Senior Counsel outlines “ambitious” five-year program to transform Australia’s aged care system

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Senior Counsel Assisting Peter Gray QC has revealed a grand vision for what the country’s aged care system could look like in 10 years’ time – if the Commissioners and the Government agree.

The Senior Counsel provided a timeline for implementing the 124 recommendations proposed by the Counsel Assisting that would see activity ramp up from June 2021, continue at an increased pace throughout 2022 and 2023 with the new system to be in place by 2025.

An implementation unit would be put in place immediately to begin rolling out the reforms, with a formal evaluation scheduled for 2026 and 2030 to ensure all of the measures are being met and are proving effective.

There were also a number of recommendations that will have a major impact on residential care providers.

‘Big box’ residential care on the way out

Residential care operators would be expected to move to smaller-scale housing models integrated within the local community within four years under a strategy outlined by Senior Counsel Assisting Peter Rozen QC.

He said the evidence to the Royal Commission had shown smaller scale accommodation provided greater quality of life and better quality residential aged care than larger-scale models.

Under their three-step process, dementia-friendly principles would become part of the national guidelines for building new residential care facilities by 2023 with the national construction code amended by 2025.

Financial incentives would also be provided for developments that meet best practice as well as capital grants for small home models of accommodation.

While there was no direct mention of options for seniors’ housing such as retirement villages and land lease communities, the focus on people receiving care at home – with supports delivered in – suggests the retirement living model will be given a big tick in the box.

Antipsychotics “overused” in residential care

Unsurprisingly given the focus on the issue of chemical and physical restraints during the Royal Commission, the Counsel Assisting also made a number of further recommendations to crack down on their use.

In particular, the prescription of antipsychotics would be restricted with only a psychiatrist or geriatrician able to initially prescribe antipsychotics from 1 November 2021.

“In the future, the system should never again be involved in, and the community should never be confronted by, this apparent resort to antipsychotics in place of proper care of the people showing the so-called challenging behaviours,” said Mr Gray.

Greater financial transparency for aged care providers

Funding was also the subject of a series of recommendations designed to prevent the Government of the day cutting funding as happened with ACFI in 2012 and again in 2016.

This includes an increase of $10 a day in the Basic Daily Fee – but providers would need to file annual reports to justify the extra cash.

Longer-term, there would also be incentives to reable residents, reporting of staffing hours and changes to co-contributions and means testing arrangements.

However, the Counsel Assisting had not finalised its recommendations on the long-term financing of the sector such as the introduction of hypothecated levy to fund aged care.

We will have more discussion of the major issues raised by the Senior Counsel in next week’s Daily RESOURCE and Weekly SOURCE.

All eyes on the release of the final report

In his closing address, Commissioner Tony Pagone QC described the recommendations as “courageous” but insisted this was a positive description.

“The submissions are perhaps courageous because they cause us to ask about what system we want and what system will best serve the future, whether it’s the system that has the features that you (the senior counsel) have recommended or others,” he said.

“Might I in that respect simply join with Commissioner Briggs in seeking responses to the various matters you’ve raised with us and ask the question, is what we have as good as we can get?”

We will have more discussion of the major issues raised by the Senior Counsel in next week’s Daily RESOURCE and Weekly SOURCE


About Author

Lauren is the Editor at DCM Group and has guided its range of media including The Weekly SOURCE, The Daily RESOURCE and The Donaldson Sisters since 2016. With 13 years’ experience as a journalist, editor and commentator, Lauren is the only journalist to have attended every session of the Royal Commission into Aged Care Quality and Safety, producing 300 issues of the subscriber-only The Daily COMMISSION which offers exclusive insights and analysis of the issues surrounding the Royal Commission and the aged care sector.