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Coalition parties & aged care industry unhappy with federal government proposal to make care providers criminally responsible for abuse and neglect of vulnerable older Australians in their care

 

In 2018 the Morrison Government established the Royal Commission into Aged Care Quality and Safety.

The Royal Commission's Final Report was delivered to the Federal on 1 March 2021. The Summary contained in Volume 1 of the report stated in part;

Over the course of 2019, we heard from many people about substandard care—those who experienced it, family members or loved ones who witnessed it or heard about it, aged care workers, service providers, peak bodies, advocates and experts. We heard about substandard care during hearings and community forums. We also were informed about it in public submissions. Substandard care and abuse pervades the Australian aged care system.

The accounts of substandard care were always sad and confronting. They were no doubt difficult to tell, and very difficult to hear and read. We acknowledge the courage people have shown in sharing their experiences with us. Their contributions have been essential to our inquiry and we are grateful.....

The abuse of older people in residential care is far from uncommon. In 2019–20, residential aged care services reported 5718 allegations of assault under the mandatory reporting requirements of the Aged Care Act. A study conducted by consultancy firm KPMG for the Australian Department of Health estimated that, in the same year, a further 27,000 to 39,000 alleged assaults occurred that were exempt from mandatory reporting because they were resident-on-resident incidents. In our inquiry, we heard of physical and sexual abuse that occurred at the hands of staff members, and of situations in which residential aged care providers did not protect residents from abuse by other residents. This is a disgrace and should be a source of national shame. Older people receiving aged care should be safe and free from abuse at all times......

Commissioner Briggs attached 148 specific recommendations to her final report and it is unclear exactly how many have been acted on to date, apart from the initial response found in the Aged Care and other Legislation Amendment (Royal Commission Response) Act 2021 and the subsequent Albanese Government's Aged Care and Other Legislation Amendment (Royal Commission Response) Bill 2022.

So it should come probably come as no surprise that disturbing media reports were still surfacing in 2023.

May 2023 - a NSW police officer deliberately tasered a 92 year-old woman on a walking frame at the nursing home of which she was a resident. She died of her injuries.

July 2023 - an 89 year-old woman was allegedly bashed to death inside a Sydney nursing home room by a fellow dementia patient with his walking frame. She died of her injuries.

Nov 2023 - A woman in her 90s died in hospital after allegedly being sexually assaulted by an intruder in a nursing home on the New South Wales Central Coast.

Dec 2023 - A woman in her 70s was sexually assaulted in her room at an aged care facility on NSW north coast.

By 13 February 2024 The Guardian was reporting:

More than 1,000 cases of neglect are being reported in residential aged care homes each month, prompting a warning from the sector’s regulator.

The Aged Care Quality and Safety Commission (ACQSC) has flagged “a concerning spike” in neglect cases over the past 12 months and raised concerns about inadequate care standards.

So it was a relief when on 3 April 2024 the Albanese Government announced in a media release that it will:

• Introduce criminal penalties – including jail time - for dodgy aged care providers who seriously and repeatedly facilitate or cover up abuse and neglect of older Australians, and who deliberately breach the general duty of care they owe to their residents.

• Introduce a new duty of care, owed by providers, to recipients of aged care services, including a compensation regime when the duty is breached. This will create a path for class actions against dodgy providers.

• Create a new aged care complaints commissioner, to ensure complaints against providers are properly and thoroughly dealt with.

• Introduce new civil penalties for aged care providers who punish aged care workers, residents and families in retaliation for complaints.

• Give stronger investigative powers to the Aged Care Quality and Safety Commission, including powers to enter and remain in an aged care facility at any time to ensure the safety of residents, as well as full access to documents and records.

• Introduce measures to ensure the 215 minutes of care and nursing that Labor has pledged per resident per day is actually spent on care and clinical support - not on marketing, administration, maintenance or other activities that are not direct care.

• Require providers to publicly report on the expenditure of residents’ and taxpayers’ money – including a breakdown of money spent on caring, nursing, food, maintenance, cleaning, administration, and profits....

These measures implement and build on the Royal Commission recommendation to establish a General Duty of Care for aged care – which will set minimum standards to protect residents and workers....

However, it seems that the Albanese Government's plans to reform the dysfunctional aged care system have met with political headwinds.....

The Saturday Paper, 13 July 2024, "Criminal penalties proposed for aged care bosses", excerpt:

The Serious Incident Response Scheme (SIRS) – instigated after the royal commission to track and reduce the frequency of major incidents, including unreasonable use of force, neglect, psychological and emotional abuse, unlawful or inappropriate sexual conduct, stealing or financial coercion, inappropriate use of restrictive practices and unexpected death – came into force in April 2021 in residential settings. In December 2022 it was added for home care. This scheme, which asks providers to self-report serious incidents, has shown concerning levels of delusion and dishonesty among providers.

In the most recent SIRS figures, providers self-assessed that of the 2257 incidents of unlawful or inappropriate sexual contact in Australian nursing homes from April 2022 to March 2023, 95 per cent of residents affected had experienced no or only minor psychological impacts. Put another way, providers reported that only 5 per cent of aged-care residents who experienced serious and unlawful sexual contact or conduct have had major psychological impacts afterwards.

In the same report, providers self-assessed that of the 28,890 incidents of unreasonable use of force in the same year, 98 per cent of residents had no or minor psychological impact and 92 per cent had no or only minor physical impact. In the scheme’s first six months of operation, 75 per cent of the nation’s home-care providers had not reported a single serious incident of any kind to the aged-care regulator.

These figures reveal a sector that is still fundamentally in denial about its own performance and the effects of abuse and neglect on older Australians in its care.

Now, as the federal government attempts to muster bipartisan support for its new act, the aged-care lobby is circling its wagons again, this time to fiercely oppose the government’s proposed imposition of a statutory duty of care on aged-care providers and responsible persons that could result in civil and criminal penalties, including potential jail time in especially egregious cases.....

Nonetheless, providers, peak bodies, the Australian Institute for Company Directors and shadow minister for aged care Anne Ruston have all come out swinging at the proposed introduction of criminal penalties. 

They claim the penalties will lead to vast increases in insurances for directors, are unnecessarily punitive and will discourage good people from working in the aged-care sector. This is a bit like arguing we shouldn’t have child-abuse laws or require police checks to work with children as that might stop good people from opening kindergartens.

The extraordinary optics of arguing against criminal penalties – even in cases where there is no reasonable excuse for failures of care that have led to death or serious injury – seems to be lost on providers and the federal opposition.

To find that the ANZ, Bendigo and Adelaide, Commonwealth and Westpac banks are not above squeezing the poor is not really news - but to find that one particular squeeze employed by these banks seemingly targeted Aboriginal customers living in regional & remote areas is shocking

 

Australian Securities & Investment Commission (ASIC). media release:

Bigbanks to refund millions in fees to low-income customers followingASIC report

Published 15 July 2024

Bank customers on low incomes, including First Nations customers, will be refunded over $28 million dollars after a first-of-its-kind ASIC review revealed four Australian banks systemically charged high fees to those customers who could least afford it.

ASIC's Report 785 Better banking for Indigenous Consumers (REP 785) found that the ANZ, Bendigo and Adelaide Bank, CBA and Westpac kept at least two million Australians on low incomes, including many relying on Centrelink payments to make ends meet, in high-fee accounts.

ASIC Commissioner Alan Kirkland said the banks had caused financial distress through avoidable fees and complicated bank processes, often creating barriers for regional and remote consumers.

‘Banks knew that many of these customers on low-incomes were in inappropriate high-fee accounts, and it has taken ASIC’s intervention to force them to act,’ Commissioner Kirkland said.

‘Before our review, most banks only provided their customers with difficult 'opt-in' processes for switching to low-fee banking options, including forcing some consumers to travel hundreds of kilometres to their nearest bank branch.’

ASIC’s review was focussed on improving financial outcomes for First Nations consumers by addressing avoidable bank fees. The findings have resulted in broader outcomes for people on low incomes nationwide.

Following ASIC's review, the banks have migrated more than 200,000 customers into low-fee accounts, saving these customers an estimated $10.7 million in future yearly savings.

As a result of ASIC’s review banks will return over $28 million in fees to these customers over the next 12 to 18 months, including $24.6 million to be refunded to customers receiving ABSTUDY payments and those in areas with significant First Nations populations. [my yellow highlighting]

Commissioner Kirkland welcomed the steps the banks had taken but said more needed to be done to ensure the issue didn't happen again.

‘This is the second report from ASIC in the last two months that highlights where banks have failed to put customers’ needs at the heart of their operations,’ Commissioner Kirkland said.

‘It highlights the impact the banking system can have on Australians. Fair banking services for all Australians, including those on low-incomes or located in regional or remote areas, are critical for our financial system.

‘Banks need to ensure they have systems and processes in place so customers on low incomes can easily transition to low-fee accounts, regardless of their location.

‘We expect all banks – not just those we reviewed for this report – to consider these findings, improve the accessibility and distribution of low-fee accounts and commit adequate resourcing to specialist First Nations services,’ he said.

Download

Report 785 Better banking for Indigenous Consumers (REP 785)

Infographic: ASIC’s Better banking for Indigenous consumers project (PDF 1.2 MB)

Better banking for Indigenous consumers report: Case studies (PDF 747 KB)

Background

ASIC’s review focussed on banks with a presence in regional and remote locations. In July 2023, ASIC wrote to the banks calling on them to improve their processes and target market determinations (TMDs) and refund past fees incurred by low-income customers in high-fee bank accounts.

ASIC analysed each banks’ TMDs and data on fees charged to customers on low incomes. ASIC considered how banks met the design and distribution obligations and asked each bank to address fee harm for people on low-incomes in high-fee transaction accounts.

REP 785 is an outcome of ASIC’s Indigenous Outreach Program, which works with a range of organisations, including the financial services industry, to influence system change and drive positive financial outcomes for First Nations peoples. The outcomes align with ASIC's Indigenous Financial Services Framework and ASIC's Reconciliation Action Plan. This is the first intervention project of its kind to compel widespread meaningful benefits for low-income consumers, including First Nations customers since the release of ASIC’s Indigenous Financial Services Framework.

ASIC advises all consumers to talk to their bank to understand what fees they are paying. For further information they could speak to a free and confidential financial counsellor at the National Debt Helpline or through Mob Strong debt helpline.

Byron Shire Council being less than transparent over a proposal to cut more than 30 shire residents off from a reliable town water supply as a cost cutting measure

 

Echo, 10 July 2024, Residents face being cut from Mullum’s water, excerpt:

More than 30 affected residents say their properties are at the bottom of Wilsons Creek and some areas of Mullumbimby Creek, and they were only told they will likely be cut off from town water after questioning Council staff about the Mullumbimby Water Supply Strategy.

Spokesperson for the Wilsons Water Rights Action Group (WWR) Mel Macpherson said she was shocked to find out from a neighbour about Council’s plans to remove their connection to town water without any direct written or verbal communication.

‘One would think the appropriate action for Byron Shire Council would be to talk to us individually, and let us know that their preferred water strategy means cutting us off – for the 30 residents this has drastic ramifications, we have a right to know.

‘I honestly feel the communication from Byron Council has not been acceptable at all. This decision directly affects our health, businesses, infrastructure and property values. Relying on us to scan social media or listen to the radio to find out we are getting cut off has left me baffled.

‘I only found out because my neighbour who has lived here for 90 years told me, and knew the history of the weir and local infrastructure, and noticed this in the water strategy plans......

Echo, Letters to the Editor, Losing town water access,13 July 2024:

I grew up and live in Mullumbimby, and I know locals have a strong opinion about the Byron Shire Council. I had always given them the benefit of the doubt – as it’s not an easy job. But last week I changed my mind.

Our neighbour, Ray Musgrave, alerted us and other neighbours we’d be losing town water access on our properties. At first, I thought this was simply the Mullum rumour mill, but I called around at Council and found out it was true. Without any doorknocks, phone calls, or letters, we found out dozens of residents at the bottom of Wilsons Creek, including us, would lose town water access if Mullum is connected to Rous water.

While this decision has not been officially made by Council – yet – we all know it is the likely decision. I work in media and communications, sometimes as a consultant for state and federal government, and I’ll admit that tactics are sometimes a little underhanded, but, when it comes to infrastructure and impacting households like this, there would always be doorknocks to every home at a minimum in the communications plan. So, I’m simply shocked at these sneaky tactics by our local council.

Luckily, we have all been neighbours for decades or generations here and were able to quickly agree to work together to try and save our town water. Wish us luck!

Casey Fung, Wilsons Creek

According to the Byron Shire Council website as of 15 July 2024:

Regional water supply

All urban areas in Byron Shire are supplied water from Rocky Creek Dam, which is managed by Rous County Council.

Mullumbimby is supplied from Council's Lavertys Gap Weir.

Rous County Council supplies drinking water to seven reservoirs in the Byron Shire Council from the Nightcap Water Treatment Plant.

Under the Water Supply Agreement, we are responsible for maintaining water quality in the reservoirs and reticulation system......

The Mullumbimby Water Treatment Plant provides treated, filtered, and disinfected drinking water to Mullumbimby.

The drinking water supply is sourced from Wilsons Creek via the Lavertys Gap Weir.

Water flows to the plant by gravity through a heritage-listed race, via a mountain tunnel.

Council documents indicate approximately 13 properties along Wilsons Creek Road are connected to the trunk main from the water treatment plant.

The preferred option of council staff coincides with advice contained in a Hydrosphere Consulting Pty Ltd report (updated May 2024) which clearly stated in 12.4 Option 4 - Full Connection to RCC Regional Supply:

The customers along the Wilsons Creek Road trunk main would not be serviced with this arrangement.

In an alternative scenario within Option 4 Hydro Consulting suggested an Option 4B - emergency connection to regional supply:

As an alternative, the existing RCC emergency supply pipeline could be extended to service the remaining areas of Mullumbimby as an emergency supply only. BSC would then retain Lavertys Gap Weir and WTP as the normal supply regime with future augmentation with another raw water supply source. The customers along the Wilsons Creek Road trunk main would still be serviced by the weir supply and WTP if there was sufficient water in the weir storage. [my yellow highlighting]

However, Byron Shire Council on its public exhibition webpage did not immediately draw attention to the fact that some properties may lose a reliable long-term connection to town water. 

In the first instance it presented the case thus, with the fate of Wilsons Creek Road concealed in webpage links:

Mullumbimby’s water supply scenarios

The consultant’s report short-listed four water supply scenarios, summarised below.

Each scenario has associated benefits and costs.

Council’s engineering staff recommend Scenario 3 – permanent connection to the Rous County Council water supply.

For each scenario, some factors remain the same, including:

• continued use of the weir and Water Treatment Plant (WTP) in the short term

• short-term WTP upgrades to ensure consistent, safe water supply

• extension of the Rous County Council emergency bulk water supply connection to all of Mullumbimby.

Indeed within its boasting about the benefits of what it calls "Scenario 3" it is clear that the potential loss of a long-term reliable town water supply for 30 shire residents & ratepayers is a short-term cost cutting measure.

Scenario 3 – Full connection to Rous County Council

Rous County Council is the regional water supply authority for the Byron Shire, with the exception of Mullumbimby.

Rous also supplies:

• Ballina Shire

• Lismore Shire

• Richmond Valley Shire.

Permanent connection to the Rous regional water supply would mean that water is no longer sourced from Lavertys Gap weir and the Mullumbimby water treatment plant (WTP).

As a result, there would be no need to build a new WTP at Mullumbimby.

Permanent, full connection to the regional water supply is the option recommended by the consultants and Byron Shire Council staff based on the environmental, economic and social assessment.

Benefits of full connection

Connecting to the regional supply has significant benefits over local supply scenarios. [my yellow highlighting]

Full connection offers:

• minimal environmental impact

• lower energy consumption

• reduced infrastructure modifications.

There are significant capital cost savings in avoiding the need to replace the WTP and upgrade the weir supply in addition to constructing new infrastructure. However, the ongoing costs of a regional supply are higher than local scenarios. [my yellow highlighting]

Permanent connection to the regional supply means Mullumbimby’s long-term water security is determined by Rous County Council's bulk supply system, as is the case for the rest of Byron Shire.

Byron Shire Council is scheduled to decide on its water supply strategy at its August monthly meeting.

12,000-year-old GunaiKurnai ritual passed down 500 generations may be world’s oldest archeologically documented ritual

 

IMAGE: The Conversation, 6 January 2021

To the best of my understanding, Cloggs Cave formed in the Middle Devonian & sited 72.3m above sea level, is on the country of and under the cultural care of the Krauatungalung clan of the GunaiKurnai nation.

Nature Human Behaviour, 01 July 2024:

Archaeological evidence of an ethnographically documented ritual dated to the last ice age

Bruno David, et al

In societies without writing, ethnographically known rituals have rarely been tracked back archaeologically more than a few hundred years. At the invitation of GunaiKurnai Aboriginal Elders, we undertook archaeological excavations at Cloggs Cave in the foothills of the Australian Alps. In GunaiKurnai Country, caves were not used as residential places during the early colonial period (mid-nineteenth century CE), but as secluded retreats for the performance of rituals by Aboriginal medicine men and women known as ‘mulla-mullung’, as documented by ethnographers. Here we report the discovery of buried 11,000- and 12,000-year-old miniature fireplaces with protruding trimmed wooden artefacts made of Casuarina wood smeared with animal or human fat, matching the configuration and contents of GunaiKurnai ritual installations described in nineteenth-century ethnography. These findings represent 500 generations of cultural transmission of an ethnographically documented ritual practice that dates back to the end of the last ice age and that contains Australia’s oldest known wooden artefacts.

Determining the longevity of oral traditions and ‘intangible heritage’ has important implications for understanding information exchange through social networks down the generations. This can be achieved by tracking the origins and transmission of ethnographically known cultural practices through their associated material culture. However, understanding the issue of transmission has been fraught with difficulties. People often re-interpret and re-inscribe what they observe with new knowledge, altering the original information along the way (the hermeneutic process). Additionally, exposed material evidence can be seen for generations after a site’s construction, leaving it open to copying and re-interpretation under changing cultural contexts. One way out of this dilemma is to discover archaeological materials that could not have later been seen and copied, but that rather needed to have been passed on through intentional information exchange, such as through formal or familial education and training. In this Article, we report two examples of one such set of cultural materials from GunaiKurnai Aboriginal Country in southeastern Australia. Each consists of a wooden stick made from a Casuarina sp. tree stem. Each stick had been trimmed by cutting or scraping off smaller twigs flush with the stem. Each trimmed stick was smeared with fatty tissue. It was then placed in a low-temperature miniature fire, which burnt for a very short duration of time. The two installations were made deep in a secluded cave that was never used for everyday occupational activities. In each case, the miniature fireplace and its trimmed wooden artefact was rapidly buried by accumulating sediments at the Pleistocene–Holocene transition and remained in situ until they were archaeologically excavated in 2020 CE, preserving the installation’s structural integrity in the process. Such wooden artefacts and their fireplace installations were previously only known from local nineteenth-century ethnography, but have now been archaeologically found dating back to the end of the last ice age, as reported here.

The examples we document here are testimony to the endurance of cultural practices and oral traditions unaffected by complications of visibility and copying. According to nineteenth-century GunaiKurnai ethnography, the ritual practices involving the construction of such installations took place in secluded locations. Additionally, their key wooden components normally decayed within a few years or decades, preventing them from being regularly seen by the broader population and copied over extended periods. Furthermore, the archaeological wooden objects were juxtaposed to or smeared with fatty tissue from animals or humans when they were used, matching ethnographic practice. This association of the artefacts with fat would have remained invisible to the naked eye and is thus not amenable to copying. The suite of factors contributing to the survival of both the installations and their wooden artefacts provides unparalleled insight into the resilience of GunaiKurnai narrative traditions and the passing down of knowledge. These artefacts, along with ethnographic evidence, demonstrate the transmission of ideas and practice over a timespan of 12,000 years.

The excavation methods used in this study are reported in Methods. All stages of the research comply with all relevant ethical regulations including the Australian Archaeological Association and the Australian Institute of Aboriginal and Torres Strait Islander Studies Codes of Ethics. This research was requested and led by, and undertaken with the participation of, the GunaiKurnai Land and Waters Aboriginal Corporation, representing the Aboriginal Traditional Owners of the study site. At the corporation’s request, the ethical protocols for this partnership research were formally written into a memorandum of understanding checked for ethical compliance and co-signed by the GunaiKurnai Land and Waters Aboriginal Corporation and Monash University on 23 October 2018.....

Cloggs Cave contains a number of archaeological features characteristic of GunaiKurnai ritual installations and practices. The following ritual features date to various times that together span some 23,000 years, indicating that the cave has been used for a range of ritual activities over this period of time: (1) a stone arrangement occurs at the back of a shallow recess towards the rear of the cave (the alcove). (2) Up to 80 cm above the floor of this recess, on the alcove’s low ceiling within human reach, many of the stalactites were artificially broken. Uranium–thorium ages for the bases of ‘soda straws’ (stalactitic filament regrowths) growing on the broken stalactite stumps indicate they started growing between 120 ± 30 and 23,230 ± 300 years ago, signalling that the stalactites had been broken within the period of confirmed Aboriginal presence in the cave, which began by ~25,000 cal BP (calibrated radiocarbon years before 1950 CE). (3) On the floor adjacent to the stone arrangement is a large patch of powdered (crushed) calcite. (4) A portable grindstone with traces of crushed calcite crystals, dated to between 1,535 and 2,084 cal BP, was excavated 8 m away near square P35 (refs. 13,14). (5) One hundred fifty-eight broken soda straws and crystal quartz artefacts were found in the excavations in squares P34–P35 and R31 (ref. 15). Nineteenth-century GunaiKurnai ethnography, along with current GunaiKurnai knowledge holders, identify these objects as bulk (pebbles) and groggin and kiin (crystals). Each of these object types was documented to hold ritual power and to have been used to perform magic and medicine. (6) A fully buried standing stone, around 2,000 years old, was excavated in square P35 (refs. 13,17). (7) Despite the presence of tens of thousands of bones from small vertebrates (from natural deaths, mainly from owl roosts), there are no vertebrate animal food remains in the excavations. (8) Local ethnography and current GunaiKurnai knowledge document that caves such as Cloggs Cave were never used for general occupation in GunaiKurnai Country; the lack of archaeological food remains in such caves is consistent with the ethnography. Rather, the caves were the retreats of mulla-mullung, powerful medicine men and women who practiced magic and rituals in secluded places.....

The full report can be downloaded at:

https://www.nature.com/articles/s41562-024-01912-w.pdf

ABC News article of 2 July 2024 can be read at:

https://www.abc.net.au/news/science/2024-07-02/gunaikurnai-ritual-fireplaces-sticks-cloggs-cave-archaeology/104034756

IMAGE: ABC News, 2 July 2024

Cartoon of the Week

Read the complete First Dog On The Moon cartoon at:

https://www.theguardian.com/commentisfree/picture/2024/jul/10/protesting-stuff-is-your-democratic-right-or-is-it

Tweet of the Week

 

So what do you really think? pic.twitter.com/iFTgOP4LYw

— Hugh Riminton (@hughriminton) July 8, 2024