Mark Butler, the new Minister for Mental Health and Ageing, recently commented in the West Australian, ‘ that Australia has one of the best aged care systems in the world’.

Well, he would say that, wouldn’t he? Because that’s what they all say... the various Ministers who have been given the responsibility for the care of Australia’s frail and vulnerable! At least Minister Butler had the grace to qualify his statement with .....‘but the Government was aware it needed reform’.

This ‘we are the best’ attitude is concerning. Firstly, because one wonders on what possible basis the assertion is made. What knowledge do the various politicians have of the way frail, aged people are cared for throughout the world?

Secondly, because it portrays such a childish attitude – with rings of the schoolyard chant...my house is better than your house etc etc.. And really, it just doesn’t matter if it is the best or the worst - if people are not receiving quality care at the end of life.

But mainly because such an attitude does not accurately indicate the level of urgency needed to fix the significant cracks in the system. While we continue to believe that we are the best in the world, we are not facing up to the realities experienced by those who are currently receiving, or seeking, residential aged care.

Of course there are some aged-care homes providing good care and there are many, many nurses and carers who go above and beyond the call of duty to do their best for those for whom they are responsible.

But all is not well in aged-care land. How else to explain the extraordinary number of complaints made to the Complaints Investigation Scheme (CIS) – complaints that are surely just the tip of the iceberg as many do not get that far?

The Report on the Operation of the Aged Care Act 1997 - 1 July 2009 – 30 June 2010 published on November 24 this year states that the CIS received 13,166 ‘contacts’ and found 8,055 of these to be ‘in scope’ (and therefore worth investigating).  1,642 referrals were  made to external agencies, 3,197 site visits were made and it was found that there were 931 cases where an Approved Provider had breached their responsibilities under the Aged Care Act. 

Who knows what truths really lie beneath that set of numbers. One thing for sure is that there was a lot of complaining going on.

Then we have the vexed matter of aged-care staffing. Many people are absolutely bamboozled when they learn that there are no mandated staff/resident ratios in Australian aged-care homes.  Why not? We have them when other vulnerable people are at risk ... like... babies, little kids in child care, people in hospital etc etc.. It seems that anything is good enough for those approaching the end of life. Providers cry ‘flexibility’! Now, that would have to be a weasel word if ever there was – particularly if you look closely at the staffing levels operating in some homes.

Yet poor staffing ratios are often at the bottom of the various complaints about neglect and poor care.

A report published this time last year by Access Economics clearly outlines the enormous pressures on aged-care staff and the need for reform.

And here is a recent comment reflecting the personal, and not uncommon, experience of an aged-care nurse:

"... At one time I was giving out meds to 60 patients whom I did not know much about, worrying that the Sched 8 drugs were doing their job, but as most of them were not communicative, I could not tell. Walking off after the shift knowing full well there was more to do. Were they all lying there silently screaming and insane? 

I didn't last very long as I would arrive home utterly exhausted, and no satisfaction at having completed a 'good' shift.  I (sadly) resigned ..."

Complaints investigation and staffing are just two of the many issues that must be dealt with by the Inquiry, 'Caring for Older Australians', currently with the Productivity Commission. There are 482 submissions listed on the Commission’s web site and many make disturbing reading.

So it might be a good idea to wait until the Productivity Commission comes up with its good ideas and see whether the Government actually implements them before we start boasting about the best aged-care system in the world.