The Morrison government has been warned not to delay sweeping reforms to the aged care system in the rush to the royal commission.
On Sunday the prime minister announced a royal commission into aged care ahead of the first episode of a two-part Four Corners exposé which will chronicle damning neglect, abuse and negligence in nursing homes across the country.
Kate Carnell, the independent reviewer of aged care audit procedures and a former ACT chief minister, told Guardian Australia on Monday the royal commission would give people an opportunity to talk about their negative experiences in residential aged care, and that was positive.
But she said the government needed to press ahead as soon as possible with a number of reforms stemming from a review she spearheaded in 2017 that reported to the government last October.
“Legislation is on the table, the new quality framework is on the table, the legislation to set up the new entity that brings together all this stuff with an integrated data management system is all under way, and we don’t want to wait,” she said. “There is no reason to wait.
“We’ve got to push forward with the reforms and get them on the table as quickly as possible, because right now, today, if you were looking for a residential aged care facility for your parents, you wouldn’t be able to access any data to assess quality.
“That’s not alright. That is absolutely not OK.”
She had flagged her concerns with the government since the unveiling of the royal commission, and had been given reassurances, but she insisted urgency was required because the reforms recommended as a consequence of the review she undertook with patients’ rights expert Ron Paterson “will make life better for people coming into aged care and people who are there now”.
She also raised a couple of concerns about the likely direction of the royal commission. She was concerned it could get “sucked into the vortex of more doctors and nurses” when a lot of the problems were about suboptimal care rather than poor clinical judgments.
“It’s not just about more doctors and nurses,” she said. “These are not hospitals. What is really important is when a resident pushes the button because they need to go to the toilet, that someone comes, or when they can’t manage to cut up their dinner that someone is there to help cut it up.
“ … People need care. I’d hate the outcome to suck the system into the clinical side rather than the care space … and there’s a chance that will happen.”
She was also concerned about the effect of the royal commission on Australia’s smaller aged-care providers.
“We need to make sure the royal commission doesn’t cause too much damage to the small- to medium-sized providers, who are often not for profits,” she said.
“The big operators … a lot of them are very good, but they’ve got grunt and they’ve got balance sheets. A lot of the suppliers in residential aged care are small operators …
“I worry a little about the impact on them.”
The Turnbull government commissioned Carnell and Paterson to review commonwealth regulatory practices relating to monitoring the quality and standard of care in residential aged care facilities after South Australia’s Oakden aged care facility was closed following horrific evidence of elder abuse and neglect.
Morrison said at the weekend the royal commission would begin before the next federal election and run until the second half of next year at least.
It will focus on the quality of care provided in residential and home aged care to senior Australians but will also include young Australians with disabilities living in residential aged care.
It will also investigate residential, home and community aged care, which includes home support packages and services such as social support and meal delivery.
On Monday morning Morrison was asked why he had called the inquiry when the aged care minister, Ken Wyatt, had denied the system was in crisis.
Morrison said the royal commission would determine whether or not there was a crisis in the system: “What I’m looking to do here is get ahead of these problems.”
The royal commission would answer the question about how widespread the problems were.
“Until that question can be fully answered then I don’t have the confidence – and I think the Australian public won’t – about when they make the hardest decision they ever make about their loved ones, they need to do that with confidence.
“I want to give them that confidence.”
