The Royal Commission into Aged Care Quality and Safety: The First Public Sitting

We summarise the key concepts from the preliminary hearing below. A full transcript of the statements by the Commissioner and Counsel Assisting for the preliminary hearing held on 18 January is available on the Royal Commission’s website^[1]

Key themes

• The main goal of the ACRC is as follows: To create a world class care system in Australia, which has the people’s confidence. One that is simple to understand, easy to navigate and accessible. One that provides services which are compassionate, customized to the individual, and has the highest standards in terms of quality and safety. And one that can do this all while being sustainable.
• Issues which will be discussed in future commission sittings include: young people with disabilities who live in aged care facilities, access and inclusion, availability and affordability of care, diversity issues, dementia patient treatment, staff ratios and training, diversionary therapy and behavioural supports and person centred care, loneliness, community visitation, interfaces and transitions, safety systems and the regulatory framework, access and navigation of the aged care system, remote geographical issues, future challenges, the demand profile and how to deliver quality care in a sustainable way.
• Requests were sent to 1,982 health care providers in November 2018, relating to approximately 2,000 services and outlets. 83 out of 100 large providers responded by their deadline (7 January 2019). The remaining providers’ submissions are due by 8 February 2019. The main issues which have arisen from this requested information so far include: elder abuse, medication mismanagement, food safety issues, not responding in a timely manner to resident help requests and inadequate wound management leading to death. 
• Research and conclusions, particularly those with regulatory, structural and policy reform may be made public and accessible on the royal commission website for comment and discussion, if deemed necessary.

Key Dates

• Submissions by the remaining 1,882 approved providers are due by 8 February 2019.
• The first substantial hearing transcript will be released on 18 February 2019.
• An interim report will be released no later than 31 October 2019.
• A final report will be issued no later than 30 April 2020.

Other notable information

• The process has been set up to allow any member of the public to provide submissions. These can be anonymous. Direct emails and phone calls can also be made to provide information. Approximately 5,000 submissions were made to the Department of Health before the ACRC began. Since 24 December 2018, approximately a further 300 submissions have been made on-line using the ACRC’s website. Out of the 300 approximately 81% have been concerned with provision of care. The most common issue was about substandard or unsafe staffing (54-59% having these issues).
• Other information the ACRC will access includes the 2011 Productivity Commission Report titled ‘Caring for Older Australians’, the 2017 Aged Care Legislated Review, The Australian Law Reform Commission’s report (2017). Also, the ACRC has held meetings with consumer groups, key government agencies and other stakeholders.
• Direct testimony by those receiving health care, their families or other carers will be made about their experiences in future ACRC sittings.
  

Of interest

• A significant focus has been put on understanding the current aged care system layout. Therefore it has been announced that site and community visits will start to take place.
• New commission powers which are being used for the first time in the ACRC: The power to issue notices requiring the production of documents and/or requiring individuals to provide information or a statement in writing.
• The ACRC expects to be able to call evidence from age care staff, experts, advocacy bodies, workforce representative bodies, professional bodies, aged care sector representative bodies, aged care providers and government bodies.
• Public (and in some cases, private) hearings, together with roundtables and community consultations, will be conducted throughout this year and into next year. Information on the community roundtables will be released as soon as they can be organised, and are set to be in the capital city of each state/territory and in various rural centres around Australia. 
• Commissioner Tracey sent a clear warning: “We would be gravely concerned if any operators in the aged care sector or government bodies were to instruct their staff not to talk to the Royal Commission or to withhold information from us.”
• The ACRC’s next meeting and first substantive hearing will commence on 11 February 2019, where evidence about the key features of aged care quality and safety is expected to be heard. Complaint systems and how they work will be the main discussion points. Information about the challenges faced by the aged care system and how these systems are expected to operate from 2019 onward will also be discussed. This sitting will be webcasted on the Commission’s website. We will issue another client alert following this next sitting.

Support and Next Steps

We continue to advise our clients to let us know of any response required by the ACRC and to ensure that they make prompt and regular disclosure to insurers as required under their Statutory Liability, D&O, Medical Malpractice and/or Liability insurance policies.

For assistance regarding the potential impact of the ACRC on your insurance program you can contact Lyle Steffensen at lyle.steffensen@marsh.com or 02 8644 7582.

_{DISCLAIMER: This document is not intended to be taken as advice regarding any individual situation and should not be relied upon as such. This document contains proprietary, confidential information of Marsh which may not be shared with any third party, including other insurance producers, without Marsh’s prior written consent. Any statements concerning legal matters are based solely on our experience as insurance brokers and risk consultants and are not to be relied upon as legal advice, for which you should consult your own professional advisors. Any projections are subject to inherent uncertainty and could be materially affected if underlying factors change. The information contained herein is based on sources we believe reliable, but we make no representation or warranty as to its accuracy. Except as may be set forth in an agreement between you and Marsh, Marsh shall have no obligation to update this document and shall have no liability to you or any other party with regard to it or to any services provided by a third party to you or Marsh. Marsh makes no representation or warranty concerning the application of policy wordings and makes no assurances regarding the availability, cost or terms of insurance coverage.}

_{[1] This link is shared pursuant to public license ‘Creative Common Attribution 4.0 International’, the terms of which can be found at https://creativecommons.org/licenses/by/4.0/legalcode, including the disclaimer of warranties at section 5. Material obtained from the website is © Commonwealth of Australia 2019.}