Aged Care Royal Commission: now for the real reform!

Article published 24 February 2021

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THE Aged Care Royal Commission’s final report will include many of Counsel Assisting’s recommendations to the two Commissioners.

One issue on which the two Commissioners were at odds was whether there should be a new, statutory agency to be the aged care regulator, or whether the Department of Health should continue to regulate aged care.

From the Department of Health’s response to Counsel Assisting’s recommendations, it’s clear that the Department considers that it should continue in this role, although its track record is woeful.

In its response, the Department of Health was at pains to point out that theirs was a departmental response, not a Government response.  It seems very unlikely, however, that the Department wouldn’t have checked with its Minister prior to lodging this response.

So, its Minister also seems to be of the view that the Department of Health should continue to regulate aged care.

The Department’s responses to each of Counsel Assisting’s 124 recommendations tell a grim story of disagreement with the Royal Commission. The Department supports only eight recommendations entirely, does not at all support thirteen recommendations, has mixed feelings about twelve recommendations (support, not support, support in principle) and supports the vast majority (91) in principle only.

Supporting ‘in principle’ is a bit like saying “glad you could make it” to someone who turns up to a black-tie event in a Hawaiian shirt.

However, on the important issue of nursing home staffing, the Department (and therefore the Government) agree that there should be mandatory staffing levels in nursing homes. Both agree that it should not be a case of so many nurses to so many residents, but that staffing should vary according to the care needs of residents in a particular facility.

There seems to be agreement on case-mix funding based on care needs. Tied to this will be a staff time and skills requirement, and the Department of Health is already well-advanced with the development of this case-mix model.

Unfortunately, the Department only supports ‘in principle’ the recommendation by Counsel Assisting that the Home Care Package (HCP) waiting list should be cleared by the end of this year. It may be a tall order, but the Department seems to think the Government is doing enough by releasing arguably large numbers of HCPs without a plan or a timetable.

A response like that is proof positive that the Department of Health should be replaced with a dedicated agency as the aged care regulator, as happened when a disability care regulator had to be found.

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