked at the government's proposal to transition over 800,000 older Australians who are currently receiving care under the Commonwealth Home Support Program into the Support at Home program no earlier than 1 July 2027. There were some really consistent themes in the evidence that we received. Across the board—whether providers, advocates, older people, or their carers or advocacy networks—nobody who came before the inquiry said that the government should be transitioning CHSP into Support at Home on 1 July 2027. In fact, the evidence before the committee was that if that was to occur, the outcome would likely be catastrophic. It's important to note that, while this inquiry was on foot, the Auditor-General conducted an audit into the Commonwealth Home Support Program and that audit report basically said that the government fails to undertake appropriate modelling, monitoring and reporting in relation to the Commonwealth Home Support Program.

We heard from the Inspector-General of Aged Care, who said that they had not seen any modelling or cost-benefit analysis that demonstrated the government has done the work required to transition people from Commonwealth Home Support Program into Support at Home. We also heard very clearly that CHSP is providing aged care, particularly in remote and regional areas, particularly for First Nations people who have trouble accessing any other forms of care. The block-funded nature of CHSP really allows care to be provided in thin markets and it gives providers flexibility to provide the sorts of services that people need at the entry level of aged care. We heard that transitioning community support into the Support at Home individualised package model would be catastrophic. It would be virtually impossible for many providers to provide the services that older people need to stay mobile and active in their communities if block funding is lost.

We also heard from service providers that they have a high level of anxiety regarding this proposed transition because they've been given no information from the government about what it would entail. I think that was a theme throughout this whole inquiry—that everyone is in the dark on what it even is that the government is proposing in relation to this transition, in terms of the work that providers will have to do. There is no information out there in terms of cost-benefit analysis. In fact, the department told us that they hadn't recently done any cost-benefit analysis and that that was potentially going to happen. So there's a lot of work that has to be done before the government could even contemplate a transition of this kind.

It's worth highlighting that the government really needs to learn from previous programs. They need to learn from the NDIS. It took three to four years to stand up the NDIS, and there are only around 400,000 people now on that program. There are over 800,000 people on CHSP. It is inconceivable that in 12 months time they could be successfully transitioned into Support at Home.

The committee made a number of recommendations that I want to briefly allude to. I know that there will be many providers, older people and advocates out there in the community who have been waiting for this report to be handed down. I hope that they support the recommendations that the committee has made because it is based on their evidence. The first thing that the committee has said is that the government absolutely needs to implement the recommendations of the Auditor-General. The government has accepted those recommendations, but the committee is saying that they need to be implemented immediately, and any decisions in relation to CHSP should not be conditional on the implementation of those recommendations.

The committee has also recommended that the government must commission an independent cost-benefit analysis that examines the value of CHSP against the cost of delivering aged care through things like Support at Home and residential aged care. Importantly, the results of that cost-benefit analysis need to be made public. Throughout this entire inquiry, getting information out of the Department of Health and Ageing has been like getting blood out of a stone, and people are really still none the wiser as to what it is that the government plans to do, or the modelling on which it's based, so it is really important that that cost-benefit analysis is made public.

We've also recommended that there needs to be genuine consultation and co-design in relation to any changes to CHSP, noting that it is a program that is highly valued by the people who use it but it has been underfunded and neglected for quite some time. The committee has also recommended that there needs to be an extension of funding for CHSP for three years beyond 1 July 2027. Providers need to have certainty, workers in the industry need to have certainty and, most importantly, people who access CHSP need a level of certainty into the future. The government needs to retain separate block funding to make sure that people get the care that they need. We need automatic funding in thin markets to make sure that people get access to services that they need.

In relation to the lifetime cap on home modifications and the end-of-life pathway, the committee heard clear evidence that the $15,000 lifetime cap on home modifications is simply going to push more people into having to access higher levels of support earlier, so the committee has recommended that that lifetime cap be abolished and that we have a new funding framework that's more responsive to people's needs. Finally, the committee has recommended that the time restrictions and funding restrictions placed on the end-of-life pathway also be abolished. We need a flexible, clinically guided, needs based model that provides funding for end-of-life care for older Australians wishing to receive care in their home. Finally, the key finding in this report, a consensus report—there are no dissenting comments to this report—is that the government should not be transitioning CHSP into Support at Home. I seek leave to continue my remarks later.

Leave granted; debate adjourned.