The Royal Commission on Aged Care finally reported yesterday. The two commissioners, Tony Pagone and Lynelle Briggs, between them made 148 recommendations about the industry, the people working in it, governance, regulation and, above all, funding.
But the general message of the report, however, boils down to two sentences. Australia’s aged care system is, to use a technical term, ‘buggered’. Unbuggering it demands a huge amount of money, and that money’s more likely to come from public taxes and borrowings than private sources.
If Mandy Rice-Davies were still with us she would remark, ‘they would say that, wouldn’t they’?
Eight-hundred nursing home deaths from Covid-19 last year focused public attention on aged care in a way not seen since the Howard government introduced user pays in the late 1990s. Aged care is a chronic political headache for all federal governments, and the simple fact the two commissioners reached critically-different conclusions on key issues makes the Morrison government’s job of responding effectively even harder than it already was.
Aged care funding and regulation nevertheless is a federal responsibility, and even public outlays of $21 billion a year, plus private care contributions, aren’t enough to ensure enough care places, build and maintain the infrastructure, and ensure residential care ‘customers’ have a reasonable quality of life in God’s waiting room.
But are governments – Coalition and Labor – the biggest culprit here? No, we are.
As anyone walking through the door of a nursing home to be hit by the unmistakable ammonia smell of stale urine knows, nursing homes are miserable places to visit, let alone live in. We prefer not to think about it until the time comes for us, or people we care for, to take up residence. And not just residential care is swept under the carpet: too often family members do not want even to shoulder the burden of an aged relative still living in his home, with community nursing and other support services available. Indeed, many would rather their elderly rellies die and leave them an inheritance, rather than have those inheritances frittered away in aged care contributions.
One of the sadder aspects of aged care is how many people are left to languish and die alone, rarely or never visited, ignored and forgotten by the world outside. Last year we saw angry relatives of people dying in Covid-hit nursing homes on telly berating providers and the government for failing their family members. But how many other residents had no one speaking for them, and how many of those relatives actually were speaking so angrily not because they were actively caring for a loved one, but out of guilt that they were not?
Political will is driven by public opinion. The bottom line on the royal commission’s report is this: unless we as a society accept we cannot sub-contract our family and generational responsibilities to government, nothing will change.
If successive governments have done too little on aged care, blame our collective apathy.
An earlier version of this piece originally appeared in the Spectator Australia’s Morning Double Shot email. Sign up and make sure you don’t miss out here.
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