International Conference on Public Policy Singapore 28 June 2017

Coordinating services for older people

Adam Graycar Flinders University, Australia

adam.graycar@flinders.edu.au 1

PERCENT OF POPULATION AGED 60+ (2015 AND 2030)

Source: United Nations, Department of Economic and Social Affairs, Population Division (2015). World Population Prospects: The 2015 Revision;

http://www.un.org/en/development/desa/population/publications/pdf/ageing/PopulationAgeingAndDevelopment2015.pdf

12.3 11.6

15.2

17.9

8.9

33.1

7.9

4.5

20.4

28.6

16.5 17.2

25.3

30.7

12.5

37.3

9.9

4.8

24.6

36.6

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

World Asia China Singapore India Japan Egypt Nigeria Australia Italy

Percent of population aged 60+

2015 2030

2

PERCENT OF POPULATON AGED 80+ (2015 AND 2030)

1.7 1.4

1.6

2.4

0.9

7.8

0.8

0.2

3.9

6.8

2.4 2.1

2.9

5.3

1.3

12.7

1.0

0.2

5.7

9.7

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

World Asia China Singapore India Japan Egypt Nigeria Australia Italy

PERCENT OF POPULATION AGED 80+

2015 2030

3

Source: United Nations, Department of Economic and Social Affairs, Population Division (2015). World Population Prospects: The 2015 Revision;

http://www.un.org/en/development/desa/population/publications/pdf/ageing/PopulationAgeingAndDevelopment2015.pdf

DEPENDENCY RATIO (PER 100 PERSONS AGED 15-64)

adam.graycar@flinders.edu.au 4 Source: Profiles of Ageing 2015,

https://esa.un.org/unpd/popdev/Profilesofageing2015/index.html

WORLD ASIA

CHINA SINGAPORE

DEPENDENCY RATIO (PER 100 PERSONS AGED 15-64)

adam.graycar@flinders.edu.au 5

Source: UN Profiles of Ageing 2015

https://esa.un.org/unpd/popdev/Profilesofageing2015/index.html

EGYPT NIGERIA

Policy drivers • Greater life expectancy at birth & later

• Declines in age specific mortality

• High rates of chronicity

• Surplus of women at higher age groups

• Women with no spouse

• Smaller families

• Greater urbanisation and relocation for work

• Changing nature of work and technology

adam.graycar@flinders.edu.au 6

Policy challenges (selection only)

• Income - adequacy and equity

• Accommodation for poorest elderly

• Ethnicity and ageing (migration issues}

• Health care - what sorts of interventions?

• Home care services

• Transport policies

• Consumer issues

adam.graycar@flinders.edu.au 7

Basics

• Tangible resources

• Effective services

• Close companionship

adam.graycar@flinders.edu.au 8

Who provides these?

• Government

• NGOs

• Commercial sector

• Families

adam.graycar@flinders.edu.au 9

Parliament Acts

The Commissioner for the Ageing Act (1984)

Objectives:

Foster integration; create social structures; create social ethos; understand multicultural issues

Functions

Advise; monitor; promote interests; compile data; communicate; consult; assist in coordination

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Policy questions

• What is the problem?

• Who owns the issue?

• What evidence base for policy?

• What policy instruments are used?

• What stakeholder engagement?

• What implementation issues?

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What we did

• Policy development

• Research and evaluation

• Stakeholder outreach

–community,

–industry,

–other parts and levels of government

–media

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Doing it

• What bureaucratic arrangements?

• Political/ bureaucratic interface

• How did federal/ state relations play out in this field

• Are older people better off today than they were all those years ago?

adam.graycar@flinders.edu.au 13

Outcomes

• Legislation

• Guidelines

• Programs/ services

• Information

(political benefit??)

adam.graycar@flinders.edu.au 14

Legislation

• Abolition of mandatory retirement age

• Retirement Villages Act 1987

• Licensing of supported residential facilities

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Guidelines

• Planning and design guidelines for purpose-built accommodation - having these incorporated into planning codes

• Standards for new technology and equipment used by and with older people (in conjunction with the Standards Association of Australia)

• Investment advice – voluntary code in SA

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Programs/ services (1)

• Transport – Access cabs

– Mini buses

– Petrol reimbursement for volunteers

– Public transport concessions (Seniors Card)

• Electricity – Prevention of automatic disconnection if bill not paid

– Concessions

• Insurance package for older volunteers

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Programs/ services (2)

• Home Maintenance and Security Scheme

• Continence Advisory Group

• University of the third age

• Employment services (DOME)

• Numerous other health and home service programs

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Information

• Research and info on elder abuse

• Crime prevention and safety guidelines

• Nursing Homes and Hostels Inquiry Service

• Age Line (phone information service)

• Age Pages (health information - also translated

into numerous community languages)

• Demographic information

• Hundreds of speeches and presentations

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Federal issues

• Retirement Income

• Nursing Homes

• Aged care services – Home care and support

– Residential services

– Flexible care

• Medicare/ Pharmaceuticals/ Veterans

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Lessons for today & beyond contextual issues

• Identifying future needs and issues

• Legitimacy of claims - claim shift

• Older people change - from grateful to entitled

• Challenges for public administration and revenue

• Policy ownership

• Core business and by-products

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Lessons for today & beyond policy and program issues

• Income issues/ pensions/ superannuation • Residential care/ quality/ cost/ care

workforce shortages/ carer skills • Safety & security/ elder abuse • Employment and workforce exclusion • Housing/ affordability/ homelessness/

design issues And that’s only the beginning

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