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The future we want for our elders


Governance professionals in aged care need to keep a sharp focus on their organisations’ performance

By Bronwyn Pike

The big test for any governance professional overseeing an aged care facility is to ask: ‘Would I come here myself?’ If you can’t look yourself in the mirror and say yes, you need to start changing things.

Aged care challenges

What are we asking aged care professionals to do? How are we are supporting, training and remunerating them? These questions are essential.

The disparity of our treatment of healthcare and aged care means:

  • we don’t give the same level of resourcing despite the need for physical and specialised care
  • there is a much lower ratio of qualified nurses to patients than healthcare
  • workers traditionally receive less remuneration and support
  • casual workers are used more because it’s difficult to attract a permanent workforce.

That said, many people working in aged care are enormously dedicated, professional and do the very best they can.

Humanising institutions

In Australia, we have a strong emphasis on the primacy of the nuclear family. This can mean sometimes people end up in institutions because there’s nowhere else for them to go.

Large institutions’ environment can be dehumanising. People can lose their individuality and become part of a large group of congregate care.

The only way we’ve been able to tackle institutionalised neglect and abuse is by breaking down those institutions into smaller places for a more one-on-one human scale.

There are 125,000 people on a waiting list for all categories of home care packages and more funding would be in everyone’s interest.

Every day a person lies down in a bed in a hospital costs about $1,200-$1,500 – the largest cost in our healthcare system. Healthy people require less institutionalisation. We can respond to their individual needs and reduce cost.

Aged care governance

Governance professionals in aged care need to keep a sharp focus on their organisations’ performance.

Boards need to ensure they:

  • set the culture
  • regularly review indicators on quality of care:
    • the number of pressure injuries or falls
    • the use of chemical restraints
    • the number of other incidents
    • the complaint system
    • staff turnover
  • benchmark the organisation’s performance
  • have well documented policies and practices that are clinically proven to be providing the best care
  • listen to the voices of their consumers and their families and understand what’s important to them
  • use complaints as an opportunity to look at systems and structures to ensure that mistakes don’t happen again.

Royal commission into aged care

The royal commission into aged care has a way to go.

It’s only right and proper that the scrutiny is on the performance of boards because they have overall governance responsibilities and if they aren’t happy with the performance of the administration, they have the ultimate sanction of removing it.

Directors must be cognisant and serious about the tasks they are being asked to perform and be given the appropriate level of training to be able to fulfil those tasks.

I am hoping that the royal commission has the courage to ask some of those big fundamental questions — for example, what kind of future we want for our elder relatives and ultimately for ourselves in Australia?.

Bronwyn Pike is chair of UnitingCare Australia and Western Heath, and a former aged care minister for Victoria.


Workshop: Governing reputational risk for the aged care sector

Workshops around Australia — July 2019

Your reputation is at stake in these turbulent times. So many risks have the potential to damage your aged care organisation’s reputation.

Learn how you can manage your reputation when risks threaten your organisation.

You should attend if you are a:

  • leader or manager in aged care
  • director or officer
  • risk professional.

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About us

With a membership of over 7,500 company secretaries, governance leaders and risk managers from some of Australia’s largest organisations, Governance Institute of Australia is the only fully independent professional association with a sole focus on governance excellence. For 110 years, our education, research, advocacy, and support networks have provided cutting edge governance and risk management advice to Australian business leaders from all walks of life. We celebrate Australia’s successes, and challenge it to be even better. Learn more



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