For me, the most defining image from the COVID pandemic is of a dead aged care resident being taken out of Epping Gardens nursing home wrapped in a rug. Seems the budget didn’t stretch to the dignity of a regulation body bag.
On the same day, we saw pictures of just some of the wealth accumulated by the owner of Epping Gardens. A Maserati, a Toorak house which was described by Vogue as a "mansion made for modern-day Greek gods" with a "field-sized" living room and a bathroom filled with the "goddess-worthy relic" of a bath "hewn from single-slab black stone".
Comrades. Our aged care system is broken. It was broken before COVID but the pandemic has shone a light through the cracks.
It was broken by the Howard government who essentially privatised the system and removed the very regulations which ensured aged care residents were well cared for.
We’ve been paying for it ever since – in lost lives and lost dignity.
The 1997 Aged Care Act removed reference to staffing levels and nursing care in residential aged care facilities and didn’t set any minimum requirements.
The following year, the requirement that one registered nurse had to be on duty in a home at all times was removed.
For aged care workers and residents, the concept of ‘safe staffing’ became a nefarious issue, driven by costs, and often profits, not quality care. So called ‘consumer driven’ choice which was supposed to drive quality through competition only drove the advent of fancy accommodation for those who could afford it, with little attention to the care required to keep our elderly safe and well.
During the pandemic, 683 people have died of COVID in aged care facilities. Many died undignified deaths, unable to say goodbye to loved ones, incoherent, dehydrated and confused. Families are traumatised, with a lifetime of good memories tainted by a bad death.
Aged care workers, many of whom contracted the disease themselves, fought to save every life.
Residents died because the Federal Government and the providers they regulate failed them.
The Federal Government and many providers failed to provide enough staff. They failed to ensure there was the right mix of nurses and carers. They failed to provide workers with a secure job or decent pay, so infection spread as workers moved across several facilities. The providers didn’t prioritise workers’ training or qualifications, which meant few were trained in infection control and on the eve of outbreaks in Victoria less than 1 in 5 workers had completed PPE training.
While many providers failed to look after their workers or their residents, the Morrison Government failed to step in, failed to hold them to the regulated standards and failed to heed the warnings of the Royal Commission.
Although the Federal Government spends around $20 billion per year of taxpayer funds on aged care, they require very little explanation from providers about how this money is spent. The Government allows providers to decide whether to spend Government subsidies on incontinence pads and nutritious food for residents or to pay inflated executive salaries and bank the profits. Well paid, secure carers’ jobs or dividends for shareholders? The providers can make that choice.
Don’t take my word for it. Peter Gray QC, counsel assisting the Aged Care Royal Commission found that “there is no specific requirement on residential aged care providers to spend any particular portion of that money on care."
As Rick Morton has reported, since 2015, the three listed aged-care providers have paid out almost half a billion dollars in dividends to their shareholders. Estia has paid $159 million, Regis $157 million and Japara $126.5 million.
As Anthony Albanese said “We have let humanity and dignity become subordinate to the bottom line.”
Then there is the regulator which is supposed to ensure a quality system but has fallen so far short it’s breathtaking. Out of more than 220 nursing homes where coronavirus outbreaks have been reported, only 30 have had inspections by the regulator. Fewer than 10 per cent of homes with outbreaks have been sanctioned by the regulator since the beginning of the pandemic.
The regulator operates on a workforce where nearly 30% are casual or contract, that is top heavy with managerial and executive staff, that does not seem to support its ground workers who do the inspections and write critical reports that are often overturned with no explanation.
The title of the Royal Commission’s interim report was “Neglect". Neglect is not a word that anyone relying on the aged care system wants to hear. Neglect outlines the litany of long-term, systemic problems that this Government has failed to fix during its seven-year term.
Comrades it’s easy to look at the aged care system and see a system which is too big to fail, yet too hard to reform. It’s not.
The most crucial thing to fix is the workforce issue. We need more staff and the right skill mix in nursing homes. They need the time to care for the elderly who they respect and often come to adore. Labor leader Anthony Albanese is the first leader in a long time to put aged care firmly on the national agenda by releasing an 8 point plan. His plan leads with minimum staffing levels for residential aged care.
Everything else follows.
Looking beyond the crisis, we need to re-envisage aged care, developing a system where there are supports for every stage of ageing. I want to age at home and I’m sure you do too. That means uncapping the home care package list, developing ‘nanny’ creches for daily respite, so families can stay together, revisiting retirement village development without exploitative real estate plans. When residential aged care is the only option remaining, our elderly should receive the dignity, safety, respect and high level healthcare they deserve.
Aged care has become the major issue it should be in the public domain. The Morrison Government must be held accountable for its failings at the next election. The Labor party must continue to stand up and fight for the workforce, for quality care and for a system we can be proud of.
We must make aged care an election issue. What do we do? Stand up fight back!