From where we were, to where we are, to where we want to be

I am in agreement with Professor Maddocks' approach to a community hub and see the many community benefits that he sees.

Because of my studies of market failures in vulnerable, corporatised markets, I see a real risk that the hub might be embraced and taken in under the umbrella of the present system and so be neutralised as an effective generator of very badly needed change. I think it is essential that the hub be structured so that this cannot happen.

For this reason, the hub that I have proposed above goes wider than that suggested by Maddocks. I believe that to be effective it must include the community as well as the professions as central players. It is critical that the community control the information as we will not get change until this happens. It is also critical that the hub be part of the oversight process and that it provides advice to residents and their families. It must be the customer that the provider works with in providing the service.

It is essential that the hub play an integral part in the assessment of approved providers and owners. They should have the right to veto. This will ensure that the provision of good care and a good quality of life is the key determinant for growth and corporate success, and make the market work as market theory tells us it should.

The relationship should be an amicable one. I don't fight with my architect or my builder when I build a house, but I make sure that I get the sort of house I want and we all work together.

This section explains why I think the creation of a community aged care hub like this is so important.

Linked pages in this section:

  • How we got here: traces the path from a community service to a market, but not as far back as our convict days when, as one critic has suggested, attitudes to aged care were similar to those we have today.
  • Where we want to be: examines the sort of aged care system and its relationship with the community that I am trying to achieve.

How we got here

This page looks briefly at the origins of our aged care system as a caring community activity, how it became too costly and how government came to fund, control and regulate it.  This page also looks at how increasingly, individuals and groups primarily interested in making a profit entered the sector to capitalise on the funding by government.

Finally, how the projected rapid expansion of the elderly and the potential profits this promised enthused business and scared government. The adoption of a new more radical global belief in the general utility of markets to society led to a deliberate restructuring of the sector as a marketplace in 1997.  In the enthusiasm for competitive markets as the panacea for all our problems local and multinational corporations were courted and encouraged to care for our elderly by providing services.  They were enticed by the opportunities for profit rather than a mission of care and service.

The page then looks at what we can do about the broken system that resulted from this. It looks at how the proposed community aged care hub would address the problems by creating an effective customer.  The essential conditions to give this new customer the power to be effective are listed.

Learn more: How we got here

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Where we want to be

In Part 2, I described the sort of aged care community Hub that I feel will address our problems but on that page I did not give a broad perspective.  On this next page I look more broadly at what it seeks to accomplish.  What sort of aged care system we might want and how the proposed hub would contribute to creating that.

The proposed Hub does not impose any belief system other than democracy, nor does it seek to prescribe any particular type of system. Instead, it creates a context within which sensible decisions based on logic and evidence can be developed - and if evidence is lacking it can be sought.  The structure needed to quickly gather information would be in place.

The page looks at the role of government, at the problems created by our political system and what we mean by a Civil Society, something the Hub epitomises.

Learn more: Where we want to be

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We would love to hear your thoughts on the direction aged care should take in order to make life worth living and working in Australian nursing homes: Join our conversation  Author: Dr. Michael Wynne, Copyright 2015