Counsel Assisting’s final submissions to the royal commission give hope for positive reform in the sector, aged care industry peak bodies and other representatives say.

The Royal Commission into Aged Care Quality and Safety heard 124 recommendations to overhaul 18 aspects of the aged care system from Counsel Assisting’s final submissions last week.

The key suggestions include a new act based on human rights principles, a new and independent process for setting aged care quality standards and mandated staffing ratios in residential aged care (read our story here).

The recommendations also include an independent pricing authority to determine aged care prices, compulsory registration of personal care workers, and a new enforceable general duty of care on approved providers care.

Patricia Sparrow

Aged care peak body Aged and Community Services Australia supports the recommendations for new rights-based legislation, creating a demand-driven aged care system and measures to support and retain the workforce, CEO Patricia Sparrow said.

She said further consideration of the full suite of the recommendations and reform is needed.

“The Counsel Assisting’s final submission puts the royal commission on track to better set up Australia for our ageing population and the decades to come,” Ms Sparrow said. 

Broad support from peaks

Fellow provider peak Leading Age Services Australia broadly supports the recommendations, said its CEO Sean Rooney.

Sean Rooney

“Our preliminary view is that proposals for fundamental reform of aged care institutions – including the creation of an independent pricing authority, inspector general, and overarching commission with responsibility for funding and regulation – would help remove politics from the aged care system and ensure decisions are based on evidence, and the best interests of older Australians,” Mr Rooney said.

“Counsel Assisting has also proposed clear timeframes and transitional arrangements, which will be crucial to avoiding further delay in achieving the reforms that older Australians need,” Mr Rooney said.

Nicholas Brown

However, there are some areas LASA believes may need further consideration.

“We need to better understand the potential for any possible unintended consequences of proposed personal liability measures for directors and executives and other governance and reporting requirements,” he said.

Aged Care Guild, the peak body representing the largest for-profit providers, also supports many of the recommendations including the proposal for a rights-based aged care system and a re-write of the current legislation, said acting CEO Nicholas Brown.

Mr Brown said the sector was committed to the necessary reform to enact real change.

“Counsel Assisting’s recommendations only reinforce the extent of change needed and we look forward to working with Government, workers, consumers and other stakeholders to make this happen,” Mr Brown said.

“More than ever, this period has highlighted the importance of the royal commission and its contribution to developing a long-term and consumer-centred plan for reform, to ensure senior Australians receive the quality of care they need and deserve,” he said.

Critical step forward

Health Services Union national president Gerard Hayes said the recommendations were a breakthrough moment for aged care, in particular, those regarding the skills and the size of the workforce.

Gerard Hayes

“These recommendations deserve the full support of both Government and the Opposition. They would massively improve outcomes for residents, eventually guaranteeing between 215 and 264 minutes of care for residents every day,” Mr Hayes said.

However, Mr Hayes said job security was missing from the submissions.

“We need to lift wages in aged care but we must also make employment more secure, so we can attract and retain the workforce we need. For too long, aged care has relied on the goodwill of a casualised, underpaid workforce of mostly women. This must also change for aged care to meet the level of quality our elderly deserve,” Mr Hayes said.

Carolyn Smith

United Workers Union aged care director Carolyn Smith also said minimum staffing levels would be “transformative” for aged care workers who are sometimes “left to care for 18 residents by themselves” and residents, Ms Smith said.

“There is a need for many of these recommendations to be accelerated. The disaster in aged care is happening right here, right now,” she said.

Governance Institute of Australia CEO Megan Motto said “there is an urgent need for an overhaul of governance and risk management in the aged care sector and these recommendations lay a solid path for that transformation.”

Omar Khorshid

Australian Medical Association president Dr Omar Khorshid said the recommendations back the AMA’s calls for an overhaul of the aged care system, including its call to put general practitioners the centre of planning and minimum staff to resident ratios.

“Long before our first submission to the royal commission, the AMA has been calling for systemic reform to recognise that health and aged care are two parts of the same system that should be geared towards optimising the health and wellbeing of older people,” Dr Khorshid said.

Legislation rewrite necessary

The Australian Lawyers Alliance has welcomed the rewrite of the Aged Care Act 1997, which aged care advocate and national spokesperson Catherine Henry said it has been an underlying cause of systemic problems in aged care.

Catherine Henry

“It is weighted in favour of providers and has promoted the privatisation of services and competition, allowing profits to prevail over quality of care,” Ms Henry said.

“Rewriting the legislation would provide the opportunity to address key reform issues needed such as regulation, staffing and access to transparent data on key clinical indicators,” she said.

Younger people in residential aged care

Elsewhere, disability advocacy organisations Youngcare, the Summer Foundation and Young People in Nursing Homes National Alliance threw their support behind Counsel Assisting’s recommendations to prioritise getting younger people out of residential aged care.

Youngcare CEO Antony Ryan said: “The Assisting Counsel’s recommendations are vital in supporting the Government’s action plan to ensure no younger person is residing in residential aged care by 2025. The plan without dedicated action is impractical.”

The aged care royal commission is seeking responses to Counsel Assisting’s final submissions by 12 November. Find out more here.

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