Australia’s aged care system is littered with systemic failures, rife with abuse and needs to put people first, a royal commission has heard.
Counsel assisting Peter Rozen QC put forward 124 recommendations for commissioners to consider during the second-last day of hearings on Thursday.
He said there has been an absence of leadership by successive governments in aged care.
“Even though the aged care system caters for more than 1.2 million older people, governments have treated it as a lower-order priority,” Mr Rozen said.
Recommendations suggested include a new planning regime based on demand-driven access to care rather than a rationed approach, as well as an independent process for setting quality standards.
A new enforceable duty of care, mandated staffing ratios in residential care, compulsory registration of personal care workers and an independent pricing authority to determine costs should also be implemented, Mr Rozen said.
He said new aged care legislation based on human rights principles should be brought in to override existing laws.
Final submissions will be heard on Thursday and Friday, with the commission set to deliver its final report and recommendations in late February.
Wrapping up 97 days of hearings, Mr Rozen said it was evident the level of substandard care is “far too high” and abuse “remains rife”.
Almost half of the 10,000-plus public submissions received during the two-year inquiry were marked with references to substandard care, he said.
He said 588 mentioned sexual assault, and the number of allegations reported to the federal health department rose from 426 in 2014-15 to 790 in 2018-19.
“It is more than two reports per day of sexual assault on average, every day of the year.,” Mr Rozen said.
He said the rate of alleged sexual assaults per 100 residents nearly doubled over that period.
“We submit that the weight of the evidence before the commission supports a finding that high-quality aged care is not being delivered on a systemic level in our system,” Mr Rozen said.
“The level of substandard care is unacceptable by any measure.
“At least one in five people receiving residential aged care have received substandard care.”
Mr Rozen said a “number of systemic failures” included a lack of skilled staff, poor planning, poor governance and leadership from providers and a lack of transparency generally in the sector.
“First and most importantly the aged care system needs to put people first. The preferences and needs of older people really should drive aged care,” Commissioner Lynelle Briggs said.