SPECIAL REPORT
Royal Commission
Roadmap for reform
Care and respect WELCOME to our special report on the findings and recommendations of the Royal Commission into Aged Care Quality and Safety. Like you, we have been eagerly awaiting the release of the report we now know as Care, Dignity and Respect. Inside you’ll find a summary of the recommendations including a timeline for implementation of many of the proposals. You will also find reports on the differing governance, financing and funding pathways put forward by the commissioners and how much stakeholders think the reforms will cost. There’s also a story about the responses from provider and consumer groups – including the recommendations they say should be prioritised – and the interim response from Government. Stay tuned for next issue when we cover the Government’s full response expected in the May Federal Budget. Until then,
Natasha Egan Australian Ageing Agenda Editor Tel: 02 8586 6132 Email: negan@intermedia.com.au
Contents 2 A total overhaul 3 Timeline for change 5 They said it 6 Technology implications of the royal commission 8 Digital transformation is real, achievable and necessary 10 Pathways to reform 12 How much will it cost? 14 Seeking maximum benefit
The royal commission has delivered its final report detailing the case for fundamental change. NATASHA EGAN reports.
A
fter 28 months, 23 public hearings, 641 witnesses and over 10,500 public submissions, Royal Commissioners Tony Pagone and Lynelle Briggs conclude the inquiry in a final report spanning five volumes across eight books. In their report titled Care, Dignity and Respect, the commissioners make 148 recommendations to fundamentally reform the aged care system after finding the high level of substandard care in myriad forms concerning and unacceptable. “The extent of substandard care in Australia’s aged care system reflects both poor quality on the part of some aged care providers and fundamental systemic flaws with the way the Australian aged care system is designed and governed. People receiving aged care deserve better. The Australian community is entitled to expect better,” they write. The commissioners add it is difficult to measure the precise extent of substandard care and say that must change. They also conclude that aged care funding is insufficient, insecure and subject to the fiscal priorities of the Australian Government of the day. There was $27 billion spent on aged care in 2018-19 including $19.9 billion from the Australian Government and $5.6 billion from recipients’ co-contributions. The collective decisions of successive governments have cut more than $9.8 billion from the budget for aged care in 2018–19, Pagone writes. “It is no wonder that there are waiting lists for home care and serious deficiencies in the quality of care,” he says. Limitations on funding have been a major contributor to the substandard care experienced, Pagone says. The Final Report of the Royal Commission into Aged Care Quality and Safety was delivered to GovernorGeneral David Hurley on 26 February and tabled in Parliament on 1 March. It follows a $92 million inquiry that involved eight Counsel Assisting and four commissioners. West Australian Supreme Court Justice Joseph McGrath and Briggs, a
Tony Pagone, Lynelle Briggs and David Hurley
former Public Service Commissioner and Medicare CEO, were announced as commissioners in October 2018. A month later former federal court judge Richard Tracey was appointed chair and commissioner after McGrath was excused for family reasons. In September the following year, Gaetano (Tony) Pagone, also a former federal court judge, was added as the third commissioner. He was appointed chair a month later when Tracey died from cancer, but not before contributing strongly to the interim report. Pagone and Briggs continued the inquiry to its end, but not without delays due to the pandemic and an added hearing and report on the impact of COVID-19 in aged care. It was also without full agreement with the commissioners providing alternative options for reform. Pagone says he and Briggs agreed “with some misgivings and not without anxious consideration” to make separate recommendations and express different views where they diverge. Briggs says they provide two options for the governance of the aged care system, which necessarily flows through into other recommendations (see page 10). “However, this is a secondary issue to the quality and safety task at hand, which dominates our recommendations and, importantly, on which we agree,” she says. The royal commissioners have recommended the Australian Government report its response to Parliament by 31 May. n australianageingagenda.com.au
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