After the Royal Commission

Next steps to a better future for aged care

By Kerry Jones, Director, Systems Initiative, The Australian Centre for Social Innovation (TACSI).

1. Last week’s Royal Commission into Aged Care Quality and Safety delivered its final report. It presented a picture of an aged care system that was failing many older Australians. Its vision for reform puts research and innovation at the core of a better outcome for future generations. How achievable is that vision? What will it take to get us there?

Kerry Jones, Director, Systems Initiatives at
The Australian Centre for Social Innovation.

The Royal Commission’s vision for reform is absolutely achievable and they are to be commended for putting research and innovation as a core strategy in realising that vision. Other sectors have sophisticated set-ups that drive standards and innovation, there is no reason why we shouldn’t have the same in aged care.

However, the current challenge is that the reforms have had to focus heavily on bringing the existing sector back to standard and on the track of continuous improvement.

Alongside addressing these immediate needs, we must explore the unanswered question of “How do we want to age and die in the future?’’ The Royal Commission has helpfully outlined our shared national expectations. These should provide the platform from which we reimagine what it means to age well and die with dignity.

Then the way we implement a research and innovation fund must be systemic in approach. The innovation effort needs to be connected up, a system of learning, future focussed in its orientation.

It must involve citizens, innovators, policy makers and industry, sleeves rolled up, shaping and testing innovations; creating the conditions for innovation to spread and scale.

 

2. If there is one aspect of aged care sector that most Australians understand, it is the sense that there is little scope for anything more than just doing the basics of service delivery. How do we develop the sector’s capacity?

The Royal Commission rightly identified that addressing accessibility, funding and workforce needs are a priority if aged care is going to have the capacity to deliver good quality care in the immediate future.

Beyond lifting the whole sector to that standard, to move into impactful innovation we must start with shaping a vision of the future we want to see. It is critical then to support both the capacity and capability to progress innovation through its entire journey of idea to implementation.

The Focus on education and training in aged care should include a stream for innovation in ageing - supporting innovators already in aged care to grow their capability and supporting experienced innovators to learn about ageing.

 

3. You raised an important question last week after the Commission report was released. It is a question that many of us have asked: “How do we want to age and die in the future?’’  In the aftermath of the Commission report, what comfort can we take that we have an answer to that question?

In posing the question, we acknowledge it is not any easy one to answer. It requires considered, deliberative work that engages a diverse cross section of citizens on behalf of our nation and that carefully navigates the trade-offs to be considered. 

There are certainly windows into possible futures created by innovators reinventing ageing and dying and we should value the insights and intelligence surfaced through the Royal Commission to start imagining how we want to age and die.

Unfortunately, the Royal Commission into Aged Care was not set-up to answer that question. However, they have outlined a good foundation from which to start exploring that question as a nation, through the common expectations and the aged care policy principles they have outlined. The Commission has through its discussions across the sector, with carers, families and researchers gained a deep level of insight into what Australians expect from aged care.

The Final Report makes this clear: “Over the course of our inquiry, we have identified clear common themes in what the community expects from the aged care system: dignity and respect, control and choice, the importance of relationships and connections to communities, and the desire for a good quality of life and ageing at home.”

At TACSI we have explored this very question with older people since our inception a decade ago. Our work has seen us partner with the South Australian Office for Ageing Well to hold a statewide conversation about the future South Australian’s desired and to co-produce South Australia’s Plan for Ageing Well. The Office is now on the verge of finalising the outcomes stage of the process.

 

4. There is an expectation that governments will provide some of the funding to deliver these reforms but cannot do it all: who covers the funding shortfall? What role can philanthropy play in supporting these reforms? Or is there another contribution it can make – to support research and innovation?

At best government is going to fund the reforms that lifts the sector back to a standard. In parallel, what Australia needs is research and development that sets us up for the future; this is where philanthropy can play a role.

In this article we have proposed a national conversation, and some questions to get us started. We have also proposed a ‘systems accelerator’ - a systemic approach to innovation being applied internationally to address complex, long-term challenges. 

These are two examples of things Philanthropy can make happen as you are uniquely placed to steward the future focussed, longer-term change needed. Election terms and machinery of government changes, makes it increasingly difficult for governments to play this role. These proposals require collaborations. Through pooling resources philanthropy could foster the innovation activity needed to start creating the future we want now.

 

5. What is the best way to include older Australians in the debate about their future?

First and foremost, we need to acknowledge our own ageism - after all it is our future too. Next we need to value older people as citizens who can shape their own futures (and ours) not just be ‘end users’ of a system. Then we need to listen, deeply listen, and learn.

From here we can shape teams of people to not just debate, but also imagine that future and experiment with what is possible. These teams should include citizens of a range of ages and backgrounds, innovators, policy makers, people across sectors (such as aged care, health, housing, finance), etc. It is in this diverse melting pot that older people need to be playing an active role (not just being included). But I believe the Report and the in-depth insights it has identified can help plot a national conversation about the future and assist us to drive the recommended innovation in the sector.

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