This time last year, the banking royal commission had just finished its hearings into the problems in the financial system. Now, as we prepare to enter 2020, the national attention has shifted to our aged care and disability services systems as each faces the scrutiny of a royal commission.
Central to the banking royal commission was the theme of institutions putting profits before people. We may well see similar problems as these two new royal commissions go about their work.
Aged care and disability services used to be provided by governments or charities, but are now increasingly commercialised. As governments have created markets for care and opened them up to competition, private providers have flooded in.
Whether they're small local businesses or large private equity-backed operators, they're in the business to make a profit. And that has consequences for the system. The interim report of the aged care royal commission describes a system that is designed around transactions, rather than relationships or care. That's an alarming thing to hear for anybody who needs assistance.
There is a positive motivation behind these changes. The National Disability Insurance Scheme and similar reforms in aged care have given people the right to choose how their government funding is used – including who they buy services from. This is a big improvement on the old days when many people simply had to take whatever they were offered.
The interim report of the aged care royal commission describes a system that is designed around transactions, rather than relationships or care.
But as with any market, we need to make sure we have the right protections in place. As older people, people with disability and their carers attempt to negotiate these markets, we need to make sure they have good information that lets them compare the cost and quality of services. We also need a strong licensing and accreditation system, backed by tough regulators that are willing to penalise poor conduct.
The need for strong regulation is reinforced by the fact that most services are now provided in people's homes. While this allows those people to enjoy the freedom and independence that comes with living in their own home, it also means that many people are isolated and vulnerable to abuse.
These royal commissions are coming at the right time. We need a care system that gives people real choices about the services they receive and who provides them. But that should not come at the expense of their safety or good health. This is an opportunity to make sure we get this right, for people who use services now and the growing number of people who will need them in the future.