Category: Aged Care Funding

Personal Story

Hansard

 

20 May 2019

A confidential internal inquiry into the office of the Aged Care Minister Ken Wyatt was leaked to the media during the recent election campaign. The journalist described the leaker as a “whistle blower.”

Whistle blowers are honourable people who are motivated by altruistic intentions. Anonymous disgruntled staff members who are dissatisfied with the outcome of an internal grievance process are not whistle blowers.

I have never worked in Minister Wyatt’s office so I do not have inside knowledge. However, this leak had all the markings of a political attack. Normal administrative processes resolved this grievance. That should have been the end of it.

Instead, a confidential document was leaked to the media in the middle of an election campaign. The leakers’ aim was to throw the Aged Care Minister, the first Indigenous frontbencher in federal parliament, and his Senior Advisor under the bus for political purposes.

The leakers went so far as to accuse Minister Wyatt’s Senior Adviser of bullying. The oldest trick in a bully’s handbook is to accuse others of being a bully. Is this yet another case of the pot calling the kettle black?

Recently, false allegations of bullying have been made against many strong, intelligent and forthright women in senior positions. When a male is forthright, he is “assertive”. When a female is forthright, she is “aggressive”. This gendered disparity was ever thus.

I am a researcher who advocates for improving standards of care in residential and in-home care. As such, I have had many meetings with Minister Wyatt and his Senior Advisor. Paula Gelo is one of the more honourable political advisors I have met. She is intelligent and committed to her job.

Minister Wyatt’s Senior Advisor and I often discussed my ideas for improving the aged care sector. She was not only respectful but also provided evidence to support the government’s position. I contested this evidence. Paula welcomed this robust contest of ideas.

Others on the Executive of Aged Care Matters have also challenged both Minister Wyatt and his Senior Advisor. Paul Dwyer (Aged Care Finance Solutions) said:

“I have found both the Minister and his adviser, Ms Gelo, exceptionally devoted to the aged care portfolio. Ms Gelo has been available 24 hours, 7 days a week, in any matters. She has shown me respect and courtesy, both face-to-face and via correspondence.”

In my experience, bullies do not welcome alternate views. Instead, they react aggressively. They see disagreement as combat they must win. They either attack people who disagree with them, or ignore them. Either way, they ruthlessly shut down dialogue. Bullies perceive those who disagree with them as enemies who must be silenced. If the evidence does not fit with their worldview, they will simply ignore the evidence.

A new member of the Aged Care Sector Committee blocked me on Twitter after I questioned the value of the Aged Care Workforce Strategy Taskforce’s report. He refused to engage with my alternate perspective. In contrast, Minister Wyatt and his Senior Advisor always replied promptly to my emails and texts, including when I was critical of the government’s policies. They always picked up the phone when I called to discuss an urgent matter. Most importantly, they always did what they said they would do.

On several occasions, Minister Wyatt took my request for access to data to the Aged Care Sector Committee (ACSC). On each occasion, the ACSC denied the request. For example, when Minister Wyatt requested all reports on spot checks be made available on the My Aged Care website, the committee provided a patronising response about the data being “too technical”. According to notes from meeting on 12 May 2017 (obtained by freedom of information): “Members expressed caution about releasing unpublished reports from the Quality Agency as they believed that these reports were more technical and, without explanation, may not provide useful information for consumers or their families.”

According to the media’s report: “Ms Gelo spent $108,000 on airfares as well as $31,000 in travel allowances in one year.” Why did this spark alarm? Surely Minister Wyatt was entitled to take his Senior Advisor with him when he visits aged care homes around the country.

The Aged Care Minister, Minister Wyatt and his Senior Advisor visited over 130 aged care homes in urban, regional, rural and remote locations. Unlike Minister Ley (the previous Aged Care Minister), Minister Wyatt consulted widely with residents, relatives and staff. Both Minister Wyatt and his Senior Advisor should be praised for this, not criticised.

During her Christmas-New Year holidays in 2017, Minister Wyatt’s Senior Advisor read my research report “Living well in an aged care home”. She told me she welcomed reading relative’s critical feedback. She suggested a qualitative research project with older people who receive in-home care. Paula said it was important for Minister Wyatt and herself to hear genuine first-hand experiences of in-home care.

The Commonwealth Department of Health generally commissions research from consultants working in large organisations such as KPMG and Korn Ferry. I am critical of this research – it is not only extremely expensive but often lacks rigour.

I was excited to have the opportunity to bring some genuine ‘consumer’ voices into the debate about in-home care. However, working with the Commonwealth Department of Health was an eye-opener, to say the least. Without Minister Wyatt and his Senior Advisor’s help, it is most likely my research report “Older people living well with in-home support” would have languished in the bottom of a drawer (with all the other reports that have provided the Department with unwelcomed critical feedback).

Working in a politician’s office is not for the faint hearted. The hours are long and the stress is enormous. Minister Wyatt is fortunate to have employed a Senior Advisor who showed him such loyalty.

A smear campaign in the media will soon be forgotten. Instead, aged care stakeholders will remember Minister Wyatt and his Senior Advisor’s work to improve the quality of life of older people who receive residential and in-home care.

 

29 April 2019

Our democracy depends on the robust contest of policies. Yet so far the federal election campaign has been dominated by personal insults, pork barrelling and heated discussions about preference deals. I’ve hardly heard a whisper from candidates about their party’s aged care policies.

I am standing as a candidate for Reason Australia in my local electorate (Cooper in inner city Melbourne) so I can put aged care in the election spotlight. Reason brings an evidence-based approach to all its policies, including aged care policies.

Aged care needs evidence-based, not opinion-based, policies. It also needs kindness. Rather than listen to the opinions of the usual suspects who are part of the broken system that has failed older Australians, we need new thinking. To quote Albert Einstein: “We cannot solve our problems with the same thinking we used when we created them”.

Reason Australia’s policies “Respecting older people” are:

• Implement strategies to combat ageism
• Establish a national framework of Healthy Ageing
• Support the aged care diversity framework and action plans to ensure equality in care for elder Australians
• Create age and dementia friendly environments within communities
• Re-write the Aged Care Act 1997 from a human rights perspective
• Transparency about how aged care providers spend government subsidies
• Mandatory reporting of elder abuse

ALP and Greens also released new policies on ageing and aged care. The Liberal Party has not announced any new aged care election policies. Perhaps they consider their track record speaks for itself.

Consistent with LNP’s focus on the ‘top end of town’, the government recently gave $320 million to aged care providers without any obligation that this money will improve services for older people. The Reason Party disagrees with giving providers a one off cash injection without any strings attached. Taxpayers’ moneyshould be used to improve the quality of life of older people not the pockets of providers.

The numerous aged care inquiries, reviews, consultations, think-tanks and task forces over the past decade have resulted in a large number of recommendations. Both LNP and ALP governments have ignored most of these recommendations. In fact, the 2013 aged care reforms that have marketised residential and in-home aged care have bipartisan support. This may explain why ALP is not talking about aged care.

The Greens’ policies on aged care are much more progressive than either mainstream party. The Greens are the only political party to address the low salaries of aged care workers. They also support staff ratios in aged care homes though curiously their policy does not require a registered nurse to be on site 24 hours per day. When there is no registered nurse on site, elderly residents, particularly those who are uncommunicative, do not receive timely treatment when their condition changes. In some cases, this is a form of neglect.

The Greens’ policies include the government spending a further $8.5 billion – $3 billion on aged care homes and $5.5 billion on home care packages. They sensibly include a cap on the percentage of the funding given to service providers that can be used for administration rather than direct resident care.

Although more staff, better pay and releasing more home care packages are important, we do not support the government giving more money to aged care providers until providers are transparent about how they spend this money. There must be transparency about how aged care providers spend government subsidies.

Both the ALP and Greens have policies to address elder abuse. The ALP policy states: “Labor will address the prevalence of elder abuse”. 
The Greens’ policy on elder abuse is slightly stronger, but not strong enough. The Greens state: “Measures to prevent and respond to elder abuse”. In contrast, Reason’s policy makes it mandatory to report elder abuse.

According to the Aged Care Act (1997), providers must “maintain an adequate number of appropriately skilled staff to ensure that the care needs of care recipients are met”. Although 51 ALP candidates support staff ratios in aged care homes, the ALP policy on staffing in aged care homes states: “adequate staffing levels with the 
appropriate mix of skills”. The ALP policy does not rock the boat.

Reason not only rocks the boat, we tip the boat over. Our policy is a game changer. We don’t tinker with The Act (e.g. mandate ratios), our policy is to re-write the Act from scratch.

Reason Australia envisages an Aged Care Act that focuses on the human rights of older Australians not the profits of providers. This new Aged Care Act will include transparency about staffing levels/training and data about quality indicators. Every aged care home will be required to publish data on quality indicators such as pressure sores, medication errors, weight loss, falls, infection rates admissions to hospitals. They will also need to disclose complaints and how these complaints were resolved. Finally, the new Aged Care Act will require the registration of all workers.

Reason Australia recognises that current policies on ageing and aged care are underpinned by ageism. To achieve justice for older people, we have inclusive policies to combat ageism, homophobia and racism. Our policies also focus on healthy ageing and age and dementia friendly environments within our communities. If older people choose to live in their own home, a retirement village or an aged care home, they deserve respect, kindness and love.

 

I have permission from the department to share  KPMG background paper

Letter, The Age, 2 November 2019

After reading the Aged Care Royal Commissioner’s heart breaking interim report, I realise how lucky my parents were to find an aged care home where the staff treated them with kindness and respect – and who had time to care, chat/laugh with them and take an interest in their lives.

We found the aged care home by luck. It was the only aged care home in their area that allowed them to sleep together.

Could the good aged care home providers please stand up and be counted? Now more than ever, the public needs to know you exist.

Letter to Kate Carnell and Professor Ron Paterson

26 February 2018

A shocking new study reveals aged care home spent an average of $6.08 per resident to provide residents with three meals a day. Michael Gannon, president of the Australian Medical Association, describes this as a “national disgrace”.

In aged care homes, meals are the highlight of a resident’s day. Some aged care homes provide delicious and nutritious meals. Others serve meals that are inedible.

When compared to international food budgets, Australian aged care homes spend 1.4 times less than Canada and 3.8 times less than Norway. When providers skimp on the cost of meals, they are putting residents at risk of malnutrition.

A recent study described at least half the residents in Australian aged care homes as suffering malnutrition.  Malnutrition increases risk of falls, pressure injuries and hospital admissions. This not only decreases residents’ quality of life but also increases health care costs.

The importance of older people having a nutritious, well balanced diet is widely acknowledged. Yet it is also important that older people have choice. Recently, a GP told a 94-year-old resident not to eat soft cheeses (her favourite) because it may raise her cholesterol. My mum also loved soft cheeses – and I encouraged her to eat as much as she wanted. Mum had reached an age when she could eat whatever she wanted, irrespective of her cholesterol levels. This included our regular trip to McDonalds for a cheeseburger and a chocolate shake.

In some aged care homes, residents are not given a choice. They are often served meat pies, deep-fried patties and chicken nuggets. Sugary desserts are also common. Given the incidence of diabetes, heart disease and cancer in older people, the high level of sugar and salt in the meals served in some aged care homes is negligent.

Some residents might enjoy helping staff in the kitchen. However, residents are rarely allowed to participate in food preparation. Although older women spent most of their adult lives preparing food for their families, providers claim that food preparation puts residents at risk of injury. Even a simple activity like peeling potatoes is often not allowed because residents (many of whom have peeled potatoes all their adult lives) are at risk of cutting themselves.

Meal times can be chaotic and distressing for those residents who can’t feed themselves. Often their hot meals are served cold. When an aged care home is short staffed, residents may be fed their meals too quickly. This puts residents at risk of choking.

Many aged care homes use outside caterers that deliver meals wrapped in plastic. It is difficult for some older people (e.g. those with arthritis in their hands) to access their meals. Without assistance, these meals may be left untouched. Staff are so busy they may not notice the unwrapped food remains on the meal tray.

There is also concern that residents may not be drinking enough. Mum would be given a full cup of tea and then later a member of staff would take away a full cup of tea. Staff were simply too busy to notice that Mum had eaten the biscuit but not drunk any of the tea.

The Lantern Project fed everyday Australians a typical aged care meal. The food was described as “disgusting”. Some questioned whether it was in fact food. The poor quality of food served in some aged care homes inspired the Maggie Beer Foundation to develop ‘Creating An Appetite For Life’ Education Programs. These programs raise awareness, train staff, managers and chefs to buy and serve fresh produce and make food more palatable.

Residents’ wellbeing depends on aged care homes serving nutritious and delicious meals. Replacing processed food with fresh seasonal produce makes economic sense. Many aged care homes have productive vegetable gardens tended to by those residents with green fingers.

It is beholden on aged care providers to make meal times a happy experience for older Australians living in aged care homes. This will improve the health, happiness and quality of life of residents.

Amendments 2019