Australia’s aged care services – Royal Commission Interim Report

“It is a sad and shocking system that diminishes Australia as a nation.

So the Royal Commission into Aged Care Quality and Safety concludes in its interim report issued on 31 October 2019. This statement and the report’s title “Neglect” are a stark summation of the months of hearings and volumes of requested documents and voluntary submissions that the Commission has considered to date. It is alarming damning headline, however it is unlikely that anyone will be surprised.

The Report itself is in three volumes and will take some time to digest. On initial review it is compelling and interesting as much for what it does not say, as for what it does.

The Commission has largely eschewed foreshadowing final recommendations to address each interim finding and conclusion. Indeed, it effectively warns off those who have, and would, use the Royal Commission and its interim report to call for more government funding in advance of the Commission completing its work. The Commission characterises such calls as variations on a theme of short-term, temporary fixes that ignore underlying causes and are fraught with the risk of unintended consequences, and have plagued the sector and resulted in a failing system.

The Commission has identified the need for “a fundamental overhaul of the design objectives regulation and funding of aged care in Australia” and considers this the central purpose of its further work and the objective of its final report to be issued by November 2020.

The Commission has set itself the ambitious and complex task of proposing a system which resolves identified problems in the current aged care system which it says:

  • is designed around transactions, not relationships or care;
  • minimises the voices of people receiving care and their loved ones;
  • is hard to navigate and does not provide information to enable people to make informed choices;
  • relies on a regulatory model which is not transparent and provides no incentive to improve; and
  • has a workforce that is under pressure, under-appreciated and lacks key skills.

Notwithstanding the insistence that it is time to take a holistic approach to transform our system to one that is fitting for our society and the expectations of our citizens, the Commission has called for immediate action in three key areas:

  • stop sending young people to aged care facilities and get those in there out;
  • stop the over-use of chemical restraints for management purposes; and
  • provide more home care packages to reduce the waiting period for higher level in-home care.

The Commission indicates that its work in 2020 will focus on the design of a future aged care system that puts older people first and that it will rely on further submissions, research, experts, providers and the direct experience of older people and their families. It is a big ambition in which every Australian has a vested interest, however the change required is significant and will be costly; the question as to how the burden of cost and change will be shared remains open.

One thing is certain, change will create both opportunity and risk. Success in a turbulent environment will require strategic, operational and financial resilience and agility.