Chapter 9: Conclusions and Future Directions
In this report the Taskforce has made a series of recommendations that it considers to be practical and cost-effective options for extending Carer Payment (child) to provide an effective safety net for carers of children with severe disabilities or illnesses.
Key findings
In the Taskforce’s view, a well-designed system that meets its intended purpose is, by its very nature, cost effective. Implementing the Taskforce’s recommendations will ensure that Carer Payment (child) is well targeted, fit for purpose and administratively efficient in its operations, thereby improving its cost effectiveness. Because the payment must also be seen in the context of the broader supports available to carers, the Taskforce has recommended that government further examine financial and other supports for carers.
If accepted, the key recommendations of the Taskforce will lead to:
- increased recognition for the valuable role of carers;
- improvements to Carer Payment (child) administration, including an easier application process, revised eligibility requirements and better assessment of the care needed and provided;
- more accessible information about payments;
- enhanced service delivery for carers; and
- increased support for workforce participation.
In the Taskforce’s view, there is an opportunity for national leadership in recognising the role of carers in the community through carer recognition legislation and the development of a national action plan for carers. Some state and territory governments have already been active in related areas and their experience could inform the way forward.
The Taskforce found there are many areas in which the administration of Carer Payment (child) could be improved. Access to Carer Payment (child) is currently very restricted, with around 12 per cent of applications resulting in a successful grant of payment. This is by far the lowest grant-to-application ratio of any income support payment available in Australia. The Taskforce expects that the recommended changes to the administration of the payment, particularly the assessment process, will result in an increased number of carers becoming eligible for payment. The Taskforce considers, however, that a resultant increase in recipient numbers would be a fair and equitable outcome as it is clear that the current assessment process is outdated and too limited in its application.
The current assessment process is based on section 197(2), (2AA) and (2A) of the Social Security Act 1991 and requires a child to meet the definition of a ‘profoundly disabled child’ for his or her carer to qualify for Carer Payment (child). To meet the definition, a very narrow set of circumstances must be met that, in the Taskforce’s opinion, does not accurately measure the level of care provided by the carer or needed by a child with severe disability or medical conditions. The assessment process also does not allow the carer to provide any details of the care they are providing.
The Taskforce is strongly of the view that a new approach to assessment is needed. This approach should systematically and comprehensively assess the full range of care needs of the child and activities of daily care performed by the carer and accurately distinguish the care required that is over and above regular care provided by parents for a child of the same age without disability. In the Taskforce’s opinion, this is an eminently reasonable and sensible basis on which to make decisions to grant Carer Payment (child). It would also bring the payment into line with the types of assessment used for Carer Payment (adult) and Carer Allowance (child). These processes could be made even more consistent if the definition of ‘profoundly disabled child’ were removed from the legislation and replaced with a disallowable instrument, similar in design to the instrument used for Carer Payment (adult).
In addition to amended eligibility criteria to recognise the level of care required and provided, the Taskforce has recommended the following administrative improvements:
- provision for multiple care responsibilities equivalent to the care of a child with profound disability—for example, care of an adult and a child;
- payment for short-term or episodic care situations;
- removal of the limit on the allowable number of hospital admission days, subject to appropriate review;
- recognition of shared care arrangements resulting from court orders or parenting plans; and
- revised eligibility requirements and review arrangements in respect of terminal conditions.
The Taskforce also found that there was considerable confusion in the community about the difference between Carer Payment (child) and Carer Allowance (child): many recipients were unsure about which payment they were getting. The Taskforce has recommended that the government consider revising the names for the payments and provide clear and readily accessible information for applicants to ensure they are fully informed about the financial supports available to them. The Taskforce has also recommended that the government further examine the adequacy of current financial supports for carers and the relationship between Carer Payment (child) and other payments.
On the issue of workforce participation, the Taskforce is strongly of the view that those with responsibility for providing constant care to children with severe disability or medical conditions should not be required to satisfy participation requirements as part of their income support arrangements as they are, by definition, occupied full-time with their caring responsibilities. If people satisfy the care requirement for payment, they are making themselves available for care and in effect unavailable for full-time or substantial workforce participation.
The Taskforce is aware that the stringent nature of current Carer Payment (child) eligibility requirements has resulted in a number of people with intense caring responsibilities ending up on other forms of income support that require them to look for work, such as Newstart Allowance. This situation also applies to carers of people with episodic or short-term conditions where the care load is sudden or unpredictable. While in many cases carers may be able to gain exemptions from participation requirements, this issue illustrates the point that the current income support system does not easily deal with those whose ability to work may fluctuate because of their caring responsibilities. The Taskforce expects that the number of people in this position will increase as the effects of demographic change and the ageing of the Australian population become more apparent, with the number of people requiring care predicted to increase while the number of people available to provide the necessary care is predicted to decrease.
An effective safety net
The integrity of the social security system as a whole is a major consideration for government. The Taskforce noted that there are opportunities for improving the way the system operates. The Taskforce has dealt with one small area of the system in reviewing Carer Payment (child), but the findings of the review could point the way to more far-reaching reforms for other payments—for example, Carer Payment (adult), Carer Allowance (child) and Carer Allowance (adult)—in areas such as eligibility assessment, professional verification of claims, the review regime, transitions between payment types, participation requirements, and streamlined administration.
The social security system operates as a safety net by providing protection from undue financial hardship and assisting those with the greatest level of need to meet the costs of living. In considering whether Carer Payment (child) was providing an effective safety net, the Taskforce recognised that it is necessary to look more broadly than at this one payment and consider its operations in relation to other social security payments. While some recommendations have been made to streamline the way Carer Payment (child) interacts with other payments, the Taskforce acknowledges that further work could be done to review other elements of the suite of assistance provided to carers—that is, Carer Payment (adult), Carer Allowance (adult) and Carer Allowance (child)—to ensure a more effective safety net for carers.
The needs of carers must be paramount in any consideration of the financial assistance and support the government provides to help them in their caring role. As noted above, the Taskforce has recommended that the government act to formally recognise the valuable role of carers in the community. In addition to carer recognition, the Taskforce canvassed the relative income position of carers and the higher costs they face. While government policy may not be able to reverse the impact of providing care for children with severe disability or medical conditions, it can help to lessen the impact in three ways:
- by providing income support for those not able to support themselves through substantial workforce participation;
- by assisting with the additional costs of care and costs of disability through subsidies— for example, for medical or transport costs;
- by providing or subsidising services that assist carers and care receivers, such as respite and mobility assistance.
Carer Payment currently falls under the first of these points, and the Taskforce has touched on the second point especially as raised in the many submissions from carers and in light of other related payments.
The service support system is another significant area of complexity and many of the relevant issues concerning this system were raised in the recent senate inquiry into the funding and operation of the Commonwealth State/Territory Disability Agreement. The Taskforce therefore viewed this area as outside its terms of reference, but notes that it is an integral part of any system to improve assistance for carers and that many carers nominate access to services as the most important issue they face in maintaining their caring role.
Conclusion
The consultation process conducted as part of the review generated more than 4,000 responses in the eight-week submission period. In its deliberations on ideas for improvement, the Taskforce was helped immeasurably by the many carers who took the time to contribute their thoughts and suggestions while balancing their responsibilities as carers. The wealth of material contributed through the submission process was an indispensable resource on which the Taskforce drew extensively in developing this report. In acknowledging the value of this information, the Taskforce notes that a number of the issues raised during the consultation phase were outside its terms of reference, but it expects that this material will be of great value to government and policy makers in future. In considering the future directions of the income support system, the Taskforce commends this material to government for further analysis and consideration of the issues it contains.
Recommendation 32
The Taskforce recommends that the issues raised in submissions to the review that were outside the Taskforce’s terms of reference be further considered by government.
The Taskforce considers that this report comprehensively addresses its terms of reference and that the report’s recommendations will, if implemented, result in numerous practical and cost-effective improvements to the structure and operations of Carer Payment (child). In the Taskforce’s opinion, the key to these improvements is the revised assessment process based on level of care and it commends further work on this topic to government, acknowledging that there is an opportunity for Australia to take the lead internationally in designing and implementing an assessment tool based on a well-researched suite of ‘activities of daily caring’.
The Taskforce also acknowledges that a cornerstone in any improved system of assistance and support must be choice and flexibility in the options available to carers.