Senator Santoro has stated that he is very keen to encourage community participation within the Australian aged-care system. Indeed, the 1997 Aged Care Act makes provision for some level of community involvement through the creation of Aged Care Planning Advisory Committees (ACPACs) in each state. As well, the Minister receives advice from the Commonwealth Aged Care Advisory Committee (ACAC), which came to prominence during the recent publicity concerning elder abuse/neglect and the ensuing debate on mandatory reporting.

It is worth taking time to consider whether these mechanisms provide an authentic, and effective, voice for aged-care consumers and their families.

Firstly, let’s look at the Commonwealth ACAC which famously was unable to reach a decision, after a day of debate, as to whether reporting of incidents of suspected elder abuse/neglect should become mandatory.

This Committee consists of representatives of a range of peak bodies:

• Six members represent providers
• One member is from the industry-funded Aged Care Standards and Accreditation Agency
• Other members represent advocacy groups such as Carers Australia, the Alzheimer’s Association, the Older Women’s Network, Australian Pensioners and Superannuants and the Council of the Ageing - most of whom receive some level of government funding.
• The representatives of the health professionals (nurses, doctors, and pharmacists) are there too.

Should these groups be consulted about aged-care policy?

Absolutely! Their views, and the experiences of those they represent, are critical. But this is just one side of the story.

The real stakeholders are frail older people and their families. These are the individuals at the front line of aged care. Residents can tell us what it actually feels like to live in an aged-care facility. And family members know how their relatives are faring on a daily basis. These are the voices that decision-makers must hear.

The attention of the Minister for Ageing should therefore be directed to the real aged-care consumer groups - to residents’ groups, local nursing home support groups, the various aged-care reform associations forming in most states and, of course, www.agedcarecrisis.com which receives regular, potent comment from aged-care consumers from all over Australia.

The people in these groups are activated by what they see on the ground. They know how current low staffing levels affect the daily life within facilities. They see the ‘star performances’ that are often put on prior to the accreditation visits. And I’d wager a bet that the mandatory reporting debate would have been a vastly different affair if real consumers had been invited to the recent talkfest. People on the ground in aged care know that the culture must be changed and that introducing mandatory reporting for suspected incidences of elder abuse/neglect is one of the ways to help achieve this.

Now, take the ACPACs. Here is token consumer participation par excellence. This columnist has had the surreal experience of being a member of one of these groups.

For the uninitiated, ACPACs are meant to advise the Department Secretary on the allocation of aged-care places in each state. Top heavy with Department bureaucrats (at least 8 Departmental 'advisors' at each meeting), restricted by narrow terms of reference, rendered useless by a totally unrealistic time-line and underpinned by a pervasive fear that somehow, a bunch of people dedicated to good aged care might do, or say, something out of line, ACPACs manage to waste the time of everyone involved. Maybe they were a good idea once, but in practice their impact is negligible.

Allocation decisions are clearly made by Departmental officers and thus ACPACs are an insult to those who participate with good will, and in the belief that they can contribute to the process.

When this columnist’s parent was stoically enduring long years of nursing home care, it was not uncommon for residents to be left, suspended in the lifting machine, for considerable periods of time. When the DON (Director of Nursing) realised that this was occurring, she arranged for staff training. The staff (mostly good-hearted people), who had not thought about the traumatic effect of this practice on residents, were given turns - being lifted in the machine themselves. After that, things changed.

Senator Santoro has announced that a packet of money is to be allocated for the training of aged-care workers. Fantastic – if long overdue! But please, can aged-care consumers contribute to this training? They are the ones who can tell it like it is. Talking to the CEO’s of peak bodies will hardly get to the truth of the matter.