Articles

Aged care in Australia is not alone. The same policies were introduced in the USA and the UK as well as other countries. Those with experience and knowledge of human behaviour tried hard to warn us that this would not work. They were ignored. The same or very similar adverse consequences have developed in aged care in these countries as well.

Background

Aged care as a wider societal problem: Over the last 30 to 40 years there have been multiple failures in the market, particularly in those where participants are vulnerable and easily exploited. This has occurred in the USA, UK, Australia as well as other countries. Aged care is clearly part of a wider problem which we are not acknowledging. It is simply one of the worst affected.

To understand the significance of the appointment of Butler as Shadow Minister for Ageing, we need to understand two other issues:

  1. There has been a deep divide around the belief and implementation of free markets that has split both major political parties into factions since the late 1970s. This was exemplified by differences in policy between Fraser and Howard, Hawke and Keating, Beazley/Rudd and Gillard, and Turnbull sandwiched between Abbott/Morrison. The second of each paired group followed free market policies more aggressively.
  2. These differences have had a profound influence on aged care policy. On the one hand there are those who see aged care as a market conforming to neoliberal free market and management principles. On the other are those who see aged care as a community service to which the market contributes. The market is required to adopt community values and meet their expectations.

Hawke's attempts to reform aged care during the 1980s were strongly resisted by vested interests and largely abandoned by Keating in the 1990s. In 1997, when Beazley was Labor leader, Senator Gibbs was able to mount a savage and prophetic attack on the Howard government's 1997 free-market aged care policies, predicting that they would fail and explaining why.

In her submission to the Royal Commission which she made public, Senator Fierravanti-Wells has savaged her colleagues in the liberal party and blamed them for the crisis in aged care.  We admire her courage and her integrity in doing so.

As a shadow aged care minister she drafted aged care policy prior to the 2013 election. At Aged Care Crisis we have been very critical of her party's policies, but in her submission she has made proposals that begin to move policy debate in a more sensible direction.  We welcome that.

Accreditation has never been an effective regulator. It has failed in the USA, the UK and Australia.

Accreditation was not designed to be a regulator, was not intended to be a regulator and between 1997 and 2014 the agency insisted it was not a regulator – although everyone else knew it was a central part of the regulation that government and industry boasted of. As the criticisms show accreditation and regulation are incompatible.

Criticism of Senate Report Community Affairs April 2019: "Effectiveness of the Aged Care Quality Assessment and accreditation framework for protecting residents from abuse and poor practices, and ensuring proper clinical and medical care standards are maintained and practiced"