The Government still doesn't understand aged care: Ciarán Foley

As Ciarán Foley steps away from his role as CEO of Allambie Heights Village, he tells SATURDAY the aged care sector remains constrained by the same challenges that existed more than a decade ago.

‘Plus ça change, plus c'est la même chose’: the more things change, the more they remain the same.

This is how Ciarán Foley describes the aged care sector as he steps away after more than 20 years of leading aged care and retirement living operator, Allambie Heights Village.

“We haven’t made, as an industry, the progress that we wanted to make," Ciarán tells SATURDAY.

His comments to SATURDAY on his departure this month echo those made in our last interview with him for this magazine back in 2021.

Despite his frustrations, Ciarán leaves Allambie Heights Village profitable and debt free.

“The finances are solid. We are sustainable. We are profitable,” he said.

The past two decades have been “amazingly good years”. It is perhaps this record that gives Ciarán the confidence to be blunt about what he believes remains broken.

“They don’t understand our business”

One of Ciarán’s strongest concerns is that the Department of Health, Disability and Ageing and the Aged Care Quality and Safety Commission (ACQSC) continue to misunderstand both business and aged care operations.

“They don’t understand our business. They don’t understand business full stop. And they don’t understand aged care," he said.

Providers continue to be viewed with suspicion, he argues, while the regulatory approach is “not just punitive, it’s threatening”.

For Ciarán, that represents a missed opportunity.

“They just do not see what I see, and my colleagues see … they just don’t see the goodness of what we’re achieving each day.”

Instead, he believes the actions of a small number of poor performers continue to define public perceptions of an entire industry.

These are not new concerns. In 2021, Ciarán told SATURDAY that the Department had “bullied” the sector, leaving leaders afraid to speak out. At the time, he also described the ACQSC’s approach to providers as “threatening”.

Four years later, he believes little has changed.

Has advocacy become too cautious?

Ciarán’s criticism, however, is not reserved for Government and regulators.

He believes aged care providers need a more assertive and united voice in Canberra – and wants advocacy organisations to focus more squarely on representing the operators who fund them.

“We can’t acquiesce. We can’t be friends to everybody because they’re not friends to us,” he said.

He also wants to see greater public advocacy from religious organisations and large For Profit providers, which he believes have tended to “ride on the backs” of the Not For Profits that consistently speak up.

“I’d like to see us a lot more united in our whole approach,” he said.

His comments raise an important question for the sector: has maintaining access and a constructive relationship with Government made provider advocacy too cautious?

Operators compete for scarce staff

Ciarán is also concerned that 24/7 Registered Nurse requirements have produced unintended consequences.

According to Ciarán, the workforce shortages that followed COVID-19 border closures and resultant cut to migration continue to reverberate throughout the sector, forcing providers to compete against one another for scarce staff.

He points to increasing dependence on agency nurses as one of the biggest structural problems facing the sector.

“The big players right now are the agencies who are getting rich on that opportunity,” Ciarán said.

Agency staffing also undermines continuity of care. “You’re not going to get consistency with a person who’s here today, gone tomorrow,” Ciarán said.

Covid scars remain

Ciarán, whose first exposure to working in aged care was in a geriatric hospital in Ireland at the aged of 18, says the COVID-19 pandemic fundamentally changed the sector and many still carry the psychological burden years later.

“So many of us still feel that,” he said. “We’re still... only a knock on the door away from that level of concern and vulnerability.”

While providers successfully kept residents safe through what he describes as “essentially a horrific working and living environment”, Ciarán believes the sector has never received the recognition it deserved.

He remains disappointed his call for a national medal recognising aged care workers was never adopted.

Retirement living deserves greater attention

Ciarán also believes retirement villages remain one of Australia’s most overlooked housing and ageing policy solutions.

While aged care demand is well understood, he believes Governments have failed to appreciate the broader economic benefits of expanding retirement living.

“We just don’t have the stock that’s needed,” he said.

Retirement villages not only provide appropriate housing for older Australians but also free up larger homes for younger families and essential workers, Ciarán said.

The opportunity is demonstrated by Bellburra Allambie Heights, which officially opened earlier this month.

Ciarán says its development loan was repaid faster than any previous retirement village loan in Westpac’s history.

Leaving on solid foundations

Ciarán informed the Allambie board of his decision to resign in April. His last day with the organisation was 8 July.

While he is taking a well-earned holiday first, Ciarán's departure will not mean leaving the sector.

Ciarán has already established a consultancy business focused on leadership and training and intends to continue contributing to aged care from late August, early September.

He remains “a friend of Allambie”.

After two decades, Ciarán may be stepping away from the CEO’s office, but not from the sector.

Nor is he leaving quietly.

His final message is that Government still does not understand aged care – but the sector must also ask whether its own fragmented and cautious advocacy has allowed that misunderstanding to endure.