industry & reform
At their core were the world leading Aged Care Assessment processes which helped divert many older people from residential care . This reduced pressure on the services that continued and laid the groundwork for fundamental improvements in service quality and culture by providing alternatives that benefitted many older people who needed care , but had previously received no assistance at all .
Other policy reforms introduced at the time saw the development of costeffective alternatives to residential care through the introduction of the Home and Community Care ( HACC ) program . Unpaid family carers were recognised for the first time . The Carers Pension and other related developments also saw such carers given a voice and included in service planning .
In-service training and other educational programs were introduced to lift the expertise of care staff . Wages increased and conditions improved for staff , if only modestly . And so the list goes on .
History also shows that many of the improvements in the system were subsequently undermined and ignored . Policy changes saw essential system design features broken . They were replaced by simplistic concepts in a race to build a profitable industry that was typically cheered on by many of the industry leaders .
Beginning with the introduction of the Aged Care Act ( 1997 ) and exacerbated by the later shift of all governmental responsibility to the federal level , wellgrounded foundations of good practice were simply eroded .
A second , alternative perspective , that of international comparisons , also provides evidence that we can do much better . It is a sad but telling comparison ( at least for Australians ) to compare the outcomes of policy change in aged care over the past 25 years across the Tasman with those in this country .
Our Kiwi cousins have shown us that things can get better without breaking the national budget . Many other countries , too , have shown us that we can do much better . Now it ’ s our chance to show that we can learn , we can innovate , and we can build .
A great starting point is the early working life experience of the new Aged Care Minister , Anika Wells , who as a law student was employed as a kitchen hand more than 20 years ago in a nursing home and did relief work as a diversional therapist , facilitating recreational programs for the residents . She is reported as saying that : “ It demonstrates that clearly there were staff shortages , even then .”
Systematic change is certainly required in almost every area of aged care . This is not the time for despair . We need to rejoice and get to work . Finally we can start tackling the challenges that need to be met . ■
Michael Fine is Honorary Professor in the School of Social Sciences at Macquarie University .
For nearly 20 years , Aged Care Insite has remained the respected industry journal aimed squarely at the growing number of Australians working in the burgeoning aged care industry .
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