Rachel Siewert (WA, Australian Greens) Share this | Hansard source

I present an interim report of the Community Affairs References Committee on aged care assessment and accreditation.

Ordered that the report be printed.

I move:

That the Senate take note of the report.

This particular interim report—I will go into why it is an interim report during my remarks—looks at the effectiveness of the Aged Care Quality Assessment and accreditation framework for protecting residents from abuse and poor practices and ensuring proper clinical and medical care standards are maintained and practised. This inquiry was established to look at the effectiveness of the current frameworks in ensuring that older Australians get quality aged care. In the first instance we had a focus on the shocking revelations of abuse and lack of care that were made about the Oakden facility and specifically the Makk and McLeay wards.

At this point I thank all of the witnesses who gave us evidence, particularly those—by and large they were the relatives of former residents—who shared the most personal experiences of the appalling treatment that many of their relatives received. Many of those witnesses shared evidence that was deeply concerning and troubling both to them and to the members of the committee that heard it. Quite frankly, how long this outrageous situation went on for still boggles my mind. Our report goes through the time line of accreditation and review from when the processes began there in 1998 until it closed. There were many failures on many occasions. Despite this it took a long time before the alarm was raised about the appalling circumstances in Oakden, many of which have been aired in the media.

In February 2016 Mr Bob Spriggs, a resident of Oakden, was admitted to the Royal Adelaide Hospital emergency department with unexplained significant bruising to his hip, a chest infection and severe dehydration. In June 2016 the Spriggs family made a complaint to the Principal Community Visitor in South Australia, who raised concerns with the Northern Adelaide Local Health Network, commonly known as NALHN. After repeated unsuccessful attempts over four months to seek a response from the NALHN and the Office of the Chief Psychiatrist SA regarding the complaint, the Principal Community Visitor noted the inaction in his annual report, which was sent to the South Australian Minister for Mental Health and Substance Abuse on 30 September 2016. The principal visitor wrote to the South Australian minister on 14 October 2016 to formally request a review of the service delivery at Oakden. Then the Northern Adelaide Local Health Network met with the Spriggs family regarding their complaint.

The annual report was tabled in the South Australian parliament on 7 December 2016 and generated media interest with the issues it contained. Subsequently, the chief executive officer of the NALHN agreed to meet with the Spriggs family in December 2016 and, after this meeting, requested the chief psychiatrist undertake a review of Oakden. We know that that ultimately led to Oakden being closed. That's how long it took. We should note that Mr Spriggs's family were not the first family to raise concerns.

I'll cut to the chase here because I know there are a number of other people who want to speak. The report states:

4.70   The evidence presented to this inquiry, which includes the reports of two in-depth inquiries into the services provided at Oakden, shows that Oakden had a toxic culture of wilful negligence, cover-up and avoiding management and regulatory responsibilities, which resulted in a 'care' service which shocked the two external reviews tasked with making an in-depth investigation into Oakden.

4.71   Services at Oakden included appallingly sub-standard clinical and personal care, as well as abusive practices, some of which have now been reported as criminal acts. Evidence of this substandard care was noticeable to anyone who cared to pay attention, but it seems that no-one in a position to effect change wanted to pay the required attention.

I am quoting directly from our report here:

4.72   The committee commends the SA Government for the extensive actions taken to remediate the services at Oakden. However, the committee must also strongly condemn the length of time it took for the relevant SA authorities to take action after receiving serious complaints and clear warnings relating to Oakden. Some of the instances of abuse or neglect occurred well after the date of the Spriggs family complaint, and most likely would not have been possible had appropriate action been taken at the time of the complaint.

4.73   The committee is deeply concerned that the Quality Agency visited Oakden and had no concerns with the service as late as November 2016. This a mere month before the CEO of NALHN formed a serious view about the quality of service at Oakden, a view that was based on complaints made five months earlier. The Committee is not convinced by the Agency's explanation as to how this came about.

4.74   The committee believes that if a situation like that at Oakden can occur for many years under the eyes of the regulators, then there are serious concerns about the quality of oversight for the broader aged care sector, and the quality of care being provided to vulnerable aged Australians.

4.75   The committee cannot be confident that there are not other aged care facilities where abuse and neglect are occurring elsewhere in Australia.

4.76   The committee notes that while the two key inquiries into the standards of care at Oakden have concluded, investigations into individual instances at Oakden are ongoing. These investigations are by the Australian Health Practitioner Regulation Agency into the standards of professional care being given by individual registered health practitioners, by SA Police into assaults on residents under the guise of restrictive practice, and by SA Independent Commission Against Corruption into the appropriate actions of individual local, state and federal management personnel.

…   …   …

4.77   The committee strongly agrees with the views expressed by the majority of submitters that while Oakden is at the extreme end of sub-standard aged care services, it exemplifies broader concerns with the quality and oversight frameworks for the overall aged care sector.

4.78   Of particular concern to the committee is the body of evidence relating to model of care issues, definitions of personal versus medical care, and clinical governance within aged care facilities. The aged care sector appears divided in how it defines the provision of allied health or medical services, and who takes ultimate responsibility for the quality of service provision or the oversight and regulation of that health service.

As you can see, we were very concerned about the evidence that we heard. I'll cut very quickly to our recommendations, but I should preface this by noting that the government commissioned, as part of the response to this, the Carnell-Paterson report, in which they've responded to one of the recommendations, and we received evidence that they'll be responding further, most likely as part of the budget announcements later in the year. There's other ongoing work as well, including the new Single Aged Care Quality Framework, due to be introduced in July 2018, which will play major roles in ongoing examination of the Aged Care Quality Assessment and accreditation framework. Continued inquiry from this committee as part of the ongoing work of this inquiry will be directed at the outcomes of these external bodies.

So our first recommendation is:

The committee recommends the extension of this inquiry into the effectiveness of the Aged Care Quality Assessment and accreditation framework for protecting residents from abuse and poor practices, and ensuring proper clinical and medical care standards are maintained and practised.

The other recommendation is:

The committee recommends that in the current aged care oversight reforms being undertaken, all dementia-related and other mental health services being delivered in an aged care context must be correctly classified as health services not aged care services—

this was another significant issue during the inquiry—

and must therefore be regulated by the appropriate health quality standards and accreditation processes.

We heard a large amount of evidence. My colleagues, I know, will share their thoughts and experiences during the inquiry. We'd like to take this opportunity to very quickly thank our secretariat, who, as usual, did a brilliant job pulling this together. I urge the government to take on board our recommendations.