Speech by Senator the Hon Mitch Fifield

Dementia Care – Core Business for Aged Care

Location: Oaks-on-Market, Melbourne


I am very pleased to be here today at the first Ministerial Dementia Forum.

And I want to thank you all for making time in your busy schedules to attend and contribute to this important event.

This Forum will be held annually. It will consider issues related to dementia care and provide advice to both myself and Health Minister Peter Dutton.

We are fortunate that Associate Professor Susan Koch and Sue Pieters-Hawke have both agreed to co-Chair and provide leadership to the Forum.

Their commitment is very much appreciated and will no doubt be of enormous value.

As you all know age is a major risk factor for dementia, with the prevalence of dementia rising from 1 in 10 people aged 65 years and over to 3 in 10 people aged 85 years and over.

Our population is ageing and as a result of this ageing the number of people with dementia is projected to increase to 900,000 by 2050.

Hopefully, as a result of prevention, education, detection and management improvements, the predicted prevalence rates may change.

But they serve as a pointer for why it is critical that we get the care of people with dementia – be that in their own home or in a residential facility – right.

We need to get it right for the current generation of people with dementia and also for the future generations.

To this end, the government makes a significant investment in dementia care.

It has committed $200 million to dementia research.

It provides recurrent funding for dementia care through the ACFI and in packaged care.

It also funds more than 20 specialist dementia activities, including the Dementia Behaviour Management Advisory Service, in aged care facilities and in the community.

Since 1 July 2012, more than $121 million has been invested in these specialist dementia activities.

It’s fitting then that this first forum has the theme of dementia care being core business for aged care.

Today presents a great opportunity to talk about how we support all people with dementia who need support from aged care services.

How we encourage best practice generally.

But also to think through how we best support people who exhibit severe behaviours.

It would be remiss of me not to talk about the difficult decision I had to make when faced with the blow out in the cost of the Dementia and Severe Behaviours Supplement.

I want to deal with this only briefly as I think most are aware of the issue and it’s really what comes next that is a more important focus.

The supplement was poorly designed and implemented.

Designed to support the care of 2,000 residents with severe behaviours, at last count it was supporting 29,000 residents.

The supplement cost $110 million over just 11 months – far exceeding its $11.7 million budget in the last financial year.

Had it continued, the payment would have cost $780 million over four years, rather than the $52 million budgeted, and over $1.5 billion over ten years.

This meant the only responsible decision I could make was to cease its payment.

Sometimes difficult decisions have to be made and I won’t hold back from making them.

For there to be effective ongoing support for people with dementia, including those who exhibit severe behaviours, and long term confidence in the sector, there has to be long term sustainability.

This means that initiatives have to be financially sustainable and can’t blow out in the way the Dementia and Severe Behaviours Supplement did.

I want to work in partnership with the industry.

It’s fair to say that the Dementia and Severe Behaviours Supplement was no model for partnership – from design, through inception and implementation to cessation.

But I want to be clear.

What comes next is my focus.

This is not a talkfest.

From the advice provided by you – the Ministerial Dementia Forum – a replacement for providers, whose operations are affected by supporting that small group of people with severe behaviours, will be developed within the existing funding envelope.

From the advice provided by you – the Ministerial Dementia Forum – strategies will be identified for Government consideration to improve the adoption of better practice dementia care and support in both residential care and support in the home.

Thank you all for attending this significant event and being prepared to contribute your knowledge and ideas.

I am certain that the wealth of expertise in this room will provide me with good advice on which to determine a way to support people with severe behaviours as well as strategies that ensure dementia care is core business in aged care.

I look forward to receiving your advice and wish you well in your deliberations today.

Thank you.