Is Homecare following the ignoble tradition of dodgy operators leaping onto government-funded gravy trains? Pressure selling through doorknocking happened with home insulation and vocational education and it's already happening with Homecare; threats by Aged Care Minister Ken Wyatt to impose sanctions may mean the government doesn't intend to get fooled again.

The rollout of 10,000 new federally subsidised home care packages has commenced and the wait-list stands at 127,000. There are now 900 operators offering in-home services such as bathing, cooking and cleaning. Providers are supposed to meet the National Home Care Standards. Two providers were recently found to fail nearly all of the standards. Sanctions are beginning to be applied - funding gets withheld for any new clients for a period of six months. The brand new Aged Care Quality and Safety Commission will oversee the whole aged-care industry.

This is good news, as standards become meaningless when there is no compliance regime. Imagine the roads if there was no enforcement (go to Russia or India if you can't). Unwitting students were left with thousands of dollars of VET fee debt after being signed up for shabby courses on the promise of a free iPad. Although a few training providers were shut down, the regulatory system could not respond quickly enough to save the pockets of students (or taxpayers, depending on whether the student ever ended up earning enough to repay the debt). 

More tragically, four workers died as a result of the Energy Efficient Homes Package in 2009. Opportunists don't waste time when it comes to making money from taxpayer funded schemes. In the free-for-all that follows the government can't afford to waste any time when implementing a national framework of compliance. 

The Aged Care Royal Commission has already yielded stories of disgusting meals, festering commodes and of course violence - these in the context of institutional care which is not as private as home care. How to monitor the care of vulnerable older people in their private homes?

Besides the risk of inferior care there are also opportunities for financial exploitation. These may be deliberate fraud and theft, but also in the form of hidden fees: entry, exit, administration - recall the banking Royal Commission! It might only be a matter of time until there is another 'I fee dead people' revelation.

However, the answer is not necessarily piling on more and more regulation. Anyone familiar with the VET sector will be aware of the onerous compliance requirements asked of a Registered Training Organisation - and they still weren't effective. Homecare providers need to pay staff or consultants to do the compliance administration, which, because of the costs, can take away from the providing the quality of direct care that standards are supposed to guarantee.

The new Aged Care Quality and Safety Commission commenced operation this month. It has a budget of $300m which $48 million for monitoring activities and the employment of scores of compliance officers. It will conduct quality reviews of home services to assess whether a provider delivers services in accordance with the applicable aged care quality standards. Let's hope it manages to oversee quality Homecare without getting in the way too much. It is required to assess and report on its own performance under the Australian Government’s Regulator Performance Framework. Interesting.

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