To understand the significance of the appointment of Butler as Shadow Minister for Ageing, we need to understand two other issues:

  1. There has been a deep divide around the belief and implementation of free markets that has split both major political parties into factions since the late 1970s. This was exemplified by differences in policy between Fraser and Howard, Hawke and Keating, Beazley/Rudd and Gillard, and Turnbull sandwiched between Abbott/Morrison. The second of each paired group followed free market policies more aggressively.
  2. These differences have had a profound influence on aged care policy. On the one hand there are those who see aged care as a market conforming to neoliberal free market and management principles. On the other are those who see aged care as a community service to which the market contributes. The market is required to adopt community values and meet their expectations.

Hawke's attempts to reform aged care during the 1980s were strongly resisted by vested interests and largely abandoned by Keating in the 1990s. In 1997, when Beazley was Labor leader, Senator Gibbs was able to mount a savage and prophetic attack on the Howard government's 1997 free-market aged care policies, predicting that they would fail and explaining why.

In her submission to the Royal Commission which she made public, Senator Fierravanti-Wells has savaged her colleagues in the liberal party and blamed them for the crisis in aged care.  We admire her courage and her integrity in doing so.

As a shadow aged care minister she drafted aged care policy prior to the 2013 election. At Aged Care Crisis we have been very critical of her party's policies, but in her submission she has made proposals that begin to move policy debate in a more sensible direction.  We welcome that.

Accreditation has never been an effective regulator. It has failed in the USA, the UK and Australia.

Accreditation was not designed to be a regulator, was not intended to be a regulator and between 1997 and 2014 the agency insisted it was not a regulator – although everyone else knew it was a central part of the regulation that government and industry boasted of. As the criticisms show accreditation and regulation are incompatible.

Criticism of Senate Report Community Affairs April 2019: "Effectiveness of the Aged Care Quality Assessment and accreditation framework for protecting residents from abuse and poor practices, and ensuring proper clinical and medical care standards are maintained and practiced"

Aged care is currently undergoing major changes following the Federal Government’s decision to open the aged care sector up to the market. We believe that these changes will increase many of the pressures, which currently prevail within the sector.  For example, staffing is the largest on-going expenditure faced by aged-care providers and pressures to reduce costs will undoubtedly affect staffing levels. 

There is evidence to suggest that nursing home managers are under pressure to meet their profit targets and reducing staff to do so, often placing vulnerable residents at risk of elder abuse. When staffing is reduced and registered nurses are replaced by lower-skilled staff, care quality suffers. 

A number of articles and presentations suggest that family members have "unrealistic expectations" in aged care.  However, there are major problems in the aged care system and too many residents are suffering as a result.  

Claims about "unrealistic expectations" are a cop out.  If some have unrealistic expectations, it's because of the branding and marketing by the aged care industry and the unrealistic image of a "world class system" promoted by government.