24 September 2010

The Hon Mark Butler MP
Minister for Mental Health and Ageing
Parliament House
Canberra, ACT 2006

Dear Mr Butler, 

Introducing www.agedcarecrisis.com

The team at www.agedcarecrisis.com warmly welcomes you to your new post as Australia's Minister for Mental Health and Ageing and wishes you well as you seek to address the issues facing frail, older Australians. 

The Aged Care Crisis (ACC) team consists of a group of independent advocates who have supported loved family members through the current system of aged care and found it wanting in many respects.  We are proud to be one of the first groups to bring modern technology to assist consumer involvement within the aged-care area.  We receive a high level of feedback through our web site.  Sadly, in spite of the best efforts of many dedicated aged-care staff, we hear stories of neglect or substandard care of residents in aged-care facilities, almost every day.

ACC has played a unique and pivotal role in examining events and trends within the aged-care sector.  We have taken the time and effort to gather scattered information and compile it for critical examination.  We have also analysed the inter-dependencies of the Department of Health and Ageing, the Complaints Investigation Scheme, the Complaints Commissioner and the Aged Care Standards and Accreditation Agency.  We have published articles from the coal face and created a forum where participants can tell of their experiences and comment critically.  We also have an Aged Care Column, a Legal Issues Column and produce a periodic newsletter.

We seek to make a constructive contribution to any efforts to review and reform aged care.  This is evidenced by our submissions to various Commonwealth inquiries, including the current Productivity Commission's Inquiry Caring for Older Australians. 

You are undoubtedly aware of many of the problems encountered by frail older people as they seek support and care towards the end of life, and of the staff who provide the direct care.  Critical issues impacting on the lives of vulnerable older citizens remain unaddressed and there is an urgent need for an overhaul of many aspects of the current system.

We draw your attention to the following specific issues identified as of critical importance:

  • The increasingly low staff/resident ratio currently operating in many aged-care facilities.  For example, it is not at all uncommon for our correspondents to inform us of situations where there is just one staff on duty for 80 residents.  Most people are unaware that such a low staff/resident ratio does not infringe any current regulations.
  • An accreditation scheme that concentrates on processes rather than on measurable adverse events.  Measurable levels of real care (performance) such as bedsores and weight loss are not recorded nor reported publicly.  Instead, the Agency refers to "indicators" and looks at whether processes are in place to prevent and treat these failures in care.  Their success in doing so is neither evaluated nor reported.  While these processes are important for improvement they are not the measures of performance which truly informs regulators, citizens or researchers.
  • A complaints system that is embedded within the same Department that regulates, funds, and sets policies for aged care.  The current complaints scheme, like its predecessors,  is not responsive to residents and their families.
  • The increasing reliance on the market economy for the provision of care to a significant proportion of frail, older Australians, whereby the interests of shareholders is given more significance than concern for the well-being of residents. In particular, the pressures associated with cost cutting are driving many of those staff who seek to provide humanitarian and personal empathic care out of the sector.
  • The community has been promised greater transparency in all spheres of government, but there is little evidence of this within the aged care sector.  ACC asks that there be real transparency, accountability and disclosure in all aspects of aged care.  Aged-care providers receive billions of dollars of taxpayer funding.  There should be full disclosure as to how that money is being spent.

Critically, important questions about transparency include:

  • The absence of information about staff rosters and staff/resident ratios.  This is essential. 
  • The lack of up-front information about accommodation bonds 
  • Why it is possible for a home to breach its responsibilities as an approved provider under the Aged Care Act, and have serious complaints substantiated, yet still avoid any public scrutiny?  As well as providing increased transparency for consumers, such disclosure would undoubtedly encourage improvement in residential aged-care services.

We look forward to working with you to ensure that the voice of frail older people and their families is indeed heard and that high quality care and support is given to all those who live in residential care.  ACC supports greater community involvement and participation in aged care.  The whole community has a stake in a system that cares and protects vulnerable people at the end of life.  One that lurches from crisis to crisis leaves everyone wanting.

ACC is particularly encouraged by comments made by the new Prime Minister, Julia Gillard, in promoting a "more open parliament".  We are hopeful this openness will be extended to consumers of residential aged care and to those staff who seek to support them.