Bring on the royal commission, but we have a plan to act on aged care right now

There has been no shortage of inquiries into the aged care system over the past few decades. That shocking systemic problems of neglect and abuse remain, as revealed by the ABC’s recent Four Corners expose, highlights the failure of government and industry to act on the recommendations arising from these investigations.

We can only be optimistic that the royal commission into the quality and safety of aged care will help change that. A royal commission will capture the public consciousness in a way other inquiries have not. It will document hundreds, if not thousands, of individual stories. Its proceedings will lead to extensive media coverage, and invite a national conversation. Its recommendations should prove harder for governments to shelve.

But there is no reason for government and industry to wait years for the royal commission to hand down a report. They can act now to make real progress, based on what we know already.

Read more: We've had 20 aged care reviews in 20 years – will the royal commission be any different?^[1]

Three months ago the Aged Care Workforce Strategy Taskforce, which I chaired, delivered its report on ways to improve aged care^[2]. Based on listening to thousands of people throughout the aged-care sector over nine months, our report outlines 14 areas for action^[3] to support Australia’s aged care workforce in their essential role of caring for some of the frailest, most vulnerable members of society.

There is no need to wait on making the changes our report recommends.

By acting immediately, meaningful strategic reform can be implemented within the next three years. It can make a real difference to the quality of aged care well before the royal commission has completed its work.

Fragmented industry needs a unifying code

The aged care industry is fragmented, made up predominantly of small to medium enterprises spread across community, home and residential care settings. It relies on a diverse workforce under pressure from rising expectations and other changes much outside its direct control.

Read more: Aussies are getting older, and the health workforce needs training to reflect it^[4]

Our report’s central recommendation is the need for the aged care industry to embrace a voluntary code of practice. This code can help focus the minds of care providers on standards, workforce practices and commitments to quality and safety. This in turn will focus attention on the need to attract and retain committed, high-quality staff.

We are pleased the industry has embraced this idea. Industry leaders have also supported initiatives to improve the skills and qualifications the industry demands of its workers.

There is a need for the education and training sector to get on board, ensuring graduates have the skills and knowledge that support safe, quality care.

We need a holistic approach to care

One important finding from our investigation is that those in care, and their families, want a more holistic approach to caring. What they don’t want is narrow “clinical” care, one that treats mental health with a pill or judges a meal just on its calories. Well-designed care needs to consider all aspects of health, as well as cultural needs and aspirations around “living well”.

Read more: How our residential aged-care system doesn't care about older people's emotional needs^[5]

There are clear funding implications. To provide holistic care requires changing how money is spent, as well as how much.

Simply stated, as a society we have been short-changing the elderly.

That is why our first recommendation is the need for a concerted social change campaign to reframe caring and promote the importance of aged care as a work vocation.

As the report notes, shifting negative attitudes towards ageing, the elderly, death and dying is a social challenge:

It begins with understanding that care for older people is broader than organised, professional care. These factors contribute to the perception that aged care is not a career of first choice. The opportunities that ageing and aged care present in terms of employment, research, contribution to the economy and as a driver for innovation also go largely unrecognised.

The spotlight the royal commission will place on aged care should help provoke some serious social soul searching. We need a national conversation about our attitudes to ageing. We need to recognise the problems besetting the industry are but a subset of a wider attitudinal problem that has undervalued the elderly.

But the royal commission must not be used as an excuse to procrastinate. There are actions now we know we can take. We should take them.

References

1. ^{^} We've had 20 aged care reviews in 20 years – will the royal commission be any different? (theconversation.com)
2. ^{^} its report on ways to improve aged care (agedcare.health.gov.au)
3. ^{^} 14 areas for action (agedcare.health.gov.au)
4. ^{^} Aussies are getting older, and the health workforce needs training to reflect it (theconversation.com)
5. ^{^} How our residential aged-care system doesn't care about older people's emotional needs (theconversation.com)