Commissioner Lynelle Briggs has called Australia’s aged-care system “a national disgrace” after hearing evidence of staff abusing helpless elderly residents and wounds left to fester so long they became infested with maggots.
The AMA’s 53-page submission – to be made public on Monday – calls for a significant increase in federal government aged-care funding, matched with tighter regulations to ensure that providers do not siphon off the extra money to bolster their bottom lines.
It links funding levels with poor facility planning and design and a shortage of properly qualified staff, resulting in overuse of restraints – both chemical and physical – along with medicine mishaps, unpalatable food and avoidable trips to the hospital.
Australian Nursing and Midwifery Federation secretary Annie Butler said the “often horrific” evidence presented to the royal commission and revealed by the ABC’s Four Corners were “simply confirming” what the union’s members “have known for many years, and are reporting to us with increasing despair”.
“Underpinning so many of the problems that are being exposed across the aged-care sector is systemic, chronic understaffing, leading to unacceptable instances of neglect, abuse and too many preventable deaths,” she said.
Prime Minister Scott Morrison has granted a six-month extension to the commission’s hearings and its final report has been pushed back from April to November 2020.
Ms Butler backed the AMA’s argument that a shortage of general practitioners was affecting patients’ care and that disturbing mistreatment reported to the royal commission could be prevented if aged-care centres employed enough properly trained staff.
“The government can start on this immediately by requiring aged-care providers to publish the staffing ratios in their facilities and to transparently report on their use of publicly funded subsidies … then determine where additional funding is needed and ensure that it is provided,” Ms Butler said.
AMA surveys have shown the number of GPs willing to work in the aged-care space declining due to what they see as inadequate Medicare rebates and frustrations over a lack of nurses and treatment rooms on-site.
Doctors want the rebate for aged-care visits to be increased by more than 50 per cent, saying the current $55 callout fee, on top of $37.60 for a standard consultation, does not compensate for the time it takes to travel to a centre, find parking, locate and treat the patient.
The AMA also calls for a big investment in home-care packages after the royal commission heard there were 119,524 older people waiting for the level of package they had been assessed for in June – and16,000 people had died waiting for one.
The submission said delivery of the home-care packages would save the government money by preventing the need for “more complex” and expensive care in aged care facilities and hospitals.
Government expenditure on residential care was $12.2 billion in 2017-18, an average of $66,000 per resident – compared to $50,000 for a Level 4 home care package.
Dr Bartone said while the AMA supported the royal commission, “the matter is too urgent to wait for [its] recommendations before any action is taken”.
He said older Australians “have the right to live in dignity and have safe and appropriate aged-care services”.
“The government must act now.”
Dana is health and industrial relations reporter for The Sydney Morning Herald and The Age.