The Royal Commission into Aged Care Quality and Safety has appropriately spent time looking at the specific and, at times, unique problems Indigenous Australians face in relation to aged care.

The aged care system is failing older Australians and these issues are magnified for Indigenous Australians.

The Royal Commission held hearing in Broome in May 2019.  As its hearings came to a close in October 2020, counsel assisting made specific recommendations to the Commissioners on reform relating to Indigenous Australians.

Broome hearings – issues and needs of Indigenous Australians needing aged care

The Broome public hearing inquired into access and inclusion. That included the unique needs of Aboriginal and Torres Strait Islander people, especially those living in rural and remote areas.

The Commission also looked at barriers to accessing aged care services and the challenges of maintaining an adequately skilled and culturally appropriate workforce.

Witnesses said the barriers include red tape and a lack of culturally safe services. I remember hearing one witness saying that residential care is seen as “a death sentence” by many older Aboriginal people.

The other glaring issue is the lack of cultural understanding in aged care facilities and the need for better training of staff. This is exacerbated by a lack of Indigenous people working in aged care.

Counsel Assisting recommendations on Indigenous Aged Care

During the final two days of hearings held by the Commission on October 22 and 23, Counsel Assisting submitted a lengthy list of 124 recommendations. These considered and sensible recommendations are heartening. They go to the root cause problems for the sector such as legislation, governance, regulation, public availability of aged care provider performance against benchmark quality indicators as well as minimum staffing, improved pay for aged care workers, and workforce training.

Eight of these were specifically related to Aboriginal Australians. Counsel assisting has attempted to address the issues raised in the Broome and other hearings. The recommendations are summarised below.

• An Aged Care Commissioner within the Australian Aged Care Commission with oversight of Aboriginal and Torres Strait Islander aged care
• Requiring all aged care system workers, to undertake regular training about cultural safety and trauma informed service delivery
• Requiring all aged care providers to ensure that they are at an advanced stage of implementation of the Aboriginal and Torres Strait Islander Action Plan under the Diversity Framework
• Ensuring care finders serving Aboriginal and Torres Strait Islander communities are local Aboriginal and Torres Strait Islander people and that – wherever possible – aged care assessments are conducted by Aboriginal and Torres Strait Islander people
• Assisting Aboriginal and Torres Strait Islander organisations to expand into aged care service delivery
• Developing a comprehensive national Aboriginal and Torres Strait Islander Aged Care Workforce Plan in consultation with the National Advisory Group for Aboriginal and Torres Strait Islander Aged Care
• The Australian Government should block fund providers under the Aboriginal and Torres Strait Islander Aged Care Service Arrangements
• Establishing or providing greater flexibility in funding streams for infrastructure, service delivery and to help ensure Aboriginal people in aged care who need to return to country can do so.

What lies ahead?

The Commission’s final report is not due until the end of February 2021. The Federal Government appears content to wait until then before deciding how to act in regard to aged care reform. My concern is that the government has a lack of will and sense of urgency to implement real reform. In the recent Budget there was little real action or funding in relation to aged care. How long it will take for the Government to act on the Royal Commission’s findings and reports? Meanwhile, more older Australians will needlessly suffer or die, including Indigenous Australians.