The Royal Commission into Aged Care Quality and Safety Report was tabled in Parliament on Monday. The final report, titled Care, Dignity and Respect, made 148 recommendations following a two-year investigation into the structural issues in governance and funding in the aged care sector.
While commissioners Lynelle Briggs and Tony Pagone disagreed on 43 points, both commissioners said the sector needs a significant boost in funding, a levy similar but separate to the Medicare levy and to bolster the role of an independent pricing authority for the sector.
The commissioners recommended a new Aged Care Act be put in place by July 2023, recommending a system based on a "universal right to high quality, safe and timely support and care".
Adrian Carson CEO of Institute for Urban Indigenous Health (IUIH) said it was clear that the commissioners listened to Indigenous Elders and Indigenous community-controlled providers of aged care services and their experiences.
"Our Elders experience challenges attempting to navigate and access their entitlement to aged care," he said.
"The series of significant recommendations reflect what the sector has been saying for some time, the report called the system out on a few big things, including the complete silence around the new national Closing the Gap agreement, it didn't pay attention to the needs of our Elders, it didn't set targets or have health commitments for our Elders.
"It was a huge oversight and I commend the Royal Commission for calling that system out, we're keen to ensure that not only the recommendations happen, but that the needs of our Elders are reflected in the broader conversation when talking about how we close the gap."
Matthew Moore General Manager of Aged and Disability Services at the IUIH said the Aboriginal and Torres Strait Islander industry were consistent with their messaging to the commissioners.
"They're underrepresented in a system where they should be overrepresented," he said.
"Seventeen per cent of Aboriginal eligible Elders that are over 50 access a part of the aged care system compared to the mainstream engagement that sits [at] over 27 per cent.
"Some of the recommendations made, if the government do uptake, have real potential to address the disparity and meet the needs of our Elders."
Chapter seven of the report, titled Aged Care for Aboriginal and Torres Strait Islander People, made seven recommendations including:
An Aboriginal and Torres Strait Islander aged care pathway within the new aged care system
Ensuring cultural safety in the aged care sector
An Aboriginal and Torres Strait Islander Aged Care Commissioner
Prioritising Aboriginal and Torres Strait Islander organisations as aged care providers
Employment and training for Aboriginal and Torres Strait Islander aged care
Setting a funding cycle for Aboriginal and Torres Strait Islander aged care
Providing appropriate funding and program streams for Aboriginal and Torres Strait Islander aged care.
Carson said there was a strong focus in the recommendations on community control of aged care services and ensuring that services are delivered by local communities.
"It's an important role, supporting Elders to navigate what is a very complex and fragmented system," he said.
"It's fundamental to our community, we're culturally obliged to take care of our Elders and the system needs to embrace and support community-controlled delivery to Elders, to ensure cultural safety but also to ensure cultural obligation is delivered.
"The data is clear in a lot of ways, care for Elders has been outsourced which undermines our important cultural foundations and values that support our communities.
"It's important that access occurs and equity is achieved but fundamentally as Blackfullas, it's important that the system starts to reflect and support cultural obligations."
Carson added that the commissioners have done their job and it's up to the government as to how they respond to the recommendations.
Prime Minister Scott Morrison has warned reform could take years, calling the Royal Commission a "harrowing process" and "the inquiry we needed to have" in a press conference on Monday.
"It will take quite considerable time to achieve the scale of change that we want to and need to, the commission itself sets out a five-year time frame for the measures set out in the report," he said.
By Darby Ingram