industry & reform and the nature of who the Commissioners are I think goes some way to explaining why they have opted for what looked like two diametrically opposed approaches .
Commissioner Pagone : a federal court judge , a lawyer focused on an expertise in taxation . Commissioner Briggs : a health bureaucrat . So you see the legal mindset about having an independent group that has a specific rule book and direct duties where there can be no ambiguity or confusion , which is in a sense the legal approach . The health approach is in a sense more flexible , but sometimes with that flexibility you lose accountability and you get the crossover or leakage in terms of where the boundaries are .
I take it that Commissioner Pagone has lost faith in the health department and the government to manage aged care given the history of the multiple inquiries over the last two decades , and the failure to advance or improve aged care . I certainly fall within that mode of thinking that the system that we had has failed us .
Commissioner Briggs is saying that the health department deserves a second chance . I ’ m not really in favour of a second chance given they ’ ve probably had 18 chances now , if you count the number of inquiries without significant changes to aged care , and I ’ m not sure what changes could occur within the health department that would guarantee the sort of changes that are needed .
Each has chosen an approach and each approach has its limitations . If we give the health department a second chance , the thing we must remember is that health spending is about 10 times greater than for aged care . So aged care is always going to be the little brother or the orphan when there are issues to do with how funding is allocated , how decisions are made . For every one aged care bureaucrat you ’ re likely to have nine healthcare bureaucrats . So getting anything done in aged care is always going to be a struggle in that huge structure .
Commissioner Pagone ’ s idea of moving to an independent group sounds great until you think about the practicalities of how you ’ re going to make that happen . Where are you going to get the people to staff that ? And are you going to draw the people from the existing bureaucracy within Canberra and within the existing health and aged care groups ? The idea on paper I think looks great , but when you translate it , are you simply going to move the current workforce in the departments across to this new organisation and do they bring with them innovation and accountability ?
Is Commissioner Briggs just being a pragmatist ? Maybe it will be quicker to work within the existing system . Anytime we ’ ve become pragmatic means that we ’ re compromising . And so the question here is , should we compromise , or what do we gain by compromising ? I don ’ t think there are sufficient gains to simply say we should compromise because Commissioner Briggs ’ model doesn ’ t provide a level of reassurance that the health department is going to profoundly reform or deliver .
“ If we want
something badly enough , and if we think it ’ s important , we can actually do it and do it quickly .
When we want something in our own lives and when government wants to do something , stuff can happen pretty damn quickly . People are slow to change and slow to do things when they don ’ t really want something to happen . In no time at all , the government found $ 200 billion for JobSeeker , JobKeeper , and that was rolled out quick smart .
So if we want something badly enough , and if we think it ’ s important enough , we can actually do it and do it quickly . So Commissioner Pagone ’ s model is eminently doable , but there were some other issues around when you start to turn the theory into practice . Do you hold onto the core or the heart of what it is that he has in mind ?
What the report doesn ’ t address is the cultural workplace failings that lead to the lack of accountability and lack of performance in aged care . And if the commissioners had said that aged care can stay within the Commonwealth , but these are the fundamental problems and need to be redressed , then I think you might ’ ve had a workable solution .
What we have here is an all or nothing response where Commissioner Pagone has completely lost faith and gone for independence and Commissioner Briggs has been forgiving and hoping things will be better : but neither truly address the fundamental that the way bureaucracy operates does not give us confidence in delivering what ’ s needed for residents .
The notion I think they ’ ve both agreed on in having an inspector general is in a sense having a strengthened auditing office . The Australian National Auditing Office could have been given a much bigger role to oversight aged care as an independent group to make sure that both commissioner ’ s models actually deliver .
Since the final report the prime minister and government have had their hands full with sex scandals and gender politics . Do you expect that we ’ re really going to get some answers , some real idea of where it ’ s going to go by the May Budget ? I think the issues that the government face now are symptomatic of government , not unique to this current parliament . But what we see is a culture that does not respect people , that is not accountable to the taxpayer . There ’ s a lack of accountability , there is absolutely no transparency and there ’ s no respect for others .
They ’ re the fundamental things that have led to aged care becoming as dysfunctional as it has . So I ’ d be surprised if they come up with a preferred model . I think that the government will just quietly keep going with the health department . I don ’ t see them wishing to fund a separate organisation . They also have the other issue to sort out with the future funding of aged care . And so there ’ s division there . There ’ s a number of things that are immediately doable . In terms of the core issues raised by the Royal Commission , the government can certainly get underway immediately a review and rewriting of the Act as well as a number of other initiatives to do with staff training , salaries , education review of quality standards , a number of things that could start without having to determine who ’ s oversighting it .
If we wait until the government decides who ’ s going to be leading this , then I think that will slow it down and there ’ ll be an enormous debate because clearly the commissioners didn ’ t resolve it . And that was the job that they were paid and commissioned to do , to come up with ideas .
They spent months , they had a team of in excess of 50 staff , they had submissions and experts to draw upon and they came down on a split decision . ■
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