Under normal circumstances Australians do not spend much time thinking about aged care facilities.
If we have to mention them, it is usually by way of euphemism: we talk of twilight homes, or God’s waiting room. This is not meant to be derogatory – it is more about denial. We hope we can avoid the places for ourselves and our relatives, so we hope by being silent they might just go away.
There is a similar approach to other institutions, notably prisons: we don’t really believe we will ever be incarcerated in one, so we try to ignore them. We assume that someone else (preferably the government) will take charge of them while we get on with more salubrious pursuits.
This attitude is entirely understandable, but it can be very dangerous, because if the someone else turns out be negligent, or worse, deliberately callous in pursuit of their own agenda, considerable damage can occur before the inevitable storm breaks.
And it is for this reason that it is never a good idea to hand over such public responsibilities to private interests. When profit becomes the primary motivator, prisons – and aged care residences – can become easy cash cows for unscrupulous operators to the detriment of their immediate victims, but ultimately also to the commonwealth, because in the end the commonwealth has to clean up the mess.
This can produce an immediate conflict, because it was the commonwealth that passed the places over to the entrepreneurs in the first place and gave them effectively carte blanche to manage a problem various governments have found all too hard: they can save a lot of money and angst by duck-shoving the sector across to the eager Gordon Geckos, while mouthing the false platitude that everyone knows private enterprise is always more efficient than government, and of course we don’t need a lot of regulation – unnecessary red tape, just let the system work itself out.
Until it doesn’t, and then the shit hits the fan. This was on schedule last week, when the hateful lefties of the ABC promoted a Four Corners special which would turn over more than a few damp stones. And everyone, especially Scott Morrison, knew there were plenty to upend.
It is not as if the abuses and even deaths in the aged care regime had not been noticed: since 1997, when the then minister Bronwyn Bishop (known as the Minister for Caged Hair) had to explain why residents were being bathed in kerosene to get rid of constant infestations of lice, there have been a stream of inquiries and promises of reform. But little if anything has improved, and governments from both sides have been happy to let things slide – to move on, as the saying goes.
However, the prospect of a major scandal just as the new Prime Minister was trying to settle into his none-too-comfortable chair had to be countered. It was not politically feasible to shut it down so Morrison did the next best thing: he pre-empted the ABC and called a Royal Commission.
There was no time for consultation or warning for the aged care sector – it was simply a matter of getting the headlines out and such minor details as terms of reference, finding staff, even alerting the bewildered government troops, could be sorted out later. And unfortunately that included working a credible justification for Morrison’s own record.
A great many aged care homes were run on a profit basis, but a lot more were not – the privatisation was at best somewhat haphazard. However, the economics of the industry worked on the basis of massive government subsidies.
There was little serious oversight of just where the government money went; but the bean counters, including Morrison, who was then Treasurer were always after savings, and because at the time aged care was not a big story, Morrison cut some $1.2 billion from the Aged Care Funding Instrument, claiming (as always when it came to government agencies) that there was waste, inefficiency, over-servicing and rorts.
This was at best arguable, and there were protests at every level, but Morrison held his ground at the time. Now, however, it has come back to bite him. Since then there has been more money from the government, so he can (and does) shout about the fact that the financial situation has improved.
But the row could have been avoided with a little more caution. And indeed, so could the whole Royal Commission, and the Four Corners investigation that triggered it. We have known for decades that the aged care industry is largely unaccountable and unwilling to reform, but the government, muttering vaguely about self-regulation, has been reluctant to do anything – in spite of paying a large chunk of the bills.
We have also been told many times that trained staff levels are far too low, supervision slack and at least some auditing procedures need overhauling. And overall the oligopoly – a cartel of a few mega-operators dominates the sector – is extremely profitable. All of this and a lot more besides could and should have been addressed years ago. But except for the occasional revelations by whistleblowers and media, aged care has never been a barbecue stopper – until now.
Once the commission gets under way there will be no shortage of atrocity stories – but there were plenty already and had been over many governments for many years. The real scandal is that the industry has been allowed to make its own rules without effective oversight. Morrison will get a brief boost from his announcement, but he is unlikely to get much lasting credit – it is more probable that critics will ask why the coalition has ignored all the warnings for five years on its watch just as it did with the banks.
Which is no doubt why Morrison is throwing buckets of money at every target he can find – farmers, Catholics, strawberry growers, anyone who may have a hip pocket and a vote. And don’t worry, there will be plenty for pensioners (sorry, richly deserving senior citizens) in the pipeline. There will have to be: like a shark, Morrison’s only hope is to keep moving constantly, keeping the electorate off balance. Even a momentary hesitation may consign him to a retirement village himself.