Australian aged care – “a shocking tale of neglect” and “woefully inadequate”

The report, named Neglect, outlines the whole industry as not performing or delivering safe and adequate care, that seems to systemically treat older people unkindly and, in many instances, neglecting them. 

The Commissioners, the late Richard Tracey AM RFD QC and Lynelle Briggs’s AO, investigation into Australia’s aged care system led them to describe the aged care system as “a shocking tale of neglect”.

“The neglect that we have found in this Royal Commission, to date, is far from the best that can be done. Rather, it is a sad and shocking system that diminishes Australia as a nation,” says the Commissioners.

The report looked over Government action around the aged care industry, finding in many cases that the Government barely implemented recommendations suggested to them over numerous inquiries, and in some cases, not even responding to inquiry reports at all.

It was acknowledged in the report that “it is impossible to escape that melancholy conclusion that aged care services and the people who receive them have simply not been seen as a priority by successive Australian Governments.”

In the report, the Commissioners call for a dramatic overhaul of the current system, including the design, objectives, regulation and funding for the aged care system.

The report says, “Australia prides itself on being a clever, innovative and caring country. Why, then, has the Royal Commission found these qualities so signally lacking in our aged care system? 

“We have uncovered an aged care system that is characterised by an absence of innovation

and by rigid conformity. The system lacks transparency in communication, reporting and accountability.

“It is not built around the people it is supposed to help and support, but around funding mechanisms, processes and procedures. This, too, must change.”

The Commission has found that the systemic problems in aged care include the system being “designed around transactions, not relationships or care”.

The Commissioners believe all of the problems brought to light in the report can be resolved, which is what will be delivered through recommendations in the Final Report from the Commission in 2020.

However, the Commissioners identified three areas that need immediate action:

• More Home Care Packages to reduce waiting list times for higher level care at home

• Respond to the over-reliance on chemical restraint in aged care, including through the seventh Community Pharmacy Agreement

• Stop the flow of younger people with disability into aged care and start removing younger people from aged care.

The Commissioner says there is no reason to delay the above recommendations.

Volume 1 of the Interim Report flagged recommendations that will be in the Final Report, including:

• Whole aged care system reform and redesign

• Improvement to the My Aged Care website and call centre which has “failed to provide adequate information to people about aged care and how to access it”

• Necessary additional funding for Home Care Packages, especially for High Level 4 Home Care Packages, which have an “unacceptable” 12 month or more waiting time

• Better support for Aboriginal and Torres Strait Islander people in aged care with a more flexible, adaptable and cultural safe aged care system

• Early action from Government on the overuse of “inhumane, abusive and unjustified” restrictive practices on older people in aged care

• Improvement to the industry workforce to replace the current system of poorly skilled and underpaid workers

• Swift action to remove younger people with disability from aged care and a change in the “lack of will and effort” to address this issue by Government

What the industry is saying

National peak body of older Australians, Council of the Ageing (COTA) Australia, has congratulated the Commission on its Interim Report, which recognises not only the neglect of older people within the aged care system, but also the neglect of successive Governments who have failed to implement many recommendations from over 18 Government inquiries.

COTA Chief Executive, Ian Yates, has welcomed the confirmation that neglect, abuse and poor care and more widespread than Governments and many providers have been prepared to accept.

“COTA agrees with the Royal Commission that older Australians should be more valued by the wider community. It’s not just about loving your grandparents, Australians need to also reach out as a community and support their elderly neighbours and fellow citizens, many of whom are still waiting to receive the care they’ve been assessed as needing and won’t even be in the formal care system,” Mr Yates said.

“If the government is taking the Royal Commission seriously and is also serious about respecting the many people and experts who have given their time to the process so far, then they cannot ignore this report and must commit more funds in the forthcoming [Mid-Year Economic and Fiscal Outlook] (MYFEO).” 

COTA says while some areas need to wait for the Final Report of the Commission in a year’s time, the three highlighted areas in the report need to urgently be addressed.

Industry peak body, Leading Aged Services Australia (LASA), believes this Interim Report signals urgent change for the aged care system.

LASA Chief Executive Officer (CEO), Sean Rooney, says this report will allow for a more sustainable and respected aged care service that supports older Australians well through care, support and accommodation that is quality, safe and compassionate.

“This is a beacon for immediate reform, a critical pointer to ensure older Australians receive the quality care and respect they need and deserve. We 100 percent back the need for reform of the aged care system, “says Mr Rooney.

“It is unacceptable that the system does not deliver uniformly safe and quality care. The Commissioners are right to say that this shocking tale of neglect diminishes Australia as a nation and it is time for a reality check.

“Our sector is steadfast in our commitment to do better and to hold to account any individual or organisation that is either unwilling or unable to meet industry standards and community expectations.

“This is a once-in-a-generation opportunity for change and is too important not to get right.”

Following the Interim Report, LASA has asked for the Government to invest a further $1.3 billion into aged care and another $500 million Home Care Packages to reduce wait times to 90 days.

Peak body for non-profit aged care providers, Aged and Community Services Australia (ACSA), agrees with the Commission that Australia can do better in how they treat older Australians, saying there needs to be an investigation into financing and workforce solutions.

ACSA CEO, Patricia Sparrow, says, “The Royal Commission has been important to expose significant problems and challenges. We can do better and we will do better. Now we hope it will investigate specific care models and set the standard of what is required to fix them and ensure older Australians get the care they deserve.

“There are some hard conversations that are still being avoided. The big improvements we are working towards in aged care at the moment won’t be fully realised unless we see a commensurate response on the structure of and funding for the sector, and the entire community taking responsibility for our ageing population.”

Consumer peak body, National Seniors Australia, has called the Interim Report a “damning wake up call” to the aged care sector and the Government, who need to respond immediately to failures in care, health and safety.

National Seniors Chief Advocate, Ian Henschke, particularly welcomes the recommendation to increase the number of Home Care Packages.

“When you have more people waiting for home care than actually receiving it, you know you have a broken system,” says Mr Henschke.

“There are about 99,000 older Australians receiving home care right now and 120,000 on the waiting list and that’s just an abject failure by the government.”

Paying tribute to Commissioner Tracey, Mr Henschke says, “Commissioner Tracey is to be applauded for the work and his frankness in his investigation.

“The best way we can honour his legacy is to take heed of his advice in fixing a system which is letting down not just older Australians but their families as well.”

“Today signals a new dawn in the era of aged care. We have an opportunity now to serve the people who have served us throughout the years and they deserve much better than rotting in an aged care bed, with maggots feeding on festering sores.”

Peak social advocacy organisation, Anglicare Australia, has described the Interim Report as a “wakeup call” for the sector and for the Government.

Anglicare Australia Acting Executive Director, Roland Manderson, says, “It’s fitting that the Commissioners have called their report Neglect. It describes a system which can’t assure us that people will be well cared for, valued or respected. Worst of all, the problems it faces have been known for years.

“The Commission has shown how many factors come together under this broken system – overworked staff, distressed families, a broken funding model, and older people who should be at the centre of aged care and are instead ignored.

“Anglicare Australia members know that the responsibility for the success and the failures of this system are shared. It’s up to all of us to reflect on our role in this broken system and do better for the people we serve.”

The response from Government

The Minister for Health, Greg Hunt, and Minister for Aged Care and Senior Australians, Senator Richard Colbeck, released a joint statement in response to the Interim Report, saying the report has been tabled in Australian Parliament and the findings will be carefully considered.

They say that the Interim Report and Royal Commission hearings to date have shown aged care providers are “falling far short of delivering the safe, high-quality care” that should be provided to senior Australians

“We acknowledge that the Government also has work to do and will consider and act on the Royal Commission findings, whilst noting significant reforms are in progress,” the Ministers say.

“The problems raised [yesterday] in the Interim Report have challenged governments, industry and the community over many decades and require a coordinated response from all involved.

“We are shocked by the stories that have arisen but we must and we will learn from them – bringing Australians together to ensure, as a community, we are providing the care and respect senior Australians deserve.”

Minister Hunt and Senator Colbeck acknowledged the professionalism, compassion and leadership of the Commissioners, especially the late Commissioner Tracey and his work on the Interim Report. 

The Final Report will be delivered by 12 November, 2020.

To read over the Interim Report, head to the Commission website.