Research Page

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

Has government by media replaced consideration of evidence in aged care?

Before jumping into another expensive royal commission, it would have been prudent for Scott Morrison to review the numerous inquiries that both LNP and ALP governments have initiated over the past decade. Surely the government didn’t need Four Corners to inform them that the aged care sector is a national disgrace.


Funding is not the problem

HeraldSun 4 April 2022

I have spent six years trying to improve the aged care system on behalf of older people and families. This has been done as an unpaid advocate with no government funding.

The aged care system is broken. Numerous inquiries, including a royal commission, have revealed evidence of poor care, negligence, neglect, abuse and assault.

We know what needs to be done. The solution to the crisis starts with transparency and accountability. 

I have become a stuck record in my calls for the federal government to demand transparency from the aged care providers in return for the billions of taxpayers’ dollars they get each year – some $125 billion over the next five years.

Take the latest example. The May 2021 budget gave providers an extra $10 a day per resident to improve the quality of the meals. Some $460 million has already been spent, with an estimated $700 million to be spent this financial year. And what do providers have to do in return? Simply give an undertaking that they will report to government on a quarterly basis what they spend on food.

The royal commissioners had warned that aged care providers have a long history of not spending extra government money on what they are supposed to. So why give them a further $700 million without directly tying this money to food?

Many residents have told me they are still being served unappetising food. It seems many providers have not used this extra money on what they were supposed to.

The Aged Care Minister Greg Hunt and Minister for Aged Care Services Richard Colbeck claim that “the Morrison Government has achieved significant reform across the five pillars of its five-year plan to deliver respect, care and dignity for every senior Australian”.

“We responded to the (Aged Care royal commissioners’) recommendations and are now implementing this once-in-a-generation reform that puts senior Australians first,” Minister Hunt said.

Seriously? There has been practically no progress on most of the recommendations one year after the royal commissioners released their final report.

Labor has proposed some measures to improve aged care in Australia. However so much more is needed to solve the crisis in aged care.

The failure of successive governments to respond meaningfully to the crisis in aged care has prompted me to put my hand up to replace the Aged Care Minister in his seat of Flinders. After years of advocating from the sidelines, it is clear aged care needs a strong advocate in parliament. 

Dr Sarah Russell is the Voices endorsed Independent Candidate.