aged care
(Image: AAP/David Crosling)

Transparency is a key mechanism for improving service performance in government. It’s one of the true boons of the internet that consumers can now easily obtain independent, government-guaranteed performance information about crucial services.

School performance is available via the MySchool site. Hospital performance is available via the Australian Institute of Health and Welfare’s MyHospitals site. Superannuation fund performance is available via APRA. The Australian Energy Regulator publishes performance information on energy retailers.

But not so much in aged care.

The lack of performance information in aged care is notorious. The Rudd government’s National Health and Hospitals Reform Commission urged better reporting of the sector a decade ago. The Productivity Commission dedicated a section of its 2011 inquiry into the sector to the need for much better performance reporting.

An array of key players — the Audit Office, the Victorian government, seniors’ groups, unions — queued up to urge much better performance reporting or a MyAgedCare-style website.

Nearly a decade later there’s a MyAgedCare site, a National Aged Care Mandatory Quality Indicator Program that commenced last year, and much better sector-level reporting. But when it comes to readily and easily identifying non-compliant and under-performing aged care providers, things haven’t improved significantly. Indeed, events this week showed the government appears to go out of its way to keep performance information confidential.

First, Health Department secretary Brendan Murphy — whom, people seem to forget, is a public servant, for a government that demands that public servants serve the political interests of the Coalition — refused to disclose aged care facilities that had suffered COVID-19 outbreaks. “Some of the facilities don’t want it publicly known that they have outbreaks,” he told a parliamentary committee. “They’re obviously worried about reputational issues.” Public awareness would put “stress” on them, Murphy said, creating a “public hit list of facilities”.

Presumably Murphy will now move to end hospital reporting information too. After all, we don’t want hospitals suffering reputational damage and stress by being on a “public hit list”.

Or is it the reputation of the government itself that Murphy, and his minister Richard Colbeck, are concerned about?

Unlike hospitals, aged care regulation is entirely in the control of Murphy’s department and its brand new bespoke regulator, the Aged Care Quality and Safety Commission. Failures in aged care are a direct result of the failures of the federal government; it’s presumably just a coincidence that that’s the sector where the government prefers to obscure performance information.

The head of the Aged Care Quality and Safety Commission, Janet Anderson, also told the Senate COVID-19 committee that

“Since May 2020, we have issued ten Notices to Agree relating to approved provider responses to COVID-19 outbreaks to ensure that necessary actions are taken to manage risks and provide safe, quality care to residents.”

Now, you can find those, though not, curiously, on the Commission’s Notices To Agree page; you have to use the Commission’s Non-Compliance Checker — a useful and user-friendly tool, except that it reveals how few Notices To Agree were recorded as issued by the commission.

This year, in addition to the 11 it has issued in Victoria of late, it has issued just five Notices To Agree in NSW but none anywhere else (except three in Western Australia), suggesting the sector is apparently performing well apart from its pandemic-related lapses.

Today, The Australian reported that around 70% of the aged care facilities that had not complied with COVID-19 control standards had been kept secret from the public and residents. You will certainly have no joy looking for details of the facilities in the Non-Compliance Checker, which now seems rather inaptly named.

As Michelle Grattan notes, these are all institutions that benefit from — indeed, wouldn’t exist without — public funding.

The idea that they get a pass on the kind of transparency other publicly funded institutions are required to display is absurd. There’s also something deeply immoral about elevating the reputations of aged care providers — and of the government — over the need of residents and their families to know which providers are complying with the kind of measures designed to prevent infection — not to mention upholding normal aged care standards.

As the Productivity Commission and a line of stakeholders argued over a decade ago, transparency and performance information is crucial to improving the performance of any sector. Consumers have a right to know, their families have a right to know, and taxpayers have a right to know.

Peter Fray

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