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Prime Minister Scott Morrison announcing the Royal Commission, alongside Minister for Health Greg Hunt and Minister for Senior Australians and Aged Care Ken Wyatt. Photo: Twitter

Royal Commission into aged care sector: nurses react

The government has decided to establish a Royal Commission into the aged care sector to address areas of concern regarding the quality and safety of services.

Announcing the Royal Commission yesterday, Prime Minister Scott Morrison said it will be about proactively determining what the nation needs to do in the future to meet community expectations about the standard of aged care.

“Incidences of older people being hurt by failures of care simply cannot be explained or excused,” Morisson said. “We must be assured about how widespread these cases are.”

The Prime Minister added that the Royal Commission is not about pre-determining outcomes. “Whether there is a crisis in aged care or not is to be determined. That is the point of holding a Royal Commission.”

The Australian College of Nursing (ACN) voiced its support for the call.

Adjunct Professor Kylie Ward, ACN chief executive, said the Royal Commission must be used as an opportunity to independently review the aged care sector to ensure the system, including its workforce, provides quality care.

The college would like to see focus placed on improving quality and control of services, increasing informed consumer choice and securing the future workforce.

“In 2016, the nursing profession made up 15 per cent of the aged care workforce,” Ward said. “Therefore, we expect the views of nurses to be sought as the Royal Commission strives to find solutions to identified issues.”

She added that the Royal Commission should consider the recommendations made in David Tune’s Legislated Review of Aged Care 2017 and Review of National Aged Care Quality Regulatory Processes penned by Kate Carnell and Professor Ron Paterson, as well as the Aged Care Workforce Strategy Taskforce report, as it moves towards starting its investigation.

Leading Age Services Australia chief executive Sean Rooney said the sector needs adequate funding and support structures to better enable, develop and grow the aged care workforce, and implement optimal staffing models.

Rooney added that the government must not lose sight of making the system better right now.

This point was echoed by COTA Australia, which stressed that the Royal Commission must not delay significant aged care reforms underway and in the wings.

Chief executive Ian Yates said while the Royal Commission does its work, the government should get on with reforms surrounding greater consumer control and choice, tighter regulation of aged care quality, improved capacity of the aged care workforce, and greater transparency.

“Both the Tune Review and the Carnell/Paterson Report into our aged care sector made significant recommendations on how we can and must improve regulation, funding and transparency in our aged care sector,” Yates said.

He said some of those recommendations are in train and must not stall while Australia waits for the outcomes of a Royal Commission that will run well into 2019.

Indeed, that concern seemingly informed the government’s lack of interest in pursuing a Royal Commission earlier. In a recent interview, Minister for Senior Australians and Aged Care Ken Wyatt told Four Corners that: “A Royal Commission after two years and maybe $200 million being spent on it will come back with the same set or a very similar set of recommendations. The Governments will respond and put into place similar bodies.”

He has since tried to shed light on those comments. “I said I would rather spend the money on frontline services on aged care than a Royal Commission at that point,” he told reporters after Morrison’s announcement. “But there are a set of circumstances that I have seen in aged care since that time, including in my own electorate, that take me to the point that it is a crisis issue that individual families face when a daughter wants to get her father into aged care, has him placed, and then the aged care provider in that circumstance says, ‘we can’t take him’.

“On that basis I gave reconsideration to the need for a Royal Commission.”

Aged & Community Services Australia (ACSA) said the sector does not fear scrutiny or accountability. “We have actively participated in multiple and substantial government-led inquiries and reviews over the years with the aim of improving and delivering quality aged care services,” the peak body for Australia’s not-for-profit aged care providers said in a statement.

“We will participate fully and transparently in the Royal Commission towards the same ends.”

ACSA wants the Royal Commission to focus on the critical issues facing aged care and drill down into any root causes. “This will give us the foundation to deliver on public expectations in the future.”

But the Australian Nursing and Midwifery Federation (ANMF) said the Royal Commission will “do nothing to fix the crisis in aged care” unless the Government introduces mandated staffing ratios in residential nursing homes.

ANMF Federal Secretary Annie Butler said: “We can’t allow a Royal Commission to delay action from the government any longer. This government has had five years to fix the problems in aged care – they must stop the suffering now.

“While the current aged care crisis clearly warrants a Royal Commission, we know what the problems are.

"We have two decades of reports and inquiries outlining the problems. It’s time to take action. Let’s start by introducing a safe staffing law.”

While Morrison said the Terms of Reference will be determined in consultation with the community, he expects that the Royal Commission will cover:

  • The quality of care provided to older Australians, and the extent of substandard care
  • The challenge of providing care to Australians with disabilities living in residential aged care, particularly younger people with disabilities
  • The challenge of supporting the increasing number of Australians living with dementia and addressing their care needs as they age
  • The future challenges and opportunities for delivering aged care services in the context of changing demographics, including in remote, rural and regional Australia, and
  • Any other matters that the Royal Commission considers necessary.
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  1. This is like the ‘crisis we have to have!” One of the issues is – last Liberal Government wanted to do away with Registered Nurses altogether. The community thinks that all staff in Facilities are RN’s! There is not enough training for staff (care workers and RNs re Dementia) . Until we recognise – mandatory training for all staff in Acute Care, Community Care and Facilities re “Experiencing Dementia Training”, mandatory staff ratios (RN’s and AINs + MDT) we have come full circle in my view – we have wanted RACF to be more home like, we have the highest care needs of residents of all time and – Gov wants no RN’s – what do they expect really. The system is broken (and the community MAC & HCP providers) is not an easy system – heaven help you if you do not have a family to advocate for you. We have set up all these systems and we now need consultants to guide us through!!!

    • All very valid points – we are indeed dealing with our older people who are living at home longer & so care needs are much greater & much more complex by the time they require entry to residential care. It therefore follows that we need a higher skilled workforce to meet those needs – people leave their homes due to increased needs which are unable to be met at home and so we cannot equate residential care to home. It needs to be a center where people receive high quality, skilled care to meet their, often very complex, medical & nursing care needs on a 24 hr basis. The reality then, would be much less need for older people to be transferred to acute hospital for basic issues such as a urinary tract infection !!!!
      Prior to 1997 there was specific Quarantined funding for care staff – then Proprietors were handed the bucket of money to provide ‘appropriate’ care – this has not worked as many operators do not understand the proper concepts of ‘assessment of need’…….it has been down hill from that point….
      The current situation is most distressing for those of us who worked so hard to develop a system which worked so well …..

  2. There does need to be staff to resident ratios implemented, to stop greedy propertiers and management treating the elderly like commodities even in Christian based organisations. There are very few Australian nurses in these facilities now where I live and they are underpaying cheap overseas labour, who won’t speak up until they get their citizenship. There are issues with cultural differences, poor communication and not doing the job for the right reasons (some are pushed into doing nursing by their parents) and then there is the issue of them taking not just one but quite often 2 jobs so they are too tired to do their jobs properly. Australians need work too. Wait until these overseas nurses learn that they can go to the Fair Work Commission to get their right rates of pay and they can be backpaid. Sean Rooney does not seem to realise that they most likely make him a special meal in a private facility, where image is everything and the level of care is poor. They would rather spend the money on the look of the facility rather than getting good staff. If he went to a Christian run organisation at night time chances are he would find that the residents are eating party pies that are full of air and very little meat. It made me laugh that even the particpants on the show “Google box” even though they are lay people realised Sean Rooney had no idea about what he was talking about.

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