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.

Civil society, Government and Markets: In traditional capitalist democracies civil society develops and fosters responsible individuals and societies based on community values like altruism. It is the driving and controlling force setting the limits of acceptable conduct within the market and government.

It protects the freedom of individuals while restraining them from harming others or society. Special care is taken to ensure that only those who can be trusted are permitted to care for the vulnerable. Government serves society, legislating and regulating in order to support it in controlling unacceptable behaviour by markets and individuals.

The erosion of society and the ascendancy of markets since the 1980s

A new pattern of thinking called neoliberalism, economic rationalism or free markets has radically altered the way our societies have organized and operated over the last 30 to 40 years. We have seen the ascendancy of markets and market thinking that places competing self-interest above cooperative responsibility. This has been accompanied by the decline and marginalization of civil society and government. Previous knowledge and insights were ignored.

Communal civil society values and responsibilities have been undermined by free market philosophy. They have become subservient to competition and the self-interest it generates. 

Government have aligned themselves with the market and represent them rather than citizens who are increasingly treated like customers. We can see this as the root cause, the social disease, responsible for many of the failures we are witnessing.

Health care – an example we can follow: Health and aged care in the USA soon became victims. Doctors were tied into a complex system of contracts and trapped in the system. While one of the most expensive in the world both sectors have been victims of widespread fraud and the exploitation of patients for profit. Many have been harmed rather than helped.

Australian doctors became aware of what was happening in the USA in the 1990s. When their warnings were ignored they united and resisted government attempts to force them into similar contracts to those in the USA. They then used their market power to put companies that behaved in this way out of business. While healthcare has been affected by these policies it could have been very much worse.

Warnings about aged care in Australia were ignored. Doctors had no power in aged care and it has born the full brunt of these policies. Over the last 20 years it has deteriorated far more that the USA. Far more neglect and abuse has occurred than in the USA.

The lesson from this is that we need a rebuilt civil society that reclaims the power it actually has in a democracy. It should then use that power to set the limits of acceptable conduct in aged care, allow only those who are trustworthy to provide care and put those who are not out of business.

The structure of the new system

Civil society, once the bedrock of our democracy and the protector of our rights was bizarrely seen as a threat to both our democracy and our rights as individuals. As a potential threat it has been managed and manipulated by government and industry. 

Social scientists in the 1990s described the adverse impact of these policies on society but their warnings were ignored. We are paying a huge but unrecognised price as the social bonds and trusting relationships that are so important for fulfilled and well lived lives have broken down. 

Governments have been tamed and made subservient to free market beliefs. Instead of governing it delegates to and depends on advice from the market. The market is ascendant and credibility in society is based on conformance with market beliefs and financial success.

Many are now aware of the problems: Groups that examine society and democracy have been alarmed at the impact, particularly on our democracy. In seeking reform they have used terms like deliberative democracy, participatory democracy, neighbourhood democracy, and open democracy.

Over the years groups of concerned citizens, who realise the vital role that civil society and the communities that comprise it should play, have continued to advocate for change. There are groups in the USA, the UK, Australia and more widely that recognise the value of the social capital developed within civil society for individuals, for society and the importance of this for our democracy. 

Understanding the Royal Commissioners and their report

People who believe in a one size fits all ideology like this and build their lives using these ideas, find it very difficult and sometimes impossible to challenge them and accept that they are flawed. There are a range of psychological strategies including willful blindness and strategic ignorance that believers use to protect themselves from confronting the consequences of their actions and so protect the beliefs.

The Commissioners appointed by government have all spent their lives and their careers working within the current marketplace belief systems. To understand their report and the decisions made as well as their omissions, we need to understand their backgrounds.