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Flowers placed outside Newmarch House in April. Photo: Ryan Pierse/Getty Images

What really matters: Time for a new vision of ageing and care

Despite all the scientific and medical advances of recent centuries, nothing can bring back the dead we have lost due to the pandemic. Nor can the prosperity and general affluence of modern life erase the pain of losing loved ones or compensate for neglect and violation of those who have suffered needlessly.

But the publication of the Special Report on Aged Care and COVID-19 by the Royal Commission into Aged Care Quality and Safety on 30 September does mark a point at which Australia can at last begin to hope that a new era for ageing and care is possible.

It is not a difficult, lengthy or obscure report. In 25 easy-to-read pages it makes six clear, practical recommendations. While they fall well short of a new blueprint for the future, these should go a long way to preventing the continuation of unnecessary deaths of residents of aged care homes if adopted and implemented.

Normally, aged care is an issue that receives little public attention. This low level of interest is reflected in the inadequate public funding, the poorly developed policy and in the shabby way in which so many who work in the field are treated financially and professionally.

But since the pandemic arrived the idea of normal no longer applies. As the special report points out, 74 per cent of all Australians who have died from COVID-19 to date were residents of aged care homes.

There has also been a very heavy toll amongst staff. If effective policies for the management of infection within these homes had been in place, the death toll in this country could have been as low as one-quarter of what it has become to date. Effective measures against the pandemic in aged care are not just essential, they are clearly justified as a cost-effective response to the prevention of further pandemic pain and mortality.

The Royal Commission’s six modest recommendations are unlikely to cause controversy. What is liable to be controversial is their eventual implementation. Does the Australian government have what it takes to admit responsibility for the policy failures and follow up with corrective action?

It is notable that the Prime Minister has not acknowledged the report or promised any remedial action. Senator Richard Colbeck, the Minister for Aged Care, however, has given the undertaking that the government accepts all recommendations and is prepared to spend an extra $40m on meeting four of them.

Confusingly, however, the minister also claimed that “the Government maintains its position that it has a plan in place.” In declaring this he was responding to the Royal Commission’s key finding that there was a need for an over-arching “defined, consolidated, plan”. The key recommendation of the report is the establishment of a national aged care advisory body intended to provide the advice necessary to enable the Australian Government to play the vital leadership role it must play at the national level. The Commission has called for it to be based on members with expertise in aged and health care, including clinical geriatric care, as well as experts in infection control … in a “home-like setting” and who can advise on the operational requirements of a range of aged care services.

The body, with widespread representation, would also be responsible for developing protocols between the Australian Government and the states and territories that will “maximise the ability for people living in aged care homes to have visitors and to maintain their links with family, friends and the community”.

It would also have a range of other functions which would, presumably, extend to providing advice on staffing standards and other issues that today continue to hold back the delivery of appropriate care for all who require it.

The Royal Commission has spoken on COVID-19, but its main report is still to come. But as the pandemic has shown, we cannot just sit and wait for the oracle to speak while postponing urgently needed reforms. It is a time when we need to acknowledge the problems we have long seen covered up.

It is clear that it will take more than $40m to fix the system and that we can no longer just trust the market to self-correct. What is required is a new approach.

With the pandemic in this country at least in retreat, now is the time we must mourn. We need to honour the dead and the wounded and, in their name, dare to dream again, and make sure our voices and those of consumers and carers are heard.

Michael Fine is an honorary professor at Macquarie University.

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