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The many extracts on these pages are from copyright material. They are owned by the reference given or its owner. They are reproduced here for educational purposes and to stimulate public debate about the provision of health and aged care. I consider this to be "fair use" in the common interest. They should not be reproduced for commercial purposes. The material is selective and I have not included denials and explanations. I am not claiming that the allegations are true. The intention is to show the general thrust of corporate practices as well as the nature and extent of any allegations made. Any comments made are based on the belief that there is some substance at least to so many allegations.

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By 2006 morale in nursing homes had reached an all time low. Neglect, elder abuse and apathetic staff were prevalent. When government claimed that the rape of multiple patients in a nursing home was an isolated event in a well functioning system the floodgates opened. The government was forced not only to act but to act more effectively. The measures set in place are likely to restrain and contain the worst excesses. They do not address the key issues in policy responsible for what happened. Government used its response as an opportunity to promote its ideology in the nursing home context. This page charts these events.

 Australian section   

The Rape and Sexual Abuse Scandal
Santo Santoro
2006
 

  

CONTENTS


Overview

By 2006 there was a new federal aged care minister Santo Santoro. Six months earlier a senate committee review had pinpointed serious problems in nursing homes, in the complaints system and in the accreditation process. It had made recommendations but the previous minister had ignored them.

Santoro’s mettle was soon tested as a new scandal erupted and as further deficiencies were revealed in the complaints mechanism and in the accreditation process. It was now clear that something had to be done and it is to his credit that he managed this much better than his predecessors.

That said there are limits to what a politician tied to inappropriate policies by party doctrine and a business constituency can do. Santoro introduced far more stringent oversight, police checks on employees, mandatory reporting and hopefully a workable complaints system. He seems to have recognised the deskilling and understaffing which had resulted from his government policies but did not properly address them.

Details are not available but it seems that some proposals have been watered down. He did not even consider the underlying problems inherent in government policy. While this was a good effort which will help to contain abuses it was still a band aid solution.


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Background

The situation in 2006

While the government's public relations efforts had made much of what it was doing for the aged it is clear that there was little real motivation behind the claims. A series of ineffective ministers had held the portfolio. The government was way behind in its new beds target, and its accreditation and refurbishing program. Conditions in nursing homes were steadily deteriorating. This was in large measure a result of the profits before care culture consequent on government policies.

Geriatricians once had input into the way the aged were cared for in nursing homes but government had put an end to it. A culture of caring had been replaced by a culture of disinterest and apathy, one based on process and minimal requirements. This was so bad that even a senior person such as a nursing supervisor was so apathetic that she did not see it as her role to report the rape of one of her charges.

Meaningful social interaction had broken down to the extent that some staff aided and abetted each other in taunting residents. Social misfits who would rape 90 year olds continued in the system, operated in several homes and were not reported by staff. In a functioning and caring community of which the residents were a part these people would be shunned and pushed out.

Apr 2006 Bed shortage gets worse

THE number of nursing home places in almost every region of South Australia is lagging behind the Federal Government's target ratio of available beds.
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While no official waiting lists are kept, Productivity Commission research suggests waiting times are increasing.

In 2000, almost 87 per cent of people got into a nursing home within three months of being assessed. Now almost 30 per cent of people assessed as needing nursing home care take longer than three months.
SA nursing homes struggling to cope with rising demand Aged care crisis looms The Advertiser April 7, 2006

Apr 2006 Summarising the position

FOR too long the Federal Government has ignored the neglect and abuse of the elderly and impaired in some of the nation's nursing homes.

Six years ago the Herald Sun exposed the scandalous kerosene baths affair where 57 elderly patients were bathed in kerosene to treat suspected skin conditions.

Since then there have been repeated example of outrageous neglect and abuse, ranging from allegations of rape, assaults, medicine confusion and fire-risk homes.

This appalling state of affairs has been overseen by the bureaucracy under successive ministers.

Supervision relied on an absurd process in which nursing homes were told in advance of inspections. This gave them the chance to clean up their act.
Someone cares at last Herald Sun EDITORIAL April 11, 2006

Apr 2006 Elderly residents starving across Australia

Some residents in WA's nursing homes are so malnourished that they are turning up at emergency departments with symptoms similar to AIDS victims, according to a leading aged care specialist.

Royal Perth Hospital aged care services physician Roger Warne said the "revolving door" of malnourished elderly patients was partly because of inadequate staffing and training at nursing homes.

Dr Warne said that while some patients were malnourished because they were seriously ill or dying, others found the food unappealing or couldn't physically feed themselves.

"The quality of feeding programs at some residential facilities is not optimal. Increased staff numbers and better training could allow elderly residents to be manually fed," he said.

He called for an aged care teaching program to be set up in Perth and for more co-operation between Perth's major hospitals and nursing homes.

"You've got no control of what's going on once you've sent the (patients) out," he said.

"Aged care physicians consult in institutional care but are not involved in medical direction as used to occur in government nursing homes, which have been closed."
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Victoria's Austin Health aged care director Michael Woodward said people were dying of malnutrition in nursing homes across Australia.

"There is no doubt that if a person is about to die they are less likely to eat. But some are about to die because they haven't been given the opportunity to eat," he said. "There is a real problem with resourcing and we need better awareness."

UWA geriatric medicine professor Leon Flicker said some elderly people were not getting the assistance they needed to eat.

"A lot of people in residential care are confused, can't eat, don't want to eat. Good quality care is when people help them eat," he said.
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Aged Care Crisis Team spokeswoman Lynda Saltarelli said she regularly got complaints from relatives of nursing home residents, who said their loved ones were starving.
Aged 'starving' in nursing homes The West Australian April 29, 2006


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The nursing problem

It is clear that large numbers of motivated nurses and nurse aids had been doing what the residents could not do and walking away from the sector. The causes of this seems to be multifactorial including the governments abandonment of adequate staff patient ratios, changes in society, low pay and poor work conditions, and the valuing of money and paperwork over people and their humanity. This is exactly what happened in the USA in response to a similar situation.

As a consequence the dregs of society including criminals, psychopaths, sexual predators and every other misfit have been drawn into the system. They can get nominal training in which they display little interest. Morale breaks down. Apathetic staff tolerate the abuse and ridicule of residents by these misfits without complaining. As in the USA elderly ladies were sexually abused and raped. This is clearly much more common than those who should be doing something about the situation will concede. Those nursing homes where morale has been lost and staff are most demoralised are the ones where residents are neglected and misused. They are most at risk of elder abuse rape.

 


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The scandal - it grows and grows

The George Vowel scandal

The scandal broke at the George Vowel Nursing Home in Victoria. The home had a poor track record and was owned by a company where another home had problems 2 years earlier. Four George Vowel patients in their 90s were repeatedly raped or sexually abused. Staff who knew about it did nothing and when management found out they apparently mounted their own investigation and only called in the police when instructed by the agency.

Worse still it was revealed that the offender worked for an agency and had been sent to other homes. There is no report into an investigation at these other homes. How many of these other at risk seniors were raped?

Feb 2006 Minister responds to rape allegations

SENATOR SANTO SANTORO: Again, that's something I need to be advised on, but the important thing is that after we were made aware, after the Department was made aware of the rape allegations we immediately on November 24 visited the facility. We instructed the provider to notify the police of the incident, or the allegations, and we also independently advised the police.
Aged care debate
LATELINE ABC TV February 21, 2006

Feb 2006 Residents at several homes at risk from rapist

The Australian has learned the accused man worked at several other homes in his capacity as a temporary carer working for an agency.
Summit ordered on aged care abuse The Australian February 22, 2006

for more reports see
Lateline reports in February 2006

The family of one of the residents had complained repeatedly to the aged care agency about standards of care and neglect at the home. Their complaints had been ignored.

The George Vowel scandal is described and analysed on the Ellis and Elfam company's web page. Only the consequences and governments response are addressed here.


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More examples

The George Vowel scandal caused others to come forward and there were soon more complaints. There were tales of systematic management cover ups and bullying

Feb 2006 More damning allegations

LILLIAN JETER: Well first of all, I want to say that the three of them (nurses) came to me. They were absolutely distressed. These are carers that have been in aged care for quite a long time. So they're not new to the system at all. They said that not only was there physical abuse with the pinning and the restraining of that particular female resident. She was hearing impaired, she was also blind. They put her and forced her into the chair that she was in and threw her across by the chair, through the dining room, to humiliate her in front of the other residents. She is a dementia resident along with the other residents. And then, later when she was very quiet, they went with her, with water bottles and then they used the water bottles...
----------------------------
Not only that, Tony. There was also one gentleman who was forced into the shower. He's naked, they're forcing him and taking control of him. There's also faeces that are smeared on the walls of the facility. There's a lot of questionable safety issues with the keys going missing to that facility for a long time. Intimidation, fear, harassment, harassment of the employees. These are carers that are trying to do the right thing for dementia residents.
--------------------------------
They were so upset at what is going trying to do their best as carers, but because of the management, because of the culture, they cannot do what they want to do - what they need to do.
---------------------
AGED CARE WORKER: A staff member plus another member, one afternoon with this same woman, squirted a water bottles at this woman, antagonise behaviours, just because why not? It's fun.
----------------------------
In the kitchen this woman was seated in a chair, walked by with a water bottle and squirted water at this woman.
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On her face, on her body and it happened more than once. I believe it was twice or three times that it has happened. The person that saw it a second time mentioned it to the manager. Nothing was done, there was no reprimand, there was no nothing. And this person that has also seen other instances go on is now afraid to say anything. When she has in the past, our manager currently there just says, "Don't worry about it, it will be fine."
---------------------------------
This particular woman was antagonised continually to upset behaviours. The culture, I believe, the reason behind it is to medicate residents so that they are just sitting doing nothing and therefore they don't have to actually attend to them, care for them.

REPORTER: Oh my gosh. So what you're saying is that they bring on bad behaviour, so they have an excuse. So then they don't have to...

AGED CARE WORKER: To make them worse, because then I can either have them transferred to a nursing home or they're medicated to the point that they're just blubbering messes, sitting there doing nothing and I don't have to look after them.
--------------------------------
AGED CARE WORKER: In the facility, in this particular facility, it was starting to happen before I left more and more and you feel you have - you can't do anything. You have no recourse to say anything. Because if you do say anything, you are then bullied by management, from right up, the head office right the way down. You have no recourse. There is nowhere - you put in reports and say that this is happening. Nothing is ever done. It disappears never to be seen again.
---------------------
These people, these residents deserve better than what they are getting and to be put to bed early for no reason - when I mean early, five o'clock in the afternoon, laying in bed all night, not moving literally.
----------------------
REPORTER: Why do they have to go to bed so early?

AGED CARE WORKER: They don't, but so the staff don't have to care for them.
-------------------------
TONY JONES: I should interrupt here to say we have had a short response from the Health Department, a spokesperson for the Health Department tonight, in fact, on behalf of the federal Minister for Aged Care. They're saying these allegations have been investigated and that no issues of abuse were substantiated. Are you aware of that investigation?
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REPORTER: In the cases when medications have been mixed up and you told us a terrible story where people were left on the wrong medication for four days...
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AGED CARE WORKER: The words that were told to me by the acting manager at the time that came in to deal with this incident was, "This will not be discussed with anybody."
---------------------------
The families have never, to my knowledge, been actually told what happened. One of the family members came up to me on more than one occasion and said, "What happened?" And I had to say, "I do not know, I'm sorry, I cannot help you. Ask the manager. I don't know, they haven't told us what happened." I could not tell these people what had really happened.
------------------------------
I think there should be an investigation, not only of that particular facility but we're getting - the association, the Elder Abuse Prevention Association, every single day I get more cases and more carers and more complaints coming from not only residential care but community care. So this is not one facility, it's many across the board. And obviously, there's problems behind closed doors.
Allegations of abuse at aged care facility
Lateline ABC TV February 20, 2006


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Response to the rapes at George Vowel

The new aged care minister Santo Santoro now had no choice and he commenced an elaborate process of consultation and meetings with "stakeholders" from all sections promising more changes. He may have been genuine. As I understand it no attempt was made to seriously confront the critical underlying issues such as the effect of the competitive market and the drive for economic efficiency on staff morale, staffing levels, staffing skills and so on standards of care, neglect and elder abuse.

Santoro’s hands were tied. These were issues which no minister in the coalition government could credibly address.

I suspect that no one challenged him on this. Submissions and ministerial meetings are the art of the possible and compromises must be made if anything is to be achieved. I discussed this with some of those who were to meet the minister.

We realised that to emphasise the critical role of market forces and government policy would compromise their credibility and be counterproductive. Instead they concentrated on better oversight, mandatory reporting and other measures of control - patching the leaking bucket instead of replacing it. I even put my name to a submission.

This is of course not a sensible way to deal with the problems. The USA has done the same thing on multiple occasions and continues to do so. It has simply provided a temporary respite before the next scandal occurred.

Some in the USA are beginning to challenge the market solution. There is little prospect for real change while the marketplace maintains its current credibility and while John Howard and George Bush drive local and international marketplace policies. We are likely to go through many cycles of bucket patching and serious leaks before there is enough public angst and insight to challenge ideology and try another more sensible path.

Feb 2006 Santoro makes promises

SENATOR SANTO SANTORO, MINISTER FOR THE AGEING: Look, I feel tremendously for the granddaughters. I watched the program last night and I've watched further interviews and there clearly is anguish, there clearly is shock, there clearly is a crying out to the ministers like myself and Gavin down in Victoria for us to do something to improve the system. I'm here to tell you and I'm here to tell your viewers that we are going to work together, we are going to go about improving the system so we can eliminate as much as is possible the sort of abuses that we have heard over the last day or so.
-----------------------------
Out of this experience we are going to learn how to improve a system, Tony, which I think is working well, but clearly it needs to be fine tuned, it needs to be certainly better performing and I'm prepared to put every bit of energy that's available to me to make sure that it works better.
--------------------------------
I intend to consult stakeholders and my ministerial colleagues interstate. I intend to be very proactive, very open and I'm inviting anybody who has any issue with the department, with the complaints resolution scheme to come directly to my office, and I'm saying to my office, not necessarily the Department, although I want the Department to be fully involved because we need to learn from this experience.
Aged care debate
LATELINE ABC TV February 21, 2006

 


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Putting a fence around the George Vowel rape

Both Santoro and John Howard were soon in damage control expressing shock and trying to quarantine what had happened as an aberrant isolated event rather than as a clear pointer to pervasive and deep seated problems in the nursing home sector - a consequence of government policy and years of neglect. As information about more cases of sexual and other elder abuse was exposed they tried unsuccessfully to minimise the extent of the problems.

Feb 2006 Calling it isolated

SENATOR SANTO SANTORO, MINISTER FOR AGEING: We are acting as swiftly as we can in terms of this isolated case of abuse.
-----------------------------
DANA ROBERTSON: Santo Santoro is confident the current reporting mechanisms are working well, although he is seeking to improve them. He says last year there were 6,000 complaints about aged care and only 1 per cent related to abuse. While John Howard's expressed his horror about the revelations at the Melbourne nursing home, he's been quick to reassure the families of other elderly people in residential care.

JOHN HOWARD: I don't think, of course, it would be fair to extrapolate from this incident, if it did take place, a general view about nursing homes in Australia.
---------------------------------
DR MERRILYN WALTON, UNIVERSITY OF SYDNEY: These complaints, certainly in my 20 years experience of looking at complaints about nursing homes, have been repetitive and it doesn't seem to me that we make the improvements, so I don't think it's a one-off thing, no.

DANA ROBERTSON: She says it seems in the last 10 years little has changed.
Politicians respond to abuse allegations
LATELINE ABC TV February 21, 2006

Feb 2006 Reassuring public - Howard

But Mr Howard says the majority of elderly Australians are well cared for in the nation's aged care facilities.
------------------
"I think it's important that people who have relatives in nursing homes in Australia be reassured that ... 99.9 per cent of them are operated in a caring, sensitive way and people are properly looked after."
Nursing home rape allegations appalling and tragic: ABC radio PM February 21, 2006

Feb 2006 Reassuring public - Santo Santoro

"But I just wish to assure the Australian public ... that the vast majority of residents receive the best possible care by people who are caring, dedicated to looking after the welfare of our elderly in nursing homes.

"The vast majority of providers provide excellent, excellent care for nursing home residents."
Elderly people in nursing homes safe, Santoro Australian Associated Press General News February 21, 2006

Feb 2006 Conflicting views

But Mr Howard and his new Aged Care Minister, Santo Santoro, insisted that the overwhelming majority of homes were free of abuse - despite a damning Senate report last June that criticised the complaints scheme for discouraging complainants.
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HSU state secretary Jeff Jackson said bullying, intimidation and abuse of aged care workers meant that carers were often terrified of reporting.
New laws loom on nursing home rape The Age February 22, 2006


The nursing home community were a little slower in coming forward to put a fence around what had happened. Compare this with what was actually happening to the accreditation agency and the complaints mechanism.

Feb 2006 Market urges public to have confidence

Despite the troubled past of the aged care sector, and the recent instances, Greg Mundey from Aged and Community Services Australia says Australians should have confidence in the system.
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"There is a very elaborate system of quality control and complaints handling that applies to aged care because we know that our clients are frail, they are vulnerable."

New Minister for the Ageing, Santo Santoro, also insists the alleged sexual abuse is an isolated incident - an exception in an otherwise reformed aged care sector.
Nursing home allegations rock aged care in Australia Australian Associated Press General News February 24, 2006


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Critics challenge this position

The self-serving political and market dishonesty, and the attempt to hide the fact that the rapes were simply the symptoms of a deeply pervasive flaw in the aged care system were confronted by some of the critics. The ongoing saga over the preceding 6 years made the minimisation position untenable for those who had studied the system. A forceful advocate, Lillian Jeter, took this head on. Other critics supported her and drew attention to community apathy and to the important role of competitive commercial pressures in all this. There were more and more reports.

Feb 2006 Lillian Jetter speaks out

Executive director Lillian Jeter, a former US police officer who has been investigating abuse against the elderly for more than 20 years, says neglect, exploitation and sexual, physical and psychological abuse are commonplace in Australian nursing homes.

"It's deeply unsettling but it does happen, it happens all the time," Ms Jeter told AAP.

"It's horrific, families pay these facilities good money to ensure the health and safety and well-being of their loved ones."

She says many of the facilities, increasingly privately-run, are staggeringly understaffed, and many of the staff they do have are non-professional, low-paid immigrant workers.

"The biggest money gets poured into their foyers, on chandeliers and nice carpet to impress the families that might want to bring their loved ones in," she said.

"The attitude seems to be the residents are dying anyway, why should we spend money on them?"
------------------------
"People are compassionate when it's brought to their attention but for the most part it's out of sight, out of mind," Prof Russell (age researcher) said.

She believes Australia's "extremely unhealthy preoccupation" with youth has lead to widespread ageism.

There is a more meaningful debate in Australia about Botox than there is about the realities of ageing and the lives of the elderly, she said.
----------------------------
Private nursing home operators are generally only interested in making a profit, and treatment will not get better until regulations tighten, Prof Russell says.

"But if really top quality care was mandated I really don't think it would be profitable anymore, and all the stakeholders want to keep the business profitable, and the government does not want to have to provide subsidies," she said.
-----------------------
"And the provision of community services often amounts to no more than a few hours a week and if you don't have a family available it's not adequate for a decent quality of life."

Ms Jeter does not have very high expectations for the federal government's aged-care summit.

"It's not going to be good enough to sit around a table in Canberra and talk. We have got to put things in place and start filling the gaps. Now. People are suffering here," she said.

"We should honour, and respect and revere our elderly people, put them on a pedestal. The way we treat them is shameful, and I think it's a very bad reflection on us."
Recent events highlight shameful neglect of Australia's elderly Australian Associated Press General News February 24, 2006

Feb 2006 True incidence of sexual abuse of elderly

The hospital estimates that at least 80 elderly women would have been treated for sexual assault in Sydney during the past 10 years, and that more than 450 others could have been attacked but did not report the attacks.

Ms Kelly (Lauren Kelly, acting coordinator of RNSH's sexual assault service) said many aged care staff were hired through specialist employment agencies, meaning that if there were concerns about them being involved in a sexual assault they would often leave their job and move to another facility.

If staff had to undergo security checks, the risk of elderly women being assaulted could be reduced, she said.
-----------------------------------
"We have a (sexual assault) case or two in our area where we can tell the same worker is working in the same area but moving around but it's really difficult to do anything.

Ms Kelly said the problem of sexual assaults in nursing homes was compounded by the fact that many of the women victims were reluctant or unable to report the attacks.

Some had dementia, others Alzheimer's disease while many were just too embarrassed and ashamed to report the attacks to police.
Govts urged to make aged care workers have security checks Australian Associated Press General News February 24, 2006

Feb 2006 Things are bad in homes and Victoria is the worst

VICTORIA is the worst state when it comes to looking after its elderly citizens, making up almost half the official sanctions on nursing homes, and a third of all complaints.

The state is consistently at the bottom of the list for aged care. Despite having fewer beds than Queensland and NSW, Victoria has proportionately higher complaints of neglect, mistreatment and substandard service of its elderly.
----------------------------
The Herald Sun has been contacted by dozens of families concerned about the welfare of their parents and grandparents, with some resorting to:

MARKING bed linen in pencil with a date, to see how often the sheets are changed. One woman reported her 98-year-old mother's sheets weren't changed for a month.

BRINGING fresh fruit to loved ones, because of concern they are malnourished.

SUPPLYING incontinence pads in bulk because some homes only provide two a day for residents, leaving them to "hold on" for hours.

LABELLING clothes and personal items to prevent expensive goods vanishing and turning up being worn by other residents.

KEEPING diaries of incidents and discussions with nursing home staff as potential evidence.
---------------------------------
Since sanctions were introduced, 44 Victorian nursing homes have been penalised with the loss of government funding, and an enforced timetable to improve services -- more than double the next highest, in Queensland, and more than triple NSW.
Aged care in a sorry state Shame of our nursing homes Herald-Sun February 27, 2006

Mar 2006 Elder abuse in one in 25

ONE in 25 elderly people is abused by a carer, with wheelchair users over 75 and people with dementia most at risk.
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Elder abuse expert and author Gerry Naughtin said "gerophilia" accounts for more than 90,000 cases of abuse in NSW, Victoria and SA each year.

Mr Naughtin's figure included sexual, physical, financial and psychological abuse.
Elderly abuse set to rise Herald-Sun March 6, 2006

Mar 2006 More sexual abuse in Queensland

The federal government may investigate the alleged abuse of an 83-year-old woman after a pornographic image of her was circulated in an email calendar.

Federal Aged Care Minister Santo Santoro today described it as an "horrific" example of elder abuse.

The woman died nine years ago and had been in the care of a southern Queensland aged care centre and a hospital.

The woman's daughter June Small said she was horrified when she saw her naked mother in the graphic email and the image of a young man kneeling beside her.
Investigations into pornographic image of 83-year-old woman Australian Associated Press General News March 6, 2006

Apr 2006 Unnatural deaths in nursing homes

SIXTY-THREE residents of Victorian nursing homes - more than one person a week - died from unnatural causes in 2004, an Age investigation has found.

But this figure may be a significant underestimate, with one expert suggesting such deaths are under-reported and that a proper process is needed to record and investigate them effectively.
Homes hold deadly secrets The Age April 15, 2006

Apr 2006 Jetter insists it is widespread

FORMER police officer Lilian Jeter has been exposed to some of the worst examples of inhumanity and depravity. She sees the abuse, neglect and exploitation of older people as a shameful indictment on Australia society and a failure of officialdom to protect its most vulnerable citizens.

People - who built the community, raised its children and fought for their country - are suffering everyday behind closed doors in nursing homes and the community, she says. ''I've seen an older vulnerable person who was first victimised in the community. They went to hospital and were abused. They went into residential care and were abused. This is the same individual,'' Jeter, who is director of the Elder Abuse Prevention Association, says.

Jeter is a 21-year veteran in the fight to stamp out elder abuse - first as a police officer in the United States and now as an advocate in Australia.
Failing to protect our elders Canberra Times April 15, 2006


The extent to which the culture in nursing homes and the sort of person working in them has changed in the 10 years since the government started its policy of marketisation is revealed in a comment by the minister himself. No amount of mandatory reporting, police checks and spot checks is going to change that.

Mar 2006 Not manager's job to report sexual abuse

Senator Santoro said he had been shocked to hear in a recent briefing that in one home subject to allegations of sexual abuse the manager "stated that she did not believe it was her job to report allegations of sexual abuse".

He said it took one month for the abuse to be reported to police.

Senator Santoro refused to give details about the home, but said "remedial action" had been taken and the manager was no longer in the job.
Reporting sex abuse not part of my job: aged-care manager The Sydney Morning Herald March 16, 2006


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More and more rapes

To confront the self serving nonsense by the government, Lateline documented another two rape and sexual abuse allegations a few days later. One in Victoria and another in Queensland. We can only guess at the real frequency in a situation where nursing home owners, the complaints division, the accreditation agency and their political masters would all be acutely embarrassed by revelations that such practices were common under their brief. We now know that all these parties will rationalise and misinform when they can get away with it. They will not go looking for more trouble.

Feb 2006 Another not so isolated rape

MARGOT O'NEILL: The alleged rape of elderly women revealed by Lateline in a Melbourne nursing home last week was described at the time as an isolated incident by the Aged Care Minister, Santo Santoro.
----------------------
But Lateline has confirmed that the Victorian police are investigating new rape allegations against a male carer at another Melbourne aged care facility - allegations first made nine months before police were alerted. The initial allegation came from a 73-year-old woman with dementia in March last year, but instead of immediately contacting her family or the police, Lateline's been told the facility's manager questioned the woman and dismissed her claim. Then late last year, another female resident also made sexual assault claims and the police were finally called. The number of alleged victims in this case is unclear, but Lateline's been told that the facility's file notes suggest a pattern of disturbing behavioural changes in some elderly women after a particular male carer had been in contact with them. There are also new allegations about sexual abuse by a male assistant nurse at a Sunshine Coast nursing home.

SENATOR SANTO SANTORO: I am aware of allegations of inappropriate handling of residents by an assistant at the Immanuel Gardens Nursing Home. The matter as Senator McLucas may not be aware - but I'm making her aware of it now - is in the hands of the Maroochy Criminal Investigation Branch of the Queensland Police.
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MARGOT O'NEILL: This incident took place at the Millward residential care facility in Doncaster East. Rather than contacting her family or the police, Millward's nursing director forced Catherine's mother, who suffers from a brain injury, to repeat her allegation in front of the male carer she alleged assaulted her.

MARILYN BREWWIN, MOTHER: I had to stand up in front of him and he denied it completely, he denied it in front of me and the nurse, the director of nursing in Melbourne said she didn't believe me. It's terrible, it's shocking because I'm not a liar, I'm not a liar at all.
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MARGOT O'NEILL: It was six weeks before Catherine found out about her mother's claim. There'd been no medical examination and no contact with the police.
More abuse allegations
LATELINE ABC TV February 27, 2006

Feb 2006 All instances not reported

JEFF JACKSON, HEALTH SERVICES UNION: All the incidents that are occurring in aged care are not being reported at the moment because the Howard Government hasn't been brave enough to introduce legislation that would encourage and then also protect those who come forward.

MAURA ANGLE: The union says police checks for aged care workers should be introduced along with mandatory reporting of cases of abuse and mistreatment. The Elder Abuse Prevention Association says urgent action is needed.
Govt calls for action on elderly abuse claims
Lateline ABC TV February 28, 2006

Feb 2006 The second Victorian home where rapes occurred

Police are investigating claims that nursing home residents at a second Victorian facility have been raped by a carer.
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The number of alleged victims is unclear.

However, - - - has been told that the facility's file notes suggest a pattern of disturbing behavioural changes in some elderly women after a particular male carer had been in contact with them.
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The cases have prompted concern about how quickly some nursing homes contact residents' families and the police.
New rape claims add to aged care woes Delays: The cases have raised concerns about the way rape claims are handled. Australian Broadcasting Corporation (ABC) News February 26, 2006

Feb 2006 Queensland police investigating too

The Federal Government has revealed Queensland police are investigating more claims of patient abuse in a nursing home.

Aged Care Minister Santo Santoro says a former worker at the Immanuel Gardens Nursing Home on the Sunshine Coast was sacked after the allegations surfaced.
Police investigate new nursing home abuse claims Australian Broadcasting Corporation (ABC) News February 27, 2006

Feb 2006 It is a home with a history of problems

EMBATTLED Federal Ageing Minister Santo Santoro has been forced to defend why it took seven months to impose sanctions on a Sunshine Coast nursing home for failing to properly care for residents.

An inspection of the Immanuel Gardens nursing home at Buderim last August found the facility failed to comply with 15 of 44 care standards, including clinical care, infection control and pain management.

Federal Parliament was told yesterday that formal action was not taken against the facility until February 6.
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The same nursing home is already being investigated by Sunshine Coast police over allegations that several elderly residents were "inappropriately" touched by a former employee.
--------------------------------
"On 6 February 2006, the department imposed a sanction on the Lutheran Church of Australia Queensland District, the approved provider of the Immanuel Gardens Nursing Home.
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Senator McLucas said the report showed the facility had persistently failed to comply with accreditation standards over the past three years.
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This follows concerns that wounds and dressings of residents were not "consistently assessed" or attended to.

An audit team also found there was no effective infection control program in place, with pans and urinals sitting on benches and sinks.
Santoro on back foot again over aged care The Courier-Mail February 28, 2006

Mar 2006 Queensland man charged

A 51-year-old man will face Maroochydore Magistrates Court on the Sunshine Coast on April 26, charged with six counts of indecent assault of an intellectually impaired person.

Police claim the Mooloolaba man interfered with three of the village's elderly residents, aged 92, 87 and 85 years.

The offences allegedly occurred in 2004 and 2005 at the Immanuel Garden Retirement Village at Buderim, where the man was employed as a nurses' assistant.
Alleged abuse at retirement home sparks protocol review Australian Associated Press General News March 9, 2006


More and more allegations of elder abuse and rape were reported in the press. Within the first few months of 2006 four homes were implicated. These events occur in nursing homes where the caring culture has been destroyed and where there are already serious problems so that sexual abuse is easier. These are the homes that use agency staff. Deviant individuals who would not fit into a functioning community of carers are readily taken on by the agency which makes money from them. An agency job gives a predator greater opportunities.

Mar 2006 And more sexual abuse/rapes in Canberra

And just this weekend, fresh sexual abuse allegations surfaced in Canberra.

It has been revealed that a male nurse has been charged with the rape of a 72-year-old woman at Ginninderra Gardens Nursing Home and Hostel.

The 26-year-old was arrested in January and will face court next month.

The shocking allegations have prompted fresh calls for mandatory reporting of assaults against the elderly.

Minister for Ageing Santo Santoro says he is willing to consider any measures that will help stamp out elderly abuse.
----------------------
"While they are isolated cases, they are a blight on the industry and must be stamped out."
Police checks and mandatory reporting to be focus of summit Australian Associated Press General News March 13, 2006

May 2006 And another one in Queensland

POLICE are investigating another case of alleged abuse of a resident by a staff member of a Queensland nursing home.

Ageing Minister Santo Santoro confirmed the investigation yesterday but refused to reveal the nursing home.
Elderly abuse crackdown widens The Courier-Mail May 29, 2006\


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The blame game

It is tempting to vilify politicians, the complaints department and the agency but this would be counterproductive. These are people who were once well motivated but who are trapped in a system and a pattern of beliefs which puts them in an impossible position. The social forces and the pressures in the system are simply too strong. Apathy sets in as their mission becomes impossible.

They are responding as humans do. The system selects for those who are prepared to do what it takes to survive in that context and then rationalise their actions. The complaints department was not permitted to investigate a complaint to see it was valid and then take action. They were required to "mediate" between complainant and the nursing home without knowing what actually happened.

Feb 2006 Even Santoro agrees and is not shifting the blame

"I believe that the department that I'm overseeing is made up of well-meaning and competent people who do their best to service a part of our community which requires proper and constant care," Senator Santoro said.
Nursing home rape allegation probe ends AAP Bulletins February 27, 2006


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Advocates gain leverage

Advocates who had been powerless against government indifference suddenly found themselves with something they could take to the public - and enough leverage to drive a reform process. A senate inquiry in 2005 had recommended major changes including many of those advocates wanted. The government had simply ignored it.

Leading the charge was an American Lillian Jeter who had extensive experience in the USA where the only effective measures had been punitive. Ted Quinlan a long time critic from Western Australia also took the opportunity. The Aged Care Crisis Centre established by Lynda Saltarelli and others had been collecting information and posting it on their web site. They sent out a regular email newsletter.

Advocates pressed strongly for real regulatory changes, effective screening of employees, regular oversight, mandatory reporting, proper investigation, protection of whistle blowers, and effective criminal processes. The nursing unions and the Australian Medical Association were also pushing strongly for changes.

Feb 2006 Residents will not complain - need more than that

"We're talking about criminal type cases or borderline criminal cases," said Ms Jeter, who used to specialise in elder abuse in her position as a police commander in the US state of South Carolina.

"For mistreatment, abuse and neglect, we need people to actually go in and investigate the facilities immediately.

"The victims aren't going to report the abuse - the same hand that feeds them is the same hand that's abusing, neglecting or intimidating them."
Nursing home allegations rock aged care in Australia Australian Associated Press General News February 24, 2006

May 2006 Ted Quinlan wants a bill of rights and criminal prosecutions

A veteran WA campaigner against the "profit-motivated" sector of the aged-care nursing home industry wants a Bill of rights introduced to protect the residents of such facilities around the nation.

Ted Quinlan, 88, founder and acting secretary of Concerned Citizens for the Frail Aged, said yesterday the mere use of regulations to penalise operators failing in their duty of care was an insufficient deterrent.

"We have laws against the neglect and abuse of animals and children so why not have the laws to protect vulnerable, elderly people?" he said. "We need to enshrine the basic rights of nursing home residents and provide criminal sanctions to force the bad operators to face up to their responsibilities.
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He said that if the Aged Care Standards and Accreditation Agency could not launch criminal prosecutions, a Federal guardianship board should be established with power to do so.
Bill of rights needed to stop aged care 'profiteers' The West Australian May 1, 2006


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The Government Acts

There was so much pressure generated that the government buckled to the needs of the community. The minister made a show of calling a summit of those involved in aged care. Conspicuous was the absence of those who had been criticising the system. Instead it comprised mostly the ministers "stakeholders" - the foxes meeting to confront mobilisation of the hens.

The minister made much of listening to everyone and of his consultation with state ministers. The minister did make an effort to consult with the critics. They were interviewed separately where their different views could be isolated and dealt with and they could not challenge the stakeholders and rock the boat.

Santoro’s control and handling of the situation contrasts sharply with Bronwyn Bishop’s panic stricken and inept behaviour in 2000. In fairness to Bishop, by 2006 both the government and the market were no longer able to resist the pressure and had to accept changes. Bishop was captive to both and had no room to move. Six years of recurrent scandals had some impact.

Even though the market tried to remonstrate on some issues, particularly mandatory reporting they were forced to express support or lose all credibility. What was advocated and partly accepted did no more than plug the holes in the rusty bucket more securely. Tighter regulation has done little to change the corroded bucket by establishing a new system congruent with the service. Santoro was soon talking about choice and market and once again subsidising the market system and facilitating the move to corporatisation.

Jeter, Quinlan and Saltarelli’s remarks suggest that they were well aware of the underlying problems including the commercial forces at work. They were pressing for what was possible. Hopefully they will maintain their drive and momentum to direct attention at the causes of the problem and the need to change the whole system.


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The 2005 Senate report

A senate committee investigation into nursing home care had reported in June 2005. It was critical of what was happened in nursing homes and recommended many of the changes wanted by advocates. Then minister for aging Julie Bishop ignored it. The government had earlier commissioned an economist, Warren Hogan, to produce the sort of report they wanted.

Feb 2006 Calls for mandatory reporting

A Senate inquiry last year recommended random checks and new laws to protect whistleblowers. In Melbourne, a staff member is said to have witnessed one alleged assault but took two months to report it. That's prompted calls for the Government to make reporting mandatory, as it is for child abuse.
AGED CARE RAPE ALLEGATIONS SBS 6.30pm TV World News Transcripts February 21, 2006

Feb 2006 Government have been told over and over but did nothing

The Federal Government did not need the allegations of rape at a Victorian nursing home to alert it to the sorry - and potentially dangerous - state of aged care. Last year's report of the Senate committee inquiry into "quality and equity in aged care" has been on Canberra desks since June, and makes worrying reading. The newly appointed Minister for Ageing, Santo Santoro, has promised to respond "expeditiously" - a shameful admission of past inaction by the Government.

The committee exposes chronic staff shortages and a declining ratio of qualified nurses to unlicensed personal carers in Australia's 3000 aged-care facilities. It raises serious concerns about the present regime of inspections, suggesting scheduled visits allow aged-care facilities to "tidy up" in advance, and concludes that random checks to catch them out are "grossly inadequate".
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There are, too, many committed nurses and carers, though less than 20 per cent feel they have enough time to do their job properly. What's going wrong? In 2002, the same Senate committee alerted the Federal Government to an "acute shortage of nurses" threatening the quality of aged care.

Since the mid-1990s, staff numbers have declined and the number of people being cared for has increased. At the same time, many qualified nurses have been replaced by unlicensed carers, imposing more stress on the shrinking professional nursing pool. There are also glaring salary disparities, making staff difficult to find and retain; public hospitals pay nurses about 20 per cent more.
Nursing home warnings ignored The Sydney Morning Herald February 23, 2006


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Pressures for change

Strong pressure came from multiple groups across Australia. Opinion was unanimous on most issues.

Feb 2006 Mandatory reporting

- - - the case has prompted calls for the introduction of mandatory reporting of abuse, as Alison Caldwell reports.
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ALISON CALDWELL: The Australian Medical Association has added its voice to the calls for mandatory reporting of abuse in aged care facilities.
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He (National Secretary for the Health Services Union) says there's no reason why mandatory reporting of abuse should not be adopted by the Federal Government when it comes to nursing homes.
Govt to hold summit to discuss abuse of the elderly Australian Associated Press General News February 21, 2006

Feb 2006 Minister in demnial

The kerosene baths scandal at a Melbourne nursing home in 2000 shocked Australia.

Six years on and the horror stories keep coming.
---------------------------------
Minister for Ageing Santo Santoro today said abuse in nursing homes was comparatively rare.

But history tells a different story.
The sad tales of neglect persist in some aged care homes Australian Associated Press General News February 21, 2006

Feb 2006 Calling for reform

Measures now being advocated include mandatory reporting of abuse and compulsory criminal checks on prospective nursing home employees.

Also advocated are random, unannounced checks on nursing homes.

Such requirements, apply to the care and protection of children. Why not the aged?
Protecting the elderly Herald Sun EDITORIAL February 23, 2006

Feb 2006 security checks

Governments across Australia are being urged to make people working in the aged care sector undergo rigorous security checks to help protect elderly women from sexual assault.
Govts urged to make aged care workers have security checks Australian Associated Press General News February 24, 2006

Mar 2006 Using children as an example

Mandatory reporting accounts for some 75 per cent of the almost 220,000 alerts about children that DOCS receives each year. Of course, the rules will have to be different for the old. They are not children, and their rights as adults must be respected. There will be problems, too, in defining just what should be reported - for example, should the rules embrace emotional as well as physical abuse, and what if the abuse is coming from other patients or a patient's family? However, difficulties in framing reporting requirements are no reason to simply shelve the whole idea.

Mr Santoro says it is rare to have serious incidents like the rapes and other sexual assaults that have prompted the current concern. But how does he know?

Last year, a Senate committee said the staff of aged care facilities - and the families of residents - were sometimes too frightened to speak out for fear of retribution. The committee's report called for an investigation of threats and intimidation of staff, residents and families who complain about inadequate care.

Indeed, the committee demanded whistleblower legislation to protect those who make complaints. Making it mandatory to report abuse in aged care facilities would help arm staff and families against attempts at intimidation and threats of reprisals.
Our duty to those in aged care The Sydney Morning Herald March 16, 2006


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The complaints mechanism

The complaints system set up by the government is 1997/8 was designed to be corporate friendly. The responsible body was required to mediate complaints with the nursing homes but could not investigate them or take action to penalise offenders. It had no teeth. The consequences of this were only too apparent in the Riverside scandal but nothing was done about it. This emphasis on mediation rather than investigation had some bizarre consequences.

Santoro promised radical changes to the complaints system but there was no mention of it in the budget and Santoro made no further comment. Could it be that he has traded this with the industry in return for accepting mandatory reporting? Time will tell.

Feb 2006 Residents and family intimidated

Catherine Gladman says her mother, Marilyn Brewwin, made claims of sexual abuse two years ago at the Millward residential care facility in Melbourne.

The police were not called and Ms Brewwin's family was not contacted.

Instead, Millward's nursing director forced Ms Brewwin, who suffers from a brain injury, to repeat her allegation in front of the male carer she alleged assaulted her.

"I had to stand up in front of him and he denied it completely, he denied it in front of me and the nurse, the director of nursing in Melbourne said she didn't believe me," Ms Brewwin said.

"It's terrible, it's shocking because I'm not a liar, I'm not a liar at all."
---------------------------
"They were pretty cheesed off that we'd found out and then tried to say, 'Well, we've dealt with it. It's not an issue, you shouldn't be involving the police'."

Ms Gladman called in the police but charges were not laid.

Last year, the Nurses Board of Victoria reprimanded Millward's then nursing director for "unprofessional conduct of a serious nature" after finding she had "failed to investigate this allegation appropriately".
New rape claims add to aged care woes Delays: The cases have raised concerns about the way rape claims are handled. Australian Broadcasting Corporation (ABC) News February 26, 2006

Mar 2006 Changing complaints mechanism

'The call for elevating the powers of investigation beyond mediation and conciliation and including a complaints commissioner is a positive initiative and is supported.

'The aged care sector needs an independent and strengthened complaints resolution body including an aged care commissioner covering human rights,' says Ms Iliffe.
Cautious welcome to Government aged care reforms Media Release: Australian Nursing Federation March 30, 2006

Mar 2006 New powers

SWEEPING powers to investigate allegations of abuse and inadequate care in nursing homes will be given to a federal body under measures to combat the abuse of elderly people.
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Senator Santoro said the current complaints resolution scheme for nursing homes, which is based on mediation, was inadequate.

"For example (the scheme) has no investigatory powers. It's more about . . . mediation and conciliation and I have always had difficulty accepting that," he said. "I just see difficulty in reconciling the attitude of, say, a rapist, with the attitude of the victim. I think there needs to be a different system that deals with the issue of rape and assault than one that focuses on reconciliation and mediation."
Action on abuse of aged The Age March 30, 2006

May 2006 Complaints system reform not in budget

A new complaints resolution body with investigative powers, which federal Ageing Minister Santo Santoro has flagged as a key plank in the Government's war on abuse in nursing homes, was not mentioned in the budget.
Seniors to cash in on the good times The Age May 10, 2006


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Whistle blowing

Whistle blowers are abused, victimised and fired in almost all situations but nurse whistleblowers in health and aged care seem to be particularly vulnerable. Most of the nurses who have spoken out about aged care have been fired and in a small workforce it is not easy to remain incognito. If their complaint is acted on and the home closed they lose their job anyway - as happened at Riverside.

The government in Australia has been particularly tardy in protecting whistle blowers and scuttled a move by other parties to protect nurse whistle blowers.

Feb 2006 Why few blow the whistle

As Health Services Union official Jeff Jackson pointed out, carers often are deterred from coming forward for fear of losing their jobs or being bullied. He has called for tighter regulation, including random audits, of aged care homes, which currently have several weeks' warning of inspections. Private nursing homes, in particular, have a potential conflict between their commercial interests and their duty of care to residents.
Mandatory reporting is not a solution to protecting the elderly The Age February 22, 2006

Feb 2006 The 2005 senate report and a culture of fear

Two recommendations stand out. The (June 2005 senate) committee wants whistleblower legislation to protect residents, relatives and staff who expose inadequate standards of care. It also wants an investigation of "intimidation and retribution" directed at residents or relatives who complain. How has such a culture of fear come to pervade a system in which we must place our trust?

Families and friends have no choice but to rely heavily on the managers and staff of institutions to whom they entrust elderly relatives. They should be able to feel confident: the industry is regulated and complaints procedures are in place.
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The Victorian case has prompted calls for mandatory reporting of abuse: the whistleblower kept the horror to herself for two months. Mandatory reporting would make it an offence to withhold such information. But mandatory reporting can also attract scurrilous allegations and personal vendettas - as it has in child abuse. And it is merely a Band-Aid unless the industry's deeper problems are addressed.
Nursing home warnings ignored The Sydney Morning Herald February 23, 2006

Apr 2006 Move to protect whistleblowers blocked

THE Federal Government has blocked moves by opposition parties aimed at providing more protection for whistleblowers working in nursing homes.

The Australian Democrats attempted to amend a non-controversial aged-care law to provide employment guarantees to whistleblowers.
Abuse debate spirals The Advertiser April 7, 2006


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The stakeholder summit

The minister made much of an age care summit but included only those from the market and some establishment stakeholders who were less likely to rock the boat.

Feb 2006 Lessons not learned : More than fine tuning needed

The Federal Government has called an emergency summit, thus repeating what has been its typically reactive response to past reports of nursing home abuse.

But it is reasonable to ask what happened to the lessons that should have been learned six years ago when the Herald Sun revealed that 57 elderly patients were given kerosene baths to treat skin conditions in another nursing home?
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There has since been a litany of complaints about nursing homes -- some branded as fire traps, some as places where frail inmates were assaulted, and others where medication mix-ups happened.
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He (Santoro) pledges to learn "how to improve a system which I think is working well, but clearly it needs to be fine-tuned".

Come on Minister. More than fine-tuning is need to rectify the grievous shortcomings revealed in this latest case.
Protecting the elderly Herald Sun EDITORIAL February 23, 2006

Feb 2006 The foxes to meet!

Federal Minister for Ageing Santo Santoro has organised a meeting of aged care industry staff and residents, to be held in Canberra tomorrow, to consider options to prevent abuse in aged care homes.
Plan to tackle abuse in aged care The Age February 27, 2006

Mar 2006 Come up with some superficial patches patches to system

The members of the Advisory Committee (attendance list attached) expressed general support for the following initiatives:

* A uniform system of police checks for workers in the aged care industry;

* An increase in unannounced spot checks for aged care facilities;

* A review of the current Complaints Resolution Scheme;

* And enhanced training for all aged care staff in relation to knowledge and awareness of abuse of the elderly and how to deal with complaints.

"On the issue of mandatory reporting, the membership of the committee was significantly divided. Some members of the committee requested additional research and information in relation to the effectiveness of mandatory reporting schemes in overseas jurisdictions."
Santoro To Go To Cabinet With Aged Care Reform Proposals Media Release: Minister for Ageing March 14, 2006

Mar 2006 Advocacy groups who have all the coalface knowledge excluded

While advocacy groups were not included in the summit, Senator Santoro said he had received written submissions from them that would be considered.

"I spoke to the advocacy groups I've got detailed submissions from them ... and there opinions will certainly be included in any deliberations," he said.
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"One of the positives aspects and outcomes of today's meeting was broad industry support for what could be termed an unannounced random inspections and spot checks," he said.
Santoro says speaking to victim made him more determined Australian Associated Press General News March 14, 2006

Mar 2006 Split on mandatory reporting - delay in acting on senate 2005 findings

Senator Santoro said experts from his Aged Care Advisory Committee - largely comprising aged-care providers - were split on the issue of forcing people to report cases of suspected abuse.

"There were people ... that were strongly in favour of a mandatory reporting system ... and there were people violently opposed to it," Senator Santoro said.
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Labor said most of the proposals agreed upon at the summit were recommendations from a Senate inquiry into aged care last year, which the government had failed to respond.
---------------------------------
"It is now over nine months since the government received those recommendations and it is unacceptable to say that it has taken these recent horrific events to spur the government into action."
Cabinet to consider plan to stamp out elderly abuse Australian Associated Press General News March 14, 2006

Mar 2006 Consulting states

Minister for Ageing Santo Santoro said yesterday he would first consult state counterparts before going to cabinet with the plan.
Act to protect our elderly The Advertiser March 15, 2006

Mar 2006 Mandatory reporting gaining ground

The federal Minister for Ageing, Santo Santoro, promised further consultation on the issue but indicated that he personally favours compulsory reporting.

"It is hard to argue against mandatory reporting," he told ABC television.
Govt must change 'culture of intimidation' in aged care Australian Associated Press General News March 15, 2006

Apr 2006 First changes to policing and oversight made

MANDATORY police checks will be carried out on workers in the $3.7billion aged care sector under sweeping reforms to protect the elderly and improve nursing home standards.

Forced to act after a series of sexual assaults in nursing homes, the Howard Government will also introduce "spot" checks as part of a co-ordinated effort to improve service quality in aged care facilities.

The Government is also considering beefing up the powers of a statutory scheme to investigate complaints against nursing homes. This follows concerns that the present system -- based on mediation -- is failing the elderly.

In the biggest shake-up of the sector for years, Minister for Ageing Santo Santoro will today unveil a suite of reforms designed to protect the 170,000 Australians using aged care services.
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Today's announcement represents the "first instalment" of broader changes to aged care, well-placed sources said.
Random checks on aged carers The Australian April 10, 2006

Apr 2006 Delayed action taken

Now the new Minister for the Ageing, Santo Santoro, has finally done what his predecessors should have done years ago -- moved to end the shameful official indifference to the plight of the vulnerable.
Someone cares at last Herald Sun EDITORIAL April 11, 2006

May 2006 More aged care places

The federal government has announced funding for more than 28,000 new aged care places across Australia.

Minister for Ageing Santo Santoro said $930 million would fund the new places, to be provided over three years.
Govt pledges more funding for aged care AAP Bulletins May 1, 2006

May 2006 Government responds to outcry but avoids addressing the problems

The government has moved to appease growing anger over standards in Australia's nursing homes with an extra $45 million to improve the quality of care, fund more spot checks of homes and boost the vetting of volunteers by police.

Following embarrassing stories of neglect and abuse in several nursing homes earlier this year, Minister for Ageing Santo Santoro announced increased funding to try to restore public confidence in the sector.
Spot checks for nursing homes Australian Financial Review May 10, 2006


The nursing unions pressed some of the key issues and the minister did listen but there is probably little he can do while Howard and Costello remain in control. Nurses wanted a system of professional registration to operate as a way of checking police records and other dysfunctional conduct. Professionalism challenges the self-interest on which market systems depend. It sets up a conflicting culture and in economic circles professionalism is a dirty word. They did not get what they wanted.

Mar 2006 Nurses want long term fixes

Short term fixes were discussed in detail but Santo Santoro, the new Minister for Ageing, seemed willing to listen to some of the longer term remedies put forward by the
ANF.

Victoria Gilmore, ANF federal liaison officer said, 'short term fixes may help with picking up and responding to the reports of abuse but the longer term solutions will be the ones that make living in aged care facilities safer for older people.'
Aged Care Summit Creates Opportunities for Long-Term Solutions Media Release: Australian Nursing Federation March 15, 2006

May 2006 The people at the coal face are unhappy with reforms - they were excluded

But for nurses and aged-care advocates who have been calling for aged-care workers to be registered in the same way as health and child-care workers, the police checks are unlikely to be satisfactory. There will be more of these unregistered workers after the budget, with $4.7 million allocated to boost the number of volunteer visitors to government-subsidised aged care homes by 912 to 7500.
Seniors to cash in on the good times The Age May 10, 2006


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Mandatory reporting of abuse

One of the most contentious issues and one pressed most strongly by advocates was the need for mandatory reporting - making it a criminal offence not to report senior abuse in nursing homes. The AMA and nurses all pressed for this but there was a lot of industry disagreement, particularly at the summit. The minister hedged for a while but was eventually persuaded that his measures would not be credible without it. Eventually the industry agreed but clearly the meetings were far from amicable. There were conflicting views about what had actually been agreed. What is apparent is that the original proposals have been watered down in some way.

Apr 2006 Not for profit's support mandatory reporting

The peak body for the aged care industry says it supports measures to make it compulsory for nursing home staff and operators to report incidents of abuse.
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One of the changes is the introduction of mandatory reporting of suspected abuse cases.

Pat Sparrow from Aged and Community Services Australia says the organisation has always maintained that criminal activity in nursing homes should be reported to police.
Industry welcomes aged care changes The changes to aged care include the mandatory reporting of suspected abuse cases. Aged care changes garner mixed reaction Aged care industry overhaul targets staff and volunteers Australian Broadcasting Corporation (ABC) News April 10, 2006

Apr 2006 Mechanism for mandatory reporting

NURSING home managers will be forced to report cases of abuse and assault to the police, or face losing Government funding, under a plan announced yesterday.

Minister for Ageing Santo Santoro said workers would be required to report cases of sexual and physical assault to their managers, who were to report to police or the federal department.
Nursing home managers warned The Advertiser April 11, 2006

Apr 2006 Confusing and unclear

But proposals for "compulsory" reporting of serious sexual and physical abuse of residents - an apparently milder version of the "mandatory" measures originally proposed - have been criticised by an industry leader as confusing and unclear.
New checks designed to target aged care abuses The Sydney Morning Herald April 11, 2006

Apr 2006 Still not clear

THE operators of aged care homes will be forced to report suspected abuse of residents in their care or risk sanctions such as losing their operating licence, under plans formulated at a meeting of state and federal aged care ministers yesterday.

But it is unclear whether individual workers would be sanctioned for failing to report abuse, as several aged care advocates have demanded.
Owners to notify aged home abuse The Age April 11, 2006

June 2000 Jetter gets her way

MANDATORY reporting of the abuse of elderly people should be introduced in Australia as soon as possible, the founder of the Elder Abuse Prevention Association, Lillian Jeter, told a meeting in Maitland yesterday.
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Ms Jeter said it was vital to introduce a legal requirement to report abuse, which otherwise tended to remain undetected.

There was a particular problem in some aged care facilities where a culture of fear and intimidation led to problems being unreported.

Ms Jeter said some aged care facilities were big businesses, but some owners knew nothing about aged care.
Move to protect elderly The Newcastle Herald June 15, 2006


If it is the disparity in power and the force of market motivation which renders regulation ineffective then one must ask whether these mandatory requirements will be any more effective than the code of conduct introduced after the Riverside scandal in 2000. Does enshrining something in law when the community that is subject to that law does not identify with its principles work?

Oct 2006 Whistle blower protection to be voluntary only

Nursing home staff would have to promptly report adverse events such as falls, injuries, drug mix-ups and significant weight loss suffered by frail elderly residents under a new draft code of conduct developed for the industry.

The code would also encourage nursing home staff to make complaints to health authorities if they were concerned about a home's standards. It says carers should be able to lodge complaints without the threat of retribution from owners and managers.
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On this point (intimidation of staff) the code says aged-care providers should: "Provide mechanisms that facilitate access for care recipients and employed and contracted staff, without retribution or threat of retribution, to advocacy, and complaints services, including the complaints resolution scheme.''

However, the code is expected to be a voluntary, self-regulated code without the force of law.
Aged Care Industry Moves To Protect Frail The Age October 17, 2000


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The staffing problem

The problem of nursing aged and demented patients has been an ongoing one. Andrew Turner’s appalling assertion that you did not need trained people or nurses in nursing homes to bath, feed, walk, dish out pills, and manage incontinence has had dreadful consequences in the USA and Australia.

As in the USA , the business community, politicians, Bronwyn Bishop and John Howard had all swallowed this nonsense at enormous cost to the nursing home community. The requirement for minimum staff levels had been removed and the decisions left to the market.

Nurses and advocates had been stressing the consequences ever since but they were seen as self interested and self serving entities. More reports were now appearing which revealed that staffing and preventable deaths were closely related.

Pressure for some sort of professional body had been rejected by the government even though this is what experts advised.

June 2006 Damning assessment of staffing problems

Nursing home residents are being put in serious danger because few of their personal carers have any training in dealing with dementia, an aged-care mental health expert has warned.

In a damning indictment of the aged-care industry, a survey by Australian National University research fellow Tony Jones found more than 70 per cent of personal carers had no training in mental illness or dementia care through the nursing home they worked in, either when they were first employed or during their employment. More alarming, those who worked in dementia units were even less likely to have relevant training.
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There was also no professional body to register and monitor personal carers, who could walk in off the street and get a job in a nursing home without any relevant experience.
Untrained carers 'risk to patients' The West Australian June 5, 2006

Jun 2006 Damning study of staffing

Untrained aged carers are regularly being assaulted, abused and overworked while looking after residents in nursing homes, an ANU study has found. Dr Tony Schumacher Jones, of the Australian National University Medical School, said the training and working conditions of aged carers, who were not qualified nurses, were worryingly inadequate. More than six in every 10 carers are working in dementia units without having ever received any training on the illness. One-quarter of carers in nursing homes are regularly assaulted by patients and 30 per cent suffer verbal abuse. Another 30 per cent said they had been touched in a sexually inappropriate way during the previous month. Carers also reported they were overworked, 80 per cent saying it was impossible to complete their allocated workload in one shift. Dr Jones said carers needed more education on dementia and aged care, better pay and better conditions.

''Aged care and the conditions under which people live in nursing homes have seldom been an election issue. ''Although we pay lip service to valuing the aged and recognising the difficult, important and socially useful work that carers do, it often appears that our actions fall well short of our rhetoric.''

Secretary of the Australian Nursing Federation ACT Branch Colleen Duff agreed that better trained staff, including more nurses, were needed in nursing homes. The study confirmed what the federation had known anecdotally - that aged care was not adequately funded or regulated by the Federal Government.

''There is nothing in the legislation covering aged care that determines staffing levels or skills. It is left up to the employer, and that is where we have the problem. ''Employers can spend their money on whatever they like, really ... they don't want to pay what nurses are worth, and if they employ someone who isn't qualified, who has not had sufficient training, it means they don't have to pay such a high wage.''

She did not believe the training provided in qualifications for aged care provided the detail needed to adequately provide for patients with dementia and mental illness. ''These people have high care needs, with multi-system failure. You can't just walk off the street and manage them. ''If people with dementia have a care plan and are managed well, you can control it [the illness and the abuse of staff], if they have a really good care plan and are medicated properly.''

Executive director of the Council on the Ageing ACT Paul Flint also agreed with the study's findings and said more education and better pay was needed. ''This research just verifies what we have been saying for the last three years, the need for better trained staff in the sector and that means they need to be better paid ... $13.53 an hour gives very few options as far as employment goes.''

The low unemployment rate meant it was harder to find suitable staff for nursing homes. Federal Minister for Ageing Santo Santoro said he would examine the results of the study and consider its recommendations.
Training void leads to abuse of nurses: study Canberra Times June 9, 2006

June 2006 Too many deaths - elderly a forgotten entity

Revealed: Hunter's hidden aged-care casualties

THE deaths of dozens of Hunter nursing home and aged-care residents over the past five years were preventable, a Herald investigation has found.

A search of the National Coroners Information System found elderly people had died from poisoning or exposure to chemicals, surgical injury and suicide.

Most of the deaths were caused by falls.

In total, 28 cases of elderly Hunter people suffering preventable or "external cause" deaths were dealt with by the NSW Coroners Court from mid-2000 to 2005.

But this figure is believed to be significantly underestimated because not all investigations are closed and some experts also fear under-reporting to the coroner.
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Health Services Union Hunter organiser Bob Hull confirmed it was not uncommon for a single aged-care worker to be looking after 50 patients at night.
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A Hunter aged-care nurse, who did not want to be identified, told The Herald the situation was at "crisis level".

The nurse said aged-care homes were "grossly under resourced" and the system was putting patients at risk. "There is an enormous gap between the standards of care expected and the resources provided," the nurse said. "The elderly are a forgotten entity, we do not have the staff or logistical resources to manage."
They didn't have to die The Newcastle Herald June 15, 2006


Not as widely discussed has been the impact of process, documentation, management techniques and bureaucracy on the number and quality of nurses caring for patients. To be promoted and increase their salaries good nurses need to enter management where their skills are lost.

May2006 Good nurses promoted to "counting toilet paper"

Changes in management systems have withdrawn many expert nurses from the work for which they were trained, taking them away from the bedsides of residents to do managerial tasks known in the profession as "counting toilet paper".

Mrs Bernoth agreed that this was a factor in the aged-care crisis, "replacing face-to-face with fiscal" responsibilities.

The results included old people not being given food, being unwashed, their teeth rotting . . . there were other examples of unsatisfactory treatment of aged-care residents in the Hunter, but you won't read about them here.

That's because, when I pressed her on the subject, Mrs Bernoth cried.
Tears of age manifest tears of rage in Maree The Newcastle Herald May 15, 2006


To Santoro’s credit he seems to have at long last accepted the need for training and for more nurses. He persuaded government to increase funding for training.

What was also required was better pay and legislated minimum staffing levels but this did not happen. Specifying staffing levels would have elicited an outcry from government supporters. Colleagues would not have supported this or agreed to increasing taxes to pay salaries. Instead of increasing nursing levels he is going to train others to do their jobs.

Mar 2006 Training staff

Senator Santoro said the Australian Government is providing $7.5 million over four years to train Enrolled Nurses to manage and administer medication as part of its $2.2 billion 2004 Budget package Investing in Australia's Aged Care: More Places, Better Care.

"The aged-care workforce is an essential ingredient in the government's plan for a quality aged-care sector and medication management is a vitally important part of aged care," Senator Santoro said.
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More than 1650 Enrolled Nurses working in residential aged care have completed or are undertaking medication management as a result of the first two rounds of grants.
Grants for Medication Training to Aged-Care Nurses Media Release: Minister for Ageing March 7, 2006

Mar 2006 Importance of nurses salaries

The aged-care sector has been the subject of numerous studies, reviews, and reports which have all emphasised the need to improve standards. And for the most part, the industry has shown a commitment to continuous improvement.

What has been lacking, however, is the commitment and drive of government to overseeing and driving the improvements. It's not as if they hadn't had well argued reminders of the need to keep their eyes on the ball.

Last year, a Senate committee report on ''quality and equity in aged care'' identified all the major problems that confront the provision of adequate care for Australia's ageing population, including the vexed issue of adequate standards of care, compliance monitoring and complaints mechanisms. The lack of a considered response to the report suggests that it's only headline grabbing accounts of elder abuse that really compel governments to life their game.
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The one thing most industry players agree on, and which the Senate report highlighted, is that the provision of adequate care has been compromised by a lack of skilled staff. In short, an expanding community care sector is unable to recruit or retain good quality nursing and generalist staff because of poor wage relativities.
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Claims of underfunding might well be exaggerated, but it would be negligent of governments to turn a blind eye to arguments that a lack of wage parity with other health-care sectors leading to a shortage of skilled staff is what's at the heart of the problems of elder abuse in the aged-care industry.
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This means realistic funding for aged care and realistic wages for carers.
Age-old issue of underpaid staff Canberra Times March 17, 2006

May 2006 Dementia training

The Minister for Ageing, Senator Santo Santoro, today announced the organisations that will provide dementia-specific training to 17,000 aged care workers across Australia, 8,000 more than was originally expected.

"An estimated 200,000 Australians are living with dementia and with the projected rise in the aged population, it's estimated that number will reach 500,000 by 2050," Senator Santoro said.
Dementia Training Providers to Reach 17,000 Aged Care Workers Media Release: Minister for Ageing May 8, 2006


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Protecting aged care bonds

In the marketplace there are winners and losers. Some go under and when they do they take the bonds paid by residents with them. This had been a problem and the government eventually undertook to refund them but not from taxes. It would put a levy on the rest of the industry. The previous minister had signalled this in 2005.

In 2004 the Hogan report had recommended that aged care bonds be protected when nursing homes entered bankruptcy. The government finally did something about it in 2006 - almost 2 years later.

Sep 2006 Promises to refund bonds

The federal government will refund accommodation bonds paid by residents of aged-care homes if their provider goes bankrupt.

Under laws announced yesterday, if the government cannot recover the bond from the bankrupt provider, it will recoup the cost through a levy on the industry.

The Minister for Ageing, Julie Bishop, said the government would pay about $8 million to fund the scheme for the first three years and then providers would be asked to take on the cost.
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The changes are in response to a 2004 report by economist Warren Hogan that criticised the lack of underwriting of accommodation bonds. Because government legislation allowed aged-care providers to collect bonds, "there is an obligation on government to ensure these funds are not exposed to any risk of loss", he said.

But DCA Group managing director David Vaux said an industry levy would unfairly penalise good operators for those who went bankrupt.
Levy to safeguard aged-care bonds Australian Financial Review September 16, 2005

Mar 2006 Some legislation enacted but sound different!

More than $4 billion worth of accommodation bonds held by the aged-care industry on behalf of residents will be given greater protection under legislation passed by Parliament today.

The Minister for Ageing, Senator Santo Santoro, said the new prudential arrangements endorsed by Parliament would protect older Australians from being financially disadvantaged in cases where nursing homes or aged-care facilities go into bankruptcy.

"This legislation sets out strict guidelines for the management of accommodation bonds, to ensure residents' money is not put at risk and can be repaid when the resident leaves the care facility," Senator Santoro said.
STRONGER FINANCIAL PROTECTION FOR AGED-CARE USERS Media Release: Senator the Hon Santo Santoro Minister for Ageing March 28, 2006


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Back to ideology - what has really changed?

While the final outcome is not yet clear it seems that many proposals were watered down or made more market friendly. Santoro was soon back talking up government policy adopting the Wooldridge 1996 formula but without mentioning the negative sounding word "market". The buzz words choice, efficiency, productivity and competition, to which we have been socialised to respond positively, were all there. What he is promising is more of the same marketplace providers. He is telling us that users, not government, will pay more to ensure corporate profit and maintain the system. He is coating it all with sugary words.

The government is paying $10 million to commission research into the issues. One way of getting what the government wants is to select the sector (eg economics) where research is done and when possible the researcher too! Hopefully this will not happen but I am not holding my breath!.

Mar 2006 The government's positive but contradictory words

Outlining the Howard Government's long-term vision, Senator Santoro said the Government was committed to the three principles of choice, quality and financial sustainability for aged care.

"Another way of putting this is to say that it must be affordable to taxpayers, to service-users and to providers," he said.

"Inevitably this will require a greater focus on productivity and efficiency so that the cost of providing world-class and innovative care to our vulnerable elderly can be met.

SANTORO ISSUES ABUSE PREVENTION CHALLENGE TO AGED-CARE INDUSTRY Media Release: Minister for Ageing March 15, 2006

Mar 2006 Back to the market - and the illusion that the aged can act as customers

(Senator Santoro said)
"We need to continue the transition away from a system in which the government pays providers for the kinds of services that they want to provide, to one in which the government pays providers for the kinds of services that individual service-users want.

"Together we should be thinking about how we can go further than that in the longer term, and move to a system in which the government funds individuals so they, or their representatives, can purchase the kinds of services they want."
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"In my view the high road to improved quality is the road of competition and innovation, with regulation playing a supporting, but necessary, role."
New focus in aged care on dignity Townsville Sun March 15, 2006

May 2006 Users to pay more

In an interview with The Courier-Mail, Senator Santoro warned it was inevitable that aged-care residents would have to pay more towards their own care in future because of the increasing pressure on the system caused by the ageing population.
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Senator Santoro also warned that "a tidal wave of change" caused by the ageing population would place intolerable pressure on the aged-care sector in coming decades.

"Government will not be able to totally fund the sector," he said.

"What we need to do as a community is look directly at the people who are going to be making use of the care and ask them to make a contribution."
Checks on aged carers The Courier-Mail May 27, 2006

May 2006 Back to market mechanisms

The Federal Government is expected to revamp aged care financing to give consumers more choice, but with scope for higher user-pays costs, including winding back the restrictions on nursing home accommodation bonds under which residents have to put up $100,000 or more to get in.

Senator Santoro did not refer directly to the sensitive accommodation bond issue, but said people should prepare for "large-scale changes" in aged care. The next generation of aged consumers would be increasingly demanding in terms of choice, amenity quality and value for money, he told an aged care conference in Melbourne yesterday.
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The senator said if consumers were to be asked to contribute more to the highly subsidised and regulated system, there had to be reforms in choice and improved incentives for aged care operators.
No satisfaction for aged baby boomers The Sydney Morning Herald May 27, 2006

Jul 2006 Money for researcch

The Federal Government has announced $10 million in funding for research into Australia's ageing population.

Minister for Ageing Santo Santoro says it is important to look at ways to improve the health and independence of older Australians.
Govt funds research into ageing population Australian Broadcasting Corporation (ABC) News July 5, 2006


So focussed on the market solution is this government that in the middle of this scandal they commissioned a report into whether a sort of Michelin’s guide to nursing homes would enable the frail elderly to act as effective customers. The researchers tactfully pointed out the stupidity of this - but it took an FOI effort to secure the release of the report and it received little publicity. So much for transparency!

Given their track record for blindness the likelihood that a report like this will even ruffle the patterns of belief in markets is remote.

Jul 2006 A Michelin's guide to nursing homes

CHOOSING a nursing home could be as easy as browsing a Michelin-style guide that assigns a star rating to the food, services, and quality of care providing by different facilities.
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"In the same way that Michelin Guides are based on the view of real consumers who go around judging the merits of restaurants, older people could interview aged care home residents in order to reach a view about the standard of accommodation," the report by La Trobe University's Australian Centre for Evidence Based Aged Care says.

But the report, obtained by The Australian under Freedom of Information legislation, finds a rating system that could be used by a matchmaking agency not dissimilar to a travel agent is not feasible at present, because long waiting lists mean most people have no choice.

It questions how useful a ratings system is "given normal market mechanisms do not operate within the aged care home industry, and the paucity of current vacancies limits the choices consumers actually have".
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"Factors such as urgent need for admission, limited availability of beds and the desire to be close to family or friends compromises any real choice. A rating system at this time may be of little value to most consumers," the report says.

"A central issue for any ranking system that allows comparison of quality is that it relies on agreed and consistent quality indicators.

"Currently in Australia, these do not exist. This is a fundamental obstacle to introducing a standards rating system at this time."
Aged care Michelin Guide mooted The Australian July 24, 2006


Lillian Jeter was out thinking the minister and her comments picking out underlying issues was published the same day as Santoro presented his vision for the sector. Other critics followed.

Mar 2006 Reforms do not address problems of motivation by the bottom line

An aged care advocate has warned plans to tackle abuse in nursing homes will do little to break a culture of fear and intimidation facing whistleblowers in the sector.
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Lilian Jeter, who heads the Australian Elder Abuse Prevention Association, warned fear and intimidation would continue in nursing homes until the government took stronger action.

"A lot of workers that approach management and complain are often shut down and nothing is done. The government needs to do more to change that," Ms Jeter said.

"It is disturbing that nobody is really considering why ... people did not report the abuse.

"The reason is this culture of fear and intimidation that exists within some homes.

"To change this, there are going to have to be dramatic changes in the running of some of these facilities because ... they're only interested in the bottom line."
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Francis Sullivan, the head of Catholic Health, which operates hundreds of nursing homes in Australia, said reform was welcome but the government must be willing to pour more money into the troubled sector.

"Ultimately the quality of care that can be delivered in aged care is determined by the funding those facilities receive from the government," Mr Sullivan told ABC radio.
Govt must change 'culture of intimidation' in aged care Australian Associated Press General News March 15, 2006

Mar 2006 A cutural change needed

'A lack of appropriate skills for workers in aged care, inadequate supervisory arrangements and an environment that puts cost savings before quality and does not encourage staff to report questionable practices all have to be addressed if older people are to be safe,' says Ms Iliffe.
Cautious welcome to Government aged care reforms Media Release: Australian Nursing Federation March 30, 2006


To the for profit aged care industry it was back to business as usual and they were soon lobbying the government to increase funding and make users pay more.

May 2006 DCA lobbying to increase fees to residents

THE chief executive of Australia's biggest commercial aged-care provider is lobbying the Federal Government for an overhaul of aged-care funding.

Amity Group chief David Armstrong will today unveil his plan at a National Aged Care Industry Council forum in Canberra on the future of aged and community care in Australia.

The plan involves lifting the maximum amount that aged-care providers can charge self-funded retirees for accommodation from $16.63 a day to $40 a day, with the price depending on the features of the facility.

"The Government's been talking forever about high-level care funding and the capital funding side of it, the industry's been talking about it forever, but what's been happening is that our operating margins are being eroded and wages are going up faster than inflation and faster than the Government care funding," Mr Armstrong said.

"If people want to have a higher standard of accommodation and facility, they've got to pay a bit more."
Aged-care chief calls on government for funding overhaul The Age May 15, 2006


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The 2006 budget

The May 2006 budget funded some of the initiatives which the minister had promised. It also gave a cash handout to large numbers of elderly seniors - a sort of bribe while at the same time it continued its policy which would see them pay more for their care. He spent more money on training and on dementia but did not reveal that some of this money was being taken from existing services or that nursing home funding was actually less than it had once been.

While the government made much of its new funding it was Warren Hogan the economist who prepared the report for the government in 2004 who revealed that they were simply robbing one sector in order to fund another.

May 2006 Making it tougher for the aged

While the Government has shared its largesse through one off payments, it has toughened asset tests for people going into nursing homes who have to pay bonds on their accommodation.

From this budget, if a person gives money or assets above $10,000 in a year to their children or relatives, the value of that gift will be counted among their assets to decide how much they should pay for aged care. The measure - which will save $71.7 million over five years-is designed to bring aged-care asset tests into line with the pension assets test. But it will also stop people from transferring assets into their children's or partners' names to stop them being counted among their assets.
Seniors to cash in on the good times The Age May 10, 2006

May 2006 Robbing Peter to pay Paul

Figures released after a question on notice by Federal Opposition aged care spokeswoman Jan McLucas show an average of $2732 was spent, for each person aged over 70 this year - a $9 drop per head, or $17 million in total.

The funds are instead being spent on community aged care packages and extended aged care at home programs.
Care burden on families The Courier-Mail May 8, 2006

May 2006 Dementia trainng centres established

NEW dementia-training study centres will be established in major universities to provide specialised training for nurses and other health workers in dealing with patients with dementia.
Study centres for dementia The Courier-Mail May 26, 2006

May 2006 Simply shifting the money about - not increasing it

HUNDREDS of millions of dollars in funding for nursing home residents with low-care needs could be reallocated under a proposal apparently being considered by the Commonwealth.

The scheme could affect tens of thousands of elderly people.

The proposal, designed to boost funding for residents with alzheimers and dementia, has been savaged by the man who recommended that the Government direct more money to care for these patients.

Warren Hogan, who reviewed aged-care funding for the Government in 2004, said that while aged-care homes should be paid more to care for people with dementia, the money should come on top of existing funding.

But the Government looked as if it was considering funding extra payments for alzheimers and dementia residents by cutting subsidies for residents with low-care needs, he said. "I certainly didn't envisage that (they) would try to do this sort of thing," Professor Hogan said.

A spokesman for federal Minister for Ageing Santo Santoro would not confirm or deny that the Government was considering cutting funding for low-care subsidies to pay for dementia care. The Government was looking at a range of options, he said.

But the Department of Health and Ageing website says "the new supplements are to be implemented from within the basic subsidy funding . . . "
Anger at aged-care funding proposal The Age May 22, 2006


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The move to home care

In 1997/8 Dr Michael Wooldridge planned to solve our hospital problems by using step down care in cheaper nursing homes to get patients out of hospital. In 2006 Santoro and his government are trying to solve our nursing home problem by providing care in a cheaper setting their homes. Both ideas are sensible within sensible contexts, but not within the context and in the way in which the ministers planned to implement them - and not in a corporate marketplace environment. Much as Wooldridge was influenced by Sun Healthcare - so Santoro is influenced by Home Instead, another US giant which has entered Australia. In both areas it renders the sector vulnerable to fraud and the residents/patients at risk of financial exploitation - and of in home care elder abuse.

The issue is addressed more fully on the home care web page.

May 2006 The home care option

LOOKING after ageing parents at home is a challenge more and more families are likely to face, with figures revealing that nursing homes have received funding cuts for the first time in a decade.

With the population ageing, the onus is shifting to family members for care, with more money funnelled into home care packages and less into nursing homes.
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"People in residential aged care are more frail than they were in 1990. It is concerning that the per-capita amount of money being spent is relatively the same," she said.

"Families do appreciate the support they can have to remain at home, however, we do need to be assured that people are choosing community care packages rather than that being the only option."
Care burden on families The Courier-Mail May 8, 2006


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How fundamental are the changes?

As indicated the thrust of almost all public discussion and even of those who complained was to patch the leaking but rusty bucket. Kerry O’Brien sums this up on the 7.30 report as a bureaucratic farce. He then goes on to document another glaring failure in a nursing home, in the complaints mechanism, in the agency and in transparency. It cost a doctor $93,000 in court appeals before she got access to a heavily censored copy of the agency’s report on what happened to her mother. We would be extremely optimistic if we believed that Santoro’s reforms are going to address problems like this. It is not in the nature of governments in power to do so. This case is explored further on the accreditation page.

Mar 2006 Are the new reforms another bureaucratic farce?

KERRY O'BRIEN: Welcome to the program. The Federal Minister for Ageing, Santo Santoro, has promised tougher measures to deal with complaints of rapes and other abuse of elderly residents in Australian nursing homes. Those measures, including more spot checks on nursing homes, police checks on staff and a review of the way the government deals with complaints, have emerged from a summit of aged care representatives yesterday. Critics of the current system say there's a lack of protection for whistleblowers who report abuses, and that the whole process of complaints resolution is a bureaucratic farce with little or no transparency.
Elderly abuse prompts Govt measures ABC
7.30 Report MARCH 15, 2006


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Quick Update July 2007

Goodbye Santo Santoro

Santo Santoro's political career came to an untimely end in March 2007 when it was revealed that he had been running a financing and investment business that he had not disclosed as required. Furthermore some of these investments were in areas covered by his portfolio. Concerns were also expressed about the allocation of nursing home licences to political colleagues and about his political dealings.

Mar 2007 Santoro's shares

FEDERAL Aged Care Minister Santo Santoro has breached the Ministerial Code of Conduct by holding shares in a company connected with his portfolio.

Senator Santoro bought a $6000 parcel of shares in Brisbane-based biotech company CBio before becoming a minister in January last year.

CBio is developing a potentially valuable drug to treat rheumatoid arthritis that could be marketed internationally.

Senator Santoro's list of responsibilities as Minister for Ageing cover "arthritis musculoskeletal conditions".
SANTORO BROKE CODE OF CONDUCT - Heat on senator over failure to disclose share portfolio The Courier-Mail March 13, 2007

Mar 2007 Goodbye Santoro

Senator Santoro called a snap press conference in Canberra today to announce he would resign his position as Ageing Minister, revealing he had failed "50 or 60" times to properly document his share trading activities.
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"Frankly, I am angry and disappointed at the Senator's conduct," Mr Howard (Prime Minister) told reporters.

"This is a clear breach of the Senate rules and of his obligation to me, he had no alternative but to resign.
Howard furious at Santoro share deals Australian Associated Press Financial News Wire March 16, 2007


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Hello Christopher Pyne

Santoro's replacement, Christopher Pyne from South Australia, has continued to closely toe the governments line. He has shown little personal initiative. His public statements place him on the corporate side of the divide in perceptions and suggest that he has little understanding of his portfolio. A new era has opened but the omens are not yet propitious. His first job was to examine allegations of favouratism in allocating hospital licences by his predecessor. He found no wrongdoing.

Mar 2007 Pyne to investigate Santoro

The Opposition, meanwhile, also claimed investigations into decisions to award lucrative nursing home bed licences by Senator Santoro would be a "whitewash" if left to the incoming minister.

Mr Howard announced in a television interview on Monday night incoming Minister for Ageing, Christopher Pyne, would look into a recent decision by the former minister to award bed licences worth up to $40,000.
New Santoro scandal The Advertiser March 21, 2007

Mar 2007 Pyne clears Santoro

A federal parliamentary inquiry found Senator Santoro did not influence a departmental decision to give Russell Egan Jr, a Brisbane Liberal branch chairman, 94 taxpayer-funded bed licences.

But the Opposition yesterday questioned the credibility of the probe after learning that neither Senator Santoro nor Mr Egan had been interviewed.

New Ageing Minister Christopher Pyne, who assumed the portfolio last week after Senator Santoro was forced to quit over his failure to declare 72 share transactions, said there had been nothing "untoward" involved in the allocation of beds to Mr Egan's company Superior Care.
Santoro inquiry slammed The Australian March 28, 2007


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More information

For Updates:- A good way to check for recent developments in aged care is to go to the aged care crisis group's search page and enter the name of the company, nursing home or key words relating to any other matter in the search box. Most significant press reports are flagged there. The aged care crisis web site has recently been restructured and some of the older links used from this site may not work.

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Web Page History
This page created Sept 2006 by
Michael Wynne
Update July 2007