The initial responses from the industry to the Final Report was unsurprising, as the Interim Report, released late 2019, and following draft recommendations, released in 2020, provided a good idea of what the Commissioners were covering.
However, no one was expecting the Commissioners to disagree on so many recommendations - 43 of the 148 to be exact.
This has led industry experts and peak bodies to worry that the Government might delay any much needed change in important areas to consider the differences in opinion.
One point of view is that the alternative options allows the Government to pick and choose recommendations that suit them, rather than have set recommendations that they should implement.
The aged care industry and related industries are continuing to respond to the Final Report Recommendations and how it will impact the sector in the short and long term.
Peak bodies and unions
Industry peak body, Leading Age Services Australia (LASA), says that the Royal Commission has highlighted the substandard care, mistreatment and abuse of older people that has no place in aged care.
While the report has outlined recommendations to improve the aged care sector, Chief Executive Officer (CEO) of LASA, Sean Rooney, feels the report also identified examples of dedicated aged care workers and services doing what they can to change the lives of older Australians.
"The report is one of national importance. It calls out to the nation to demonstrate the value we place on older Australians by reimagining aged care in Australia," says Mr Rooney.
"We must have a system that respects the rights of individuals and is focused on older people’s quality of life – a system that provides accessible, affordable care and services, available to older Australians when and where they need it, delivered by well-trained and well-paid staff, who work in a high-performing and sustainable aged care system."
LASA is proposing that the Government establish an Aged Care Reform Taskforce (ACRT) to coordinate the response to the Royal Commissions recommendations and allow for timely delivery of aged care reform.
Peak body for older Australians, National Seniors Australia, says the Royal Commission's findings were welcomed and the $452 million from the Federal Government to make changes is a good start, however, reform will take a five year journey.
CEO of National Seniors, Professor John McCallum, was called to the Royal Commission four times to provide evidence. He says tearing up the existing Aged Care Act and replacing it with a new Act focused on individual rights is the right place to begin reforming the sector.
"It is time to put the 'care' back into aged care otherwise these rights aren’t honoured," says Professor McCallum.
"The $452 million is a start but we're on a 5-year journey for change. We have said all along it’s not just about the money. We need a bigger workforce and better culture to make this transition in the aged care sector work."
He also adds that the focus on fixing home care is long overdue, as more than 100,000 Australians are waiting to receive a Home Care Package.
The Health Services Union (HSU) is glad to see its proposal of implementing a permanent funding source into the Medicare Levy, a levy for aged care, was taken up by Commissioners in their recommendations.
National President of the HSU, Gerard Hayes, says while a medicare-style levy for aged care is still a way off, the Union would like to see this implementation, as a 0.65 percent increase in the Medicare levy would raise $20.4 billion for aged care over four years.
"A medicare-style levy can transform aged care. Just like Medicare this could make the system simpler, cheaper and fairer," explains Mr Hayes.
"With a guaranteed and sustainable funding stream, we could increase the size of the workforce and pay them more so they stay in the industry. This would trigger a quantum leap forward in quality of care for residents."
Aged care experts
The National Ageing Research Institute (NARI) has welcomed the Final Report and its support for a human-rights based Act, however, is concerned that if the Government doesn't fund the structural changes needed into aged care, it won't support the Act to work at its full intent.
Director of NARI, Professor Briony Dow, says, "This report is a defining moment for aged care reform in Australia. It presents an opportunity for the Government to drive transformational change to regain public trust in the aged care system.
"All older Australians deserve access to high quality care that respects their dignity and preferences. It should encompass the right to freedom from abuse and neglect, and the right to make informed choices about their care.
"However, a human-rights based approach will remain simply rhetoric if the structural and resourcing issues in aged care remain unchanged."
NARI adds that structural change will come through better governance and regulation, well paid and trained staff, and financial transparency throughout the sector.
Dementia Australia, advocacy group for people with dementia, has welcomed the 14 areas of the Final Report that has a focus on dementia.
CEO of Dementia Australia, Maree McCabe, believes the Final Report has captured the essence of the personal views, experiences, and stories of people with dementia.
"Within the 148 recommendations are 14 key areas with a specific focus on dementia. We welcome these recommendations and now call on the federal government to demonstrate they are serious about making quality dementia care core business for aged care in Australia," says Ms McCabe.
"People with the lived experience of dementia have told us – if you get dementia care right you get it right for everyone."
Professor Julie Ratcliffe of Flinders University's Caring Futures Institute, wholeheartedly agrees with the Commissioner's observations that the quality of the aged care system is currently difficult to measure.
She says the recommended new quality indicators would help with this problem, including the indicators focus on older people.
"We need to galvanise on the report’s recommendations and continue our national conversations to ensure that all phases of the report’s recommendations are implemented successfully to deliver a high quality, efficient and sustainable aged care system for all Australians," says Professor Radcliffe.
Law and order
The Law Council agrees with the Royal Commission that there needs to be a philosophical shift in place that provides care to older people and that there is much change that needs to be done to address these systemic issues highlighted by the Commission.
President of the Law Council, Dr Jacoba Brasch QC, says, "The Law Council is pleased to see that the Royal Commission has signalled the need for a fundamental shift in thinking, towards a human-rights oriented approach as the basis for protecting and promoting the rights of older persons in aged care.
"This recommendation reflects the Law Council’s key position, as outlined in our detailed submission, in which we called for a move away from consumer-driven, market-based system.
"But as outlined by the Royal Commission, ‘rights are, of course, of little use if they are not enforceable’. That is why they must be legislatively enshrined in a new aged care Act.
"It is also pleasing to see the Report calls for the introduction of a new serious incident reporting scheme, as proposed by the Law Council."
The Law Council was also pleased to see recommendations in the Report covering independent oversight, governance and accountability, stronger regulation on restrictive practices, new staff requirements around minimum levels and qualifications, and better provision for people with diverse needs and backgrounds.
To view our coverage of the Final Report, read the article on the Talking Aged Care website.