Aged care commissioners’ split muddies hopes for reform

The Royal Commission Chair, the Honourable Tony Pagone QC, and Commissioner Lynelle Briggs AO. Picture: Arsineh Houspian

Hopes the aged care royal commission would offer the government a clear, unambiguous blueprint for reform of the sector to end the neglect of older Australians have been dashed by the final report.

The two commissioners, Lynelle Briggs and Tony Pagone, agree the aged care system is in dire need of reform, but have come to starkly different conclusions on how to govern, regulate and fund care, all critical elements in any future aged care system.

In doing so, they risk consigning their report to the same fate as so many other inquiries into the aged care system, documents full of good ideas that remain unfulfilled by the government of the day.

Both commissioners say they accept the need for fundamental reform of aged care, a system described by Commissioner Briggs as “broken”.

Both say improving safety and quality of care for hundreds of thousands of older Australians currently in the system and the millions of those who will need care in the future is their priority.

And indeed many of the 148 recommendations in their final report are shared, including the need for an entirely new aged care act that enshrines the right to quality and safety of care.

But their differences are stark, deeply philosophical, and permeate through many aspects of the lengthy final report.

Mr Pagone accepted their views “differ sharply”. He believes aged care should be governed by a body completely independent of government, a new Aged Care Commission. It should regulate providers, oversee quality and safety and commission care for older Australians with funding from the government.

He said the system needs to be rebuilt from scratch or it will be doomed to fail.

“There is, in my view, little point in repeating the same process again by asking the same Department that has overseen the current failings to build and run the new aged care system,” he said.

But Ms Briggs said the existing government bodies such as the Aged Care Quality and Safety Commission should be retained, but improved.

“Only government can do this in a system as large, complex and fragmented as the aged care system. Only Government can wield the resources and system oversight to make it happen,” she says.

The commissioners sought to play down their differences.

Mr Pagone said they “agreed, with some misgivings and not without anxious consideration, to make some separate recommendations and to express different views.”

“But we both strongly conclude that fundamental change is needed. In the end the differences between us may add to the strength of the reforms which are to be made.”

Don’t buy that for a second. The lack of unanimity makes the path to meaningful reform a far more complicated and rocky one.