Source: The Brisbane Courier Mail [Madonna King]

WHY weren't we outraged when we recently discovered that residents of one aged care home were found to weigh less than 25kg?

When did it become acceptable to treat our elderly so appallingly?

Why isn't it a barbecue-stopper that a serious lack of clinical care and basic hygiene failures are routine events in our aged care industry? Are we so convinced that it couldn't one day be us sitting in dirty incontinence pads for hours, begging for a shower, that we don't consider it a priority?

Given the status the Rudd Government has afforded aged care since its election, it hardly seems to be at the top of their to-do list. Short of a public inquiry into the industry, it is unlikely to improve before our baby boomers swell the ranks of those needing care.

Minister for Ageing Justine Elliot's response to each new shameful episode is to ask questions, seek a review - and then move on. But tinkering around the edges will not help a sector that is so unaccountable and laden with problems that those who work in it vow never to let someone they know suffer the fate of those housed there now. 

Of course, there are good homes; and even those that are dreadful attract caring and trained staff who try to do everything in their power to provide dignity to those with none. But the foundation for how aged care operates in Australia is wrong, and until the fundamental issues are addressed, it will continue to dominate headlines by lurching from one crisis to the next.

Elliot and her boss, PM Kevin Rudd, need to look at who is running  aged care facilities, what staffing levels they adopt, how complaints are investigated and the retribution suffered by those brave enough to fight for change.

Let's look at ownership first. A strong argument exists for community-based care for our elderly. Or at least to ensure ownership is tightly regulated and monitored, if for no other reason than to ensure care, not shareholder profits, is the priority.

Complex company structures that exist now mean it is sometimes difficult to determine who might ultimately hold responsibility for the standard of care at a particular facility.

This was illustrated by a recent case where attempts were made to try to identify the provider of a particular home; all paperwork pointed to someone who had ceased being the owner 10 months earlier. That means, even when there is an ownership change, probity checks are not always undertaken. Shouldn't checks be made every time a home changes to new ownership so authorities can vet an owner's criminal background and business record? Intricately linked to the ownership issue is how a home determines its budget. And most business models would suggest an easy way to increase profit margins is to cut staff numbers.

Despite staff-to-person ratios existing in our hospitals and our kindergartens, none are mandated for aged care where dementia and high-care patients take chunks of a carer's time.

That means in Queensland there are complaints of one staff member for up to 20 residents, many of them high-care. In addition to issues of ownership and staffing, the complaints scheme hampers revelations of poor treatment or clinical care.

Accusations from insiders range from the elderly being punished for wanting to go to the toilet too often, to having their food confiscated because they do not eat fast enough. Families are resorting to all sorts of techniques to prove the lack of care. In one case, a family member put a dated note in a glass of water containing her father's teeth, to prove it was months since they'd last been cleaned.

Some homes are complained about repeatedly - and yet, to the families who feel the guilt of not being able to care for their elderly, they are falling on deaf ears. What makes that complaints process even worse, is the retribution being handed out in some quarters to those who dare complain from the inside. That means workers, laden with mortgages, are remaining tight-lipped about substandard care simply because they fear dismissal.

They also see instances where those who have blown the whistle have suffered for it - and that surely flies in the face of an open and accountable system where care dominates.

As our community ages, fewer and fewer Australian families will be able to cope without using an aged care facility. The standing of those who own them and the standard of the care provided within them should be the key focus of any government with a vision for the future. Our politicians should realise that one day they may need to enter an aged care facility. Surely this should be an added incentive to fix the industry's problems.

Madonna King presents Mornings from 8.30am each weekday on 612 ABC Brisbane. This e-mail address is being protected from spam bots, you need JavaScript enabled to view it