Articles

Response to Consultation on the draft of the new Aged Care Act (2024)

Submission to Department of Health and Aged Care by Aged Care Crisis (ACC)

Introduction

In response to the Royal Commission into aged care’s final report in 2021, government has been developing a new aged care act. It has also developed what it considers to be a new model for regulating aged care. It has supported extensive community discussions, explaining the nature of these reforms. We worry that they are more interested in selling the changes wanted by government than in addressing the challenging problems in the system.

During 2023, Aged Care Crisis engaged with several other advocacy groups discussing the proposed reforms including this new act. Many have some concerns about what is being done. While smaller than most ACC has been studying this complex system in greater depth and for longer than most.

In 1999 the government were supplied with information by an ACC member. These showed that the policies based on the free-market ideology (Neoliberalism) that was sweeping the world and had been applied to aged care in 1997 had already failed in the USA where serious problems had developed. ACC was formed in 2005 after these same problems developed in Australia. 

It has been describing these problems and pressing for the system to be reformed ever since but flawed ideologies are always deeply resistant to evidence and challenge. Many others are now calling for these issues to be addressed. Our 2024 submission specifically addresses these problems.

Submission in response to the Department of Health Consultation Paper No. 2:
A new model for regulating aged care, June 2023

Background to Aged Care Crisis (ACC) Submission
Some background information will be helpful in assessing our submission.

Regulatory changes and ever more complex regulatory processes can have adverse consequences and much of that burden can fall on already stressed and over-worked staff. Change needs to be introduced incrementally and commenced in regions. Its consequences should be carefully monitored. That has not been happening.

As the Royal Commission has so clearly demonstrated, the free-market model of care has failed staff and residents. The complex reforms recommended and government action make no fundamental changes to this market model. Governments continue to marketise those sections like home care where vestiges of community-led care remain. 

The huge uncertainties and the complex changes being made are driving some of the smaller providers out of the aged care sector. They have a low staff turnover and provide better more person-centred and relationship-based care.

Introduction

In a recent webinar from the Long Term Care Community Coalition in the USA titled How Fear of Retaliation Scares Residents Into Silence  (18 Apr 2023), Eilon Caspi described his detailed research into this problem. He shows just how widespread the problem of retribution when residents complain has become in the USA. This is a valuable and important contribution. He calls for more research, education, regulation and protection of residents. He described the way the industry rejects these sorts of finding and resists regulatory efforts.

While the Royal Commission into aged care made some useful recommendations, Aged Care Crisis has been very concerned at the matters they failed to address. These are issues within our society and our political system that impact on aged care and the many other sectors that have failed. 

Our experience, our research and our analysis indicates that they were the reasons why the aged care system has failed repeatedly and so badly. This analysis also shows why policy failures like this are so resistant to change and why the failures in aged care and similar sectors keep recurring in spite of attempts to make changes.

We have been even more concerned by the response of government and industry who seem to be denying their responsibility for what the Royal Commission found to be “a sad and shocking system that diminishes Australia as a nation”. They are pursuing the same policies and behaving in exactly the same way as they did before. They have appointed and commissioned the same people from industry to advise and work with them.

We became aware of another consultation 'Aligning Regulation across Care and Support Sector' by the Department of Health and discovered that they were conducting it in exactly the same restrictive way they have done in the past. This restricts criticism and prevents other parties from seeing the criticisms that others are making. Nothing seems to have changed.

We have therefore decided to set out the result of our experience, research and analysis (PDF658.67 KB). This explains what has been happening and indicates what needs to be done to create a context where we can address the difficult problems that develop in the complex world we live in more sensibly in the hope that some will find it informative and useful.