industry & policy
The royal treatment
Government set to scrutinise
aged care sector.
Joseph Ibrahim interviewed
by Conor Burke
T
he announcement that the
government will establish a royal
commission into the aged care
sector has brought the treatment our elder
Australians face into the national spotlight.
But Prime Minister Scott Morrison and
Aged Care Minister Ken Wyatt have come
under intense scrutiny over the timing
of the announcement. Some see it as
a pre‑emptive strike before the ABC’s
Four Corners report into the sector.
Morrison allegedly cut $1.2 billion of
funding from aged care when he served as
treasurer, and Wyatt previously insisted that
a royal commission was not needed.
With an election slated for later this year
or early next, Morrison will be keen to see
this issue dealt with, while the sector is
keen to see the planned reforms go ahead
unimpeded by the commission.
When approached by Aged Care
Insite, Wyatt said:
“Following intensified policing and
inspections of the sector in the past
year, information has come to light
14 agedcareinsite.com.au
in recent weeks through the Aged
Care Complaints Commissioner, the
Australian Aged Care Quality Agency
and the Department of Health that
makes the case for a royal commission
into the sector compelling.
For instance, findings of serious risk
against service providers have risen by
177 per cent over the past year.
Referrals to the Australian Aged
Care Quality Agency have risen
188 per cent over the past year, and
non-compliance notices are up by
185 per cent. The royal commission
will get to the bottom of what is going
on. While the royal commission goes
about its vital work, the government’s
unprecedented aged care reform
agenda will continue.”
Aged Care Guild chief executive Matthew
Richter believes the royal commission will
“stimulate action and contribute to a shift
in the Australian political and social ethos
toward ageing”.
“Successive governments have conducted
numerous reviews into aged care over the
past decade. The issues are well known,
and many of the answers are already on
the table, but comprehensive action by
government has not been forthcoming to
deal with the fundamental instability facing
this important sector,” Richter said.
Benetas chief executive Sandra Hills
welcomed the royal commission with a
somewhat cautious tone, asking whether
the commission would achieve the
outcomes sought.
“Will it achieve clarity on how older
Australians can be confident they will
receive the quality of care they deserve and
address funding sustainability once and for
all? Will it determine how we, as a society,
can alleviate the concerns that residents
and families continue to raise?”
Professor Joseph Ibrahim of
the Health Law and Ageing Research
Unit, Department of Forensic Medicine
at Monash University, is surprised by the
move and believes that this could have
been avoided if previous warnings were
heeded by successive governments.
In a 2017 study, entitled Premature
Deaths of Nursing Home Residents: An
Epidemiological Analysis, Ibrahim and his
co-authors concluded that:
“The incidence of premature and
potentially preventable deaths of
nursing home residents has increased
over the past decade. A national policy
framework is needed to reduce the
incidence of premature deaths among
Australians living in nursing homes.”
The report looked at deaths in accredited
nursing homes that were reported to
coroners over a 13-year period and were
judged to have resulted from external or
non-natural causes.
They found that “of 21,672 deaths
of nursing home residents, 3289
(15.2 per cent) resulted from external
causes. The most frequent mechanisms of
death were falls (2679 cases, 81.5 per cent),
choking (261 cases, 7.9 per cent) and
suicide (146 cases, 4.4 per cent)”.
Although Ibrahim et al found
transparency to be a great impediment
to finding a true reflection of preventable
deaths in aged care, they were confident
their data challenges “the misperception
that all deaths of frail, older persons with
multiple comorbidities living in residential
care are natural”.
Ibrahim spoke with Aged Care Insite to
discuss the royal commission and the
problems facing the sector.
ACI: With the news from Canberra that
there’ll be a royal commission into the
aged care sector, how have we found
ourselves at this point?
JI: There’ve been a number of inquiries
over the past two years and certainly
over the last decade, and so the issues
confronting aged care are well known and
well publicised. I was surprised that a royal
commission is being called, as I expected
more action was possible with what we
already know now.
I think the benefit of a royal commission
is that it gives us all a chance to work out
exactly what the issues are, how to address
them, and to make sure that we plan ahead