Home | Industry+Policy | Aged care is in crisis and we don’t really care: opinion
Queenbeyan, NSW Australia during the Eden-Monaro by-election. Photo: Newswire/Photox - Canberra Photography Services

Aged care is in crisis and we don’t really care: opinion

All of us know aged care is in crisis. The problem is we don’t really care.

Harsh? Perhaps. But it’s an easily testable proposition. So that’s what Catholic Health Australia did during last month’s Eden-Monaro by-election.

When we polled voters in the bellwether federal electorate we found 84 per cent believed “the aged care system is in crisis”. We then asked these same voters to consider seven issues and rank them in terms of importance. Aged care came a dismal last. Less than 4 per cent of respondents raised aged care as an issue driving their vote. In the 18-34 age group not one person nominated investing in aged care as having an impact on their vote.

I’ve been involved in state and federal political campaigns for years and I have little doubt the major parties will have seen similar research. So is it really any wonder that aged care has been left to languish in the political desert?

We can howl at our politicians for allowing aged care to descend into crisis. But they’ve been responding to us.

Our decision-makers know that 60 per cent of residential aged care homes are running at a loss and on the verge of closure.

They know workers in aged care are paid significantly less than their counterparts in the health and community sectors, despite these industries hardly enjoying a reputation as gold mines.

They know the Royal Commission into Aged Care has described our system as a “sad and shocking system that diminishes Australia as a nation”.

But they also know that when you really boil it down, no election has ever turned on aged care. Swing voters in swing seats like Eden-Monaro recognise the crisis. But it doesn’t influence their vote.

Since I started engaging with aged care last year I’ve spoken to any number of leaders in the sector, who are bemused by how little attention governments seem to pay to their submissions. They’ve asked me if they needed better evidence. I’ve suggested that’s not the issue.

Every intergenerational report since 2002 has plainly shown the need for increased funding. The reason government doesn’t provide it is not they’re unconvinced. It’s that they know their neglect won’t be punished by the electorate.

That’s not to say they’re heartless monsters who don’t feel for seniors in substandard care. It’s just a reflection of how our modern democracy works.

So why don’t voters put pressure on governments to act?

Partly the answer has to be cultural. We’re all ageist to some degree, even if we don’t recognise it. Ever complimented someone by saying how young they look? Did you consider the converse?

People I talk to in their 70s who tell me the worst thing about getting older is becoming invisible. People don’t look you in the eye or serve you when you walk into a café. In a society in which youth is revered, the presence of the aged makes us feel uncomfortable.

But difficult though the situation is, it doesn’t mean we have to accept aged care calcifying as a pariah issue.

Covid has been a wake-up call. And those of us who care about aged care can also take considerable inspiration from the ‘Every Australian Counts’ campaign that gave rise to the NDIS.

The challenges faced by disabled Australians was hardly a hot button political issue 10 years ago. But ‘Every Australian Counts’ helped build the case and pave the way for billions of dollars of public funds to flow to a group of vulnerable Australians who had previously been overlooked.

The aged care sector needs its ‘Every Australian Counts’ campaign.

During the Eden Monaro by-election, Catholic Health Australia ran a little pilot, a ‘Fight for Better Aged Care’ campaign in both Merimbula and Bega.

Despite only three weeks of exposure and a tightly constrained budget, one in four residents in Merimbula and one in five residents in Bega, noticed the messaging. Among those who had been exposed to the campaign, the strongly held conviction that the government should prioritise fixing the aged care system, bumped up from 40 per cent to 60 per cent.

This shows there is political hope. The right public awareness campaign can move hearts and minds.

Political scientists talk about ‘Overton windows’, the range of policies politically acceptable to the population at a given moment in time. As coronavirus continues to menace our aged care sector, it’s likely the window is shifting.

Even as the pandemic-induced recession takes hold, we still live in one of the very wealthiest societies the world has ever known. With more time, a larger budget, and commitment from the sector I believe we can campaign to build the public support necessary to start treating our elders with the respect they deserve.

Pat Garcia is CEO of Catholic Health Australia.

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  1. Our failed Aged Care system needs to be completely overhauled. Giving more money to the operators will not fix this. Self regulation and a total lack of transparency around how funding is spent has contributed to where we are today. There is a growing realisation about the need for skilled clinical staffing, and mandatory nurse ratios. Making End of life care for our frail elderly a commodity in the marketplace will always be problematic. Have a look at the different outcomes between State run and Private (including ‘Not-for-Profit’) care homes in Victoria’s Covid-19 crisis. The evidence is clear.

  2. Pat,

    having been working in the areas of Hotel Services in Aged and Healthcare for the best part of 50 years, it doesn’t matter who owns and manages aged and healthcare and people come up with a myriad of reasons for failure I never see “real” investigation into the management of these services.

    Some of the main reasons for failure that are also impacting have been around and overlooked for many years and I would call these core to a well run industry:


    Policy/Procedures, Employing the right people, Training and significantly rostering (this has and is having a major impact).

    If Aged acre was better marketed as a place of worthy and enjoyable employment this would assist in having more people join the industry,

    We need specific Certificate training for Aged and Healthcare in Hotel Services (I am enthused with William Anglis making some inroads into this area).

    Before applying for more funds we should be starting a complete forensic look at the areas above as the main starting points as I believe much financial resources can be better used to improve and the most costly areas of employment if not manage well can leak thousands of dollars and from my experience many could benefit by looking at the amount of non-productive hours and the reasons for this.

    I believe like many more funding is required and some are disadvantaged more than others on location alone, however we need to do the work and start with those that have serious issue and have a number of sanctions, where we will learn.

    I think we have fantastic and amazing aged care organizations in Aged Care and above all Very Caring Staff (with a dearth of real training), however I believe where we are failing is mostly around employment and all that goes with it added to the shortage in funding where it is not a one size fits all.

    It is high time for the bureaucrats and people on the “coal face” to get together and get this fixed once and for all as it’s been happening from all levels of government since I started work in the seventies.

    I read the daily readings from the commission into Aged Care without enthusiasm as it seems with all the process it wastes so much time/cost in getting to the core issues which I believe many in the Industry already know.

    I would like to Wish all those working in Aged and Healthcare, not only a huge Thankyou for the work you do and are doing for everyone but Take Care as we want you to be safe as well and are fully supported at all government levels.

  3. So public apathy is largely responsible for the sector’s failures?

    It seems provides just cant kick their habit of blame-shifting…and asking for more funding. This is their shallow pretence of nobility…we really want to do the right thing but we just need more money.

    It’s a tired old act.

    Those of us on the floor are tired of hearing from industry experts (political hacks, career bureaucrats, accountants and peak body CEOs) who have no experience in the direct provision of care. Your ‘expertise’ has led us to our current situation and it’s time you all went back in your box.

    Faith-based NFPs contend their operations are guided by a higher moral authority…but that just doesn’t wash anymore. We all know the myriad of atrocities that have been committed in the name of Jesus. NFPs cut staffing and oversee appalling care just like every one else.

    In his brief time as CEO, Mr Garcia has written numerous articles that pretend to reference our moral obligations to the elderly…but they’re really just a cry for more money. Sure, more funding is required, but you cant use that to excuse incompetent care.

    In a Catholic Weekly article (16/07/20) Mr Garcia was again promoting his more money agenda, calling for targeted means testing and upping the user-pays funding model. And this…’if we want to treat elders with respect and dignity in the final stages of their life, then we need much more money”.

    Really? Is your current model of care so inept that it’s incapable of providing basic end-of-life care to your clients? An interesting position from a provider who, like many other NFPs, still run facilities without 24/7 registered nurse coverage and ‘low care’ residential accommodation. Your many submissions to parliamentary inquiries arguing against the need for registered nurses are on public record.

    Outdated and ignorant models of care, promoted by leaders who have never provided care, are the hallmarks of the aged care sector. You’re in no position to stand on the moral high ground.