The terms of reference for the Royal Commission into Aged Care are broad and fair. The Royal Commission can investigate anything it wants.
Reduced to brief questions, this is what the Commission is looking at:
1) What are the causes of poor quality, abuse and neglect?
(2) How should disability and dementia be managed in aged care?
(3) How is the rising demand for aged care due to the ageing population going to be managed?
(4) Who’s going to pay for better and more care?
(5) How can people receiving care remain in control of their lives?
(6) How can technology help?
So, it’s about quality of care and about money.
Question (1) is very obviously about quality.
Question (2) is about quality and the fact that people with non-age related disabilities get care which is inferior to what they would get under the NDIS.
Question (2) is also about the fact that most nursing homes have no better ways for managing people with dementia than locks, tie-downs and uppers and downers.
Question (5) is also about quality. The vast majority of nursing homes warehouse old people without much regard for the quality of their lives.
Questions (3), (4) and (6) are the money questions.
Question (3) is based on the fact that in 2017 there were 1.7 million people who were older than 75, and that this is steadily rising to a projected 4.1 million in 2047.
Question (4) represents a key term of reference. The actual wording of this term is for the Commission to inquire into “what the Australian Government, aged care industry, Australian families and the wider community can do to strengthen the system of aged care services to ensure that the services provided are of high quality and safe”. Money isn’t mentioned, but money is what it is about.
Question (6) is about technology, which can make care cheaper.
With one term of reference about the past and five about the future, it’s pretty obvious that the Australian Government concedes that the general quality of aged care in Australia is appalling and wants to know how it can be improved and what that will cost.
There is a seventh term of reference and it will be needed. It’s a catch-all “any other matter” term. Not covered in the six other terms of reference are:
(1) The lack of information about the performance and practices of aged care providers and regulators, which is perpetuated by the protected information provisions of the Aged Care Act 1992, essentially exempting the aged care sector from Freedom of Information and other types of external scrutiny.
(2) The complications associated with allowing the accommodation function and care function to be carried out by a single residential care provider, and, similarly, allowing providers to be active in community aged care as well as residential aged care.
CPSA will be making submissions to the Royal Commission.
The Royal Commission will begin immediately, but it will take time before hearings start. These hearings will be across Australia, while the Commission’s offices will be based in Adelaide. An interim report is due by 31 October 2019 and the final report by 30 April 2020.
