On a Sunday morning in Spring 2018, Prime Minister Scott Morrison called a press conference to announce a Royal Commission into Australia’s aged care system.

He was motivated by what he described as a ‘disturbing trend’ of abuse and non-compliance across the sector, brought to light in the national media over the preceding months, and in an ABC Four Corners exposé set to air the following day.

Justice Joseph McGrath was appointed Chair of the Royal Commission in October 2018, tasked with inquiring into: the quality of aged care services in Australia; the delivery of services to people with mental illness, dementia and disabilities living in aged care facilities; future challenges in delivering accessible, affordable and high quality aged care, including in rural and regional Australia; and how to ensure the sustainability of our aged care system.

The Royal Commission has received over 800 public submissions and responses from 900 of the 2000 aged care facilities operating in Australia. The first round of public hearings commenced in Adelaide last week and already there is evidence of deep and disturbing neglect, abuse and breaches of care within the sector.

Some of the key issues raised during the first days of the hearings include:

Funding – The Commonwealth Department of Health Secretary, Glenys Beauchamp, presented at the hearings this week in Adelaide, stating that while government funding is adequate to meet current needs, an ageing population and growing waiting lists are early indicators that funding levels will need to increase over the forward estimates.

Nutrition – An issue raised numerous times during the hearing’s first days was the lack of monitoring or adequate policing of nutrition standards within aged care facilities. Paul Versteege from the Combined Pensioners and Superannuants Association of NSW said malnourishment was a recurring safety breach within the sector.

Over-medication – A number of accounts presented at the hearings so far have highlighted the overuse of medication, particularly to treat residents with dementia. One witness whose husband tragically passed away while residing at a facility alleged that her husband had been administered 10 times the prescribed dose of his antipsychotic medication.

Nursing workloads – A common theme presented by the industry itself is the increasingly unmanageable workload aged care nurses are expected to carry, underscored by the high resident to nurse ratio.

Abuse – A particular focus of many presenters has been mandatory installation of CCTV cameras in all the common areas of aged care facilities, to identify and take action against any form of patient abuse.

A federal election will take place before the Commission’s final report is due, however it’s fairly safe to predict some of the outcomes. There will likely be increased funding for the aged care sector; stricter regulation and monitoring of how residents are medicated; and new regulations requiring live-monitoring of residents’ treatment within facilities, including digital recording technology.

The interim report is due in October 2019, with the final report due in April 2020.