Anglicare Australia has called the Royal Commission into Aged Care Quality and Safety’s October 31 interim report a "wake-up call" for the sector and the country.
Anglicare Australia acting executive director Roland Manderson said: “It’s fitting that the Commissioners have called their report Neglect. It describes a system which can’t assure us that people will be well cared for, valued or respected.
“Worst of all, the problems it faces have been known for years.”
The report states the country's aged care system is "sad and shocking" and calls for immediate action to be taken to support older Australians.
Among other findings, it said there was “widespread over-prescribing, often without clear consent, of drugs which sedate residents, rendering them drowsy and unresponsive to visiting family."
The report also raised the need to stop the flow of younger people with disability going into the aged care system, describing it as a human rights issue.
The Sydney Morning Herald said on October 31 that the report spoke of “about 6000 people under 65 live in residential care in Australia and that number has been ‘relatively unchanged’ for more than a decade."
"Noting that this group included people with disability and people with terminal illness, the royal commission said there was a lack of clarity about who these younger people are and uncertainty about why they are admitted to aged care homes.”
The report said large numbers of people are waiting, in many cases for almost three years, for a home care package in which the government subsidises a service provider to meet the needs of elderly people in their homes.
As of June 2019, the waiting list was 120,000.
"Many people die waiting," the commission said, noting that about 16,000 people passed away while waiting for a package in 2017-18. "We regard this as unacceptable.”
The commission pointed to "shocking evidence" of unacceptable practices in the sector, including inadequate wound management, poor continence management, "dreadful" food, high incidences of assault, the use of physical restraints and sedatives, and patchy and fragmented palliative care.
“It is shameful that such a list can be produced in 21st century Australia,” the report said.
Providers came under fire for not responding adequately to complaints, with evidence suggesting complaints processes are "hard to access, slow to act and often effectively unresponsive."
The report added: "We have heard evidence which suggests that the regulatory regime that is intended to ensure safety and quality of services is unfit for purpose and does not adequately deter poor practices.
“Indeed, it often fails to detect them."
Staffing problems are also severe. Many expressed difficulties finding people who want to work in a sector marked by heavy workloads and poor pay and conditions.
“An aged care workforce which is properly trained, appropriately paid and given the opportunity for professional development will not only provide good care to older people, but also make it easier to attract and retain staff,” the commission report noted.
A survey conducted by unions representing aged care workers — the Health Services Union and United Voice — found 9 out of 10 workers in residential and home care settings do not have enough time to provide the quality of care they think is necessary.
Part of the reason for the poor treatment of staff is that 90% of the 366,000 strong workforce are women and more than a third are migrants.
The report also noted as a fundamental failing the framing of the aged care sector as a "market", in which older people are "customers" who shop around for a service.
“The aged care sector prides itself in being an 'industry' and it behaves like one. This masks the fact that 80% of its funding comes directly from government coffers. Australian taxpayers have every right to expect that a sector so heavily funded by them should be open and fully accountable to the public and seen as a 'service' to them.”
A fundamental source of the current crisis in the sector is the growing privatisation of a significant section of providers. A Tax Justice Network study last year found that just six private, for-profit corporations operate more than 20% of residential aged care beds in Australia.
The disastrous results of privatisation, outsourcing and deregulation in the aged care sector have been further exposed in the commission’s report. The aged care system, along with health care in general, should instead be placed under public ownership and control, and made accessible to the whole community.
A government committed to putting people before profits would end public subsidies to private healthcare providers and redirect funds to boosting the numbers and pay of aged care staff.