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The Guardian - AU
The Guardian - AU
National
Henry Belot

Two-thirds of Australia’s aged care safety inspections outsourced to consultants

An elderly woman sits in her room at a nursing home, lost in thought.
Some Aged Care Quality and Safety Commission contractors have underestimated the work involved in auditing homes. Photograph: Katharine Andriotis/Alamy

More than two-thirds of safety and quality inspections at aged care homes have been outsourced to consultancy firms, despite warnings this presented a “significant risk” and that some contractors underestimated the standards of work required.

The Aged Care Quality and Safety Commission (ACQSA) audits residential facilities to ensure they are meeting mandated standards. Since 2021, four firms have been paid more than $40m for this work, which includes conducting interviews and searches.

Last financial year, the commission conducted 1,457 site audits across Australia with 970 – or 67% – conducted by third-party providers.

Former senior public servant David Tune, who conducted an independent review of the commission’s capability, has raised concerns about the reliance on contractors. His report was released in late July.

“I consider this is a core function of the commission and that the high proportion of assessments undertaken by third-party provider assessors, represents a significant risk for the commission,” Tune’s report said.

“As deeds of offer with third-party suppliers are reviewed, the commission should seek to reach a better balance to ensure more activity is brought in-house and undertaken by its permanent quality assessor workforce.”

The Tune report also revealed the commission created a “dedicated quality assurance team” to support contractors because “several suppliers underestimated the complexities, volume and standards or work involved in report preparation and gathering/documenting the evidence required by the commission to make a decision on compliance”. The report did not name the suppliers.

An ACQSA spokesperson said contractors were used to address a backlog of audits caused by “disruptions during the pandemic and workforce shortages”. They said contractors only worked on “reaccreditation” audits.

“The commission’s use of third-party providers to conduct the majority of these audits in the 2022-23 financial year reflects a decision to focus the commission’s own quality assessor workforce on targeted and specialised risk-based activities across residential and home services,” the spokesperson said.

“Our use of third-party providers has diminished and will continue to decrease across the 2023-24 financial year, following significant increases in our recruitment to quality assessor positions.”

The ACQSA spokesperson also confirmed three of four contractors were given one-year extensions in June. KPMG, HDAA and RSM Australia were awarded extensions while SAI Global was not.

Beth Vincent-Pietsch, the deputy secretary of the Community and Public Sector Union, said given the concerns raised in the Tune review, contracts should not have been extended.

“Not only does this disregard the independent work that has been done to fix the aged care commission, but it stands in stark contrast to commitments made by the Albanese Labor government regarding both outsourcing and fixing our aged care system,” Vincent-Pietsch said.

“David Tune’s capability review makes it glaringly clear that the third party provider program should be abandoned and Australian public service staff need to be brought in to take over the core work of the commission.”

The reliance on contractors for audit work was revealed after questions from Greens senator Barbara Pocock, who is part of a Senate inquiry into the government’s use of consultants.

“While there is no problem with suitably qualified people carrying out the audits and reporting directly to the commission, I cannot see the benefit in outsourcing this activity to consultants,” Pocock said.

“Whenever we see core public service functions being outsourced to the private sector there is a risk that those functions could be compromised for commercial gain. This is too important to farm out to money grabbing consultant firms.”

Government contracts show that since October 2021, KPMG has been paid $8.7m by the commission for auditing services. HDAA, which describes itself as the country’s leading human services auditing agency, was paid $4.4m. SAI Global has been paid $13.9m and RSM Global $14.2m.

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