Page:Royal Commission into Aged Care Quality and Safety Final Report volume 1.pdf/13

Rh The role of Government, and its need to make decisions between competing governmental priorities is at the heart of the failures and shortfalls in the aged care system we have in Australia today. The role of Government in aged care in Australia goes well beyond, and must go well beyond, putting in place a framework for market forces to provide individuals with care choices matching their care needs whilst ensuring an effective safety net for those with little ability to pay. We do not have an ideal market economy for the provision of aged care in Australia and we need Government to participate fully and proactively in the provision of the care which people need and which they may obtain through the complex system that has developed over many years.

Mere adjustments and improvements to the current system will not achieve what is required to provide high quality care that is predictable, reliable and delivered through a system which is sustainable. A profound shift is required in which the people receiving care are placed at the centre of a new aged care system. In the words of one commentator, aged care does not 'need renovations, it needs a rebuild'. Fortunately, the rebuild that is needed has many firm foundations that can be used. The present aged care system has a workforce whose dedication to care is impressive and worthy of more praise and reward. There are informal carers whose personal connection with the person cared for is immediate and strong. What is needed is for these positive foundations to be used for a rebuilding of the aged care system needed now and for the future.

This has been an unusual Royal Commission in many ways. I was first appointed as an additional member on 13 September 2019, after the inquiry had been ongoing for nearly twelve months. My fellow Commissioner, Ms Lynelle Briggs AO, was first appointed a member of the Royal Commission on 8 October 2018, and on 12 October 2019 the then Chair, the Honourable Richard Ross Sinclair Tracey AM RFD QC, died. The work of the Royal Commission was then substantially interrupted by the outbreak of the COVID-19 pandemic which delayed our work and put unexpected pressures on governments, providers, workers, and the many others who were to assist our inquiry during 2020. Our staff and advisors throughout these difficulties deserve special thanks and mention. Amongst them, of course, as mentioned above, are the team of Counsel Assisting, upon whose submissions I have largely relied in reaching my recommendations, the team of Solicitors Assisting, and the team of dedicated policy and other advisors as well as the many support staff. Each has made a contribution and has worked with a dedication to make us proud. There are three in particular, however, that I must mention for constant assistance and counsel. The first is Peter Gray QC, who, with Peter Rozen QC, led the team of Counsel Assisting and provided me with robust, sound and well considered counsel throughout my time as Commissioner. The second is Louise Amundsen, who as Co-Solicitor Assisting with Rodger Prince, heading the Office of the Solicitor Assisting worked with tireless dedication and impeccable attention to detail. The third is Dr David Cullen, whose wealth of knowledge of the aged care system, deep conceptual and analytical skills and commitment to better outcomes were invaluable to me in forming my recommendations. There were many others who have been invaluable to our work who should not be forgotten, and whose contribution was profound, including the many direct evidence witnesses who opened their lives and their hearts to us and to the public at large. At a personal level I should also express my thanks to my fellow Commissioner, Ms Briggs, from whom I have learned much. 3