“We consider that the extent of substandard care in Australia’s aged care system is deeply concerning and unacceptable by any measure. We also consider that it is very difficult to measure precisely the extent of substandard care, and that this must change. Australians have a right to know how their aged care system is performing; their government has a responsibility to design and operate a system that tells them; and aged care providers have a responsibility to monitor, improve and be transparent about the care they provide. The extent of substandard care in Australia’s aged care system reflects both poor quality on the part of some aged care providers and fundamental systemic flaws with the way the Australian aged care system is designed and governed. People receiving aged care deserve better. The Australian community is entitled to expect better.” [Royal Commission into Aged Care Quality and Safety, A Summary of the Final Report, p.73]
Given the three volume interim report of the Royal Commission into Aged Care Quality and Safety was titled “Neglect”, the publication of the Final Report was not going to contain good news concerning the piecemeal approach taken by the federal government to what is now a predominately privatised health care sector.
Privatisation of the aged care sector has literally made millionaires of many founders and directors of residential aged care businesses.
According to a May 2019 Tax Justice Network – Australia and
Centre for International Corporate Tax Accountability & Research (CICTAR) reportTax Justice Network – Australia and Centre for International Corporate Tax Accountability & Research (CICTAR) report, Australia’s six largest family-owned aged care companies make a up a significant and growing portion of the aged care sector and they received over $711 million in annual federal funding to operate 130 facilities, with almost 12,000 beds. This was in addition to fees received from residents. While several of the largest family-owned aged care companies, owned by some of Australia’s richest families, have complex corporate structures, intertwined with trusts, that appear specifically designed to avoid tax.
The aged care system offers care under three main types of government subsidized service: Commonwealth Home Support Programme, Home Care Packages, permanent residential care and short-term respite care.
None of these service types have met the goals assigned to them under government policy and, the distressing examples of abuse and neglect which led to the creation of this Royal Commission have not disappeared as media reports during 2020 revealed [source source source source].
Regardless of whether a residential aged care business was privately-owned, corporate-owned or a not-for profit belonging to a religious institution, too many times in 2020 their individual residential aged care facilities were cited for a failure in one of all 8 of the Aged Care Quality Standards including those of concerning “consumer dignity and choice” and “personal care and clinical care”.
The Royal Commission’s Final Report Executive Summary tells us that:
The Aged Care Financing Authority reported that in 2018–19, there were over 3000 providers of aged care services. This included 873 residential aged care providers, 928 home care providers (as at 30 June 2019) and 1458 Commonwealth Home Support Programme providers.
However, a worryingly small percentage of the workforce employed by these 3,000 aged care services hold suitable qualifications. Out of the est. 366,000 paid workers only est. 15% had nursing qualifications or were accredited enrolled nurses in 2016.
The Final Report Executive Summary also tells us that:
In 2019–20, the Australian Government’s expenditure on aged care programs administered by the Department of Health was $21.2 billion. Older people are required to contribute to the costs of their care and accommodation if they can afford to do so through co-payments and means tested fees. People receiving aged care services contributed $5.6 billion to the cost of their aged care in 2018–19.
The Parliamentary Budget Office has projected that, over the next decade, Australian Government spending on aged care will increase by 4.0% a year, after correcting for inflation. This increase will mean that aged care spending will be growing significantly faster than the rate of all Australian Government spending (2.7%). By 2030–31, aged care will account for 5.0% of all Australian Government expenditure compared to 4.2% in 2018–19.
With the current Morrison Government having displayed a penchant for whittling down funding and services for the poor and vulnerable in our society, one would be foolish to suppose that Prime Minister & Liberal MP for Cook Scott Morrison would do no more than throw a financial sop at deficiencies in the aged care system.
On the heels of the Final Report, Morrison immediately committed to spend a paltry$452m on the sector and announced a further $189.9m in “temporary financial support” without a requirement that residential aged care providers spend it on increasing staff numbers and/or providing more qualified staff – needs identifed within a number of the 148 recommendations in the Final Report.
The full final report of the Royal Commission into Aged Care Quality and Safety is at https://agedcare.royalcommission.gov.au/publications/final-report
The Final Report Executive Summary opens at https://agedcare.royalcommission.gov.au/publications/final-report-executive-summary
The preceding Interim Report is found at
https://agedcare.royalcommission.gov.au/publications/interim-report
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