The government’s pre-emptive announcement of an aged care royal commission was one part smart politics, but two parts poor policy. They were right to try to get out ahead of the Four Corners programs that would have led to huge pressure for a government reaction. But the haste of the move inevitably led to policy on the fly, as Adele Ferguson pointed out.
Moreover, the royal commission will be covering very well-trodden ground. Aged care is very likely the single most reviewed area of public policy in Australia — and has been for decades. By one account there were 30 inquiries dealing with aged care between 1997 (kerosene baths etc) and 2010, when the productivity commission began yet another aged care funding inquiry.
The Department of Health lists even more. In 2011, the productivity commission completed a comprehensive review into the aged care sector that led the Gillard government to implement the “Living Longer Living Better” reforms. At that point, the PC noted that it was the sixth major examination of the area and that they’d all come to the same conclusions. And since then, there have been over 20 more reports into the aged care sector; 2017 alone saw at least six inquiries from various government bodies. These are just the recent ones:
- Oakden scandal. A number of inquiries were launched in 2017, following the discovery of the cover-up of widespread abuse at the government-run Oakden Nursing Home in Adelaide. In mid-2017, the Senate Standing Committee on Community Affairs launched an inquiry into the effectiveness of aged care quality assessment and accreditation. However the inquiry received just 77 submissions and conducted a single public hearing last November. An interim report has been released, with the final product due this November. In December 2017, the government announced an inquiry by the House of Representatives Standing Committee on Aged Care, Health and Sport into quality of care in residential aged care facilities.
- Legislative changes. The reps committee on Aged Care, Health and Sport is also currently conducting an inquiry into the Aged Care Amendment (Staffing Ratio Disclosure) Bill, while the senate standing committee is accepting submissions on the Aged Care Quality and Safety Commission Bill.
- Carnell and Paterson Review. An independent review into aged care regulatory practices was conducted last year by Kate Carnell and Rob Paterson, also in response to the Oakden scandal. The review, which received over 400 submissions, made 10 recommendations, including the establishment of an aged care quality and safety commission, tasked with centralising accreditations.
- David Tune review. Just weeks before the Carnell and Paterson report was released, another review conducted by former finance head David Tune was tabled in Parliament, which looked at capacity issues, and encouraged changes to means testing of residential aged care.
- Australian Law Reform Commission response. In 2017, the Australian Law Reform Commission released its national legal response to elder abuse, following a year-long inquiry, recommending various reforms to safeguard against abuse in aged care, including the creation of a serious incident response scheme, enhanced screening of potential employees, and greater alignment between inconsistent rules and regulations across the states.
- Disability care. In 2015, there was also a Senate inquiry into Violence and Abuse Against People with a Disability in Institutional Settings that exposed widespread incidents of violence, abuse and neglect in disability care centres. The report, which condemned the “devaluing of people with a disability”, recommended the establishment of a royal commission.
In a way this will make the work of a royal commission easier: it will have a massive evidence and analytical base on which to draw. But it also prompts the question of exactly why a royal commission will have any more impact than the dozens of previous inquiries, including many by politicians themselves, into one of the most vexing areas of public policy.