Aged care in urgent need of reform

It used to be said growing old was what happened if you were lucky. Now, after what they have seen, heard, and read over the past 18 months - and especially since the onset of COVID-19, many Australians must be wondering if that is true.

Bill Shorten during question time in the House of Representatives. Picture: Sitthixay Ditthavong

Bill Shorten during question time in the House of Representatives. Picture: Sitthixay Ditthavong

The year 2020, and those that preceded it for that matter, have not been a good time for the frail elderly in institutionalised care. Even before the virus transformed many nursing homes into inaccessible and nightmarish incubators for this pestilent disease, the aged care Royal Commission was hearing horror stories about neglect and abuse. Some dated back many years and involved systemic failings in the privatised aged care model.

It has been heartbreaking to hear how some of our most vulnerable community members had been left in fouled beds for hours, fed poor quality food at irregular intervals, and, on many occasions, drugged to make them easier to "manage" in institutions paid good money to ensure they were cared for with respect and dignity. The worst treatment has been reserved for those who have been stripped of their self-awareness and ability to do even the smallest tasks for themselves by that cruelest of diseases, senile dementia. In some cases these patients, who have already lost everything - including themselves - have been treated as less than human.

It is painfully obvious the current system of looking after the aged and the frail is badly broken, and has been for years, perhaps decades. The Royal Commission, and the pressures created by COVID-19, have exposed "a dirty little secret", long known to politicians, aged care providers, and health officials, to the public gaze.

A privatised model of care that provides incentives for cost cutting is not sustainable.

While the current debate over how and why a succession of federal governments have failed so dismally in their statutory responsibility to manage the sector, and whether or not the current government had an effective pandemic management plan in place when the coronavirus reached our shores, is worthy, it shouldn't divert attention from the bigger picture. That is, of course, the need to find out why things were allowed to get this bad, and what can be done to fix it. This is the point Bill Shorten, the shadow minister for the NDIS, and for government services, made strongly and cogently on Sunday. He said it was wrong to blame the workers, often some of the most under-paid and most under-appreciated in the country, who were doing their best to cope with a dysfunctional system which puts profit ahead of the welfare of the elderly. While justifiably critical of the federal government's failure to manage coronavirus outbreaks in aged care, Mr Shorten was adamant many of the problems were systemic.

"Looking after elderly people with diagnosis of dementia is not cheap," he said. "So, if we want to make a profit, and you want to look after people, then you create faultlines in the system. COVID-19, right across Australian society, has revealed things which have been glossed over".

The former Labor leader's key point cuts straight to the heart of the problem: "We have to stand up and say that if we care about our parents and our grandparents, which we do, and most Australians would agree with that, you can't do that on the cheap". A privatised model of care that provides incentives for cost cutting and a minimum wage ethos is not sustainable.

While it is unlikely any government will ever have the ticker to nationalise aged care, it is now six months since the Health Services Union called for a Medicare-style aged care levy to make up a funding shortfall of between $5 billion and $40 billion dollars. Surely, given this issue touches every Australian, this deserves serious consideration.