Deadly aged-care practices ignored, royal commission told

Government dithering, slack regulators blamed for degrading and potentially deadly aged-care practices.

The standard of aged-care regulation in Australia was behind even the disability sector, the royal commission heard yesterday.

Degrading and potentially deadly aged-care practices have gone unaddressed because regulators failed to be proactive, affected clients and concerned carers were not supported, and the government dithered on reform.

The counsel assisting the Royal Commission into Aged Care Quality and Safety, Peter Gray QC, made the comments yesterday as he summed up evidence demonstrating “serious defects” in regulation.

“Equally concerning, these defects are old news: government has been tardy in implementing previously recommended reforms,” Mr Gray told the commission in Brisbane.

“There’s been no sense of ­urgency; government is yet even to reach a decision on aspects of the action that have previously been recommended by Carnell Paterson (the 2017 review by former ACT chief minister Kate Carnell and Ron Paterson).

“Government has been unable to deal with the challenge posed by the need for reform, or at least to do so promptly.

“Critical, urgent reform tasks have been outsourced to consultants and appear to be mired in protracted and multi-staged industry consultation processes.”

Mr Gray said departmental staff were preoccupied with policies and procedures, according to evidence given to the commission, and lacked “a spirit of inquisitiveness and curiosity”.

The Aged Care Quality and Safety Commission had demonstrated similar attributes, he said, and taking on the same departmental staff meant there was “no guarantee of cultural change without a transcending intervention of some kind”.

The commission has heard evidence about problems at the Earle Haven nursing home on the Gold Coast, which closed abruptly last month, forcing the emergency evacuation of about 70 residents.

Mr Gray said many of the previously identified problems and system failings were of the type ­already examined by Carnell Paterson, and showed regulators to be focused on “managing approved providers back to compliance at virtually all costs”.

Mr Gray was sceptical of the view that consumer-directed care would use market forces to ­improve results.

He referred to evidence from several witnesses, including Sarah Holland-Batt, who testified of the abuse and neglect her father ­endured at an unnamed centre and felt that the complaints officer was “kind of taking the facility at their word”.

Mr Gray said the standard of aged-care regulation in Australia was behind even the disability sector — one witness suggested up to 30 years behind — and should be aligned with the health sector.

“We submit that piecemeal ­adjustments and improvements are unlikely to achieve what is ­required,” he said.

“A philosophical shift is required, placing the people receiving care at the centre of quality and safety regulation. This means a new system, empowering them and respecting their rights.”

Debora Picone, chief executive of the Australian Commission on Safety and Quality in Healthcare, yesterday told of clinical indicators being used to gather data to not only measure and report on performance, but also give early warning of potential problems.

“Transparency is absolutely critical to the operation of the system and to the accountability that we give to members of the community,” Professor Picone said.

She said the same indicators could be easily introduced in aged care but warned “you will come against a lot of pushback”.

“They will give you every reason not to publicly report,” Professor Picone told the hearing.

“This is all abject nonsense — it is in the public interest.”