The recent aged care royal commission estimated that one in three people living in aged care in Australia experience neglect, physical or emotional abuse.
The Royal Commission into Aged Care Quality and Safety highlighted studies that have revealed “as many as 68 per cent of people receiving residential aged care are malnourished or at risk of malnutrition”.
With the first federal budget since the royal commission set to be handed down on Tuesday, here’s a look at the state of Australia’s aged care system.
We’ve heard stories of abuse and neglect
The royal commission heard of physical abuse against residents at the hands of staff members.
In its final report, released in March, the commission mentioned one family who had set up a hidden camera in their father’s room.
The footage revealed he was physically assaulted three times in 10 days by a staff member.
The report also detailed circumstances where families had discovered their loved ones were sexually abused by staff.
The royal commission heard that 50 people in residential aged care in Australia are sexually assaulted each week.
The ABC investigated a story in which a 86-year-old man — a double amputee — suffered dehydration and burns after being left on an aged care home’s rooftop terrace for two hours.
The ABC also obtained video and photos showing dementia patients strapped to their chairs in a Sydney nursing home. In one case a 72-year-old man spent a total of 14 hours in one day in restraints.
The royal commission’s final report said that from 2019-2020, residential aged care services reported 5,718 allegations of assault under the mandatory reporting requirements of the Aged Care Act.
It mentioned a further study, conducted by consultancy firm KPMG in the same year, which found that 27,000 to 39,000 alleged assaults occurred that were exempt from mandatory reporting because they were resident-on-resident incidents.
What went wrong?
The Aged Care Act introduced by John Howard’s government in 1997 overhauled the aged care system.
One of the changes it introduced was to allow independent providers into the sector, but it didn’t specify the level of care these private aged care providers had to give.
The royal commission called this a “major gap in legislation” and recommended there be a “general duty” to ensure the quality and safety of services.
This, the royal commission reasoned, would “send a clear message to providers … that the primary duty of an approved provider is to ensure the health, wellbeing and safety of its residents”.
Another issue when it comes to aged care is the cost. Looking after residents with health complications for an indefinite period of time is difficult to budget for.
But what providers can control are things like staff, wages and training.
On this point, the commission found Australia’s aged care system to be “understaffed and the workforce underpaid and under-trained“.
What is being done about it?
There have been calls to improve the aged care system for years, with 20 major public reporting inquiries since 1997.
Australia spends about 1.2 per cent of its gross domestic product (GDP) on aged care. That’s less than half the OECD average of 2.5 per cent.
Following the Royal Commission into Aged Care Quality and Safety, Prime Minister Scott Morrison committed to spending $452 million towards addressing its findings — a sum that will be included in Tuesday’s budget, which Mr Morrison says will contain a plan to transform the sector.
A Grattan Institute report calculated the aged care sector needs an extra $7 billion a year just as a starting point.
There have been reports that the government will pledge $10 billion over four years in this budget to improve the sector, with a focus on home care packages.
The royal commission also recommended the 1997 Aged Care Act be replaced no later than July 1, 2023.
The government agreed to this recommendation, but it is not certain when this will happen.
“That will be a significant process but it’s based on a simple concept of respect for the individual,” Health Minister Greg Hunt said upon the release of the commission’s findings.