The aged care royal commission has heard evidence from its first witnesses, with calls by whistleblowers for CCTV and a national database identifying rogue workers, concerns over an “unintentionally complex” aged care system and comparisons between service providers and airlines.
Barbara Spriggs, the wife of Adelaide man Bob Spriggs who died after staying at the Oakden Older Patients Mental Health Service in 2016, and their son Clive Spriggs, were the first to give evidence at the public hearing in Adelaide on Monday.
Mrs Spriggs talked about the importance of speaking out about substandard practices and encouraged others to do the same, relating how her husband, who had Parkinsons disease and Lewy body dementia, was transferred to hospital from Oakden.
He had been given ten times his dose of antipsychotics and suffering from severe bruising, dehydration and pneumonia.
She also likened his bare, locked accomodation at Oakden to “something from the 19th century” and ‘a prison’.
“I should not have had to battle so long and so hard for months to be heard” she told the commission, questioning why it took so long for red flags to be raised.
She and Clive Spriggs also called for CCTV in all common areas and optional CCTV in private rooms, as well as a national data base to “weed out” unsuitable staff.
“There needs to be a mark on their name in the system,” Clive Spriggs said.
“If they want to work in another State, the new employer needs to be able to access information about them.”
A ‘pub test’ of fairness
COTA chief Ian Yates compared aged care providers to airlines, saying safety and quality should be a given.
Mr Yates was questioned about a survey by COTA which showed that consumers rated quality of life, including being treated with respect and dignity, higher than safety and quality of care when judging aged care providers.
When pressed on this by Senior Counsel Assisting Peter Gray QC, he explained this was because safety and quality of care should be a basic assumption.
“Let this be clear, consumers and families place a very high priority on safety and care measures but in terms of quality of life … being treated with respect and dignity was seen as a very high priority by 98.7 of the people,” he said.
“I don’t think anybody would choose to go into an unsafe environment … but when we get on a plane we assume that plane is going fly safely,” Mr Yates told the commission.
“Our choice of airline is determined by a range of other factors.”
Mr Yates also raised concerns about widespread and excessive use of medication, lack of appealing and nutritionally appropriate food and the need for a “pub test about what’s fair in our country”.
A single industry body
Professor John McCallum, CEO of National Seniors, said aged care needed to be viewed as an emerging industry – “part cottage industry and part big-time” – and proposed the industry should be represented by a single body up to the job of implementing reform.
“A case can be made to reimagine the industry and government structures with powers to implement recommendations,” he said.
“We have to think … are the industry structures capable of supporting the sort of recommendations that are going to come through this?
“We’d like to see a single body as an industry representative that brings industry together.”
Mr Gray opened the inquiry with a broad overview setting the scene for what lay ahead. He thanked those who had so far shared their stories, saying while some had been harrowing, others reflected positive experiences.
Over the next eight days the royal commission hoped to call 26 witnesses who would give evidence about lived experiences, recommendations for reform, and weaknesses and failures in the aged care system, he told joint commissioners Richard Tracey and Lynelle Briggs.
He said the commission had received more 900 voluntary responses to requests for information from the nation’s more 2000 providers, from including 79 of the largest 100.
“We will follow up with the providers who have not responded to the request to ensure it has been received and has been receiving proper attention,” he warned.
The commission had also received 800 public submissions, many relating to unsafe or substandard practices he said.
Mr Gray said there had been many inquires and reviews into aged care, but they hadn’t addressed the bigger picture and reforms tended to address a problems in isolation rather the system as a whole.
“The system is overly complex. Many changes have been made over more than 30 years perhaps the frequency of these changes has led to unintended complexity,” he said.”
The commission would also look at the sustainability of the aged care system, including its financial sustainability and cultural issues including discrimination and neglect.
Some views would suggest that funding restraints come at the cost of quality and safety, he foreshadowed.
“The dominant narrative in current Australian culture seems to be that older people are a burden,” he said. “We reject that narrative. A culture of appreciation and respect for older Australians is needed”.
Witnesses slated for Tuesday include Craig Gear, CEO of OPAN, national policy manager of Carers Australia Susan Elderton and Annie Butler, federal secretary of the ANMF.
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