Fault lines in aged care exposed

There is no love lost between Morrison and Fierravanti-Wells. They share some conservative social values – both opposed same-sex marriage, for instance – but are very different.

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Morrison is the man from eastern Sydney who ran the Liberal Party in NSW before manoeuvring his way into the city’s southern electorate of Cook in 2007, a victory that delivered a seat at every Sharks game as well as in federal Parliament.

Fierravanti-Wells is the daughter of Italian migrants and grew up in the steel belt of the NSW Illawarra before battling her way through the Liberal Party to lead the most conservative wing of the state division.

When Morrison needed factional support to run for Cook, Fierravanti-Wells thought he wasn’t conservative enough and backed Michael Towke instead. The way Morrison prevailed, after losing the first preselection ballot, led to years of bad blood about his tactics.

That history gave Fierravanti-Wells no reason to pull her punches about aged care, but there were other factors that encouraged silence. The tribalism of the party system is one. Those who speak up, stand out – and mostly in a way that brings no reward. The herd mentality has a smothering effect on debate by pushing every MP into following the leader’s talking points.

Not everyone who speaks out speaks sense. While the Liberals’ Craig Kelly goes rogue on hydroxychloroquine – one of the side-effects is dizziness – Fierravanti-Wells is making a considered and necessary intervention on something more important.

Her criticism is not so much about the current ministry as the aftermath of the 2013 election, when Tony Abbott came to power and shelved the Coalition policy to fix aged care.

“Prime Minister Abbott and those advising him in the Coalition failed in their promise to reform aged care and simply opted for a shift that had no demonstrable outcome for the wellbeing of our older Australians,” she writes.

She knows this because she was the Coalition’s shadow minister for aged care for four years until the 2013 election and developed the policy that was meant to be put into place after the election. She was moved to multicultural affairs instead.

How Fierravanti-Wells would have performed as aged care minister will never be known, but at least she wanted the job. The past decade is littered with junior ministers who have been given a start in aged care while waiting to move up and out.

Labor had three ministers in the six years to 2013; the Liberals had three in the six years afterwards, then a fourth when Richard Colbeck was appointed last year. No Prime Minister considered the portfolio worthy of cabinet rank.

There has been no shortage of ideas to fix the system. The failure has always been the indecision at the top. It is almost a decade since the Productivity Commission raised ideas to inject more funding into the system – not just from governments, but from residents who could draw on assets like the family home.

Fierravanti-Wells does not lack passion for the subject. She devotes 52 pages to her submission to the royal commission into aged care, full of proposals as well as criticisms of past mistakes.

She calls the funding system a “nightmare” and says aged care should be integrated with healthcare using a Medicare model. This would mean setting up aged care “hubs” like medical clinics to look after older Australians in nursing homes or in their own homes nearby.

Fierravanti-Wells slept overnight in aged care homes when looking after her parents, so she had a close view of the pressures on families, workers and residents. Early in her career, before entering the Senate in 2005, she was a board member of an aged care facility at age 23.

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The result is a submission that blurs the usual political lines. Fierravanti-Wells has witnessed the challenge of finding and keeping a workforce for the jobs most Australians will not do. While she is a social conservative, she can sound a little like a union leader when she identifies problems with the casualisation of the workforce and the low pay rates for nurses in aged care compared to hospitals.

Confronting your own party with its mistakes is one of the hardest things to do in politics. Morrison and his ministers should listen, even if they are tempted to wave away the lessons of the past.

Having set up the royal commission into aged care, Morrison is invested in the process and any roadmap it offers for the changes ahead. He has signalled there will be more money for the sector in the October budget. He speaks as if he is determined to act on the commission’s findings.

The trouble is that so many inquiries have fallen on deaf ears. It may help to have Fierravanti-Wells in the Liberal party room to make sure the next one is heard.