More than half of the nursing homes run by Bupa, the British-based multinational company, have failed to meet government health and safety standards, according to reports and documents published by the Australian Broadcasting Corporation (ABC) and the Guardian Australia.
Confidential reports by the federal government’s Aged Care Quality and Safety Commission (ACQSC) reveal shocking accounts of patient abuse, further underscoring the human cost of privatised aged care, where profits inevitably override the treatment of vulnerable residents.
Government documents show that Bupa operates 78 nursing homes that house 6,700 residents, making it Australia’s largest aged care provider, thanks to increasing privatisation of the sector by Liberal-National Coalition and Labor Party governments alike.
Of Bupa’s nursing homes, 45 have failed to meet official health and safety standards, while 22 have been declared as putting the health and safety of residents at “serious risk” in the past four years. But only 13 homes were sanctioned, which means they temporarily lost government funding and were unable to take new residents.
Only five homes—New South Wales’s Seaforth, Berry and Eden; Victoria’s Traralgon and Tasmania’s South Hobart—have had their accreditation revoked. Except for Seaforth, all were re-accredited. This points to an ongoing failure by governments and regulatory agencies to protect patients over a protracted period.
In response to the exposures, Aged Care Minister Richard Colbeck said his department had been meeting with Bupa management each week to fix dozens of non-compliance issues across the company’s network.
According to the ABC’s “7.30” program, a 113-page confidential ACQSC report contained details of assaults, including sexual assaults, on residents by other residents, often with dementia. Other complaints included incontinence pads being left on for 12 hours, residents with dementia disappearing from a home, and dying residents being left hungry and in pain.
Because Bupa operates so many homes, some commentators have referred to it as “too big to fail”—drawing a parallel with the banks and finance houses which have been exposed as committing systemic abuses against customers but permitted to keep operating. If Bupa lost accreditation, there would be nowhere to go for almost 7,000 vulnerable people.
Both Coalition and Labor governments have overseen the privatisation of aged care facilities, with non-government organisations and private corporations now running 91 percent. The three biggest companies that run aged care facilities—BUPA, Opal and Allity—had revenues of $15.8 billion, after tax, in 2017.
The record of just one of Bupa’s facilities illustrates the extent to which the corporation has been permitted to prioritise profits over care. In February this year, Bupa Roseville, in Sydney, met 44 of the 44 expected outcomes of the official standards and its accreditation was extended until 2022. Less than three months later, it met only 13 of 44 outcomes and was sanctioned. The ACQSC halted funding and shortened Bupa Roseville’s accreditation to April 2020. The list of “serious concerns” read as a failure of every aspect of care and management.
There are four accreditation standards: (1) Management systems, staffing and organisational development; (2) Health and personal care; (3) Care recipient lifestyle; and (4) Physical environment and safe systems.
Bupa failed in these areas: “Education and staff development, Inventory and equipment, Information systems, Clinical care, Specialised nursing care needs, Medication management, Palliative care, Continence management, Behavioural management, Mobility, dexterity and rehabilitation, Sleep, Continuous improvement, Emotional support, Independence, Privacy and dignity, Leisure interests and activities, Cultural and spiritual life, Choice and decision making, Infection control, Catering, cleaning and laundry services.”
A former Bupa nursing home general manager, speaking on condition of anonymity, told the Guardian that penalties generally only resulted in short-term change in Bupa nursing homes. “You can fix all the paperwork up, anyone can do that,” she said. “You can put a Band-Aid on it, it will look good, but it will fall over in five minutes.”
She said managers of homes were under constant pressure to cut costs, including by restricting overtime, curbing the food bill and deploying fewer trained carers on the floor because they are more expensive than inexperienced staff.
During an interview on “7.30”, Bupa CEO Hisham El-Ansary claimed to be “working very hard to restore confidence” but effectively blamed staff. He spoke of the need for “good, quality people inducted into the business world who are trained in what they need to do and who are totally committed to the care of elderly residents who are in our charge.”
The use of the term “inducted into the business world” speaks volumes about the primary profit focus of corporations like Bupa, in a service that requires humanity and compassion above all other considerations.
Asked if offering higher wages might help, El-Ansary insisted there were problems attracting quality staff to regional areas, regardless of the pay offered. Less than half of Bupa’s facilities are in regional areas. It is also well known that aged care workers are underpaid and often compelled, due to profit-related understaffing across the sector, to work overtime or do double shifts.
Last year, Bupa received $460 million in government subsidies. In effect, the government subsidy provides at least two thirds of Bupa’s estimated profits in aged care, the rest being squeezed from residents, many of whom pay 85 percent of their age pension in “accommodation fees.”
Those fees leave an aged pensioner a mere $64 a week for anything else they need. Through means testing, if residents exceed $49,000 in assets or income from investments they are compelled to pay more. Services beyond the basics, such as hair and nail maintenance, toothbrushes and toothpaste, and excursions, are extra.
Another government regulator, the Australian Competition and Consumer Commission, initiated proceedings against Bupa in April for charging thousands of residents in 21 facilities for services they did not receive.
Over the past three years alone, numerous reports and parliamentary inquiries have confirmed that neglect, mistreatment and shocking conditions are an everyday reality for nursing home residents.
Last year, Prime Minister Scott Morrison announced a royal commission into the aged care sector in an attempt to quell the public outrage and divert attention from the impact of ongoing funding cuts and privatisation of the industry.
Last week, amid the latest Bupa scandal, the government extended the inquiry for six months, which means it will not report until November 30 next year. Despite the overwhelming evidence of maltreatment of patients, none of the key demands raised by aged care workers or residents, including higher wages and mandatory staff-to-patient ratios, have been addressed.
The vast control that corporate giants like Bupa have been handed over the aged care sector underlines the urgent need for decent care for all elderly people, freed from the dictates of corporate profit and government austerity measures.
The author also recommends:
Australian aged care workers confront worsening conditions
[9 January 2018]