In the first article from my podcast conversation with Australia’s Age Discrimination Commissioner, Robert Fitzgerald, I looked at control: who gets to make the decisions as we get older. Another idea he kept coming back to was community and its role in older people living a full life.
We talked about the role of the community in the Commonwealth Home Support Program (CHSP). CHSP is often described as entry-level aged care. That’s accurate, but it misses something important about what the program actually does.
Ageing usually happens gradually: someone stops driving, shopping gets harder, confidence falls and the world gets smaller. We have written before about CHSP as the front door to aged care. CHSP can step in early with transport, meals, social support or a handrail before those small changes become bigger problems.
My conversation with Robert took the idea a step further. Prevention isn't only about stopping needs from escalating. It is also about stopping people's worlds from shrinking.
Robert puts it simply:
“We've got to stop talking about ageing in place and start talking about ageing in community.”
That is a bigger idea than keeping someone safe at home. A person can remain living at home while gradually losing contact with friends, neighbours, activities and the ordinary life of their community. We can achieve ageing in place and still end up with someone isolated and lonely.
This is where CHSP has a vital role. The meal matters, but so does the person who delivers it. Transport matters, but so does having somewhere to go. Social support matters because it keeps people connected. The connection is part of the outcome.
Robert calls the broader network around this social capital. It is the relationships, organisations and informal connections that hold communities together.
There is an irony here. Before CHSP, much of this support sat within the Home and Community Care program. The community was there in the name. As CHSP is redesigned, there is a real risk that we preserve the home support and slowly design the community out of it.
That is why Robert’s view of CHSP matters:
“CHSP had to stay, because it was the element that would actually provide the community support, connections and relationships.”
That suggests a different way of thinking about CHSP. A social support group isn't just a number of hours. Community transport isn't just a trip from A to B. A local provider is more than a supplier of services. The relationships around those services are central to what CHSP provides.
As government works out what comes next, there is an opportunity to make CHSP a genuine foundational support program, with enough provider flexibility to respond to different communities. But there is also a risk that, in making CHSP more consistent and accountable, we turn it into another tightly specified service system.
The more tightly we define services, hours and eligibility, the less room there is for the local response that doesn't fit neatly into a service category. We could make CHSP more orderly and weaken what makes it work.
Measurement creates the same problem. It is relatively easy to count meals, hours, trips and services. It is much harder to measure whether somebody still has somewhere to go on Thursday, whether somebody notices when they stop turning up, or whether their world is getting smaller.
If the next CHSP measures the service but not the connection, we may end up measuring the least important part of what CHSP does.
So the question is not simply what services CHSP should fund. It is what CHSP is actually for. If the answer includes prevention, independence and keeping older people connected to their communities, then the next CHSP needs to be designed around those outcomes.
Robert’s test is a simple one. Keeping someone at home is not enough. The real job is helping them continue to live their best lives in their community.