Home' Community Care Review : CCR MAY 2016 Contents What might support in the home
look like in 2035? That's the
big question that Meals on
Wheels NSW put forward in a new report it
commissioned into the possible future of
community aged care in Australia.
Given the unprecedented changes
underway in the sector, the organisation
is keen to explore the wider environment
in which it may have to operate in two
decades' time and how it can best prepare
for that new era.
This is a time of great change. Among
the key factors driving the current
transformation of the sector are: client-
directed care (funding going to clients
to buy services, rather than going to
providers to supply them), competitive
price tendering, increased competition,
population changes impacting both client
expectations and the capacity of volunteers,
and new technologies that are reshaping
how services can be provided.
THREE WAYS OF THINKING
ABOUT THE FUTURE
One way of thinking about the future is
prediction. This means extending out into the
future some of the current trends we're seeing.
This is the most common form of thinking
about the future. A treasurer, for example, will
predict how much money an organisation may
receive and spend in the coming year.
However, the further out the prediction,
the less reliable it may become. For
example, government long-range forecasts
for the economy are usually wrong. That's
because there are too many variables, or
things that can influence the outcome, to
include and calculate.
A second way of thinking about the future
is having a preferred future, which is where a
person or an organisation has a vision which
they work towards. Meals on Wheels began
in this way in 1943, when aged and infirm
people in the UK received meals on wheels
from volunteers to replace the previous
assistance from carers who had been
recruited for the war effort. Those pioneers
had a vision of a service that could look after
aged and infirm persons in an innovative way.
With a preferred future we move from
what is currently being suggested by
prevailing trends, a prediction, to what
we would like to see happen. Prediction
and preferred future are equally valid, but
different, ways of thinking about the future.
A third way of considering the future
is examining what could happen -- this is
known as scenario planning. This is a future
that is not necessarily being currently
suggested (via prediction) and it may not
be one we would like to see happen (via
preferred futures). Scenario planning is not
so much about getting the future right as
much as it is about trying to avoid getting
it wrong. Done properly, scenario planning
reduces the risk of being taken by surprise.
The technique we used in our report for
Meals on Wheels NSW is scenario planning.
Four possible futures are outlined.
If we have done our job properly as
authors of the report, one of the four
scenarios will turn out to be a warning of
what the future will be like.
The two main drivers of change that
helped us explore what support in the
home could look like in 2035 were: the level
of government expenditure, and the level of
Government expenditure referred to the
extent there would be government funding
for community care in the home, while
social cohesion referred to the extent there
would be some form of community spirit --
or would people prefer to live individualistic
lives? Would people want to work together
to solve common problems or would they
try to cope on their own?
1. Leave it to the bureaucrats:
This scenario is characterised by high
government funding and low social
cohesion. The individualistic experiments
such as consumer directed care have
failed and there has been a decline in NFP
organisations such as Meals on Wheels,
and so government is back providing
Some of the indicators of this scenario
emerging might include failed experiments
in client-directed care, particularly for
older people, meaning government moves
back into the direct provision of care
in the home; and media scandals over
clients who have exhausted their funding
prematurely, thereby being reduced to
With so many factors and unfolding changes influencing Australia's
community care sector, organisations are struggling to predict their future.
Our new report puts forward four possible scenarios, writes DR KEITH SUTER.
16 | MAY 2016
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