Commissioner Pagone strikes down Aged Care Minister’s comments suggesting Royal Commission supported outsourcing of ACAT teams

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The Commission’s Chair Tony Pagone QC (pictured above) took the extraordinary step last week of issuing a press release distancing the Royal Commission from comments made by the Minister for Aged Care Senator Richard Colbeck that implied the Commissioners supported the Government’s plans to put ACAT assessments out to public tender.

This is an unprecedented step for the Royal Commission – and indeed, for other Royal Commissions.

Neither the Banking nor the Institutional Child Sex Abuse Commissioners released any kind of statement directed towards a Minister or the Government.

The Sydney Morning Herald had published an ‘exclusive’ (pictured above) on 29 December 2019 that revealed the Coalition was pushing ahead with plans to merge the Regional Assessment Service (RAS) and Aged Care Assessment Teams (ACAT) into a single “streamlined” service by putting the service up for public tender this year.

The timeline for the transition to be complete is April 2021 – just 15 months away.

Minister said reform was supported by Royal Commission

The story quoted NSW Health Minister Brad Hazzard as saying: “It seems pre-emptive and unreasonable to be effectively privatising health aged care services while the Royal Commission into Aged Care is still underway.”

However, Herald journalist Chris O’Keefe said Minister Colbeck dismissed the comments from his NSW Liberal colleague, saying the reform was supported by the Royal Commission into Aged Care Quality and Safety.

The Royal Commission’s statement makes it clear that Mr Pagone and fellow Commissioner Lynelle Briggs do not endorse the measure – but rather plan to monitor its implementation.

“It is desirable in view of the public concerns and statements which have been expressed that it is made clear that the work of Royal Commissioners is intended to be, and is, independent of Government. Our tasks as Commissioners are detailed in the terms of reference and we have not yet made recommendations about which sector or mechanism will best achieve an integration of Regional Assessment Services and the Aged Care Assessment Teams,” he said.

It’s an incredible statement – so how did it come about?

Fears of losing skilled assessors and geriatricians from ACAT teams

I’ve put together a timeline of events.

David Tune had recommended the integration of the two services in his 2017 Legislated Review of Aged Care, stating: “This will result in less duplication, greater efficiency, and above all, better service to consumers, who will experience less confusion and ‘tell their story’ once.”

The idea of merging the teams was put out for public consultation between December 2018 and February 2019 – with the suggestion that this service potentially be outsourced.

The 223 submissions appeared to suggest most stakeholders supported the reforms.

However, unease about the transition still seemed to be widespread.

At the October hearings into the aged care workforce in Melbourne, the President of the Australian and New Zealand Society for Geriatric Medicine Dr John Maddison gave evidence he was concerned about the role of geriatricians being cut out of ACATs if they move out of the public hospital system.

In early November, The Saturday Paper’s Rick Morton published a piece with fears from the sector about the end of “any meaningful direct involvement of geriatricians’ and other specialists”; the “de-skilling the assessment workforce through loss of clinical expertise and knowledge”; and “conflicts of interest within assessment organisations”.

Unsurprising then that the information about the new assessment arrangements was quietly published on the Department of Health’s website just before Christmas without an official press release from the Minister.

The Herald then picked up the story for its exclusive. Minister Colbeck also told ABC North Coast on 31 December 2019 that the Government has never directly provided assessment.

“It has always managed assessments through various forms of contracts or agreements with either the States and Territories or community based organisations,” he said, adding “The tender arrangements will include measures to ensure that conflicts of interest are managed.”

This alarmed consumer advocacy groups, and on 8 January 2020, Aged Care Crisis wrote an open letter to the Royal Commission asking them to confirm that the Minister did consult with the Commissioners on the changes and clarify whether they supported the “privatisation” of the new assessment arrangements and the decision to put them out to tender (leading to the Commissioner’s response).

No explanation from Department of Health for ‘outsourcing’

We put it to the Department of Health to provide detail on when the decision was made to outsource the teams – and who made it – but had not received a response by the time of publication.

In response to Commissioner Pagone’s statement, the Minister (pictured below) issued his own statement acknowledging the Commissioner’s comments – but refusing to back down.

“The Government has consistently refuted claims that our intention is to privatise the assessment process for aged care. That assertion is incorrect,” he said.

“We would welcome any views the Royal Commission has in respect of completion of this integration process.”

“The Government continues to respect the independence of the Royal Commission.”

The states are still unsatisfied with the reforms, however.

The NSW and Victorian Governments have promised to raise the issue at the next Council of Australian Governments (COAG) meeting in mid-March 2020.

The Interim Report did state that the Commissioners believed the two workforces need to be integrated “urgently” – so the comments from the Minister could simply be a poor choice of words.

But it is unlikely the way Senator Colbeck wanted to start a year in which the Royal Commission is preparing to hand down sweeping recommendations to overhaul the sector – a transformation the Government is now expected by all sides to spearhead.