MEDIA RELEASE: 24 January 2011
The Productivity Commission’s main underlying hypothesis in its recently released Report, Caring for Older Australians is that by removing regulatory restrictions on the number of bed licences – thus exposing aged care to further competition and freeing up market forces - the many problems besetting the sector will be solved.
This proposal, if translated into policy, means that by allowing more beds and therefore more aged- care homes, frail aged Australians will have more choice - the well-managed places will thrive and the poorly-managed ones will fail. Mark Butler, the Minister for Mental Health and Ageing, seems to have already supported the draft proposal, but has trivialised the issue with his first public comment "… A lot of older Australians want to be able to consider choices about having a glass of wine at night …" . Aged Care Crisis (ACC) wonders whether this Minister is really aware of the serious stresses facing both the residents of aged-care homes and the staff who care for them in making such a comment.
There is a moral imperative to aged care and this is sadly lacking in the Productivity Commission's Draft Report.
Aged care isn't predominantly about 'choice'. It should be about 'quality' – and putting the 'care' back into aged care. It is nonsense to think that frail aged individuals are your average consumers with opportunities to pick and choose! Decisions must often be made at a time of great urgency and when individuals are most vulnerable. Factors such as location and proximity to family are usually paramount.
Moreover, ACC has recently emphasised the importance of transparency, accountability and disclosure in the aged-care system. It is also nonsense to imagine that choice is available at all, without allowing residents and intending residents access to vital information which informs proper choice.
While acknowledging that the brief given to the Productivity Commission was primarily about how to fund the increasing need for aged care as the population ages, ACC is disappointed that the Productivity Commission has refused to address the critical issue of staffing and has not recommended that there be mandated, minimum staff/resident ratios in our aged-care homes. By not doing this, it has failed one of our most vulnerable groups. It has also, in our view, fallen short, in this respect, on its mandate to "systematically examine the social, clinical and institutional aspects of aged care".
ACC suggests that the Terms of Reference warranted a substantial review of current meagre staffing requirements which generally, and in our experience in seeing complaints and comments from people directly involved over the years, falls far short of what the Aged Care Act 1997 [paragraph 54-1 (1) (b)] for as "to maintain an adequate number of appropriately skilled staff to ensure that the care needs of care recipients are met ". This should have been a major recommendation of the Commission.
Private ownership of aged-care homes in Australia is now at over 34% - and rising. The primary focus of market- listed entities is the highest possible return on owner’s investment. This is the reason for entry into the retirement and aged-care sectors. Private equity groups are probably even more aggressively focused on short term profitability.
Providers, particularly those looking to make good returns on capital funds, will always seek the means to reduce overhead costs, foremost among which are to employ the minimal number of people.
Other significant proposals within the Draft Report – relating to the funding and structure of aged care - will encourage much debate and discussion. However, failing to fully engage on debate on the critical issue of aged-care staffing detracts greatly from this influential Report.
We look forward to engaging in this debate and of contributing further comment on other issues of concern to residents and their families and carers.