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.
Vulnerable people have also been harmed in many other sectors in all these countries. In Australia these other sectors include the banks, financial advice, insurance, job services, Vocational Education and Training (VET system), and more. They have all had their scandals.
The banks are major owners of nursing homes and most nursing staff are educated through the VET system. Those close relationships only compound the cultural problems they all have.
These are all systems that are vulnerable and it is clear that we are dealing with a societal problem. Trying to fix aged care by itself without recognising that is doomed to fail. Government and industry refuse to accept this. The Royal Commission kept its tunnel vision on aged care.
Something like this has happened whenever a vulnerable sector that needs to be accountable to citizens is handed over to a free and unchecked market. As in aged care policymakers have been impervious to failure and never seem to learn.
Companies have not changed their behavior even after paying huge fines. They just cannot accept that they are doing anything wrong. It has made them so successful.
This has been happening for nearly 40 years and yet our political and market leaders are still energetically pursuing the same policies.
Believers in the free market policies responsible also believe that human beings are rational and always make sensible choices. They are the best example of just how false this is.
We are very complex animals living in a complex world and we need to understand ourselves better.
How can this possibly be happening? It can’t be true - or can it?
When you first encounter a situation like this, one of the remarkable things about those responsible for most of these failures is that when you meet them they are often really ‘nice’ people.
They speak well and are sincere. They have no doubts. They are charismatic and convincing in persuading you that they are right. They are authorities in their fields. They have no doubts even when things have gone wrong. They are clearly genuine. The one thing they don’t do is accept that the things they believe in are wrong.
It doesn’t make sense. You cannot believe that they could be responsible for something like this but they are.
Similar things have happened many times over the centuries and when we look back we simply explain it away by calling them evil.
Those who have studied the complexities of human behavior over the last 2-300 years realised that it is good people who so often do the most harm in the world. This is because they believe strongly in something that is not true and as a result does harm. They have built their lives and careers using these beliefs. They simply cannot accept it is not what they expect. It cannot be failing even when it is obvious that it is.
Those who claim it is failing are not believed. Once believers hold power they take control of the collection and dissemination of information. This allows them to select what information is made public and present it in in ways that support what they are doing and does not raise issues. While the beliefs they are supporting may be illusions, their consequences can be frighteningly real for others.
Social scientists have described the strategies humans use in this situation to avoid collecting information, ignore the information and knowledge we already have, and disregard what is happening in front of them This sort of behaviour has been described as ‘Wilful Blindness’ and ‘Strategic Ignorance’.
Because this type of behaviour has become such a problem over recent years, and is so obvious to those who understand it, two books have recently been written about it. Donald Trump is a good example of someone who has relied on these strategies to maintain his view of things but you simply need to look around you to see many more examples.
- Wilful Blindness: Why we ignore the obvious at our peril. by Margaret Heffernan 2011 & 2019
- The Unknowers: How Strategic Ignorance Rules the World by Linsey McGoey 2019
They may be good people but they are still lying
Yes they are lying but, incredible as it sounds, the difference is that they are lying to and deceiving themselves. Once they have done that they can convincingly repeat that lie to us and persuade us too. The lie now rings true in the moment they say it because for them it is true. But deep down within them and at other times they do know it is false and recognise it. This is a strange and complex split personality process, and social scientists struggle to explain it.
This complex process and was first described by philosophers in the early 20th century. They analysed the way we humans build our lives as we grow up interacting with and responding to the social pressures from those around us. The ideas we develop as we grow become central to who we are and our identity. Social scientists built on the insights of those philosophers to understand human development.
It can happen later in life too, particularly when we ‘see the light’ in situations that we find confusing or when a charismatic leader sells us snake oil. We require considerable life experience, training and knowledge to recognise what is happening to us and that has been in short supply for a long time.
Fortunately most of the beliefs we acquire are helpful in turning us into good citizens. At other times they are not only false but harmful. The problem is that in both instances we instinctively defend them when they are citicised. When the beliefs are false those who try to challenge them become targets for ridicule.
Our gut first response is to defend the ideas we believe in and discredit anyone who tries to challenge the things we believe in and do. Whistleblowers are the greatest threat and are targeted.
It is because of these strategies and responses that failed social systems like our aged care system last for so long even when they are clearly harming people and this is glaringly obvious to those who look closely.
This inability to challenge belief explains why the reforms that ‘vested interests’, make when things go wrong don’t work for long. In aged care we have had 31 inquiries and reviews over the last 20 years. All that has happened is that the pieces have been moved about without changing the way the system operates. The same thing has been happening with the Royal Commission although the pieces are bigger.
This is all complex stuff and there are many different ways of looking at what is happening. They shine an additional light on it. In a root cause analysis of aged care we have tried to look at what has happened in multiple different ways. While also complex these throw more light on what has been happening and the way that people behave. Learning and understanding our complexity is a work in progress and we are still struggling to come to grips with the sort of beings we are. It’s not easy.
Once we understand that these are good people who have gone astray we can confront them kindly but very firmly. We will only be able to do that successfully when we, as a society take back the power to force them to confront the lack of evidence and logic in what they are doing and recognise the potential of alternatives. But before we include them they must acknowledge and accept their failures and take responsibility for them.
We must remember how resistant to change they are, make it very clear that this is over and that those who think and behave like this have no place in aged care in our society.
We should welcome back those who acknowledge that their thinking and policies were harmful and who set out to make amends. Many have expertise and as communities we can learn from them. But we need to very carefully evaluate their suggestions.
It was because we ignored this well-known warning, first made by the famous Scottish economist and philosopher, Adam Smith over 2 centuries ago, that we have so many problems in our market today. In writing about the market he said:
“The interest of [businessmen] is always in some respects different from, and even opposite to, that of the public ... The proposal of any new law or regulation of commerce which comes from this order ... ought never to be adopted, till after having been long and carefully examined ... with the most suspicious attention. It comes from an order of men ... who have generally an interest to deceive and even oppress the public.”
Source: Adam Smith: The Wealth of Nations, 1776.
Adam Smith would turn in his grave if he knew that governments advised by economists who claim to follow his advice have taken something as vulnerable as aged care and handed it over to the market.