Aged Care Insite Issue 123 February-March 2021 | Page 5

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Two for the price of one

Photo : Jenny Evans / Getty images
The royal commission numbers game shows there is still work to do .
By Conor Burke

The final report from The Royal

Commission into Aged Care
Quality and Safety , titled Care , Dignity and Respect , has been a long time coming . Established way back on 8 October 2018 , the commission was extended once due to the scale of the task at hand and then again due to the impact of COVID-19 .
It has been a commission of significant numbers – 125 weeks of harrowing , horrible testimony ; or 2 years , 4 months and 24 days . It lasted 745 days from the first hearing to the last .
There were 23 public hearings and 20 research papers , 10,574 submissions , 641 witnesses were heard and there were 6800 telephone calls made to the commission ’ s information line .
There has been one interim report and one special COVID-19 report , put together by three royal commissioners , but finally , as these numbers have boiled and blipped away slowly for the last two years , we are left with a thick royal commission report – five volumes , 2,828-pages long and containing 148 recommendations for a way to finally fix this mess .
The recommendations include a new aged care act , which enshrines the rights of older people and provides a universal entitlement for high quality and safe care based on assessed need .
The commission also suggests that a new governing body that is “ independent of Ministerial direction ” be implemented . An independent , dedicated statutory body should be established as system governor , administrator and regulator , called the Australian Aged Care Commission .
A new role of ‘ Inspector-General of Aged Care ’ is also recommended . This independent role will be to identify and investigate systemic issues in the provision or regulation of aged care , to make and publish reports of its findings , and to make recommendations to the System Governor and the Minister .
Workforce recommendations include increasing award wages for aged care workers and professionalising the workforce through changes to education , training , labour conditions and career progression .
It is also recommended that personal care workers be subject to registration which includes a mandatory minimum qualification of a Certificate III and criminal history screening .

The differences between us may add to the strength of the reforms which are to be made .
Minimum staff time should be standard for residential care , with registered nurses , enrolled nurses and personal care workers for each resident , and at least one registered nurse on site at all times .
The commissioners also want the current home care package wait list cleared by the end of the year , and to keep it clear by allocating a home care package at the approved level to any new entrants to the waiting list within one month of their assessment .
TWO FOR ONE DEAL Another quirk of this particular numbers game is that the government essentially got two reports for the price of one .
The commissioners agreed that for too long the focus has been on the funding of providers and not on the needs of older people . But there were many areas where they disagreed , and the report is divided into two sets of recommendations in a number of cases .
“ We have agreed , with some misgivings and not without anxious consideration , to make some separate recommendations and to express different views where we diverge . But we both strongly conclude that fundamental change is needed . In the end , the differences between us may add to the strength of the reforms which are to be made ,” said chair of the Royal Commission , commissioner Tony Pagone , in his preface .
This divergence of opinion was hinted at during the final hearing late last year when commissioner Briggs appeared to attack the recommendations of the counsels assisting midway through the hearing .
It was a rare insight into the thoughts of the commissioner , made more revealing when commissioner Pagone disagreed with his colleague , appearing to walk back her comments .
It is too early to know how this divided report might affect the process of instituting sector-wide change , but it ’ s a fair guess that it won ’ t make the government ’ s decisions any easier .
“ It ’ s real ,” Prime Minister Scott Morrison said when asked about the disagreement between commissioners . The report is complex , much like the problem and the world , he said .
Discussion will now continue about how much money is enough to fund the sector , how long should it take , and much more . But the most important number when discussing aged care is impossible to calculate . The innumerable residents , victims , families and friends that have been impacted by what has been described as “ a cruel and harmful system ” should never be forgotten as we try and forge a safer future .
At his press conference Morrison said “ he is committed to dealing with the issues that will test all of us ,” but the royal commission has provided a very important roadmap , which will help establish generational change .
Perhaps now , with this report in hand , aged care and the people in it will finally be more than just numbers on a page . ■
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