Residents to sit on boards and a national register of aged care providers with “competing” interests: Professor Joseph Ibrahim spells out his plan to fix aged care in Australia

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An indication of the extreme views that will emerge as the Royal Commission prepares to deliver its vision for Australia’s future aged care system.

The controversial Head of Monash University’s Health Law and Ageing Research Unit has penned a piece for The Conversation – which is one of its founding partners – outlining his ideas to address the “violation of residents’ basic human rights”.

These include:

A human rights-based legal centre to uphold the rights of aged care residents at policy formulation and in the courts.

Criminal charges for providers, boards and CEOs that fail to meet standards.

“The current system of weak enforcement and inconsequential sanctions must change. Approved providers, their board members and executives should be held criminally culpable for institutional neglect and abuse, similar to what happens in workplaces,” he writes.

“Without substantive consequences, government ministers, their departments, the regulator and providers will not change their behaviour.”

Greater participation by residents in the running of their aged care home and at the national level.

“Residents should, for example, be able to influence the selection of staff, sit on the board of governance, and be consulted about the operations of the care home and the whole sector,” Professor Ibrahim says.

“Establishing a national group comprised almost entirely of aged care residents, with the addition of legal and administration expertise, and people who can assist with supported decision-making, would be a positive step. This group would report to federal parliament about funding, policy and practice reforms for aged care.”

The establishment of an Aged Care Ombudsman.

This ombudsman would have the powers to investigate the performance of providers and hold all levels of Government and the regulator accountable, the Professor says.

“A more radical approach would be to reimagine our representative democracy,” he adds. “Perhaps if the 213,397 residents living in aged care could directly elect two members of federal parliament, governments may become accountable.”

Increased transparency including on staffing levels, Government funding and regulatory action.

“We should adopt a national public register of competing interests in aged care like some countries have to address the relationship between big pharma and health professionals,” Professor Ibrahim states.

He also recommends the implementation of a wider number of quality performance indicators to measure each facility’s performance; an annual national expert review of serious incidents, with lessons learned to improve the sector; and a national register that gathers data by facility on quality of life and health outcomes for aged care residents (including premature death and injury).

The Professor concludes if these issues can be addressed, then fixing other issues – such as staffing – will be worthwhile.

“But without these changes, whatever is built will simply collapse again,” he says.

The Royal Commission has actually examined all of these issues except for the legal centre and residents being represented at the national level – the Professor will have to wait for the Final Report however to find out if the Commissioners concur with his views.