Cause and neglect
The aged care royal commission must trigger a fundamental rethink
As the aged care royal commission begins hearings in regional New South Wales today, the ABC reports that a large proportion of nursing home operators are losing money. The weary conclusion is: why is anybody even trying to make money out of vulnerable old people? Over and over it seems that the attempt to impose a business model on welfare provision leads straight to corner-cutting and neglect. Now that the royal commission has handed down its interim report, slamming a system that is “designed around transactions, not relationships or care”, it would be a pity if the political system’s response is itself transactional, descending into a political argy-bargy about the amount or timing of extra funding that might be required, instead of a deeper rethink.
On the ABC’s Insiders, host Fran Kelly and the panellists expressed surprise that the government was not ready to go with an announcement when the report was delivered on Thursday evening, given that the troubles in this sector are well known based on previous reviews that have been held. Health Minister Greg Hunt launched into some feeling rhetoric, telling Kelly how “the commission went further than we expected in the sense that it identified a nationwide challenge over multiple decades… both a cultural and a governmental challenge”.
By this morning’s Sunrise program, the debate had sunk to the level of Nationals MP Barnaby Joyce and Labor’s Joel Fitzgibbon going toe-to-toe on whether or not more funding for home-care packages by Christmas was fast enough, with Joyce exclaiming: “What are we arguing over here? We’re arguing over weeks, are we? It’s ridiculous.”
On the weekend, the ABC’s Anne Connolly wrote that the aged care royal commission has had a third of the coverage of the banking royal commission. Public health researcher and aged care advocate Dr Sarah Russell says while most journalists have read the 10-page foreword, she has yet to see any good analysis of the full report. She says there are few journalists with the long-term interest and expertise to properly understand the problems of the sector – Connolly at the ABC, The Age’s Michael Bachelard and The Saturday Paper’s Rick Morton are among the honourable exceptions.
“I’m very concerned about the cherry-picking of anecdotal stories,” says Russell. “The media picks horror stories and the provider peak bodies pick positive stories. These anecdotes are symptoms of the current aged care system. The 20 or more inquiries and reviews over the past 10 or so years provide information about the causes of these symptoms. We know the causes are: (1) staffing, (2) regulation, (3) funding etc. The royal commission is an opportunity to drill down to the causes of the causes. If we want to fix the systemic issues, the royal commission must do this.”
Russell has been arguing for years that what is needed is a rewrite of the Howard-era Aged Care Act1997, which was written “by a provider, for providers”. “This legislation is the root cause of the systemic failures. Tinkering with the Aged Care Act will not fix the problem … We desperately need a new aged care act that is focused on the human rights of older Australians, not the profits of providers.”
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“The Hunting examines teenage lives online with sophistication and a sense that all relationships – not just the digital ones – are about trust and constant negotiation. Focusing on families from a range of cultural and class backgrounds, and on both private and public schools, makes for diverse perspectives where every act and outcome – texting a naked photo to a boyfriend, sharing a photo with a mate, uploading a photo on a website – is made distinct and examined with empathy, while acknowledging that there are so many grey areas around culpability.”
“While the federal government digests the aged-care royal commission’s excoriating interim report, it is pushing ahead with a plan to privatise the workforce responsible for assessing which older Australians should receive government-funded care. Experts fear the move will spell the end of ‘any meaningful direct involvement of geriatricians’ and other specialists in the assessment process.”
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Paddy Manning is contributing editor (politics) at The Monthly and has worked for the ABC, Fairfax, Crikey and The Australian. He is also the author of three books, including a recently updated unauthorised biography of Malcolm Turnbull, Born To Rule?
As the aged care royal commission begins hearings in regional New South Wales today, the ABC reports that a large proportion of nursing home operators are losing money. The weary conclusion is: why is anybody even trying to make money out of vulnerable old people? Over and over it seems that the attempt to impose a business model on welfare provision leads straight to corner-cutting and neglect. Now that the royal commission has handed down its interim report, slamming a system that is “designed around transactions, not relationships or care”, it would be a pity if the political system’s response is itself transactional, descending into a political argy-bargy about the amount or timing of extra funding that might be required, instead of a deeper...