Towards a uniform Defamation regime

On 3 October 2019, officers of the Australian Attorney Generals' Defamation Working Party provided instructions for drafting by the Australasian Parliamentary Counsel’s Committee to prepare public consultation legislation for the Council of Australian Governments.

The prposed Instructions to create a uniform defamation regime are

1 Name of provisions 

These provisions are the Model Defamation Amendment Provisions 2020. 

2 Purpose of provisions 

(1) The purpose of these provisions is to set out model amendments to the Model Defamation Provisions— 

(a) to require a plaintiff to prove serious harm for a cause of action for defamation, and  

(b) to provide for certain individuals to be counted as employees of a corporation in determining whether the corporation is an excluded corporation, and  

(c) to require a concerns notice to be given to the publisher of defamatory matter before defamation proceedings may be commenced against the publisher, and  

(d) to make various amendments with respect to the content and timing for concerns notices and offers to make amends, and  

(e) to clarify that a defendant may plead back imputations relied on by the plaintiff as well as those relied on by the defendant to establish the defence of contextual truth, and  

(f) to provide for a defence in respect of peer reviewed matters published in academic or scientific journals, and  

(g) to provide for a defence for the responsible communication of matters of public interest, and  

(h) to clarify when material is sufficiently identified in a publication of defamatory matter for it to be treated as proper material on which to base the defence of honest opinion, and  

(i) to clarify that a court may award damages for non-economic loss up to a maximum amount, but without limiting the court’s power to award aggravated damages separately, and  

(j) to require the leave of the court to commence defamation proceedings against certain associates of a defendant previously sued for defamation in respect of the publication of the same matter, and  

(k) to confirm that an election to have defamation proceedings tried by jury is irrevocable, and  

(l) to allow a court to determine costs in respect of defamation proceedings that end because of the death of a party if it is in the interests of justice to do so, and 

(m) to introduce a single publication rule requiring the limitation period for defamatory proceedings in respect of further publications of the same defamatory matter by the same publisher or an associate to be calculated by reference to the first publication date, and 

(n) to provide for the limitation period for commencing defamation proceedings to be extended to enable pre-trial processes to be concluded and to provide courts with greater flexibility to extend the limitation period. 

(2) In these provisions, the Model Defamation Provisions are the Model Defamation Provisions prepared by the Parliamentary Counsel’s Committee and approved by the Standing Committee of Attorneys-General on 21 March 2005.

 Schedule 1 sets out the model amendments to the Model Defamation Provisions.

Schedule 1 Model amendments to Model Defamation Provisions 

Section 4 Definitions 

Insert in alphabetical order— concerns notice means a concerns notice for the purposes of section 14. 

Section 7A Insert before section 8— 

7A Serious harm required for cause of action for defamation 

(1) An individual has no cause of action for defamation in relation to the publication of defamatory matter about the individual unless the individual proves that the publication has caused, or is likely to cause, serious harm to the reputation of the individual. 

(2) An excluded corporation referred to in section 9 has no cause of action for defamation in relation to the publication of defamatory matter about the corporation unless the corporation proves that the publication has caused, or is likely to cause— (a) serious harm to the reputation of the corporation, and (b) serious financial loss. 

Section 9 Certain corporations do not have cause of action for defamation 

Omit “employs fewer than 10 persons” from section 9(2)(b). 

Insert instead “has fewer than 10 employees”. 

Section 9(6) 

Insert in alphabetical order— 

associate of an original publisher means— (a) an employee of the publisher, or (b) a person publishing matter as a contractor of the publisher, or (c) an associated entity (within the meaning of the Corporations Act 2001 of the Commonwealth) of the publisher. 

employee, in relation to a corporation, includes any individual (whether or not an independent contractor) who is— (a) engaged in the day to day operations of the corporation other than as a volunteer, and (b) subject to the control and direction of the corporation. 

Section 10 No cause of action for defamation of, or against, deceased persons 

Insert at the end of the section (after renumbering the current provision as subsection (1))— 

(2) Subsection (1) does not prevent a court, if it considers it in the interests of justice to do so, from determining the question of costs for proceedings discontinued because of the subsection. 

Part 3, Division 1, heading 

Omit “Offers”. Insert instead “Concerns notices and offers”. 

Section 12A 

Insert after section 12— 

12A Defamation proceedings cannot be commenced without concerns notice 

(1) An aggrieved person cannot commence defamation proceedings unless—  

(a) the person has given each proposed defendant a concerns notice in respect of the matter concerned, and (b) the imputations to be relied on by the person in the proposed proceedings were particularised in the concerns notice, and (c) a period of at least 14 days has elapsed since the concerns notice was given in relation to each proposed defendant. 

(2) Subsection (1)(b) does not prevent reliance on— (a) some, but not all, of the imputations particularised in a concerns notice, or (b) imputations that are substantially the same as those particularised in a concerns notice. 

(3) The court may grant leave for proceedings to be commenced despite non-compliance with subsection (1)(c), but only if the proposed plaintiff satisfies the court— (a) the commencement of proceedings after the end of the 14-day period contravenes the limitation law, or (b) there are other exceptional circumstances justifying the granting of leave. 

(4) The commencement of proceedings contravenes the limitation law for the purposes of subsection (3)(a) if— (a) the court would be required to extend the limitation period to enable the proceedings to be commenced after the end of the 14-day period, or (b) the proceedings could not be commenced after the end of the 14-day period because the court will have ceased to have power to extend the limitation period. 

(5) In this section— limitation law mean [insert reference to provisions of statute of limitations]*. 

Jurisdictional note. Each jurisdiction is to insert a reference to the provisions of its limitation statute corresponding to Schedule 4.1 to these Provisions. 

Section 14 When offer to make amends may be made 

Insert after section 14(2)(a)— 

(a1) specifies the location where the matter in question can be accessed (for example, a website address), and 

Section 14(3) 

Omit the subsection. Insert instead— 

(3) If an aggrieved person gives the publisher a concerns notice, but fails to particularise adequately the imputations of concern or the location of the matter in question, the publisher may give the aggrieved person a written notice (a further particulars notice) requesting the aggrieved person to provide reasonable further particulars as specified in the further particulars notice about the imputations of concern or location. 

Section 15 Content of offer to make amends 

Insert after section 15(1)(b)— 

(b1) must provide for the offer to be open for acceptance for a period of at least 28 days commencing on the day the offer is made, and 

Section 15(1)(d) 

Insert “, or a clarification of or additional information about,” after “reasonable correction of”. [ 

Section 15(1)(f) 

Omit “offer, and”. Insert instead “offer.” 

Section 15(1)(g) 

Omit the paragraph. 

Section 15(1A) 

Insert after section 15(1)— 

(1A) In addition to the matters referred to in subsection (1), an offer to make amends may include any other kind of offer, or particulars of any other action taken by the publisher, to redress the harm sustained by the aggrieved person because of the matter in question, including (but not limited to)— (a) an offer to publish, or join in publishing, an apology in relation to the matter in question or, if the offer is limited to any particular defamatory imputations, the imputations to which the offer is limited, or (b) an offer to pay compensation for any economic or non-economic loss of the aggrieved person, or (c) the particulars of any correction or apology made, or action taken, before the date of the offer. 

Section 15(2) 

Omit “subsection (1)(g)(ii)”. 

Insert instead “subsection (1A)(b)”. 

Section 18 Effect of failure to accept reasonable offer to make amends 

Omit section 18(1)(a). 

Insert instead— (a) the publisher made the offer as soon as reasonably practicable after being given a concerns notice in respect of the matter (and, in any event, within 28 days after the notice is given), and 

Section 18(1)(b) 

Omit “at any time before the trial”. [ 

Section 18(3) 

Insert after section 18(2)— 

(3) Despite section 22(2), the judicial officer (and not the jury) in defamation proceedings tried by jury is to determine whether a defence under this section is established. Jurisdictional note. Each jurisdiction that provides for jury trials for defamation proceedings is to enact the above subsection. 

Section 21 Election for defamation proceedings to be tried by jury 

Insert after section 21(2)— (2A) An election is irrevocable. 

Section 23 

Omit the section. Insert instead— 

23 Leave required for further proceedings in relation to publication of same defamatory matter 

(1) This section applies to a person who has previously brought defamation proceedings for damages, whether in this jurisdiction or elsewhere, against a person (a previous defendant) in relation to the publication of a matter. 

(2) The person may not bring further defamation proceedings for damages against a previous defendant or an associate of a previous defendant in relation to the same or any other publication of the same or like matter, except with the leave of the court in which the further proceedings are to be brought. 

(3) A person is an associate of a previous defendant if, at the time of the publication to which the previous defamation proceedings related, the person was— (a) an employee of the defendant, or (b) a person publishing matter as a contractor of the defendant, or (c) an associated entity (within the meaning of the Corporations Act 2001 of the Commonwealth) of the defendant. 

Section 26 Omit the section. Insert instead— 

26 Defence of contextual truth 

(1) It is a defence to the publication of defamatory matter if the defendant proves that— (a) the matter carried one or more imputations that are substantially true (contextual imputations), and (b) any defamatory imputations of which the plaintiff complains that are not contextual imputations and are also carried by the matter do not further harm the reputation of the plaintiff because of the substantial truth of the contextual imputations. 

(2) The contextual imputations on which the defendant may rely to establish the defence include imputations of which the plaintiff complains. 

Section 29A Insert after section 29— 

29A Defence of responsible communication in the public interest 

(1) It is a defence to the publication of defamatory matter if the defendant proves that— (a) the matter is of public interest, and (b) the publication of the matter is responsible. 

(2) In determining for the purposes of subsection (1) whether the publication of the matter about a person is responsible, a court must take into account the following factors to the extent the court considers them relevant in the circumstances— (a) the seriousness of any defamatory imputation carried by the matter published,  (b) the extent to which the matter published distinguishes between suspicions, allegations and proven facts, (c) the extent to which the matter published relates to the performance of the public functions or activities of the person, (d) whether it was in the public interest in the circumstances for the matter to be published expeditiously, (e) the extent of compliance with any applicable professional codes or standards, (f) the sources of the information in the matter published, including the integrity of the sources, (g) if a source of the information in the matter published is a person whose identity is being kept confidential, whether there is good reason for the person’s identity to be kept confidential (including, for example, to comply with an applicable professional code or standard), (h) whether the matter published contained the substance of the person’s side of the story and, if not, whether a reasonable attempt was made by the defendant to obtain and publish a response from the person, (i) any other steps taken to verify the information in the matter published. 

(3) Subsection (2) does not limit the matters the court may take into account. 

(4) Without affecting the application of section 22 to other defences, the jury (and not the judicial officer) in defamation proceedings tried by jury is to determine whether a defence under this section is established. Jurisdictional note. Each jurisdiction that provides for jury trials for defamation proceedings is to enact the above subsection. 

Section 30 Defence of qualified privilege for provision of certain information 

Omit section 30(3). Insert instead— 

(3) In determining for the purposes of subsection (1) whether the conduct of the defendant in publishing matter about a person is reasonable in the circumstances, a court may take into account any of the following factors— (a) the seriousness of any defamatory imputation carried by the matter published, (b) the extent to which the matter published distinguishes between suspicions, allegations and proven facts, (c) whether it was in the public interest in the circumstances for the matter to be published expeditiously, (d) the nature of the business environment in which the defendant operates, (e) the sources of the information in the matter published, including the integrity of the sources, (f) whether the matter published contained the substance of the person’s side of the story and, if not, whether a reasonable attempt was made by the defendant to obtain and publish a response from the person, (g) any other steps taken to verify the information in the matter published. 

(3A) Subsection (3) does not— (a) require each matter referred to in the subsection to be taken into account, or (b) limit the matters that the court may take into account. 

(3B) It is not necessary to prove that the matter published was of public interest to establish the defence of qualified privilege under subsection (1). 

Section 30(6) 

Insert after section 30(5)— 

(6) Without affecting the application of section 22 to other defences, the jury (and not the judicial officer) in defamation proceedings tried by jury is to determine whether a defence under this section is established. Jurisdictional note. Each jurisdiction that provides for jury trials for defamation proceedings is to enact the above subsection. 

Section 30A 

Insert after section 30— 

30A Defence of scientific or academic peer review 

(1) It is a defence to the publication of defamatory matter if the defendant proves that— (a) the matter was published in a scientific or academic journal (whether published in electronic form or otherwise), and (b) the matter relates to a scientific or academic issue, and (c) an independent review of the matter’s scientific or academic merit was carried out before the matter was published in the journal by— (i) the editor of the journal, and (ii) one or more persons with expertise in the scientific or academic issue concerned. 

(2) If there is a defence to the publication of defamatory matter in a scientific or academic journal because of subsection (1), there is also a defence to the publication of any assessment of the matter in the same journal if the defendant proves that— (a) the assessment was written by one or more of the persons who carried out the independent review of the matter, and (b) the assessment was written in the course of that review. 

(3) It is a defence to the publication of defamatory matter if the defendant proves that the matter was contained in a fair summary of, or fair extract from, a matter or assessment for which there is a defence because of subsection (1) or (2). 

(4) If a journal has more than one editor, a reference in this section to the editor of the journal is to be read as a reference to the editor or editors who were responsible for deciding to publish the matter concerned. (5) A defence established under this section is defeated if, and only if, the plaintiff proves that the defamatory matter or assessment was not published honestly for the information of the public or the advancement of education. 

Section 31 Defences of honest opinion Omit section 31(5). Insert instead— (5) For the purposes of this section, an opinion is based on proper material if— (a) the material on which it is based is— (i) set out in specific or general terms in the published matter, or (ii) notorious, or (iii) accessible from a reference, link or other access point included in the matter (for example, a hyperlink on a webpage), or (iv) otherwise apparent from the context in which the matter is published, and (b) the material— (i) is substantially true, or (ii) was published on an occasion of absolute or qualified privilege (whether under this Act or at general law), or (iii) was published on an occasion that attracted the protection of a defence under this section or section 28 or 29. 

Section 33 Defence of triviality 

Omit the section. 

Section 35 Damages for non-economic loss limited 

Omit “Unless the court orders otherwise under subsection (2), the” in section 35(1). Insert instead “The”. 

Section 35(2)–(2B) 

Omit section 35(2). Insert instead— 

(2) The maximum damages amount is to be awarded only in a most serious case. 

(2A) Subsection (1) does not limit the court’s power to award aggravated damages if an award of aggravated damages is warranted in the circumstances. 

(2B) An award of aggravated damages is to be made separately to any award of damages for non-economic loss to which subsection (1) applies. 

Section 50 

Insert after section 49— 

50 Application of 2020 amendments 

An amendment made to this Act by the Model Defamation Amendment Provisions 2020 applies only in relation to the publication of defamatory matter after the commencement of the amendment. Jurisdictional note. This provision is to be inserted in the appropriate location by each jurisdiction with reference to the name of the amending Act enacted to give effect to the Model Defamation Amendment Provisions 2020. 

Schedule 4 Amendment of other Acts 

Omit section 1(2) in Schedule 4.1. Insert instead—  

(2) The 1-year limitation period referred to in subsection (1) is taken to have been extended as provided by subsection (3) if a concerns notice is given to the proposed defendant on a day (the notice day) within the period of 56 days before the limitation period expires. 

(3) The limitation period is extended for an additional period of 56 days minus any days remaining after the notice day until the 1-year limitation period expires. Example. Assume a concerns notice is given 7 days before the limitation period expires. This means that there are 6 days left after the notice day before the period expires. Consequently, this subsection would operate to extend the limitation period by 56 minus 6 days, that is, 50 days. 

(4) In this section— concerns notice has the same meaning as in the Defamation Act 2005. Jurisdictional note. Each jurisdiction is to insert the name of its defamation legislation in the definition. 

Schedule 4.1 Insert after section 1— 1A Single publication rule 

(1) This section applies if— (a) a person (the original publisher) publishes matter to the public that is alleged to be defamatory (the first publication), and (b) the original publisher or an associate of the original publisher subsequently publishes (whether or not to the public) matter that is substantially the same. 

(2) Any cause of action for defamation against the original publisher or an associate of the original publisher in respect of the subsequent publication is to be treated as having accrued on the day of the first publication for the purposes of determining when— (a) the limitation period applicable under section 1 begins, or (b) the 3-year period referred to in section 1B(2) begins. 

(3) Subsection (2) does not apply in relation to the subsequent publication if the manner of that publication is materially different from the manner of the first publication. 

(4) In determining whether the manner of a subsequent publication is materially different from the manner of the first publication, the considerations to which the court may have regard include (but are not limited to)— (a) the level of prominence that a matter is given, and (b) the extent of the subsequent publication. 

(5) This section does not limit the power of a court under section 1B to extend the limitation period applicable under section 1. 

(6) In this section—  day of first publication, in relation to publication of matter on a website or in any other electronic form, means the day on which the matter was first posted or uploaded on the website or sent electronically. public includes a section of the public. 

1B Extension of limitation period 

(1) A person claiming to have a cause of action for defamation may apply to the court for an order extending the limitation period applicable under section 1 for the cause of action. 

(2) The court may extend the limitation period to a period of up to 3 years running from the date of the alleged publication of the matter if the plaintiff satisfies the court that it is just and reasonable to allow an action to proceed. 

(3) In determining whether to extend the limitation period, the court is to have regard to all of the circumstances of the case and in particular to— (a) the length of, and the reasons for, the plaintiff’s delay, and (b) if a reason for the delay was that some or all of the facts relevant to the cause of action became known to the plaintiff after the limitation period expired— (i) the day on which the facts became known to the plaintiff, and (ii) the extent to which the plaintiff acted promptly and reasonably once the plaintiff knew whether or not the facts might be capable of giving rise to an action, and (c) the extent, having regard to the delay, to which relevant evidence is likely to be unavailable or less cogent than if the action had been brought within the limitation period. 

Schedule 4.1 

Insert after section 2— 

3 Application of 2020 amendments 

(1) The amendment made to section 1 by the Model Defamation Amendment Provisions 2020 applies in relation to the publication of defamatory matter after the commencement of the amendment. Jurisdictional note. This provision is to be inserted in the appropriate location by each jurisdiction with reference to the name of the amending Act enacted to give effect to the Model Defamation Amendment Provisions 2020. 

(2) Section 1A (as inserted by the Model Defamation Amendment Provisions 2020) applies in relation to the publication of defamatory matter after the commencement of the section, subject to subsection (3). 

(3) Section 1A extends to a first publication before the commencement of the section, but only in respect of subsequent publications after the commencement. 

(4) Section 1B (as inserted by the Model Defamation Amendment Provisions 2020) applies in relation to the publication of defamatory matter after the commencement of the section

Mental Health Royal Commission and the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability

The Interim Report of the Royal Commission into Victoria's Mental Health System states

The Commission offers this interim report in six parts. These parts cover the topics the Commission has examined so far and culminate in a series of recommendations that seek to address immediate needs and begin paving the way for a reformed mental health system. 

• Part One explores the current state of mental health in Victoria. Here, the Commission defines key concepts such as wellbeing, recovery and the full continuum of mental illness and how people experience it differently. 

• Part Two lays out the history and nature of the current Victorian mental health system. It also highlights the structural problems the Commission has identified, examines how the mental health workforce currently operates and looks at the challenges it faces. 

• Part Three focuses on several themes the Commission has examined to date. It tells the story of a system difficult to find and get into. It outlines how consumer experiences of the system can be poor and how difficult this can be for the families, carers and others providing support to those living with mental illness or experiencing poor mental health. It describes how the experiences of rural and regional Victorians are both similar and different. And it highlights the most tragic toll of all—when a person experiencing psychological distress or poor mental health takes their own life. 

• Part Four quantifies the economic cost of mental health and puts forward a case for increased investment in mental health services in Victoria. 

• Part Five offers nine recommendations to lay the foundations for future reform:

– establishing the Victorian Collaborative Centre for Mental Health and Wellbeing 

– expanding acute services in targeted areas 

– increasing investment in suicide prevention 

– expanding Aboriginal social and emotional wellbeing services 

– designing and delivering Victoria’s first lived experienced–led service 

– supporting lived experience workforces 

– ensuring workforce readiness for future reforms 

– establishing a new approach to mental health investment 

– setting up a Mental Health Implementation Office to drive the initial effort. 

Chapter 22 looks to the future, laying out the Commission’s next steps for its final year of operation.

The Interim Report articulates 'Guiding principles for Victoria’s mental health system'

The Royal Commission acknowledges that mental health is shaped by the social, cultural, economic and physical environments in which people live and is a shared responsibility of society. 

It envisages a mental health system in which: 

1. The inherent dignity of people living with mental illness is respected, and necessary holistic support is provided to ensure their full and effective participation in society. 

2. Family members and carers of people living with mental illness have their contributions recognised and supported. 

3. Comprehensive mental health treatment, care and support services are provided on an equitable basis to those who need them and as close as possible to people’s own communities—including in rural areas. 

4. Collaboration and communication occur between services within and beyond the mental health system and at all levels of government. 

5. Responsive, high-quality, mental health services attract a skilled and diverse workforce. 

6. People living with mental illness, their family members and carers, as well as local communities, are central to the planning and delivery of mental health treatment, care and support services. 

7. Mental health services use continuing research, evaluation and innovation to respond to community needs now and into the future.

The national Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability Group Homes issues paper released today

defines ‘group homes’ and the existing regulatory arrangements of group homes. The issues paper examines the shift in community attitudes towards people with disability since the early 20th century that led to the closure of large institutions. The issues paper notes that despite a shift to ‘deinstitutionalisation’, concerns for living arrangements for people with disability continue to be raised.

The Royal Commission states

Generally, ‘group homes’ refers to accommodation where services and supports (both within the home and the community) are provided to four to six long-term residents with disability. Group homes may include 24-hour on-site staff support. Group homes are defined in the National Disability Insurance Scheme (Specialist Disability Accommodation) Rules 2016 as ‘houses that are enrolled (or will be enrolled) to house four or five long-term residents… typically classified as Building Class 1(b)(i) or 3 under the Building Code of Australia.’ 

All building work must comply with the requirements of the Building Code of Australia which provides the minimum requirements for safety, health, amenity and sustainability in the design and construction of new buildings (and new building work in existing buildings). 

A group home must meet the National Disability Insurance Scheme (NDIS) criteria to be eligible for Specialist Disability Accommodation (SDA) funding. However, some group homes are run privately without SDA funding. Those homes may not comply with the Building Code requirements, and may accommodate slightly fewer, or slightly more than, four to five residents. This means that there is no official definition which covers all group homes in Australia. Until recently group homes were regulated and monitored by State agencies such as Community Visitors and Disability Commissioners. However, following the establishment of the National Disability Insurance Scheme (NDIS), the roles and responsibilities of some of these groups have been progressively transferred to the NDIS Quality and Safeguards Commission. 

Independently of the NDIS, there are many Commonwealth and State laws that apply to group homes. These include legislation relating to workplace health and safety; planning and environmental protection; and the regulation of the charities which operate some group homes. 

Why is the Royal Commission looking at group homes? 

Housing people with disability in residential institutions (often referred to as institutionalisation) in Australia can be traced back to the late 1800s. Typically institutions accommodated large numbers of people with disability in conditions that were often extremely harsh. Many people with disability living in institutions were denied basic human rights and had little or no access to the wider community. This left residents isolated and at risk of violence, abuse, exploitation and neglect. 

In the mid-to-late 20th century, community attitudes about people with disability and institutions began to shift. From the 1970s, the disability rights movement advocated for an end to institutionalisation. The United Nations proclaimed 1981 to be the ‘International Year of Disabled Persons’, and emphasised the importance of full participation and equality for people with disability. Disability advocates called on governments to legislate to prevent discrimination against people with disability and to promote the inclusion of people with disability within the Australian community. 

The Commonwealth Parliament responded to the arguments of the disability community by enacting: • The Disability Services Act 1986 (Cth) which provides a comprehensive framework for the funding and provision of support services so as to enable persons with disability to work towards full participation as members of the community; and • The Disability Discrimination Act 1992 (Cth) which aims to eliminate discrimination against people with disabilities, ensure equality before the law and promote acceptance within the community of the fundamental rights of people with disabilities. 

These developments encouraged the closure of large institutions and the relocation of people with disability to alternative forms of accommodation. Despite the marked shift away from relying on institutions, concerns regarding the living arrangements for people with disability continue to be raised. Many advocates claim that people with disability continue to experience exclusion and isolation in group homes. Over time, group homes have become a common form of accommodation for people with disability who were moved out of institutional care. The group home model was intended to provide people with disability with more independence and meaningful life choices. 

Many people think that group homes do not achieve these benefits. Disability advocates point to research highlighting that segregated environments such as group homes increase the risk of violence, abuse, neglect and exploitation for people with disability. Concerns have also been raised about the use of restrictive practices in group homes. Restrictive practices are actions that restrict the rights or freedom of movement of a person with disability; some examples are using medication, locking a person in a room or tying them to a bed.

The Questions asked by the Commission are -

Question 1: Have you, any member of your family, or anyone you care for, lived in group homes? Are you willing to share your experiences or those of another person with the Royal Commission? 

Question 2: What is your opinion of the quality of life for people with disability in a group home? 

Question 3: Are you aware of any violence, abuse, neglect or exploitation of people with disability in group homes? Are you willing to share your knowledge with the Royal Commission? 

Question 4: When violence, abuse, neglect and exploitation occurs in group homes, what do you think are the causes? What can be done to prevent violence, abuse, neglect or exploitation in group homes? 

Question 5: Do you consider the experiences of violence, abuse, neglect and exploitation in group homes different for particular groups of people with disability? For example, how does a person’s gender, age, or cultural or sexual identity impact on their experiences? What are the experiences of First Nations people in relation to group homes? 

Question 6: Is there a continuing role for group homes in providing accommodation for people with disability? If so, what is the role? If not, what are the alternatives? 

Question 7: Are you aware of the use of restrictive practices in group homes that you can share with the Royal Commission? If so, what needs to change or happen to eliminate the use of restrictive practices in group homes? 

Question 8: What barriers or obstacles exist for people with disability identifying, disclosing or reporting incidents of violence, abuse, neglect or exploitation? What should be done to encourage investigating and reporting of violence, abuse, neglect or exploitation in group homes when it occurs? 

Question 9: Should anything be done to improve or change staffing in group homes to better support the choices and potential of people with disability? 

Question 10: What else should we know? Have we missed anything?

Schoolies and and national shame

'“It's not like they're selling your data to dangerous people”: Internet privacy, teens, and (non)controversial public issues' by Margaret S. Crocco, Avner Segall, Anne-Lise Halvorsen, Alexandra Stamm and Rebecca Jacobsen in (2019) The Journal of Social Studies Research comments

 This study examines high school students' responses to a public policy discussion on the topic of Internet privacy. Specifically, students discussed the question of whether search engines and social media sites should be permitted to monitor, track, and share users’ personal data or whether such practices violate personal privacy. We observed discussions of the topic in four high school classrooms in 2015–2016, prior to the presidential election in 2016. We first explain why the topic failed to work as a controversial public issue with high schoolers. We then explain their responses to the issue. We found (1) students displayed a surprising trust in Facebook and Google; (2) students framed the issue of Internet Privacy as a conflict in values and a set of trade-offs; and (3) students tended to put more weight on personal responsibility than implications for democracy in their assessment of the (acknowledged) erosion of privacy as a result of social media and Internet search engines. We conclude with implications for social studies education and teacher education.

The Interim Report of the Royal Commission into Aged Care Quality and Safety, one of the most disquieting documents to emerge from a national Royal Commission, states 

 It’s not easy growing old. We avoid thinking and talking about it. As we age, we progressively shift our focus from work to the other things that give us purpose and joy: our children and grandchildren, our friends, our holidays, our homes and gardens, our local communities, our efforts as volunteers, our passions and hobbies. The Australian community generally accepts that older people have earned the chance to enjoy their later years, after many decades of contribution and hard work. Yet the language of public discourse is not respectful towards older people. Rather, it is about burden, encumbrance, obligation and whether taxpayers can afford to pay for the dependence of older people. As a nation, Australia has drifted into an ageist mindset that undervalues older people and limits their possibilities. Sadly, this failure to properly value and engage with older people as equal partners in our future has extended to our apparent indifference towards aged care services. Left out of sight and out of mind, these important services are floundering. They are fragmented, unsupported and underfunded. With some admirable exceptions, they are poorly managed. All too often, they are unsafe and seemingly uncaring. This must change. 

Australia prides itself on being a clever, innovative and caring country. Why, then, has the Royal Commission found these qualities so signally lacking in our aged care system? We have uncovered an aged care system that is characterised by an absence of innovation and by rigid conformity. The system lacks transparency in communication, reporting and accountability. It is not built around the people it is supposed to help and support, but around funding mechanisms, processes and procedures. This, too, must change. 

Our public hearings, roundtable discussions with experts, and community forums have revealed behaviour by aged care service providers that, when brought to public attention, has attracted criticism and, in some cases, condemnation. Many of the cases of deficiencies or outright failings in aged care were known to both the providers concerned and the regulators before coming to public attention. Why has so little been done to address these deficiencies? We are left to conclude that a sector-wide focus on the need to increase funding, a culture of apathy about care essentials, and a lack of curiosity about the potential of aged care to provide restorative and loving care—all of which is underpinned by an ageist mindset— has enabled the aged care system to hide from the spotlight. This must also change. 

Left isolated and powerless in this hidden-from-view system are older people and their families. ‘This is not a life.’ ‘This is not my home.’ ‘Don’t let this happen to anyone else.’ ‘Left in her own faeces, and still no one came.’ ‘Mum doesn’t feel safe.’ This cruel and harmful system must be changed. We owe it to our parents, our grandparents, our partners, our friends. We owe it to strangers. We owe it to future generations. Older people deserve so much more. 

We have found that the aged care system fails to meet the needs of our older, often very vulnerable, citizens. It does not deliver uniformly safe and quality care for older people. It is unkind and uncaring towards them. In too many instances, it simply neglects them. 

Confronting the system 

Understandably, it is relatively common for older people to avoid thinking about their long-term care needs or to plan for their future because this might signal their decline and eventual death. Most people remain confident that they will be looked after when the time comes. It is therefore a difficult choice when things begin to go wrong about whether to access aged care or whether to struggle along independently. Very often, older people avoid accepting care for as long as possible. Many families help their loved ones to live independently by providing ongoing support, doing their shopping, driving them to appointments, mowing the lawn, fixing the things that go wrong around the house, supporting them financially, and generally tending to their needs. Other people can buy the support they need. 

Nevertheless, there comes a time when some older people are confronted with their declining capability, poor health, failing cognitive function or a crisis involving hospitalisation. A number of people will seek out aged care services either independently or at the urging of family, friends, doctors and hospitals. Unfortunately, it is at this point, when the aged care system should be welcoming and easy to navigate, that the first problems emerge. 

People are met with a telephone and internet-based national aged care entry system called My Aged Care that many people in their eighties and nineties find frightening, confronting and confusing. They are then referred for a face-to-face discussion to assess how much care they can receive and whether that will be in their own home or a residential care provider. This is the first of many assessments. Too often they must tell their story over and over again. 

Left to fend for themselves at this point, they have to navigate their own way into the system. Older people and their families often find that their choices are limited by a combination of inflexible system design, lack of services near where they live, and cost. In these difficult circumstances, people have a right to expect that they will be given useful information in a helpful way. Unfortunately, useful information is the exception, not the rule. 

Accessing home care 

It is particularly challenging when an older person is deemed eligible for a Home Care Package, because they must first wait in the national prioritisation queue before a package of services is ‘assigned’, and then they must find a service provider to deliver their care. That can all take a very long time, especially for those who have higher care and support needs. Once someone is assessed as needing the highest level of care, a Level 4 Home Care Package, they can wait for a year and often longer for the Package to become a reality. Such waiting times would be unacceptable in any other system, but are common in home care today. 

The Australian Department of Health, which oversees this system, has no mechanism to follow up with people who are on waiting lists to give them updates, including about whether they have progressed up the waiting list or how long it will be before a Package is available. In the interim, there is a clear and present danger of declining function, inappropriate hospitalisation, carer burnout and premature institutionalisation because necessary services are not provided. We have been alarmed to find that many people die while waiting for a Home Care Package. Others prematurely move into residential care. 

By any measure, this is a cruel and discriminatory system, which places great strain on older Australians and their relatives. It is unfair. Older people should receive the home care services they need to live safely at home. Funding should be forthcoming from the Australian Government to ensure the timely delivery of these services. It is shocking that the express wishes of older people to remain in their own homes for as long as possible, with the supports they need, is downplayed with an expectation that they will manage. It is unsafe practice. It is neglect. 

The path to residential care 

Older Australians’ transition from their homes into residential aged care can be very challenging for them and their loved ones. The decision to enter residential care often follows a traumatic event, such as a fall or a sudden decline in health. People feel under pressure to find suitable accommodation for themselves or someone they care for. 

We have heard many accounts of older people and their loved ones having to contact service after service to find out if there is a suitable place available. My Aged Care often does not provide helpful information about local services. Perhaps even more worryingly, there is no easily accessible public information about the quality of services or reliable information about whether the services deliver on their advertised promises. Older people and their loved ones do not know what to look for when choosing a home. Choices about where to go are invariably rushed and made on the run, determined by whether or not a bed is available or if a service is close to family or run by a provider thought to be compatible with the older person’s wishes or cultural or religious affiliations. 

People do not usually enter residential aged care willingly. They often do so with great trepidation. They fear loss of autonomy, of individuality, of control over their own lives. They fear ceasing to be a person with distinct needs and preferences, with an emotional and intellectual life and freedom to do what they want, when they want to do it. 

We have heard countless stories about how much people grieve for all they have lost when they arrive in residential care. They become ‘just a resident’, just another body to be washed, fed and mobilised, their value defined by the amount of funding they bring with them. They become infantilised, lose autonomy, and are prevented from making decisions or doing physical things that were routine when they lived at home, on the grounds that they ‘could hurt themselves’. They lose their basic rights to take risks, to choose what to do in their day, to live a life as close as possible to their previous home and community. There is no joy in this. 

Their families and friends often feel intense guilt, loss and fear: guilt at not being able to guarantee care at home any longer; loss of the person who, even if living from dementia or otherwise cognitively impaired, is still a unique personality; and fear of how this loved older person or young person living with disability will be treated when there is no one there to look out for them. For older people who are alone before entering residential aged care, these feelings are magnified by the knowledge that no one will visit them. They are completely reliant on the kindness of strangers. For younger people with disability, their friends stop dropping by and rarely visit over time. It is an isolating and daunting experience. It is not a life. 

Given that there is so much evidence about these feelings of loss and abandonment experienced in the aged care system, we are dismayed at the apparent lack of acknowledgement and understanding by those who manage and control the aged care system. As a nation, as a community, we must find a way to ease these transitions and ensure that residential care services are made much more attractive and enjoyable for those in care. This will necessarily require a clear focus on meeting the needs of the people in care, respecting their rights, and building good relationships with them. 

It will involve finding a way to bring the outside world into residential care homes, or taking those in care out. We will delve deeply into these matters in our Final Report. In the meantime, we encourage the Australian community and the aged care sector to work with people in care to harness their ideas and to develop solutions on the ground. 

What happens in care 

We have heard substantial direct evidence about what can happen to older people once they move into residential care. The case studies have given us invaluable insights into the vulnerability and isolation of older people in care. 

Older people and family members have shown great generosity and courage in recounting painful events that have shocked and dismayed all who have heard about them. We have been told about people who have walked into an aged care residence, frail but in relatively good spirits and mentally alert, only to die a few months later after suffering from falls, 4serious pressure injuries and significant pain and distress. We have seen images of people with maggots feeding in open sores and we have seen video and photographic evidence of outright abuse. 

These accounts of unkindness and neglect have been difficult to tell and difficult to hear. 

Just as striking is the love, dedication and determination of people who are, or have been, a parent, relative, friend, carer or advocate. We have been left with a sense of great pride in the way most ordinary Australians care for their loved ones and overwhelmed by their devotion and commitment. 

We have heard about spouses who visit their partners every day to tend to their care and to keep them company. They stop doing other things or give up or reduce their work to do so, and accept the financial and other costs that are imposed on them. Such is their devotion. At a time in their lives when an older person and their family members and friends should be able to spend peaceful time together, we have heard how these relationships can become subsumed by the battle with staff and managers in aged care services to advocate for basic personal care. We now know these battles go on every day. 

Sons and daughters, aghast at seeing the poor state of a parent, insist on calling an ambulance so that they can be admitted to hospital, suspecting or knowing that a fall or other injury has occurred, or that their relative’s health is declining. They insist on talking directly to doctors, just as they insist on meeting with senior management at aged care facilities or corporate representatives of the provider, to get answers, explanations and treatment. They pay for extra services, such as physiotherapy. They bring in palliative care clinicians if their family member is nearing the end of their life. They bring in food and feed it to a relative who can no longer eat without help, for fear that not to do so will condemn them to malnutrition. They have even installed hidden cameras in a family member’s room to ensure their safety, and been horrified to see occasions of rough treatment and even assault. 

Some of these people have been prepared to bear witness to what they have seen, heard, said and done, determined to bring an end to such practices. Their insights are invaluable. 

Substandard care 

We are concerned that there are no measures available to quantify the extent of substandard aged care. However, the combined impact of the evidence, submissions and stories provided to the Royal Commission leads us to conclude that substandard care is much more widespread and more serious than we had anticipated. We consider substandard care to include care that does not meet the relevant quality standards or other legislative obligations, or which otherwise does not meet community expectations. 

The often shocking evidence reveals too many unacceptable practices and an aged care sector that is too often failing to satisfy basic community expectations or legislated requirements. 

The major quality and safety issues which have been brought to our attention during this Royal Commission are:

• inadequate prevention and management of wounds, sometimes leading to septicaemia and death 

• poor continence management—many aged care residences don’t encourage toilet use or strictly ration continence pads, often leaving distressed residents sitting or lying in urine or faeces 

• dreadful food, nutrition and hydration, and insufficient attention to oral health, leading to widespread malnutrition, excruciating dental and other pain, and secondary conditions 

• a high incidence of assaults by staff on residents and by residents on other residents and on staff 

• common use of physical restraint on residents, not so much for their safety or wellbeing but to make them easier to manage 

• widespread overprescribing, often without clear consent, of drugs which sedate residents, rendering them drowsy and unresponsive to visiting family and removing their ability to interact with people 

• patchy and fragmented palliative care for residents who are dying, creating unnecessary distress for both the dying person and their family. 

It is shameful that such a list can be produced in 21st century Australia. At the heart of these problems lies the fundamental fact that our aged care system essentially depersonalises older people. A routine thoughtless act—the cup of coffee placed too far from the hand of a person with limited movement so that they cannot drink it, the call buzzer from someone left unanswered, the meal left uneaten with no effort to help— when repeated day after day, becomes unkindness and often cruelty. This is how ‘care’ becomes ‘neglect’. 

More than half the online submissions to us raised issues about substandard care. Forty per cent raised concerns about neglect, 39% about dignity, 37% about personal care, 33% about clinical care, 33% about medication management, 25% about nutrition and malnourishment, 22% about emotional abuse, 16% about physical abuse or assault, 13% about discrimination and 13% about restrictive practices. 

A little over 1000 providers responded to our Service Provider Survey. They self-reported instances of substandard care over the five year period to June 2018, including almost 112,000 occasions of substandard clinical care and close to 69,000 occasions of substandard medication management. They also reported 79,062 complaints about substandard care. Of these complaints, 15,700 were about personal care, 8800 were about compromises to an older person’s dignity, and 7500 were about a lack of choice and control for the people receiving aged care services. 

Expert evidence on clinical and personal care has also contributed to our understanding of the extent of substandard care: • the Dietitians Association of Australia use current research to estimate that 22–50% of people in residential aged care are malnourished • an analysis of Aged Care Funding Instrument data reveals much higher than expected rates of incontinence, 75–81% of residents, with the majority in the most dependent category • recent Australia research reveals that pressure injuries occur in a third of the most frail aged care residents at the end of their lives • research involving 150 residential aged care facilities found that 61% of residents were regularly taking psychotropic agents, with 41% prescribed antidepressants, 22% prescribed antipsychotics, and 22% prescribed benzodiazepines • an Australian Department of Health expert clinical advisory panel estimated that psychotropic medication is only clearly justified in about 10% of cases in which they are prescribed in residential aged care • there were 4013 notifications of alleged or suspected physical and/or sexual assaults in aged care in 2017–18. In the face of these horrifying reports and the shocking tale of neglect we have heard throughout this Royal Commission, we will continue to attempt to quantify the level of substandard care in our Final Report. 

How does the aged care sector respond? Not very well. 

People living in residential care, or receiving care in their homes, have told us of their feelings of frustration, despair and hopelessness. Their complaints, which should be a window into care practices, often go unanswered. Many people have told us that the complaints system is hard to access, slow to act and often effectively unresponsive to the concerns of the complainant. People become unwilling to complain for fear that care will become worse, as they or their family member will be labelled as ‘difficult’ by the provider. Several submissions have highlighted occasions where the treatment of the older person deteriorated after complaints from family members—with neglect transforming into the withholding of care. It is disturbing that the aged care sector is not sufficiently mature or professional to listen to feedback from those who use and observe its services at close hand, particularly when the regulatory system appears so distant and ineffectual. 

Some providers of aged care have appeared before the Royal Commission to be defensive and occasionally belligerent in their ignorance of what is happening in the facilities for which they are responsible. On many occasions when case studies were presented in hearings, providers were reluctant to take responsibility for poor care on their watch. Some providers have shown an unwillingness to accept that they could have, and should have, done better. Others have, rightly, accepted this. Those providers who have demonstrated a commitment to building relationships with people receiving care and their families stood out in sharp relief. 

The aged care system lacks fundamental transparency. 

Witnesses from the Australian Department of Health told us that there is very little information available to the public about the performance of service providers. The number of complaints against them are not published. The number of assaults in their services are not published. The number of staff they employ to provide care are not published. Participation by providers in the collection of a very limited set of performance indicators only became compulsory on 1 July 2019. The Department has said that it will publish differentiated performance ratings of residential aged care providers, but there is still no clarity on what this information will look like. 

We have heard evidence which suggests that the regulatory regime that is intended to ensure safety and quality of services is unfit for purpose and does not adequately deter poor practices. Indeed, it often fails to detect them. When it does so, remedial action is frequently ineffective. The regulatory regime appears to do little to encourage better practice beyond a minimum standard. We were flabbergasted to hear that, until recently, it was routine practice for large sections of the reports of accreditation audits of services conducted by the Aged Care Quality and Safety Commission to be generated by computer assisted text. In other words, the same positive words prompted by computers were used over and over again. Computers cannot determine quality; only people can and should do that. 

We have heard about an aged care workforce under pressure. Intense, task-driven regimes govern the lives of both those receiving care and those delivering it. While there are exceptions, most nurses, carer workers and allied health practitioners delivering care are doing their best in extremely trying circumstances where there are constraints on their time and on the resources available to them. This has been vividly described by the former and current aged care staff who have given evidence. 

A Shocking Tale of Neglect 

The aged care sector suffers from severe difficulties in recruiting and retaining staff. Workloads are heavy. Pay and conditions are poor, signalling that working in aged care is not a valued occupation. Innovation is stymied. Education and training are patchy and there is no defined career path for staff. Leadership is lacking. Major change is necessary to deliver the certainty and working environment that staff need to deliver great quality care. 

We have also heard about how the aged care system has not kept up with changing needs and community expectations. The preference for care at home is increasing significantly. Consequently, the complexity of the care needs of people entering residential care is also increasing. The aged care system as a whole has struggled to adapt to these developments, as have specific providers. These changes require different care models, investment in new expertise, reconsideration of funding models and a stronger, closer interface with the acute health care sector. 

It is time for a reality check. 

The aged care sector prides itself in being an ‘industry’ and it behaves like one. This masks the fact that 80% of its funding comes directly from Government coffers. Australian taxpayers have every right to expect that a sector so heavily funded by them should be open and fully accountable to the public and seen as a ‘service’ to them. 

As a service, aged care is an integral part of our social support system and, as such, it must aim to be the best service that an inventive, clever and compassionate country can provide. It should be delivering aged care services of an exemplary standard, in ways that are responsive to older people’s care needs and aimed at delivering the best possible quality of life to them in their later years. 

The overall impression we are left with is of a system that is failing, but there are some positive stories emerging from our inquiries. Provider organisations and consumer representative groups have highlighted great quality care and caring environments. We have heard many examples of providers who deliver innovative and effective models of care. Crucially, we have heard about these positive examples not just from the providers themselves, but from the people they care for. There have also been many examples of individual staff members dedicating themselves to providing exemplary and compassionate care, despite the challenges of their working environment. All of these positive examples provide us with confidence that a better aged care system is possible. However, it seems that these providers and staff are currently succeeding due to their own passion and dedication. The aged care system provides no incentive or encouragement for these achievements. In short, they are succeeding despite the aged care system in which they operate rather than because of it. 

The structure of the current system has been framed around the idea of a ‘market’ for aged care services where older people are described as ‘clients’ or ‘customers’ who are able to choose between competitively marketed services. But many older people are not in a position to meaningfully negotiate prices, services or care standards with aged care providers. The notion that most care is ‘consumer-directed’ is just not true. Despite appearances, despite rhetoric, there is little choice with aged care. It is a myth that aged care is an effective consumer-driven market. 

Since the Royal Commission began its work, there have been calls from several quarters for government funding to aged care to be significantly increased, without waiting for our Final Report and recommendations. These interventions are essentially variations on a theme which has haunted this area of government policy for far too long: short-term solutions which will at best temporarily stave off the worst problems and, at worst, produce another set of unintended outcomes requiring further inquiries and reviews and further injections of public funds without addressing the underlying causal factors. These limited interventions are not enough to deliver an aged care system that meets the needs of older people. 

Nevertheless, there are some areas identified in this Interim Report where there is a need for urgent action. These are: • to provide more Home Care Packages to reduce the waiting list for higher level care at home • to respond to the significant over-reliance on chemical restraint in aged care, including through the seventh Community Pharmacy Agreement • to stop the flow of younger people with disability going into aged care, and expediting the process of getting those younger people who are already in aged care out. We see no reason to delay action in these areas. 

It is clear that a fundamental overhaul of the design, objectives, regulation and funding of aged care in Australia is required. This will be the central purpose of our Final Report and it also informs our approach to this Interim Report. 

This Interim Report 

This Interim Report traverses much, but not all, of the work the Royal Commission has done through to September 2019. It is a report in three volumes. 

Volume 1 contains the information we have gathered and some of the conclusions we have reached over the course of the hearings held since February, as well as drawing on the research done by the Office of the Royal Commission. It is organised under several themes, which broadly reflect those of the hearings. Part 1 of Volume 1, which contains the first three chapters, provides context to the Royal Commission’s work. Chapter 1, The Current System, gives a brief historical overview of aged care in Australia, followed by a description of the current aged care system. Chapter 2, The Well-travelled Path, summarises the plethora of previous inquiries and reviews of the system, including what happened (or didn’t happen) in 1the wake of their recommendations. Chapter 3, Demographic, Social and Economic Pressures, considers some of the most significant trends affecting aged care. In Part 2 of Volume 1, Chapter 4, ‘An overwhelming sense of loss’, tells the aged care story from the perspective of older peoples’ experience of the system, through direct evidence records and submissions. Part 3 of Volume 1 presents the story around a number of inconvenient truths about the aged care system: • Chapter 5, Finding the Door, describes how people find out about what aged care is available to them and how to access it. • Chapter 6, The Lottery, details the current regime for establishing and managing the waiting list for home care. • Chapter 7, ‘Elders are our future’, details the circumstances and challenges involved in providing culturally appropriate, safe and quality aged care to Aboriginal and Torres Strait Islander people. • Chapter 8, Restrictive Practices, describes the use of both physical methods and medications to restrain or pacify people who are living in residential aged care. • Chapter 9, Workforce Matters, identifies some of the problems with recruiting and retaining people to work in aged care. • Chapter 10, Falling Through the Gaps, recounts the plight of younger people who have an acute or chronic illness, have suffered a catastrophic injury or who live with a severe disability, and who are forced into residential aged care because there is nowhere else for them to go. The chapters in Part 3 provide clear guidance on our thinking to date, but do not include specific recommendations. We will formulate our recommendations on these matters over the remaining months of the inquiry, informed by the comprehensive changes which we will recommend in our Final Report. The final chapter of Volume 1 outlines the directions our inquiry will take over the next year. We will explore further quality and safety issues, provider perspectives, funding arrangements, governance, leadership and accountability, and options for systemic reform. 

Volume 2 of this Interim Report contains detailed overviews of the public hearings we have conducted up to and including the hearing in Darwin and Cairns, including our findings in case studies conducted at those hearings. 

Volume 3 contains appendices, including the summaries of the nine community forums the Royal Commission has held throughout Australia since February. We have held forums in metropolitan and regional areas to allow as many people as possible to attend. Some people have travelled considerable distances to come to forums and share their experiences of the aged care system, adding greatly to our knowledge. ...

 The Commission concludes that it 

has heard compelling evidence that the system designed to care for older Australians is woefully inadequate. Many people receiving aged care services have their basic human rights denied. Their dignity is not respected and their identity is ignored. It most certainly is not a full life. It is a shocking tale of neglect.

The neglect that we have found in this Royal Commission to date is far from the best that can be done. Rather, it is a sad and shocking system that diminishes Australia as a nation. 

Our work over the past year has shown a system that needs fundamental reform and redesign—not mere patching up. The scope and complexity of this task are great. We are strongly of the view that our recommendations must be comprehensive and must reflect all of the evidence. Therefore, this Interim Report sets out what we have learned to date, draws some preliminary conclusions and outlines key areas for our work over the next 12 months.

In due course, we will recommend comprehensive reform and major transformation of the aged care system in Australia. We will chart a new direction for the sector, bringing a clear sense of purpose and of quality, and a renewed focus on compassion and kindness. We are working from the fundamental premise that older people deserve high quality care that protects their wellbeing and dignity and is respectful of ageing. Care needs to be compassionate, empathetic and customised to high standards of quality and safety.

... We must work together as a nation to ensure that older people are a critical part of our present, a valued part of our community. Older people deserve our respect as valued members of society, with equal rights to a good quality of life and to services that support their needs. We intend to put older people first and to give them a voice.

As Mrs Barbara Spriggs, the first witness to appear before the Royal Commission, put it: 'We need to learn and move forward from our mistakes and develop an aged care system that Australia can be proud of. It needs to be one where we know that our loved ones are given the care, dignity and respect that they deserve'.