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Aged care regulator should be scrapped, LIV told

Aged care regulator should be scrapped, LIV told

By Karin Derkley

Aged Persons 

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The Aged Care Quality and Safety Commission is fundamentally unfit for purpose and should be scrapped, a recent LIV webinar on elder law was told.

What is needed is an independent commission and inspector general that reports to Parliament rather than the minister, Queensland University of Technology aged care commentator Associate Professor Sarah Holland-Batt GAICD said at the LIV's Recent Developments in Elder Law webinar.

There is an undesirable degree of "cosiness" between the regulator, the government, and the Department of Health that destroys the confidence of residents and their families, she said. "The Commission should be independent and have independent powers – because even the appearance of cosiness is enough to destroy people's confidence."

Ms Holland-Batt spoke at the webinar of her experience fighting for justice for her father who was abused and neglected in a federally run aged care facility. Her father had been "let down tremendously" by the regulator after he experienced "the whole gamut of failures that someone can experience in the system", she said.

"He experienced neglectful and negligent and abusive care from carers, failures in management culture to hold those carers to account, and failures to support whistleblowers within the aged care system."

After the aged care provider had ignored her complaints, the regulator had also failed to independently investigate her complaint, taking the provider's assurances at face value. When she then reported her father’s abuse to police she was told it was a civil law matter – "placing the onus on me to achieve justice for my father at the very same time that we were trying to achieve dignified care for him".

Her father as well as other aged care residents had been let down by "successive federal governments whose intransigent insistence that we have a world class aged care system in spite of overwhelming evidence to the contrary means crucial reforms that might have helped my father were not implemented over many years", she said.

She criticised the "hands-off market-driven approach" to aged care that ignores the "inconvenient fact that the physical and mental frailty of aged care residents combined with the dearth of public information available about provider performance means aged care so-called customers are precluded from exercising any meaningful choice".

The "foundering" regulatory system and lack of a national plan were particularly exposed during the COVID-19 pandemic this year, when the government actively resisted simple measures that would have improved providers’ capacity to plan for and combat the spread, and failed to ensure a standardised approach to infection control.

The regulatory response was arguably even worse than the government’s, she said, when it allowed providers to self-assess their own readiness for COVID-19 outbreaks. “It wasn't until August that the regulator commenced an infection-control monitoring program. In the meantime residents suffered appalling outcomes."

Last year’s Royal Commission into Aged Care Quality and Safety, at which Ms Holland-Batt testified, proposed many of the same remedies as previous reviews, including public reporting of complaints and investigations, the implementation of a public star-based rating service to track provider performance, increased powers for the complaints commissioner, and the adoption of clear clinical care measures in the assessment and accreditation processes.

"These are fine ideas but ones which have been recommended before in many inquiries. The question is not whether the … recommendations would improve the system, but rather whether they'll be implemented at all, and with the alacrity that the crisis in aged care requires."

Many of the recommendations are not scheduled to be implemented until 2023 or 2024, which means the current cohort of residents and those who follow them for the next two to three years will be subjected to the same substandard conditions that prompted the Royal Commission, she pointed out.

"The paucity and inadequacy of the quality standards at present has been apparent to all and sundry for a very long time," she said. "In my view we cannot afford to kick the can down the road with aged care again, and if the Royal Commission is to make a difference it also must convey the urgency of these undertakings to the government and insist that aged care is pushed further up the government's agenda as an urgent priority."


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