The Guardian • Issue #1953

The Aged Scare industry: how privatisation leads to suffering and death

Horrifying stories of neglect, abuse and poor treatment of elderly people in Aged Care facilities and homes across Australia have been exposed after the Royal Commission into Aged Care Quality and Safety released their final report just two weeks ago. Although the Morrison government pledged to provide $452mil to Aged Care following these findings, it has completely disregarded the foundational issue which continues to cause countless nightmarish experiences for people’s loved ones nearing the end of their lives – the privatisation and deregulation of the Aged Care industry, stemming back to the Howard administration.

The investigation was announced in October 2018 – well before the COVID19 outbreak – after a number of concerned citizens had already released disturbing information about the Aged Care industry to the media. Over 10,000 submissions were made detailing negative experiences in Aged Care, from patients, residents, family members, organisations and workers up until September 2020.

In one submission, a woman described finding her incapacitated husband under a delirious medication-induced state, about to drink from his own catheter because no one would bring him a drink. There were not enough staff available to make sure he was supervised or cared for. In another, a daughter gave an overview of her mother’s treatment in a facility in which she believed over-medication led to her being unable to eat, and therefore dying from malnourishment.

Many accounts come from patients themselves, in their eighties and nineties who have continuously requested assistance in the facilities and not received it due to minimal staff and poor communication amongst the workers. Elderly people living at home are also being neglected by the slow approval and release of Home Care Packages, sometimes up to thirty-four months. Many people died before receiving them. Without access to home care services that meet their assessed needs, people face risks of declining function, preventable hospitalisation, premature entry to residential aged care, and death.

One of the notable common complaints was the “My Aged Care” government website and phone line, which is the starting point for elderly people to access government-funded aged care services. People complained about having no face-to-face assistance, and having difficulty finding information to help them make decisions about their needs. They reported the experience as time-consuming, overwhelming, frightening and intimidating.

As of September 2020, while the inquiry was still under way, 629 people who were living in aged care homes in Australia died as a result of COVID19, out of 844 Australian COVID-19 deaths in total. While the majority of COVID19 victims were elderly, the Aged Care and COVID19 Special Report outlined that Australia’s death rate in Aged Care facilities was disproportionately high by international standards. Health practitioners submitted their concerns regarding the lack of PPE or lack of use of PPE, empty soap dispensers and hand sanitisers, in-room isolation of residents, and lack of training for frontline staff.

Systemic issues were also raised, in which residents and families indicated a massive power imbalance against speaking out about neglect or abuse. In some cases family members were also bullied and treated with contempt. Many workers who were concerned about their patients also felt disempowered to speak out, in fear of losing their jobs. There is little doubt that casual Aged Care workers who have few employee protections would avoid rocking the boat.

While the Royal Commission highlights the poor treatment of residents and those in need of home care, many stakeholders are concerned that the prolonged announcement of the recommendations, and the continued inefficiency of the Morrison government to address these concerns, could mean the elderly population remain at risk for longer than required. This has also been found to be a concern amongst those seeking justice for their loved ones, where neglectful actions resulted in their death or lasting impairments.

The final report made recommendations which include but are not limited to:

A new aged care act which supports the ability for elderly people to live meaningful lives and maintain independence;

Long term support which includes social engagement and mental health services;

A registered nurse always being on duty in an aged care facility;

More respite services, more assistive technology, and more options for care at home, or to return home;

Immediate funding for education and training to improve the quality of care, as well as additional support for informal carers and volunteers;

Improved accommodation;

More specific Aged Care for Aboriginal and Torres Strait Islander people, including a Commissioner to address specific needs, and more opportunities for First Nations people to train as Aged Care workers;

Better access to health care for those in remote and regional areas; and

Legislative amendments for those in leadership to have more accountability and responsibility, as well as protection for whistleblowers.

In response, the Morrison government has pledged $452mil to address the recommendations over five years. While this may seem hopeful, the underlying reasons for the major issues in Aged Care have not been addressed, which raises concerns for how impactful the funding will be. Most notably, the privatisation of health care industries has caused the most suffering and tragedy for the working class and their elderly loved ones.

When the Howard government introduced the Aged Care Act 1997, it allowed private investment, which meant private equity firms, foreign investors, and property real estate investment trusts were able to enter the residential aged care market, focusing on profits rather than care. The reforms were made under the premise that it would make nursing homes more competitive and increase the industry’s revenue by introducing means testing and admission fees.

Additionally, Howard shut down the state run standards monitoring process and replaced it with an industry-controlled accreditation scheme. He also ended public funding of the Australian Pensioners’ and Superannuants’ Federation, which was the leading advocacy group for improving standards in Aged Care.

These aberrations lead to further deregulation, such as the removal of resident to carer ratios, meaning hundreds of elderly people in a facility could be under the care of very few staff, or in a facility with no registered nurse on duty. Working in Aged Care became an increasingly stressful and depressing job with poor conditions and very poor pay – leaving the industry with a large turnover of staff. Without public standards, elderly people have been neglected and forgotten about, in dangerous situations with incompetent carers, left to suffer or even die. These are the effects privatisation has on people’s lives.

The Royal Commission suggests residents receive a minimum of three hours and twenty minutes care per day by a mix of nurses and personal care workers. Right now there simply aren’t enough staff to provide this. On top of that, it begs the practical question of how private Aged Care facilities will be audited. Private Aged Care businesses have argued for self regulation and lobbied against staff to patient ratios for many years, and have set these low standards based on their profit margins.

The reality is that Australia needs to re-nationalise the Aged Care industry to make any lasting change to the standards. Frail elderly people are the most vulnerable people in society, and should not be taken advantage of by private money-making leeches. However, bringing Aged Care back into public ownership remains a pipedream whilst the neo-liberal LNP government remains in power. Even under the Labor Party it is questionable whether this would happen. Australians need to fight to take back their public assets, to save the lives and livelihoods of their loved ones.

Elderly people are our mothers and fathers, our grandmothers and grandfathers – people at the end of their lives who have spent their lives labouring, sacrificing and building. A society which treats these people poorly will no doubt experience an existential crisis of meaning and value. Are today’s working class doomed to the fate of today’s elderly people, to be humiliated, and suffer in their final years? It seems a perfect analogy for how the bourgeoisie value the working class once their labour has been expended. Furthermore, there is much to be learnt from the First Nations people, who value their Elders as the knowledge-holders, and pivotal community members in tackling issues that arise in country.

The working class needs a government that supports its interests, both now and later in life. It’s time for those in Australia to really consider the adverse impacts of privatisation and demand a government that makes decisions in the majority’s interests.

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