Where on earth are aged care CEOs taking us? – opinion

Businesses are shaped by the stories their CEOs tell. And aged care is no exception.

We found aged care CEOs mostly talk about the tragedy of frailty, and their organisation’s heroic
efforts to address this. But overlooked the deep meaning in frail older people’s lives, and how they
can learn from those who’ve worked through this.

Because this was so at odds with the many committed CEOs we had met. We used an aged care
conference to listen to what else they talk about.

We heard a lot about the aged care rules, how bad the umpires are, and how much better off they
would be if Government gave them more money and got out of the way.

Competition was intense. It wasn’t hard to work out the criteria for winning. Reputation, scale,
margin, survival.

But they didn’t seem to compete for better lives for frail older people. In fact, it looked to us like
they colluded to deliver at a level well below what most of us would expect.

This is “mission-fixing”. And like price-fixing, it locks clients out of pushing the whole aged care
program to provide them with something better.

Sure, the Government constructs the rules of their program. Which includes a clear specification for
the minimum level of care they require. But nothing’s stopping CEOs striving to go way beyond this
to whatever their clients require to live their best lives.

Which we might have expected in spades. Given the career choice, values and obvious humanity of
so many of these CEOs. And their consciousness of all this expressed in their exemplar stories about
clients who do particularly well in their care.

Nothing’s stopping them, but nothing’s making them.

We wondered if this was a question of aged care CEOs doing what they are held accountable for.

More than what they believe in.

They are clearly accountable to their boards for their business success. Which includes meeting the
programmatic requirements of the funder.

But they have no accountability for the mission responsibility that also comes with this tax-payer
funding and trust. To deliver a community benefit that honours older Australians with care and
advocacy, that enables the best and most inclusive life possible.

No accountability to the ATO, to the funder, to their boards, to their staff, to their clients, to the
community.

Or even, it seems, to themselves. Which suggests that aged care CEOs don’t hold their missions as
enough of a winning aspiration to want to insert serious accountability of themselves and their
organisations.

And why would they when they hold such a rosy view of their clients’ lives.

Even when review after review, finds that this rosy view is not shared by many others.

This is “industrial blindness”. And it’s the biggest occupational hazard of aged care CEOs.

Sustained through this lack of mission accountability. But not helped by a community that’s
endlessly forgiving, even admiring, of them for delivering a life nobody wants. Because they do for
the community what no one else wants to do.

Worse still, in allowing this, aged care CEOs create community organisations that embed prejudice
about the value of the lives of frail older people. Not challenge it.

We did find a few CEOs taking a stand on this prejudice. Mostly small, local organisations and start-
ups a long way from Canberra. They had ways of listening to their clients. And practised “service-
calling” at least as much as service-excellence.

And in here somewhere is the cure for “industrial blindness”.

But CEOs don’t want it.

Seems it’s too hard to survive if you can see the suffering. Especially if you’re causing it. Easier to
discount the listeners as inefficient, hopeless romantics or even dangerous.

Not done yet, we set off to see what the strategic plans of aged care CEOs did say about their
winning aspirations. Here, we were looking for two things:

• How are they improving their current businesses to build better lives?
• How are they building new businesses that might do this even better?

We found their plans were mostly about operations, growth and survival.

Behaving more like coaches of teams competing within a set of rules. Than CEOs whose job it is to
break the rules when they don’t work for their clients.

We wondered if the CEO “imports” were any different. Those high-profile, experienced and
successful CEOs coming from other sectors.

They’ve certainly brought their corporate skills, with welcome changes in systems, services,
technology, efficiencies and scale. The CEO of the recent Baptistcare merger saw his gains as
financial health, meeting mandated standards, and service capacity and quality. Not bad.

But we couldn’t find them bringing significant change to the lives of their clients. Seems these
market-savvy CEOs get lost without a market to push them around.

Which just demonstrates the quite unique skill set needed for aged care CEOs. To have both service-
business skills and community-champion skills. And you can’t buy that off the CEO supermarket shelf.

So, we really have no choice but to do our own CEO skilling. Perhaps more than anything else in the
reform program.

Starting with how to join up the two skill areas when they might look like they’re on different trams.
Then a winning aspiration that inspires both clients and staff. Some mission accountabilities. And
expecting clients to bring their networks and resources to the table.

Big ask? That’s what happens when you lead a community benefit organisation. Regardless of
where your profit goes.

Mike Rungie specialises in the intersection between good lives and aged care. He is a member of a number of boards and committees including ACFA, Every Age Counts, and GAP Productive Ageing Committee.

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