[Theme Music Starts]

RUBY:

From Schwartz Media, I’m Ruby Jones, this is 7am.

Last week, the most significant report to examine aged care in Australia was released.

The Saturday Paper’s senior reporter Rick Morton has been covering every step of the journey to get here.

Today, he tells us why this could be the moment we change the broken system that tries - and fails - to take care of older Australians.

[Theme Music Ends]

RUBY:

Rick, you’ve been covering the aged care sector for nearly a decade now. We’ve talked to you about your reporting time and time again on the show. You were there when Scott Morrison first announced the Royal Commission into Aged Care. So, what was that like?

RICK:

Yeah, well, I mean, the very first story I ever wrote that had my social affairs by-line on it covering social policy was in 2013, it was about a nursing home in Sydney where Gough Whitlam stayed and about residents with concerns there about substandard care.

And over the years since, I was in every budget lock up when aged care funding was announced or taken away. So I'd watched all of this stuff up close.

Archival tape -- Scott Morrison

“Well good afternoon everyone, I’m very pleased to be joined by the minister for health, Greg Hunt, and the minister for senior Australians and aged care, Ken Wyatt…”

RICK:

I was working, just as luck would have it, on a Sunday in, I think it was September 2018 when all of a sudden Scott Morrison announces - he's only just become Prime Minister - announces that there's going to be a royal commission, and he does his big press conference in the Prime Minister's courtyard.

Archival tape --

“And that’s why as Prime Minister, last week we discussed this together as a cabinet and we decided that it was necessary to move forward with a Royal Commission into the aged care sector…”

RICK:

So I just rock up on this Sunday shift - I'm working in Parliament House - and I grill him.

Archival tape -- Rick Morton:

“Prime Minister when you were treasurer you cut $2 billion from Aged Care-”

Archival tape -- Scott Morrison:

“No that’s what the Labor party said.”

Archival tape -- Rick Morton:

“No no, you did.”

Archival tape -- Scott Morrison:

“No, I - no, the Labor Party said that”

Archival tape -- Rick Morton:

“You cut $1.2 billion-”

Archival tape -- Scott Morrison:

“No, I don’t accept that. If people want to put questions, they’re not allowed to put lies. Ok?”

RICK:

The senior journos in that instance let me go for as long as what seemed reasonable, because they wanted me to ask the question.

Archival tape -- Scott Morrison:

“This is why we’re gonna have a Royal Commission.”

Archival tape -- Rick Morton:

“Are you ignoring the facts?”

Archival tape -- Scott Morrison:

“No. I’m not ignoring the facts, that’s why I’m calling a Royal Commission!”

RUBY:

Ok, so that standoff that you had with the Prime Minister, that was two and a half years ago, and it was really the beginning of the Royal Commission process. And now, we’re at the end of that process. Last week Scott Morrison handed down the commission’s report at this pretty hastily arranged press conference. Can you tell me about that?

RICK:

Yeah, well, there wasn't a lot of time. You know, the government made a decision to release this report on Monday and announced this last minute media conference at Kirribilli House where the Prime Minister stays when he’s in Sydney.

Archival tape -- Scott Morrison:

“Good afternoon, everyone…”

RICK:

Journos were given half an hour to get there and were given less than an hour to read this five volume, 2500 page document ahead of the Prime Minister's press conference, so there's no way for anyone to get across the detail in any significant sense.

Archival tape -- Scott Morrison:

“I’m here to release the Royal Commission into Aged Care quality and safety, I’ve been joined by Minister Hunt and Minister Colbeck…”

RICK:

The landmark report was spat out without almost any fanfare in the middle of a rolling series of crises relating to allegations of sexual assault and involving the parliament of Australia.

Archival tape -- Scott Morrison:

“We are all part of a system that is supposed to be providing the best quality care we can for older Australians, particularly as they age…”

RICK:

We didn't know when, but we knew the report was coming because they had already been selective leaks to favoured media outlets - in fact, that's when I first knew that this was happening on Monday because I saw the front page of The Australian newspaper late on Sunday night.

And those leaks in particular enraged some people, particularly within the commission, because there is a process that is almost always followed here. And I was talking to a senior source within the commission who told me that the selective leaking of the final report to these favoured media outlets was infuriating.

And, you know, they said that the leaking tells us very clearly, before the public has even had a chance to see the findings, that they are willing to play politics with this historic moment. And they went on to say that that was a vindictive act and speaks volumes about the government's commitment to the process.

RUBY:

So things not exactly off to a good start then, Rick. What about the report itself? When you did manage to spend some time with it, what did you find? What does it say?

RICK:

It's 2580 pages long, and the extent of it, as laid out by Lynelle Briggs and her co commissioner, Tony Pagone QC, is an invitation to despair. It's a shattering report. It really is.

I mean, I first read the executive summary, which is itself a hundred and something pages long, but even that will get you across the bare details, which is that there are some 5000-and-something reportable assaults in aged care homes in Australia every year.

And we heard in the royal commission's final report that between 27000 and 39000 assaults each year go unreported. Commissioner Lynelle Briggs went on to say that she thinks there's at least one third of all nursing home residents in home care package recipients have experienced substandard care. There is almost nothing within the system that escapes criticism.

The regulator, the watchdog is timid. The Department of Health, uninterested, and the relevant ministers over many years unwilling to discharge their responsibilities to steer the system toward quality.

Governments over many years have spent almost all of their effort and energy putting out spot fires in the system and have completely ignored or left unattended the structural failings in the system that caused these problems.

RUBY:

OK, so the report is laying out the problems that we know exist in aged care, things like assaults that aren't reported, substandard care. And on top of that, though, it's also critiquing the way the government has tried to attempt to fix those problems, those sort of reactive attempts. Rick, I want to talk a bit about how the report recommends fixing this, because a lot of big figures have been thrown around for quite a long time about what it would actually take to fund the aged care system properly, billions and billions of dollars. So did the commissioners land on a number here?

RICK:

Royal Commissioner Lynelle Briggs actually put a figure on it and she says that it will cost at least $30 billion a year now to fix the problems in aged care. Currently, the Australian government spends $20 billion a year, so she's talking about at least an extra $10 billion every year in Commonwealth funding that would be needed to to bring these reforms to fruition and to bring the sector up to an acceptable standard, and even, dare I say it, a high quality standard.

And so how much money the government puts in the budget this year is going to be crucial, and it needs to be recurrent funding because the real damage that was done to the sector, the reason a shortfall even exists in the first place is because of some of Scott Morrison's actions as treasurer and some of the predecessor ministers for health and aged care over the last two decades, but particularly compounded by Scott Morrison in the 2015/2016 budget cycle.

RUBY:

Tell me about that?

RICK:

So while Morrison has denied that he stripped more than two billion dollars in care subsidies from the sector since late 2015, the commissioners he appointed actually lay out the truth clearly in their report; this is the first time we've had somebody who is beyond reproach saying what frankly, I've been writing since 2016, and that is that, since 2015-16, expenditure per person in the 70 plus years population on aged care has been falling. So I want to be clear here. Both Labor and the coalition have done similar things to what we call kind of indexation of the care subsidy funding on the aged care funding instrument.

But it was only the coalition during Morrison's tenure as Treasurer that pulled the money from the aged care funding instrument and took it out of the sector altogether.

And since then, all of these issues that had been bubbling away and growing over, you know, 15 years since Morrison's decisions, they have catapulted this sector into absolute crisis mode.

RUBY:

We'll be back in a moment.

[Advertisement]

RUBY:

Rick, Australia's aged care system has been deeply dysfunctional for a very long time, and that has impacted on countless families. There's so much pain here. Can you tell me a bit about how some of the residents and their families, how they feel about this report and the response to it?

RICK:

Yeah. One man in particular who kind of helped trigger this royal commission is Stuart Johnston, whose mother, Helen, was abused as a resident of the now shuttered Oakedon older person mental health service in South Australia. This was the place - the exposure of the abuses within it - that launched this royal commission.

So I was talking to Johnston and I was talking about, you know, the original abuses, but also how these things get compounded by what appear to be, to you and I, the simplest things. And the classic example is the way the government launched this report. And I asked Johnston what that felt like and he said it was horrific.

Archival tape -- Stuart Johnston:

“So the whole lead up to it was really just bad and then to be left hanging all day. And that affects everyone, not just media, affects families. And so many people waiting on the report being released sitting there the whole day. It was just...it was horrific…”

RICK:

You know, here is someone who has spent the last, you know, decade in a bit campaigning for transparency and just a voice for the elderly in parliament. And they get completely locked out.

Archival tape -- Stuart Johnston:

“I still held hope because this is an opportunity for Morrison to have a legacy. But I think once he opens his statements with 10 adjectives or whatever the hell he came out with, the whole kit and caboodle of just one liners. Apart from the fact he kept everyone waiting for so long and we all didn't have an opportunity to have a look at it, I think I lost faith there.”

RICK:

They had no idea what was in the report. They had to spend all of Monday guessing until it was finally tabled in parliament in the afternoon, which meant it then became publicly available.

Archival tape -- Stuart Johnston:

“There's hundreds of thousands of families that are really hurting right now in this nation and 700 people's families just in Melbourne because of the Covid bungle in aged care, which should never have happened…”

RUBY:

Rick, can you tell me a bit more about what is likely to happen next? Because the whole purpose of this royal commission is to prevent things like what happened to this family from happening to any others. But for that to happen, there has to be money and then that money has to be spent in the right way. So can you tell me about what the commissioners are recommending?

RICK:

Yes, this is a really, really important point because nobody, myself included, Stuart Johnston included, and other people in the sector, nobody wants to see bucket loads more money going to the same system that in theory, and in practise in some cases, can allow company directors to buy Lamborghinis or Ferraris to flee the country when, you know, their residents have been caught up in this horrible Covid-19 pandemic, as happened to a Victorian aged care service - that is simply not going to do.

So what the aged care royal commission is recommending is a whole suite of reforms that must all be implemented. Because without any one leg of it, the whole system loses the integrity that they have envisaged. So, yes, they're recommending a whole lot more money, but there are finally going to be conditions attached to that money, according to their recommendations.

They have heard very clearly that aged care quality and safety is directly dependent on the number and quality of the people who provide it; the staff, in other words. They say the aged care workforce must not only grow in size, but also in skillset. So since 2003, the proportion of registered nurses, enrolled nurses and allied health staff in aged care have all declined by significant amounts.

Commissioner Pagone recommends the entire system, the entire aged care system, be removed from ministerial direction and put in the hands of a truly independent body, which he has decided to call the Australian Aged Care Commission.
Both Pagone and Briggs agree that an inspector general of aged care needs to be created to keep watch over both the development and maintenance of this new aged care system.

RUBY:

And, Rick, that is really what we're talking about here. We're talking about a new aged care system because these changes, they're fundamental. And I'm just wondering, as someone who has spent a lot of time reporting on what seems like a really callous system and and a really heartbreaking way to treat people, I wonder how you are looking at the prospects of a fundamental shift in aged care in Australia. Do you think that it's going to happen?

RICK:

I do. I think it will be very hard to pull off, but it has to be done. And you know, what this commission report has done is it's belled the cat on the real problem here.

Providers can be good or bad, right? And there are some really bad ones. But even in this shocking system, most of the ones in the middle are failing purely because there is not enough money.

And the government has turned a blind eye - deliberately in some cases, according to the commission - because they don't want to spend money on this system. And so they have actually deliberately run it into the ground. And that has to change. And the thing is, interestingly, the sector - providers, consumer advocates, staff groups, nurses unions - all of them are so angry and they have been fighting for years now to try and reframe this as saying; ‘look, where we have failed individually, we take responsibility for that, but the biggest cause of neglect and substandard care in this system is the government itself’. But, you know, finally, there is nowhere for the government to hide.

If we implement the royal commission's reforms, all of them, that will actually be a kind of catalyst for this change in understanding, because sometimes you need to have a language for what it is that you're trying to articulate.
And maybe the language we need to say that nursing home residents are human beings, rather than just objects in a home or a facility, maybe the change we need is actually enshrining that in the legislation, which is what the royal commission recommends; rewriting the entire Aged Care Act, tearing it up, having an entirely new one in 2023 that explicitly says these are people with human rights.

And maybe if there are resources thrown at it, we can actually have a broader conversation then about the fact that these are not numbers on a budget line item, but they are people and they will be us one day as well.

RUBY:

Rick, thank you for your time.

RICK:

Thanks, Ruby.

[Advertisement]

[Theme Music Starts]

Also in the news today...
Australia is suspending military ties with Myanmar, as the death toll rises following a coup led by the country’s army.

Foreign Affairs Minister Marise Payne has condemned the use of lethal force and violence against civilian protesters.

And Meghan Markle - the actress and wife of Prince Harry - has said that when she was first pregnant with her son Archie, there were concerns raised within the palace about how dark his skin might be.

The statement is one of many revelations made by Meghan Markle and Prince Harry in a two hour interview with Oprah Winfrey, broadcast yesterday.

I’m Ruby Jones, this is 7am, see you tomorrow.

[Theme Music Ends]