Elderly people talking on couches in a group

Will the Royal Commission into Aged Care create a future you want to age and die in?

The Royal Commission’s final report into aged care proposed major reforms to the industry to address substandard care and build in innovation. Alongside these critical and welcomed reforms, says TACSI systems initiatives director Kerry Jones, we also need to have a national conversation about our preferred future for ageing and dying in Australia.

By Kerry Jones, Director, Systems Initiatives

On February 26, 2021, the Royal Commission into Aged Care Quality and Safety handed down its final report on the quality of aged care. The commissioners found substandard care and neglect at a number of levels: in the provision of care, in the government’s funding of care and stewardship of the industry; and in how society views and discriminates against older people. 

The report proposes major reforms to make sure we’re providing enough care, and that the care is delivered with dignity and respect, and in a way that puts older people first. Research and innovation has been made core to the new system design to ensure that the system stays ‘dynamic’ into the future. This includes new funding for research and innovation – equivalent to 1.8% of government expenditure on aged care – that will prioritise co-design with older people.

This level of commitment to innovation and co-design is rare, and should be celebrated

However, innovation will not achieve impact through funding alone. To realise the potential of the investment, parallel strategies must be implemented to ensure a new culture is embedded within a sector that’s long been starved of the opportunity to innovate. Building the capacity for innovation leadership in the sector, and designing the funds in such a way to support the complete innovation journey – from research and ideation to design implementation and scale – will be critical and require an ecosystem approach.

 

The final report answers the question of how to reform today’s system, but the question that looms in baby boomers’ minds is: “How do we want to age and die in the future?”

Our approach to aged care can only be fit for the future if we have a national conversation about what that future should look like, and take intentional steps to get there.

We need to start talking about:

  • What status do we want older people to have in our society?
  • What are the options for where, how and with whom we live?
  • What do we want our neighbourhoods to look like?
  • What’s the future of care work?
  • How do we want to experience dying and death? 
  • What services and products might support us to live the life we want to lead? 

Without pursuing future-focused reforms alongside current system improvement, we’ll anchor ourselves in the past, rather than pull ourselves into the future. Only through future-focused research and development do we ever stand a chance of genuinely meeting the needs and aspirations of the baby boomer generation, and the generations that follow. 

These conversations require imagination, and they need to include older people, the next generation, the aged care industry, and the future providers of services and support in later life. Public deliberative processes, like the recent Citizens Convention for Climate in France – which shaped the nation’s approach to climate change – provide a practical model of how to do this in a way that creates an authorising environment for politicians to embrace new alternatives on contested issues.

 

What could incubating and accelerating future systems look like?

There have been a number of investments made into incubators and accelerators for technology in aged care. But overseas this concept has been applied much more broadly, in a way that concurrently accelerates the development of whole future systems, products, services, policies, mindsets and social norms, in line with a preferred future. 

There are proven results: in Canada it’s been used to develop a more inclusive economy; in the UK to create a safety net for gig workers; and in Basque Country to support a ‘just transition to green jobs’. UK-based systems innovators ALT/Now are the designers of the model, and in 2019 we worked with them and the Australian Government to design a multi-million systems accelerator adapted for Australia.

Elderly lady

A national conversation on the future of ageing and dying, and a systems accelerator for the future of aged care would:

  • Develop a vision of a preferable future (eg 2040) that provides a national guide for the Australia people want to age and die in. 
  • Assemble networks of everyone who can shape this future, and go broader than the aged care industry and the responsible department. 
  • Accelerate innovations in products, services, markets, policy and social norms to deliver that future.

The reforms proposed by the Royal Commission will bring the industry up to standard and set up continuous improvement. A national conversation on the future of ageing and dying would help us set a standard for the future, and a systems accelerator for the future of aged care will help us get there.