industry & policy
Vital independent streak
Rae Lamb
Some good news, for a change. According to the first report by the Aged Care Complaints Commissioner, complaints about aged care have risen substantially over the first six months of this year.
How is this good news, you ask? Because it shows that the public is willing to trust an independent commissioner.
There seems to be less reluctance to lodge an official complaint than there was previously, when complaints were handled directly by the Department of Health. At least this is what the complaints commissioner, Rae Lamb, and the minister for health, Susan Ley, suggest as a likely explanation for the rise in complaints over the first six months of the commissioner’ s operation.
If this is not the case, then the 11 per cent increase in complaints over the same period a year ago could only indicate that the system is getting worse, rather than better. If that’ s the case, then an independent commissioner is even more important.
The great majority of the complaints
The Aged Care Complaints Commissioner is off and running; maintaining the public’ s trust in the office will require unbiased reviews.
By Michael Fine about aged care in 2016, 81 per cent, related to residential care. A surprisingly high proportion, 13 per cent, concerned home care packages. Of the remainder, 5 per cent were about Commonwealth Home Support Program( CHSP) services and the remaining 1 per cent were about other flexible and community care services.
A worrying trend is the rise in the proportion of complaints about homedelivered services. Since the introduction of Consumer Directed Care( CDC), both the absolute number and proportion of complaints has risen – from 12 per cent in 2015 to 18 per cent of the larger total in 2016.
Given these trends, it should be a real concern for staff and consumers, as well as all policymakers, that the long-awaited Legislated Review of Aged Care reforms since 2012 is to be headed by a commissioner, David Tune, who already chairs the committee responsible for recommending the very changes being reviewed.
The legislated review has been planned since the release of the Living Longer,
Living Better reforms in 2012. These promised a comprehensive review of changes after five years to inform ongoing reforms to the sector.
Tune, listed as the independent chair of the Aged Care Sector Committee( ACSC), is an eminent public servant with an outstanding record that includes previous service as secretary of the Department of Finance and senior positions in the Department of Prime Minister and Cabinet, and Treasury. It is quite appropriate that he chair the ACSC committee. However, a problem, which some may consider a potential conflict of interest, arose when he was appointed to review the changes he was responsible for recommending as chair of the ACSC. It is also of concern that his appointment to head the review was immediately endorsed publicly by members of that powerful committee.
The independence of those responsible for major reviews of reforms in aged care in the past was always regarded as essential to the credibility of the results and the adoption of ongoing reforms.
These concerns are heightened by the importance being placed on the upcoming review in light of emerging data. Research published in the UK and elsewhere shows that many of the changes we are adopting in Australia have not led to the improvements promised by their advocates but to financial and operational problems for government and decreased access for consumers – especially those from low-income groups.
Just recently, for example, a new report, Social Care for Older People, Home Truths, released by the independent but normally conservative Kings Fund in the UK, pointed to the growth of alarming problems with the provision of aged care that it linked to reforms that are remarkably similar to that currently set out in Australia by the ACSC’ s Road Map. Similar problems have emerged elsewhere, including in the Netherlands, where marketisation of services and the move towards giving consumers personalised budgets in place of services has led not to savings but to massive cost blow-outs, requiring painful budgetary cuts by the Dutch Government.
We must think hard about the value of independence in the one chance there is for a review of the most important reforms to aged-care services in a generation. ■
Michael Fine is an adjunct professor at Macquarie University.
12 agedcareinsite. com. au