16 December 2021
Response to consultation paper:
Aligning regulation across Care and Support Sector
Our submission responds to the major issues raised.
1. What is working well
For the last 40 years sectors and systems serving vulnerable citizens have failed across western societies. Aged care in Australia is a good example. More concerning is that vulnerable citizens have been exploited and harmed whenever others could profit from their vulnerability. The three systems referred to are a part of this. All are deeply flawed and none of them are working. What is proposed does not address the problems. It shields them from scrutiny.
2. Key challenges
Origins of the problems: The principal challenge to Government's response and these proposals can be traced back to an ideology developed by economists in the turbulent 1930s and 1940s. It was a libertarian movement that claimed that individuals expressed their freedom through markets, which, if left alone, always worked. This was an illusion.
It was later joined by libertarian movements in the USA. Many were attracted to the philosophy of a Russian emigrant who condemned selflessness and promoted selfishness as a virtue. She described altruism as a disease imposed by society and relationships between citizens as transactional based on mutual interests and not on empathic engagement.
Self-interest was central to both movements and any control was condemned. Both saw community action and community restraint on individual action as a threat - describing this as ‘the collective’. Society, its values, its responsibilities, and the governments it elected threatened freedom.
Spread: These two movements were very appealing and gradually came together. Think tanks were formed to spread the message across the world. There are now many hundreds across the world including Australia.
This belief system became dominant and unchallenged in the 1980s and 1990s. These ‘neoliberal’ free market ideas became the basis for market globalisation so bringing them to most of the world.
These theories were adopted by business schools and schools of management. A centralised managerialism based on these ideas was applied to markets, governments and society. Many warnings were ignored.
Consequences: The consequences have been huge. Civil society and its core values have been undermined and eroded. The public service has been decimated and believers put in charge. It now lacks capacity and has become a rubber stamp. Its functions have been outsourced to marketplace advisers.
Government and political parties, assisted by advisers whom they select from those they see as credible, largely manage and control policy and regulation. The system has been captured by industry. It is not possible to manage a whole country in this way.
Most politician’s careers are tied to these beliefs. They are unable to see things in any other way. Industry now funds political campaigns. Elections cannot be won without their support. Those who think differently and break ranks are dispensed with.
A belief system that began as a response to totalitarianism has created a form of market totalitarianism that is undermining our democracy, muzzling critics, and imprisoning, those who expose its failures.
The market, a vitally important structure that sustains and builds capacity in capitalist democracies has effectively kidnapped the society of which it is a part. It is feeding on its vulnerable citizens, and is holding its government to ransom.
Addressing these issues is the first essential step to reform.
3. Possible solutions
Understanding the social pathology: Human services to the vulnerable have been detached from the communities they serve and the values on which their success depends. This was never going to work.
Society is composed of complex social systems and subsystems in which multiple pressures coming from different parts of the systems balance and respond to each other as all the participants interact and work together. This makes social systems work and allows them to respond to changing situations. They become resilient to shocks like COVID-19.
Centralised and highly managed systems are soon dominated by factions and ideologies with rigid beliefs. They readily become unbalanced and fail. Currently our social systems are dominated by unopposed pressures from the self-interested and from the market. Large numbers have failed. Attempts to fix them without addressing these issues have failed repeatedly.
These systems go through cycles of failure as vested interests take back control after each failure and then make centrally controlled changes that protect their interests. Each cycle compounds the problem and makes the system worse. This is the third cycle of central management and control by the same vested aged care interests. It will make the situation even worse.
Solutions: The dominance of vested interests must be broken to rebalance the system and undo the damage done by 40 years of ideology.
Civil society must be rebuilt and re-empowered so that it can fulfil its central and regional democratic roles, functions and responsibilities. This will create a platform for real change. Human services are well placed to lead the way.
The management, oversight and regulation of community services should be decentralised. Local communities should be encouraged, engaged and empowered to take control of these complex services and adapt them to the often very different needs of their communities. This cannot be a one size fits all central process.
Local communities should have the power to ensure that those providing services to their communities embrace their values, are trustworthy (probity) and will work with them to provide care. They must have the power to replace those who do not meet their expectations.
These changes would restore the balance of forces by enabling communities (civil society) and their values to exert much greater pressure in vulnerable sectors.
In the past this well-established principle has been supported by probity regulations. These were abolished in the 1997 Aged Care Act.
4. A roadmap
The 20th century was a century of huge technological advances. It was dominated by ideologies that created conflicts and wars.
The ideology that has dominated since the 1980s has been destructive of society and its values. We are still trapped within its debris and seem unable to extricate ourselves. Unpicking the social debris of 40 years is no easy task and it will take more than one generation.
Rebuilding society, encouraging it to grow socially and helping it use its network of intellects to analyse, challenge and take control of its affairs in a changing world must be a long-term project, one that will extend across generations. If we are to use our intelligence to progress humanity and build capacity, we have no alternative. We should embrace it enthusiastically. Projects like this are stimulating and bring people together.
Careful planning is required. Artificial intelligence and robotics will release us from the stranglehold of markets, open up wider horizons and expand our human potential. There are huge unaddressed problems and huge opportunities.
5. Focus on alignment
What is proposed in the discussion paper is another centrally managed process, which will leave central managers in control. It will be easier to keep failures out of public view, crush critics and control dissenting views. This will make the problems worse and should be abandoned.
Aligning these different sectors is desirable. These services are provided locally. They are far too personal, individual and diverse to be effectively managed or regulated centrally. Alignment will be developed locally by communities in ways that serve their needs. They should be supported but not controlled by central agencies.
6. Government policies and its consultation
Government and industry are unable to accept that this is a “shocking system that diminishes Australia as a nation”. They are making every effort to minimise the issues by developing an essentially similar system, keeping the same people and groups as advisers, and outsourcing government advice to the same consultants. The powerful perverse forces in the system are unchanged. Similar processes are being followed. Policy is trapped within the same flawed belief system.
Government still considers this as primarily a market and as market-led. The community is once again being managed. This has failed many times.
The processes set up to address the consultation paper illustrates this:
- It remains industry-led. The proposals were developed with industry before it was taken to others, who do not have access to those submissions and discussions. The agreed proposals are presented positively by making multiple assertions about outcomes that are unlikely to be met. Communities remain an afterthought that are again being managed and directed.
- Unstructured submissions are restricted to 1500 words so preventing critical analysis and criticism.
- Submissions are not being published so restricting public debate and preventing citizens from learning from their peers and commenting on their suggestions.
Aged Care Crisis does not want to be involved in a process that is so deeply flawed and is likely to make the situation worse. If however, anyone is interested in discussing the issues we have raised and is prepared to address them then we would welcome the opportunity to discuss them and or make further submissions.
It is not possible to do more than outline the problems in such a complex system in 1500 words.
We have published a more thorough analysis, fully supported by references and links elsewhere on our web site.
- Consultation: Aligning regulation across Care and Support Sector (Department of Health)