Since 1902 a total of 135 Royal Commissions have been held in Australia (not counting state and territory commissions and inquiries), the first being convened to look at the transport of troops returning from service in South Africa in the S.S. Drayton Grange. Another, two years, later investigated ‘the affray at Goaribari Island, British New Guinea’.
Since then better known RCs have looked at British nuclear tests, Aboriginal deaths in custody, the Chamberlain convictions, home insulation (the pink batts) and the treatment of people with disability, as reported in this issue of NorDocs.
None have focused on the wellbeing of more Australians than the Royal Commission into Aged Care Quality and Safety, given that 15 percent of the population is now over 65 years, and the number is growing exponentially. Its interim report from late 2019, covered in NorDocs, described the aged care system as being in ‘a shocking state of neglect’. The final report, Care, Dignity and Respect, was released on 1 March 2021, and made for further harrowing reading.
By their nature, RCs are seldom called by governments to celebrate good news. Rather, the aim (in addition to getting the heat off governments) is to air problems that could not be uncovered by other means. The surprises, when they come, usually relate to the extent of the revelations, the RC into financial services, including banking, being a prime example.
Chief among the many analysts of the aged care RC has been the Council on the Ageing (COTA Australia), which has been ‘working methodically through the report’ - five volumes in eight parts with 148 recommendations - to learn the lessons of the thousands of older people and their advocates who contributed.
In a conclusive summary the report noted, “The extent of substandard care in Australia’s aged care system reflects both poor quality on the part of some aged care providers and fundamental systemic flaws with the way the Australian aged care system is designed and governed. People receiving aged care deserve better. The Australian community is entitled to expect better.”
The Commissioners’ call for fundamental reform of the aged care system would require a new Act, based on human rights, and while this may appear a lengthy process, COTA says it should not be a barrier to commencing urgent reform.
COTA’s initial priorities are: A plan and timetable to clear the Home Care waiting list; Workforce reform, particularly mandated increases for quality staffing, including a star rating system; A new Act, based on human rights, empowering, and protecting consumers; Greater transparency across the whole system including publicly available information on service provider performance, quality and safety measures and costs: A stronger regulator with increased capability and capacity to act quickly against poor providers, address poor leadership and service culture, lack of clinical governance and low staff numbers.
‘COTA Australia is campaigning now to get the Australian Government to do its part,’ said Ian Yates AM, the body’s Chief Executive.
‘The task is getting the bad operators out of Aged Care, better supporting the good ones, and ensuring every older Australian can get the care they need, when they need it, and how they want it. To read our full analysis and position, download our Policy Alert here.’
Also having a key role in reforming the aged care system is the Australian Nursing and Midwifery Federation, which says boosting staff numbers is the key to reducing waiting times for in-home care for the elderly and improving services and employee satisfaction across the sector.
However, funding alone isn’t the answer, according to its federal secretary Annie Butler.
‘There are many ingredients to fixing the system but until you get the workforce right you’re not going to fix it completely. It’s the cornerstone,’ Ms Butler said.
The Senate estimates committee was told recently that more than 96,000 people are on a waiting list for their approved home care package as of December, although this was a slight drop from the previous quarter.
The Opposition aged care services spokeswoman Clare O’Neil said aged care workers needed better pay and more support, a widely held view in the industry. Better training is also an essential, most believe, and to this end nearly one-quarter of the $452 million announced when the government released the final report will be earmarked for a new workforce support program that includes additional training for existing staff to help them support 13,000 new personal care workers.
This shows the importance of funding and highlights the need for more of it, but in a post (hopefully) pandemic environment, with massive budget deficits, the quest to find the money goes on.
The Health Services Union, which covers many workers in the aged care sector, says a 0.65 per cent increase in the Medicare levy would cover funding for 59,000 additional jobs, quality training, a 25 per cent wage increase and an extra 90 minutes of direct care for residents each day.
It remains to be seen whether such a proposal might gain traction with a philosophically anti-tax government, or, for that matter, one not known for acting decisively on recommendations from a Royal Commission, the one on financial services being a particular case in point. It is widely believed that, despite all the exposure, the banks are behaving badly again. The risk is that the less scrupulous aged care facilities, and those under-trained staff who know no better, might also revert to, or continue, their bad old ways.