PM calls for ‘once in a generation change’ to aged care

Commissioners, Tony Pagone QC and Lynelle Briggs AO, handed the report to Parliament on Friday, 26 February, and the Government used the weekend to review the findings.

Prime Minister Scott Morrison has welcomed the Final Report and says it’s important for the systemic change needed in the aged care sector.

“The Royal Commission has now, I think, set out a very important roadmap, which I think will establish generational change in our country when it comes to aged care,” explains PM Morrison.

“It was the inquiry we needed to have, it’s well-considered, it’s honest, it’s positive, it’s compassionate, it’s comprehension, it’s candid, it’s passionate, it’s ambitious. All the things I hoped it would be when I called it.

“… This will take time, quite considerable time, to make the scale of change we want to and need to. The Commission itself, set out a five-year time frame for the measures they set out in their report.”

PM Morrison also announced the immediate release of $452.2 million for the aged care sector to help with any urgent or short term priorities that have been set out by the Royal Commission.

However, he says that the Government response needs to exercise care and thought whilst implementing change in the sector.

PM Morrison adds that the report will test the Government and the Budget, however, it is a ‘once in a generation opportunity’ to change aged care for the next generation.

Minister for Health and Aged Care, Greg Hunt, outlined the pillars of the five-year model which will transform aged care – home care, quality and safety, services and sustainability, workforce, and governance.

He says there are 1.3 million people receiving a form of aged care, and this Final Report, which took two years to produce, will have a big impact on future aged care.

“The central vision is of a nation where we value our elders, we respect them and provide care and provide dignity and we respond to their individual needs,” says Minister Hunt.

“It includes a five-year roadmap – ambitious, challenging but achievable.”

Minister for Senior Australians and Aged Care Services, Senator Richard Colbeck, had similar thoughts, saying he knew the findings of the Commission were going to affect everyone after viewing the Interim Report released in October, 2019.

“I said when we received the Interim Report it would put us all on notice, and it did. It put the Government on notice, it put the aged care sector on notice and it put the Australian community on notice,” says Senator Colbeck.

“It talked about the fact that there has been a lot of cans kicked down the road for 20 years by successive Governments and the attitude of the community more generally is not what we want it to be. We now have an opportunity to get it where we want it to be.

“It is now our role to engage with the sector and Australians to commence that reform process.”

Sector responds

The Australian Aged Care Collaboration, a collective of aged care peak bodies, is hoping that the big picture reform released today will set the bar for quality care that older Australians deserve and need.

The AACC consists of Aged & Community Services Australia (ACSA), Anglicare Australia, Baptist Care Australia, Catholic Health Australia, Leading Age Services Australia (LASA) and UnitingCare Australia. 

Representatives for AACC, Chief Executive Officer (CEO) of ACSA, Patricia Sparrow, and CEO of LASA, Sean Rooney, say that over 20 Government aged care reviews in 20 years have found a broken system and that the band-aid fixes need to end.

“There have been some terrible examples in aged care where individuals or services have failed in their duties to provide safe and quality care,” says Mr Rooney.

“As we have said in evidence to the Royal Commission, these failures are unacceptable, and we are sorry for the harm they have caused. As a sector, we are doing what we can to ensure these failures are not repeated.

“But we cannot do this alone – we need new system settings around policy, outcomes, regulation and resourcing to enable and support providers to deliver the best care possible for our elders.

“Successive federal governments over the past two decades have failed to act on many independent reports highlighting the need for major reform.”

Ms Sparrow adds that currently over 4.1 million Australians are over the age of 65, and this is expected to rise to 8.8 million by 2057, which is why aged care change needs to happen now.

“While the sector overwhelmingly is trying to do the right thing, we need to recognize that Australia spends less than half what other comparable countries do on aged care,” Ms Sparrow said.

“As a result, under-resourced aged care homes were described by Counsel Assisting the Royal Commission as in an ‘impossible situation’, and were struggling to maintain standards and staffing, whilst fighting to keep their doors open.

“Older Australians want and deserve more staff to care for them, ensure they are better paid and better trained – along with better facilities and even better meals. We view the Royal Commission report as one of national importance, which we hope will involve a complete redesign of the system.

“After 20 years of missed opportunities, Australia cannot let the release of the final Royal Commission report pass without taking real action.”

Consumer peak body, Council on the Ageing (COTA) Australia, has highlighted that the onus of change is now on the Morrison Government to fix the systemic issues in home care, nursing home regulation, staffing, and transparency.

Chief Executive of COTA, Ian Yates, explains, “When it comes to the crisis consuming our aged care system, the Royal Commissioners are unanimous in identifying the issues of neglect, abuse, indifference, and poor leadership.

“It’s now the Federal Government’s job to map out the structural reforms needed to build a safer, accessible and transparent system in an accountable way.

“The fact that there are a few alternative recommendations from the Commissioners on the best way to manage and fund the aged care system in no way lets Government off the hook. There are no barriers to commencing urgent and long-awaited reforms.”

He adds that the evidence from the Royal Commission is overwhelmingly pointing to major transformation in the aged care sector.

Key recommendations

Over the past two years, the Royal Commissioners, Tony Pagone QC and Lynelle Briggs AO, have come to the conclusion that the aged care system needs fundamental reform.

“The extent of substandard care in Australia’s aged care system reflects both poor quality on the part of some aged care providers and fundamental systemic flaws with the way the Australian aged care system is designed and governed,” say the Commissioners.

“People receiving aged care deserve better. The Australian community is entitled to expect better.

“To deliver an entitlement to high quality care and support for older people, and to ensure that they receive it. The care and support must be safe and timely and must assist older people to live an active, self-determined and meaningful life in a safe and caring environment that allows for dignified living in old age.”

Commissioners provided 148 recommendations covering a variety of important issues currently challenging the aged care sector, including:

• A new Aged Care Act

• An integrated system for the long-term support and care of older people

• Establishment of a System Governor to lead and shape the system

• Establishment of an Inspector-General of Aged Care to investigate any systemic issues in aged care

• Establishment of an Aboiriginal and Torres Strait Islander Aged Care Commissioner

• Updated accessible information about providers and services

• A new aged care program focussed on providing greater access to care at home

• A clear home care waiting list

• Establishment of an Aboriginal and Torres Strait Islander aged care pathway

• Establishment of registration for personal care workers

• Minimum quality and safety standards for staff time in residential care, including skill mixes and at least one Registered Nurse on-site at all times, and minimum qualifications for personal care workers

• Increase in aged care award wages and improved remuneration for aged care workers

• A strengthened quality regulator

• Overhaul of the aged care workforce including future planning

• Establishment of a dementia support pathway and specialist dementia care services

• Regulation of restraints in aged care

• Restricted prescripts of antipsychotics in aged care

• Urgent review of the Aged Care Quality Standards (by 15 July 2021)

• Development of star ratings of providers for people seeking care

• Accreditation requirements for General Practitioners working in aged care facilities

• No younger people in residential aged care

• Civil penalties for contraventions of general duty by approved providers and compensation for people who experience contravention of civil penalty provision

• Establishment of a Pricing Authority

• Changes to funded areas of aged care, including the basic daily fee, fees for residential aged care, indexation amendments, the means test, and more

• Investigation into financing an Aged Care Levy past the Productivity Commission

• Phasing out Refundable Accommodation Deposits (RAD)

Commissioners highlighted that they have also provided alternative options for reform that the Australian Government can consider.

Commissioner Pagone and Briggs had differences of opinion on some areas of aged care, resulting in separate recommendations from both Commissioners.

The Final Report stipulates that the Australian Government should report to Parliament about their responses to the Final Report by 31 May, 2021.

To view the full report, head to the Royal Commission into Aged Care Quality and Safety website.