In 2000, when Bronwyn Bishop was the minister responsible for aged care, a horrific story came to light where residents of an aged care home were subjected to kerosene baths in order to control an outbreak of scabies. Several suffered second-degree burns and blisters. One woman, aged 84, died two days later.
Reports of similar horrors across the country followed as health workers, relatives and pensioner groups seized on the rare media attention to speak out.
Prime Minister John Howard adamantly defended his minister, Bishop, and denied the existence of any nursing homes crisis. “I don’t accept it’s a crisis,” he said on the ABC Lateline TV program. “I mean that is just a ridiculous exaggeration. It is a very sad and regrettable incident concerning one nursing home.”
Yet a litany of reports surfaced in the media about conditions in other nursing homes, indicating that the problem was systemic. Bishop acknowledged that her department had received over 4,000 complaints in the previous two-and-a-half years but had not withdrawn any licences.
So how did this situation come about?
In the 1996-97 budget, the Howard government slashed $1 billion from aged care funding and introduced its Aged Care Act, claiming that higher fees and bonds would provide the incentive for investors to expand and improve the industry. Instead, conditions in nursing homes deteriorated and average waiting time lengthened significantly.
Under the Act, nursing home operators no longer had to allocate a set proportion of government subsidies to patient care. Links between the level of funding received and the number of qualified staff employed were removed. In 1998 the previous requirement for a registered nurse to be on duty was scrapped.
Homes and hostels were to be licensed for three years, with standards monitored through spot checks. Yet no such checks were ever conducted, Bishop admitted. According to Tim Burns, the general manager of the Aged Care Standards and Accreditation Agency, its ability to carry out monitoring was severely compromised due to insufficient funding. He stated during Senate estimates hearings that the agency was 60 to 65 external assessors short in New South Wales and Victoria alone.
The Aged Care Act specified that audit reviews of nursing homes be made public on a regular basis. However, in late 1999, a list rating nursing homes was removed from the Aged Care Standards and Accreditation Agency’s web site in order “not to put undue pressure on homes, which may be rapidly moving to improve their situations”.
The government’s changes made the industry a more lucrative target for corporate takeovers. Under the headline, “Golden Oldies,” the Sydney Morning Herald reported on 2 March 2000 that “Nursing homes are big business, with handsome profits, for some”. American-based corporations were “moving into Australia to capitalise on a growth industry protected by an assured flow of government funds”.
Managing director Kevin Moss said:
“Once you are in the business you have a guaranteed government income. It’s a very good business. It’s been a cottage industry in Australia … and some have milked the cow. But we are trying to get it more corporatised and professional.”
Having been given cash to spend as they saw fit for the previous three years, business operators were free to exit the industry before January 1, 2001, the next accreditation deadline, without having invested a cent in improvements, and then sell their bed licenses for up to $35,000 each, the going price on the Sydney market at that time.
The doctors’ organisation, the Australian Medical Association, and the nurses’ union, the Australian Nursing Federation, warned that between 600 and 2,500 beds would close on January 1 in the state of Victoria alone, intensifying the crisis.
In 2000, Regina Lohr and Mike Head ended their article about the aged care crisis with a chilling warning:
Like every other aspect of life, aged care has become an increasingly two-class system. High quality homes with modern facilities, strict medical and hygiene standards, fresh and nourishing food and tranquil surroundings exist – but they are reserved for the wealthy who can afford fees in the order of $900 a week and entry bonds around $250,000. For lower middle class and working class retirees, the conditions have become Dickensian.
Increasingly stripped of all protective and regulatory remnants of the post-war welfare state, the unleashing of the “free market” is producing conditions where the majority of elderly people are treated as so much unwanted refuse. Medical science has significantly increased life expectancy, but, under the imperatives of the profit system, those who suffer the misfortune of being poor are simply being disposed of as cheaply and quickly as possible.
Twenty years later, we are paying for a Royal Commission to try to clean up the mess caused by Howard’s funding cuts and the tragedy of sacrificing our elderly to appease the Liberal Party’s obsession with deregulation, corporatisation, and profits for big business.
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