Articles

Regulatory changes and ever more complex regulatory processes can have adverse consequences and much of that burden can fall on already stressed and over-worked staff. Change needs to be introduced incrementally and commenced in regions. Its consequences should be carefully monitored. That has not been happening.

As the Royal Commission has so clearly demonstrated, the free-market model of care has failed staff and residents. The complex reforms recommended and government action make no fundamental changes to this market model. Governments continue to marketise those sections like home care where vestiges of community-led care remain. 

The huge uncertainties and the complex changes being made are driving some of the smaller providers out of the aged care sector. They have a low staff turnover and provide better more person-centred and relationship-based care.

Introduction

In a recent webinar from the Long Term Care Community Coalition in the USA titled How Fear of Retaliation Scares Residents Into Silence  (18 Apr 2023), Eilon Caspi described his detailed research into this problem. He shows just how widespread the problem of retribution when residents complain has become in the USA. This is a valuable and important contribution. He calls for more research, education, regulation and protection of residents. He described the way the industry rejects these sorts of finding and resists regulatory efforts.

While the Royal Commission into aged care made some useful recommendations, Aged Care Crisis has been very concerned at the matters they failed to address. These are issues within our society and our political system that impact on aged care and the many other sectors that have failed. 

Our experience, our research and our analysis indicates that they were the reasons why the aged care system has failed repeatedly and so badly. This analysis also shows why policy failures like this are so resistant to change and why the failures in aged care and similar sectors keep recurring in spite of attempts to make changes.

We have been even more concerned by the response of government and industry who seem to be denying their responsibility for what the Royal Commission found to be “a sad and shocking system that diminishes Australia as a nation”. They are pursuing the same policies and behaving in exactly the same way as they did before. They have appointed and commissioned the same people from industry to advise and work with them.

We became aware of another consultation 'Aligning Regulation across Care and Support Sector' by the Department of Health and discovered that they were conducting it in exactly the same restrictive way they have done in the past. This restricts criticism and prevents other parties from seeing the criticisms that others are making. Nothing seems to have changed.

We have therefore decided to set out the result of our experience, research and analysis (PDF658.67 KB). This explains what has been happening and indicates what needs to be done to create a context where we can address the difficult problems that develop in the complex world we live in more sensibly in the hope that some will find it informative and useful.

Aged care in Australia is not alone. The same policies were introduced in the USA and the UK as well as other countries. Those with experience and knowledge of human behaviour tried hard to warn us that this would not work. They were ignored. The same or very similar adverse consequences have developed in aged care in these countries as well.

We have a system that was largely designed by industry, for industry. By consulting with the same architects of the existing broken system, proposed system improvements by the recent Royal Commission and various consultations and inquiries following, are likely to suffer the same malady. We will be back here sometime in the future, but only after more needless suffering of vulnerable residents in aged care.