Government policy provides a statement of principles and actions to achieve a defined goal. Over the last decades improvements in health care have resulted in increased life-expectancy and hence demand for aged care in Australia. This has been accompanied by an increased focus on aged care and highlighted the need for changes to existing policy and development of new policies to cater to this demand.
Some key reviews have shaped current aged care policy in Australia. These are reviewed in the 2019 Royal Commission background paper Navigating the Maze: An Overview of Australia’s Current Aged Care System.
In brief, the landmark Productivity Commission report of 2011, Caring for Older Australians, might be viewed as the beginning of aged care reform in Australia.  In response to this the Living Longer Living Better Act was introduced to address recommendations in the report. These and subsequent reviews and changes are reviewed in detail in the 2017 Tune Report Legislated Review of Aged Care (2.88MB pdf). The Department of Health also has information on over twenty aged care reforms implemented in relation to various programs since 1997. Essentially the aim of reform was to ensure provision of care that was responsive to an ageing population, accommodation of preferences for people to remain in their homes longer, and improve access and understanding of the aged care system in Australia. 
The Aged Care Act sets out the responsibilities of approved providers in relation to quality of care, user rights and provider accountability.  In response to evidence of system fragmentation and short-comings, including major failures relating to the 2017 Oakden Older Persons Mental Health Facility review, the Australian government commissioned a review of national aged care quality regulatory processes (2.11MB pdf).  In line with recommendations of that review an independent Aged Care Quality and Safety Commission (ACQSC) was established. ACQSC is responsible for aged care quality and handling of complaints, and from 2020 is expected to regulate aged care provider approval and compliance. Their role is to protect and enhance the safety, health, well-being and quality of life of people receiving aged care. The new single set of quality standards for all aged care services that come into effect on July 1, 2019 were developed by ACQSC. These standards replace the previously separate standards for home care and accreditation.
A second important policy driver in the aged care sector is a focus on consumers. The 2011 Productivity Commission Report and the 2017 Tune Report, proposed that aged care should be a ‘market’ whereby the consumer is given the power through control of funds and access to information on provider performance. This would enable people to make choices over where the aged care services are provided (ie. in a residential care facility or at home), to have the freedom to select (ie. purchase services) from any approved provider of services and to make a payment for those services on a capacity to pay basis. The person’s rights are also acknowledged in a Charter of Aged Care Rights. This articulates 14 consumer rights for all aged care recipients making it easier for older people, their families, carers and representatives to understand what they can expect from an aged care service.
The challenges within aged care leading to and addressed by the multiple reviews since 2011 can be summarised as follows;
- The growing number of people aged over 70
- Increase in aged care service demand
- Associated funding and workforce requirements
- Increasing demand for aged care services delivered in home
- Demand for care that is more responsive to individual needs
- Concern over the reported abuses of older people and service quality in residential aged care.
The substantial number of Government and Parliamentary initiated inquires and reports in recent years (see policy time line) reflect a growing urgency to address these challenges. In September 2018, the Prime Minister announced the establishment of a Royal Commission into the Aged Care sector. In the Australian system of government, royal commissions are the highest form of inquiry on matters of public importance.
Page created 25 June 2019