Header Minister orders review of aged care assaults

Mark Butler asks DoHA to investigate the rise in reportable assaults following coverage by television news. Linda Belardi reports.

The minister for ageing, Mark Butler has directed his department to compile a detailed report on the incidence of assaults within aged care facilities.

A spokesperson for the minister said Butler had made it clear that any abuse of aged care residents was completely unacceptable and "has asked the Department of Health and Ageing to provide further advice to explain the increase in the number of reportable assaults".

Data released by the Department of Health and Ageing showed the number of alleged reportable assaults had risen to 1814 from 1488 in the previous year - continuing an upward trend since the introduction of mandatory reporting in July 2007.

While there was widespread support for improved data around mandatory reporting, the internal report will fall short of the full review being called for by providers, unions and consumer advocates.

It was also unclear if the finished report would be made available to the public.

It also appears that the review was prompted by reports of the rise in assaults by Channel Seven news.

Paul Sadler, CEO of Presbyterian Aged Care NSW/ACT, said a detailed report on the prevalence of elder abuse in residential aged care was long overdue.

Despite four years of the mandatory reporting regime, the department published very limited data on the prevalence or risk factors for abuse.

"There is no analysis of the reports beyond a very crude division of which types of incidents were notified to the department and police," he said.

It was also not possible to determine from the department's annual statistics the proportion of alleged assaults that were subsequently substantiated.

A spokesperson for the department said that because it was the responsibility of police within each state and territory to investigate an alleged assault, the department could not release the number of substantiated assaults.

There was also no public record of the number of arrests, charges or convictions against alleged perpetrators of assaults. The department said it was not the responsibility of the police or the courts to advise the department of these outcomes.

However, without this information, Sadler said it was not possible to determine the effectiveness of the regime in responding to allegations of abuse.

Sadler, who was also the author of the 2009 ACSA survey which reviewed the first 18 months of the reporting system, said the impact of legislation should be comprehensively and independently reviewed.

Paul Gilbert, assistant secretary at the Australian Nursing Federation (Victoria branch) said the high number of alleged assaults in the system did not correlate with a high number of substantiated assaults.

"Of those who end up being accused of an assault, I'm yet to meet one against whom the Victorian police laid charges or the employer ultimately found that their employment should be terminated," he said.

Further, elder abuse expert Linda Starr from the School of Nursing and Midwifery at Flinders University said that a lack of forensic evidence may be playing a role in the low number of police investigations and prosecutions.

Aged care staff, especially personal care workers, often lack the confidence and training to appropriately document a report, she said.

Despite this low conviction rate, the personal price on staff could be high, said Gilbert. Nurses who were the alleged offender of an incident could experience significant mental hardship and loss of reputation after being stood down for a suspected incident that was subsequently not substantiated, he said.

Similarly, in evidence to the March hearings of the Productivity Commission's inquiry into aged care, Jill Pretty, CEO of Aged Care Services NSW/ACT spoke of reports of staff who had been exonerated, but had attempted suicide.

The potential impact of the legislation on the civil liberties and autonomy of residents who wish not to have an incident reported also needed attention, she said.

While Sadler continued to advocate for the complete repeal of the legislation, he conceded it was an unlikely outcome.

He said possible positive amendments to the reporting system could include increasing the threshold for reporting or allowing more time for providers or the police to establish the validity of an incident before it is reported to the department.

Elsewhere, elder abuse prevention advocate, Lilian Jeter, whose revelations on Lateline in 2006 helped trigger the legislative reform, said she also supported a review of the mandatory reporting system.

"Everything that has ever been put into place, regardless of what it is, should always be reviewed," she said.

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