People and Not Profit Must Be at the Heart of Care

Queensland nursing home crisis

70 elderly patients were thrown out when Earle Haven, an aged care centre in Queensland was abruptly shut down on 11 July.

It took eleven hours for paramedics to evacuate the senior citizens, about 90% of whom suffer from dementia. The immediate cause was that HelpStreet Group, a subcontracted firm which operated the home had disputes on payments with People Care Pty Ltd., the care facility provider. It thus stripped the retirement home of valuables, drugs and patient records, amongst other materials!

The  Australian federal government has ordered a full inquiry into this disgraceful development. And the Queensland Nurses and Midwives Union called for criminal charges to be considered and subcontractors banned from running aged care facilities.

It is clear to the union and all well-meaning persons that we cannot allow the lives and dignity of aged people to be treated with such disdain by for-profit interests.

Grossly understaffed, it failed 15 of 44 standards and made spirited but futile attempts to employ more staff in March 2017 only when the situation there had already become public knowledge.

The retirement home has a 12-year history of being repeatedly sanctioned over quality of care and breaching of regulations. In 2007 it was sanctioned four times, including temporary forfeiture of public funding for new patients. And this year alone there had been no less than 22 complaints made against it to the Aged Care Complaints Commissioner, before the saddening incidence.

The shame at Earle Haven is not some one-off happenstance. It reflects a deep crisis confronting aged care and social care in general, marked by underfunding on one hand and sharp practices of private providers whose primary concern is profit. Probably the turning point in what has become an avalanche of revelations that show this crisis in sharp relief over the last two years, was the Oakden nursing home scandal.

The aged mental health centre was shut down in 2017 after a major scandal that drew attention to the worrisome regime of aged care in Australia. Grossly understaffed, it failed 15 of 44 standards and made spirited but futile attempts to employ more staff in March 2017 only when the situation there had already become public knowledge. Abuse and neglect dating back 10 years were uncovered when the home was investigated that year.

In September 2018 Prime Minister Scott Morrison announced a royal commission into Australia’s aged care system. The commission’s focus was residential and in-home aged care for the elderly, but also covered care for young people with disabilities who live in aged care homes. The Prime Minister further informed that the Australian government had closed one aged care centre a month for not meeting set standards since the Oakden scandal a year earlier!

At the heart of this terrible situation is that private providers are wont to deploy any and every possible cost cutting stratagem they can get away with (and even a few of those that they should ordinarily not be able to get away with).

These include bypassing registered nurses to employ less-skilled personal care attendants (PCAs) who are not adequately trained for the job. With the explosion of privately-owned aged care homes, the proportion of registered and enrolled nurses have drastically reduced over the last decade and now stands at just over a quarter of the aged care workforce. Liberalisation of labour hire practices through sub-contracting have also helped worsen the situation as was demonstrated in Earle Haven.

Family-owned aged care companies, which comprise a significant proportion of the for-profit private interest in the sector, con the public twice. Not only do they provide sub-standard services to maximise profit, they are also tax cheats.

A report from the Tax Justice Network Australia and the Centre for International Corporate Tax Accountability & Research highlights concerns about “aggressive tax minimisation strategies”, of some of the biggest family-owned aged care companies in the country.

Despite (or to help ensure getting away with?) tax avoidance, some of these companies have not been averse to donating hundreds of dollars to parties such as the Liberal National Party over the past few years.

And it is not only family-owned companies that are involved in sharp tax practices. Bupa Aged Care for example has been the subject of an audit by the ATO, as Jason Ward, spokesperson for TJN Australia and CICTAR noted. The company was also been charged to court in April for charging residents in 21 aged care homes a fee for extra and often expensive services that were not provided or only partly provided.

They might care less about the quality of care delivered to residents of the aged care homes they own, or to account for billions in taxpayer subsidies they receive, but these Czars of for-profit care delivery sure know how to take good care of themselves. 77-year old Arthur Miller is the man behind People Care Pty. Ltd, the company which owned Earle Haven. He lives in a $2 million mansion at Clear Island Waters.

An unacceptably dreadful state of aged care, whilst private providers of social care (who in 9 cases out of 10 benefit from public funding) smile to the bank is not something simply Australian. Five years ago, The Lancet pointed out that elderly care was in crisis, globally. This was in the wake of the Crisis in care 2014 report published by Age UK. The report showed that public funding for older people’s social care in the UK fell by a massive £1.2 billion (15.4%) in real terms between 2010-2011 and 2013-2014.

Declining public funding for social care as part of the austerity measures being implemented by governments across the world is matched only by the rabid concern of private sector operators to maximise profits. Neither of these two ends which both prioritize profit over people can be tolerated, any longer.

PSI and its affiliates are committed to fighting against these wanton demonstrations of inhumanity on the altar of Mammon. Evidence-based policy advocacy for increased funding for aged care and social care in general is central to our work. In this regard, we will be publishing a report on “The ‘Care Economy’ and Social Care Workers: Trends, Trajectories and Targets” before the end of the year.

The health sector unions in Australia have played a central role in helping to unearth the inhumane order prevailing in aged care when it is subjected to the whims and caprices of profit seeking interests. Their campaign serves as inspiration for the struggle that lies ahead for us to once again put social care where it belongs i.e. at the heart of our being human. And this can be done only when people are unambiguously put over profit.