industry & reform
No second prize
Does the health department deserve a second chance to fix aged care ?
Jo Ibrahim interviewed by Conor Burke
We are still largely in the dark on how the government might seek to change the aged care sector following the release of the final report from the aged care royal commission in early March .
Professor Jo Ibrahim , the Head of the Health Law and Ageing Research Unit at the Department of Forensic Medicine , Monash University , joined Aged Care Insite to look at the report .
We discussed a potential new aged care act , the two systems of governance proposed in the report and whether the health department deserves a second chance .
ACI : The first recommendation in the final report is that there be a new aged care Act . Is this more than just a symbolic thing , and in what ways would this help ? I think it ’ s important to understand that a new act is a new set of rules . And although people find legislation and formulation of law quite boring and don ’ t feel that it contributes to their day to day life , it ’ s a profound shift to set a new rule book . The question we always have to consider is , will the rule book change enough ? And will it focus on the things that need to be addressed ?
The 1997 Act is now 24 years old and was formulated presumably in the early nineties . So in reality , the existing act reflects the culture and knowledge of the world as it was in 1990 . So it is really out of date .
The current Act doesn ’ t really address the issue of evidence-based practice , it doesn ’ t include any of the notions that we now understand about systems of care , how you organise care , quality and safety and the science behind teamwork , organisational culture , the nature of dementia and knowledge around that which has advanced substantially . The issues of elder abuse really came to the fore in the mid-2000s . So again , all of these things have occurred since the original Act was written .
The other thing is now we know that the 1997 Act brought to us a Royal Commission that said we ’ ve got an awful system of aged care in place . So it ’ s critical that it ’ s revised and we start from a blank slate essentially . And one of the key things with the Royal Commission is to have the focus of the Act on the resident and recognising that the resident has rights .
The 1997 Act was far more corporate in that it was focusing on the relationship between the funder or the government and the provider and the owners ; the resident was really a by-product and didn ’ t get the attention nor the direct confirmation that they have rights , and that those rights should be respected and if you don ’ t there will be consequences .
If aged care is going to change , the starting place is obviously with a new set of rules that we agree on that protect the rights of older people . That ’ s clearly articulated in the recommendation . Item 3B is about protecting and advancing the rights of older people to be free from mistreatment , neglect and harm from poor quality or unsafe care , and to continue to enjoy the rights accessible to members of society in general . I think that really nails the issue about the discrimination that ’ s occurred against people in residential aged care over the last 20 years .
We need to be very vigilant . When you ’ re writing a rule book , you want to have a close eye on what ’ s being written , what ’ s being included , what ’ s being left out and not to be fooled or bluffed by the government or parliament . We want a new Act but we want a specific type of Act , and we want specific conditions and terms written into it . We don ’ t just want them to revamp and keep the ideas that are antiquated and haven ’ t worked .
A major part of the report itself was the two systems of governance that have been put forward . Commissioner Pagone recommends an independent commission with greater independence from the government and the separate institutions . Commissioner Briggs basically recommends keeping the current institutions , but reforming them . What are your initial thoughts on these two options ? The first thing I ’ d say is it ’ s incredibly disappointing that the commissioners provided two differing opinions . I think that doesn ’ t provide guidance , and it allows the government to dismiss both and come in with a third option . The lived experience
12 agedcareinsite . com . au