A co-operative or mutual approach can make aged care organisations directly accountable to the people they serve, writes Melina Morrison.

We are now just a few weeks away from the release of the final report from the Royal Commission into Aged Care Quality and Safety. Whatever the recommendations from the royal commission are, the lessons of 2020 are beginning to crytalise and these can and should be considered in the context of aged care.

Through the evolving COVID-19 crisis, our sense of citizenship was invoked. There was a call to act and in turn be treated in a way that recognised the value of our humanity and that we exist in an ever-shifting balancing act between our rights and our responsibilities, rather than in a transactional quid pro quo arrangement.

Citizenship, humanity and agency should all be considerations in the delivery of aged care.

Aged care can and should be integrated into our communities where possible; allowing people to age in a familiar setting has significant benefits for mental health and can be structured to reduce pressure on systems of care. Individualised responses to individual needs are achievable if we get the design right.

We released a report this month, Action to Empower, which addresses the potential contribution of member-owned businesses to innovate and reform the way aged and disability care operates.

Institutionalised aged care cannot meet all our ageing needs.

Community connectedness, local responses and personalisation of care are rarely served by a one-size-fits-all model. When the provision of aged care services is seen as a transaction and the extraction of profits is put above the person, the person suffers. 

Co-operatives and mutuals are uniquely placed to deliver a way of operating and governing aged care organisations that makes them directly accountable to the people they serve. This delivers three main benefits:

  • improved organisational performance and efficiency
  • consumer and employee engagement, with a resulting influence on service improvement and workforce development
  • wider benefits to society resulting from a greater sense of citizen empowerment and responsibility

By empowering members, be they consumers, employees, communities or a mix of these, providers can be held accountable for outcomes so that older Australians are cared for with the respect and dignity they deserve.

Despite the challenges of the past year, people working in aged care report high levels of engagement in their work. They are motivated to provide high quality care – so we need to put the right structures in place for them to do it.

Experience in the UK demonstrates that the co-operative model is one way to do that – empower staff to take control of their work and the financial and patient care returns speak for themselves. Increased engagement in the business means more eyes on the business and higher quality outcomes.

The returns achieved in a co-operative or mutual (surpluses) are reinvested back into the business, building on the successes year on year. In the right environment, this results in better staffing ratios and remuneration, increased access to training and career development, increased patient autonomy and a more personalised experience for those in care.

We can give people back their agency and their dignity, treat them as citizens in a community, and elevate the voices of those who care for our families to be a driving force behind how they are cared for.

Melina Morrison is chief executive officer of the Business Council of Co-operatives and Mutuals, the peak body for co-operatives and mutuals in Australia.

Access the Action to Empower report here

Main image: Melina Morrison

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1 Comment

  1. At Aged Care Crisis we welcome this report and its lofty objectives and agree that Mutuals and co-operatives are preferable to profit driven enterprises. But they are not immune to the perverse pressures that compromise care in free market systems like ours and some have failed. They must conform to survive.

    We believe that good care is primarily relationship based care and that guided choice, dignity and more is a product of the trust engendered. Without it they are readily tokenised. These empathic relationships are integral to professional and civil society. We think that they rather than Mutuals should be the primary drivers of care.

    These co-operatives and Mutuals need to be freed from the constraints of the current free market policies and operate within a market that is regionally and community driven and managed. This market needs to be designed to operate primarily as a community service and specifically within these sectors.

    The Grattan Institute has recommended a regional restructuring that would open the sector to greater community involvement and control so potentially make probity and performance in meeting community expectations critical to success. It would be a significant base from which to create the sort of community service that would enable and encourage Mutuals and Cooperatives to give expression to these aspirational values and release them from the perverse pressures in the current system.

    It will be interesting to see if a Royal Commission appointed by governments that are so deeply wedded to free market principals will recommend something so challenging to policy and whether these governments would actually do it.

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