The past week has seen yet another report from the royal commission into aged care, against pointing out the sub-standard services provided at Rolls-Royce prices by entrepreneurs making enormous profits, as well as the low standards being set for the non-profit sector.
Aged Australians in nursing homes have been receiving insufficient professional medical care, and, often, inferior food and, critically for the pandemic an acute absence of infection controls. The result has been a very high Covid-19 mortality among residents of aged persons homes, aggravated by nursing staff shortages and movements between different nursing homes.
Despite earlier fervent denials, it is now accepted that the Commonwealth, which has the major (although not the exclusive) public duties in relation to care of the aged, did not have in place plans, strategies or resources to help homes deal with the problems, even when the need was evident. By the end of the pandemic, epidemiologists will be assessing the “overburden of deaths” among particular sectors and groups of Australians — that is to say deaths which should have been avoidable, even in a pandemic. It seems clear that many of the deaths will be attributed to negligence or inadequate attention to duty by Commonwealth officials. (Others will be baying for actions against Victorian officials over hotel guards, and for offending News.com, and News Ltd; against NSW for cruise-ship contagion, and Border Force, for airport contagion. )
The Budget will give some extra funding for nursing homes, as well as reorganization of regulatory structures, in line with recommendations made by the royal commission into nursing homes. That’s good, but it ought only be a starting point, because the recommendations are much more focused on dealing with the obvious inadequacies exposed by the pandemic than on a major systemic improvement of the quality of care in all nursing homes. The fact is that the overwhelming majority of Australian nursing homes are well below the standards expected and required around most of the industrialised world — even in countries, such as the United States which have a markedly inferior social security system.
Yet the cost to taxpayers, and to most nursing homes residents are high by international standards. And so are the profits going to the big operators — most of whom (surprise surprise) are big political donors with big professional lobbying outfits behind them. AS with similar problems in the disability care sector, it is almost impossible to avoid the suspicion that the poor regulatory regimes, the lack of prosecutions, the lack of focus on quality care and patient rights have been in response to political demands for “light-touch” regulation, without disincentives against inferior service. It’s also clear that in these areas, as with the banks, one reason why the markets are not operating effectively is because of the sheer greed of the players.
Now the point about this is not to separate off aged care, or disability care, as problems of government which ought to be addressed while we are trying to re-start the economy and get Australians back in jobs. It is that they could be the same problem — the solution representing a major step forward in improving the quality of life of elderly Australians, one creating new permanent and long-term skilled employment opportunities for people displaced by the pandemic.
Likewise with improvements in childcare, and pre-schooling — where again there are challenges in meeting international standards, and where the general community stands to benefit from more effective and more efficient systems. Major public re-investments in this area also create new opportunities for leadership of such programs. That need not necessarily represent public control, at least by old systems. But the evidence and experience of private sector provision would suggest that we need new and stronger levels of public supervision of quality, and innovative ways of involving the families of the consumer. This is not a problem likely to be solved by handing over more money and bigger profits to providers.
If we need more resources going into aged care services (in the community, and with low-level care as much as in intensive nursing homes), with child care, with disability care, and with services focused at Aboriginal Australians, migrants and other vulnerable people, we ought necessarily be requiring more training places for the men and women who will have to be providing such services. Whether in the vocational training sector, or in universities, a new public investment must be creating new jobs. And contrary to the assumption sometimes seeming to be made by the diminishing numbers of capitalists who “make things” rather than provide services, these are jobs that add to the national wealth, cause economic growth and improve our measurable standard of living.
Just as do jobs involved in improving health (which might be jobs for engineers, sewer workers and waste collectors as much as for doctors, nurses and public health workers), or reinvesting in infrastructure fit for the next 40 years, and the facilities (including access to the internet and modern communications) and workforce able to constantly improve it.
Investment in such sectors, including the quality of facilities, improving the breadth and depth of staff, and preparing for the post-pandemic economy should not be regarded as a dispensation, given with surliness because it is seen to take money away from a “proper nation-building” project such as a road or rail program, some belated recognition that we need a quality rather than an inferior broadband, or some special favours for folk and friends in the water and energy sectors.
New jobs making Australians healthier, better educated, better trained are rather more the winning industries of the future, than the relatively few jobs able to be created in capital-intensive physical industries. Despite the prime minister’s assertion that Australia has a comparative advantage in the fields he has selected for extra care, extra investment, and extra protection from external competition, it is by no means certain that any of them will play much of a role in Australia’s future. Particularly if some of the logical consequences of Australia’s current foreign policy, particularly in relation to China, are realised.
Economic recovery by Australia does not depend only on the economic decisions made by the federal government, or even by the National Cabinet, or at least so much of that as can be said to have survived the experience of the pandemic. It also depends on a recovery in world growth and world trade, as well as skilful management, by other countries as much as by Australia, of resurgences and second, third and fourth waves of the virus in the community. As with the right time to open borders, external and internal, these cannot be successfully incorporated in appropriation bills.
Yet there could be few countries on earth better situated for a smooth recovery, if one a good deal more bumpy than originally expected. Some skill and some luck, and some learning from mistakes, has kept infection rates, and death rates (even in Victoria) at a fraction of the levels of many other countries, including Britain and the United States, as well as India.
On the face of it, however, three of the nations best positioned for a recovery, in terms of current economic activity are China, Australia and the United States, and several of our other major trading partners, such as Japan, South Korea, and many of the islands and nations of ASEAN are picking up faster than others. Even so, one can expect that the way out will be slower, more bumpy and more subject to regional and local variations than anyone had expected.
But even if Australia gets to growth and economic activity rates similar to those of 2019 (a weak state, to be sure, but a milepost to pass) it would not prove that the Government’s strategy was completely right. It will have recreated an economy and a society fit for the 20th century. Time to be creating the 21st century nation of tomorrow. With a cleaner environment. A healthier, better-educated citizenry. More fair, more just and more politically stable than before, and one considerably more kind to its most vulnerable, and to those of neighbouring countries, on whose stability we depend.