We need a complete rethink on aged care


23 January 2019

The Royal Commission into Aged Care Quality and Safety began last Friday. Scott Morrison announced the Royal Commission on the eve of last year’s ABC Four Corners’ investigation into inadequate personal care, negligence, neglect, abuse and assault in aged care homes.

Before jumping into another expensive royal commission, perhaps Scott Morrison should have reviewed the numerous inquiries, reviews, consultations, think tanks and task forces over the past 10 years. These inquiries provide evidence of appalling standards of care in some aged care homes. They have also resulted in a large number of recommendations, most of which have been ignored by successive governments.

The most dispiriting aspect of all these inquiries is the number of submissions by residents, relatives and staff that have been ignored. Submissions to the recent Review of National Aged Care Quality Regulatory Processes indicated strong support for mandatory staff ratios in aged care homes and for registered nurse to be on duty at all times. However, there was no mention of this in the report.

To prevent poor standards of care in aged care homes, a sufficient number of trained staff must be employed. Although it’s not the only remedy, evidence shows the value of mandating staff ratios in aged care homes.

The government values the safety of children in childcare enough to mandate ratios. The government also values the safety of patients in hospitals enough to mandate ratios. Clearly the government does not value the safety of older people in aged care homes enough to mandate ratios.

The Terms of Reference for the Royal Commission are primarily about the future of aged care. However, if the Royal Commission does not look back, it will not be able to move forward without making the same mistakes. As Albert Einstein said: “We cannot solve our problems with the same thinking we used when we created them”.

To improve standards of care in aged care homes, The Commissioners must review evidence on quality indicators such as pressure sores, medication errors, weight loss, falls, infection rates admissions to hospitals, staffing levels and training in all aged care homes. Currently, these data are not publicly available.

Who decided that data on residents’ safety and wellbeing in aged care homes must be kept top secret? To answer this question, we need to go back more than 20 years when the Aged Care Act 1997 was drafted.

The Aged Care Act 1997 was a turning point for aged care policy in Australia. It encouraged a large increase in private investment. Private equity firms, new foreign investors, and superannuation and property real estate investment trusts entered the residential aged care market. Many of these companies focus on profits rather than standards of care.

The dean and head of the University of South Australia’s law school Wendy Lacey has criticised the Aged Care Act, arguing that there is “a complete absence of any positive and mandatory legal obligation on the part of facilities to take proactive measures to promote mental health and wellbeing of their residents”.

The standards of care in aged care homes are a human rights issue. The only way to ensure higher standards of care is for the government to rewrite the Aged Care Act. The government needs to work not only with aged care providers, but also staff, residents and their families.

We need a new Aged Care Act that focuses on Human Rights of older Australians not the profits of providers. We need a new Aged Care Act to ensure the highest possible standards of care in all aged care homes.

Dr Sarah Russell is the Director of Aged Care Matters

Royal commission proves we need a new Aged Care Act

 The royal commission enabled older people and families to tell their stories. A 105-year-old woman living in an aged care home was the oldest witness to give evidence. Hearing firsthand accounts has illustrated the failures in the aged care system.

The royal commission also released 20 research papers. This research will enable an evidence-based approach to aged care policy. For far too long, aged care policy has been based on opinion.

On February 26, the commissioners will release their final report. The counsel assisting’s 124 recommendations provide a glimmer of hope that the final report will outline a plan to fix aged care. But will the government act on the recommendations?

Opinion piece in The Age