The Guardian • Issue #2086

Humanity outsourced

  • by Anna Pha
  • The Guardian
  • Issue #2086

Photo: Claudia Love – unsplash.com

The Aged Care Quality and Safety Commission (ACQSC) is responsible for auditing residential aged care facilities to ensure they are meeting mandated health and safety standards. Since 2021, four global consultancy firms were paid more than $40 million for carrying out audits for ACQSC, which include conducting interviews and searches.

The four firms – RSM, HDAA, SAI Global and KPMG – have conducted more than two-thirds of all ACQSC’s audits since 2021.

Alarmingly the head of ACQSC reported to a Senate Inquiry that one third of these outsourced audits were initially rejected because they were not up to standard!

This is of particular concern when the findings of the Royal Commission into Aged Care are taken into consideration. The residents of these centres are some of the most vulnerable people. The Royal Commission estimated that one in three residents in aged care facilities have experienced substandard care.

Issues revealed included: failure to meet personal and clinical care requirements, staffing shortages, undervaluing of staff, casualised and low-waged workforce, substandard food, preventable deaths and injuries, drugging of residents, abuse of residents, lack of accountability and transparency, poor management, and much more.

To its credit, Labor introduced the requirement for a 24/7 onsite and on-duty registered nurse to be present in nursing homes and has a schedule for increasing mandatory minimum times of care per resident.

CONFLICT OF INTEREST

Outsourcing brings with it additional costs with a layer of profits but also the risk of a conflict of interest and substandard work. As was seen with PWC which advised the Australian Taxation Office and assisted its clients using the ATO’s knowledge, conflicts of interest can arise when consultancies serve two masters, such as a government agency’s clients and shareholders.

The four firms reported more than 520 real, potential, or perceived conflicts of interest in relation to their work for ACQSC in just two years!

Even worse than that, ACQSC last year revealed two thirds of the audits were rejected as they did not meet standards set by the federal government, which needed to launch a specialist unit to support the consultants and improve their work. In other words, as a result of outsourcing more than 40 per cent of total audits were substandard.

At a recent Senate inquiry into the government’s extensive use of external consultants, ACQSC’s outsourcing instead of employing public servants came to light.

At the inquiry, Senator Barbara Pocock pointed out that: “Whenever we see core public service functions being outsourced to the private sector there is a risk that those functions could be compromised for commercial gain. This is too important to farm out to money-grabbing consultant firms.”

Former senior public servant David Tune, in a 2023 independent inquiry into ACQSC, also raised concerns about the reliance on contractors.

“I consider this [auditing] is a core function of the commission and that the high proportion of assessments undertaken by third-party provider assessors, represents a significant risk for the commission,” Tune said.

He could have added “and to the residents.”

Taxpayers continue to fund a largely unaccountable and costly system of outsourcing, wasting billions of dollars, in a process riddled with conflicts of interest that result in massive private profits. At the same time the public service is robbed of its skills base with thousands of jobs lost. Under the former Coalition government, it had reached a level where the equivalent of one third of the public service’s jobs had been outsourced.

RESTORE THE PUBLIC SECTOR

AusTender recorded more than 800,000 contracts outsourced to the private sector by the Australian Public Service and government agencies to the tune of $565 billion over the past decade. Most of these contracts were for work that would previously have been carried out within government departments and agencies such as the former Commonwealth Employment Service.

Anyone attempting to deal with Services Australia for aged care services, Medicare, natural disaster support, parenting, unemployment benefits, Austudy payments or any other service will know just how difficult it is. Understaffing, outsourcing, and underfunding have combined to make access extremely difficult with little accountability.

Labor came to office promising to boost the use of inhouse workers and rebuild a gutted public service. It should get on with it without wasting any time. It should ensure adequate staffing and staff training, and the barriers to access are removed.

Services Australia should provide quality accessible and accountable public services.

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