Aged care - an election issue?

Most of the major newspapers, editorialists and other enlightened commentators are telling us with nauseating frequency that "Aged Care" will be an election issue!

Unfortunately, the statement that "Aged Care" is or should be an election issue is almost as meaningless as the assertion that "globalisation" is responsible for the destruction of all that is good and decent in Australian society!

Both sentiments are essentially nonsense because one would have to suspect the proponents don't actually understand or can hardly define exactly what the key terms are.

For example, what is meant by "aged care"?

Is it as simple as saying "caring for elderly people"?

Is it meant to encompass the institutional care of frail, elderly people who are unable to live by themselves?

Or does it include societal definitions of aged people and where they "fit"?

Is the concept meant to encompass medical care only or physical and emotional support and spiritual succour etc?

Do those who use the term freely have particular geographic locations in mind; hospitals, nursing homes, hospitals?

What about retirement villages?

What about community care providers?

What about families-siblings, children or partners who care for elderly relatives in their own home without assistance?

What about wonderful organisations such as Meals on Wheels?

At the end of the day, the industry would have to suspect (with a sinking feeling no doubt) that "aged care" as an election issue means rehashing and point scoring on kerosene baths, accreditation (and its alleged shortcomings), nurse / resident ratios, registered nurse shortages, double beds in nursing homes etc etc etc.

It is actually an ideal election issue for the following reasons;

• it is emotive
• it involves care of the helpless and frail (there's nothing more self satisfying than a good old-fashioned sense of moral outrage!)
• its an issue which doesn't involve critical self examination - after all isn't it "the government’s" responsibility?
• it doesn't impact on most people's daily lives and;
• it will disappear quickly off the media’s radar screen (without anything meaningful having been done in the first place) when the attention shifts elsewhere.

Indeed, one could be forgiven for saying that a cosmetic "head in the sand" approach to aged care policy is a sound political strategy. When the current government five years ago set out to realistically address the shortcomings of the system they inherited - as highlighted by Professor Bob Gregory in his independent review - they were pilloried almost without exception right across Australia!

In what is no doubt one of the most breathtaking displays of hypocrisy, some of the more sanctimonious at the time now look solemnly into the camera and explain that the concept of accommodation bonds for high care is actually one that they would be prepared to consider after all - its just that the government didn't "explain it" well enough at the time!

The key problem of course is that a ridiculously short electoral cycle does not lend itself to problems requiring long to medium-term solutions.

Whilst it is encouraging to hear groups such as the AMA now echoing the industry's calls for an "Aged Care Summit" it would be staggering if the sectarian interests involved could even agree on terms of reference.

However, TriCare is prepared to nail its colours to the mast and suggest they be as follows;

• What is the community’s expectation of a reasonable "standard of care" for those too frail and elderly to care for themselves? Should we expect a standard equivalent to that which people were able to provide for themselves before they became frail? Should we expect something superior to this? Should the community expect "value for money"? Or is any discussion of resources and their limitations distasteful in connection with care of the aged?
• Is there a role for the private sector in aged care at all? If aged care is purely a matter of charity and "putting people before profit" (I absolutely love that one!) then should the private sector exit the retirement village, residential aged care and community care sector altogether?
• Given the undisputed statistics concerning the growth in numbers of those who will require some form of assistance in the future, how will the enormous capital and operational costs be met? Increased taxation? More contributions from residents? Death duties?
• How will this funding keep pace with changing costs and the growing sophistication of medical technology?
• What type of choices do aged consumers really want?
• How can a 20-year strategic plan be created which will enjoy the support of all sides of politics?

At the end of the day, the answers can be found - provided a responsible, reasonable and un-emotive dialogue occurs - however, this almost certainly guarantees that we won't find any answers for a long time to come.

Perhaps we need to start with reform of the media?