After two years of often harrowing evidence from 450 witnesses and 10,000 submissions, the Royal Commission’s multi-page report has fallen short on a clear path to lasting and meaningful reform.
First, the report failed to spell out how much its reforms will cost, only that aged care will be more expensive than the predictions made in any of the multiple intergenerational reports before it. This inability to provide a proper costing makes it difficult for society and government to assess what is financially viable and what is not.
Second, the report fails to deliver a clear consensus on a way forward. Commissioners Tony Pagone and Lynelle Briggs disagreed on nearly a third of their recommendations, most notably on governance and funding.
Pagone recommends an Independent Commission model; Briggs favours a Government Leadership one.
Pagone’s model would end what he sees as a concentration of powers and functions in the Department of Health and its minister, and suggests creating a new independent statutory body. Briggs disagrees with Pagone on both his premise and his solution, arguing for a ‘new, enriched role for government’.
And then, of course, there’s the huge issue of funding.
‘I fear that society as a whole undervalues older people and their contribution. The acceptance of poorer service provision in aged care reflects an undervaluing of the worth of older people, assumptions and stereotypes of older people and their capabilities, and ageism towards them.’
Sustainable funding, and making it politically acceptable, is critical to the success of any nation-building reform. Senior government ministers were hoping for a clear recommendation on that, but it never came.
Briggs wants a 1 per cent Medicare levy increase, branded as aged care improvement, and which will be tipped into consolidated revenue. Pagone punted on the possibility of a ‘hypothecated levy’ to the Productivity Commission for their consideration.
These two divergent approaches don’t give much political cover to politicians looking for ways to fund the reform.
It is no surprise then that Treasurer Josh Frydenberg immediately played down any prospect of a new tax: ‘I notice that the Commissioners had different approaches with respect to the levy or the tax proposals, but it is fair to say our government’s track record has been about delivering lower taxes.’
This is not to devalue its contribution, but merely acknowledge that it has failed to meet some of the more difficult challenges put to it — that it reach consensus on a pathway forward, that it work