How feasible is the potential new Aged Care Act?
The Royal Commission into Aged Care Quality and Safety exposed a litany of complaints from aged care users in Australia, and was a wake-up call for policymakers and service providers throughout the sector, writes AMY SARCEVIC.
One key revelation was that the current Aged Care Act 1997 is no longer fit for purpose, given its lack of emphasis on the quality of life of service users.
“It is structured around providers and how to fund them — not about the people accessing services and what they need,” said a spokesperson for the Aged Care Quality and Standards Commission (ACQSC).
This has prompted the design of a new Aged Care Act, focused on the safety, health and wellbeing of older people.
This year, subject to it being passed by the parliament[U1], Australian aged care providers, workers and subcontractors will have to abide by this new Act, which carries larger penalties and added consumer safeguards.
So, what does the new Act entail and how feasible will it be for aged care providers to meet its obligations?
Person-centred care
The Royal Commission heard countless stories of aged care consumers having their dignity undermined through transactional rather than person-centred care.
Alongside allegations of abuse, people in residential aged care facilities were allegedly given nutrient-poor diets and inadequate dental care, and were subjected to demeaning practices around incontinence management.
In response, the new Act places the safety, health and wellbeing of aged care users at the heart of its requirements. These extend from peoples’ initial contact with aged care providers, right through to routine elements of daily care.
Aged Care Consultant Professor Rodney Jilek said these provisions are a welcome move, but is concerned about the sector’s capacity to meet person-centred interventions.
“Provisions of the Act around person-centeredness and individual rights are in conflict with the building blocks of the aged care sector, which is about providing basic care for the masses, at the lowest cost,” he said.
“In one way, this Act is trying to move aged care closer towards the NDIS, but without the resources and funding to do it. That will be a big struggle for providers, even those with the very best of intentions to be compliant.”
In fact, Jilek is concerned some of the provisions may do more harm than good, by robbing resources from direct care.
“The new Act looks great on paper. The reality is, the administrative burden on providers is getting larger and, without any increase in resources, I’m worried it will take attention away from where it is needed most: with the people who use the services.”
At best, the provisions are unlikely to create meaningful improvements, he said.
“We have seen this already with the 2023 mandate for sufficient nurse staff ratios. This sounded great, but the reform should have come in 15 years ago with an adequate build-up. Instead, we tried to go from zero to 100 in six months and wondered why we couldn’t meet the obligation — there was no workforce to pull from.”
That said, Jilek is pleased to hear that those who expose misconduct might be better protected under the new Act, given the legal repercussions whistleblowers sometimes face.
“If added whistleblower protections do come into effect, they will be very welcomed. It’s difficult for people to highlight problems or take action now, as everything is protected information. All reports from the Royal Commission are heavily redacted and bear little resemblance to the original SITE audit reports. So hopefully they do fix that,” he said.
Some rethinking of traditional processes may be needed
Health Economist and Board Director Dr Stephen Duckett is more optimistic, claiming a small shift in management priorities could help providers meet their obligations.
“It will require change — but not impossible change,” he said. “For example, at the moment, a lot of providers prefer the flexibility of having lots of part-time staff. But I think a person-centred approach will require permanent, full-time workers who can develop an ongoing relationship with consumers. And with wages on the increase this finally looks like a more reasonable prospect.
“The same applies for improving meals,” he continued. “We have all seen terrible pictures of food in aged care facilities. It doesn’t cost a lot to make more appetising food, especially now we have the funding mechanisms to support that. It just requires management to stop and think about who they are hiring for catering and how they might do things differently.”
The ACQSC acknowledges the challenges of meeting the new obligations, but said it is prepared to support the sector.
“We understand that the new Act represents a significant amount of change across the aged care system, and that providers and workers will need support to understand what this means for them. The department will continue to work closely with the aged care sector on this significant reform […].”
