While Scott Morrison was correct when he said his government was not solely to blame for the parlous state of Australian aged care on Monday, the ball is now firmly in his court.
The Royal Commission into Aged Care Quality and Safety's final report has ripped the band-aid off a national disgrace, and one of the worst failures of privatisation and governance this country has ever known.
Governments, regulators, aged care providers and the public can no longer turn a blind eye to the appalling neglect, abuse, and human suffering that festered behind closed doors in institutions where human greed has been allowed to trump human need for decades.
The commissioners have drawn our attention to a national crisis that is just as serious, and even harder to manage, than the coronavirus pandemic. It is possible to vaccinate against COVID-19. There is no cure for old age.
Unless things change the vast majority of us will finish our lives in some form of institutionalised care dependent on the kindness of undertrained and overworked strangers.
The report made it clear existing aged care models, and the way they have been regulated, have failed. The system is badly broken and needs to be fixed.
The big question right now is if this government, whose agents have already pre-emptively rejected six of the 124 recommendations made public last October, is up to the task.
While much has been said about the dedicated efforts of the commissioners, including the inaugural chair, Richard Tracey QC, who died in harness, the real credit for this inquiry, and its 148 potentially life-changing and life-saving recommendations, belongs to the tens of thousands of ordinary Australians who shared their stories, experiences, and concerns.
A remarkable 10,574 submissions were received. More than 6,800 calls were made to the commission's information line. Another 641 witnesses testified at 23 hearings and workshops. The final report's executive summary runs to 115 pages alone and, even in this condensed form, makes for distressing reading.
While the authors have been careful to stick to the facts there is an underlying tone of disgust at what is nothing short of a national disaster, and one that could have easily been averted if different decisions had been made, and more humane policies put in place, over the decades.
Perhaps the most damning passage is that: "Those who run the aged care system do not seem to know about the nature and extent of substandard care, and have made limited attempts to find out. There has been a reluctance to measure quality".
While it is obvious, given the scale of the problems, the system will take many years to fix there is much that can be done now to make life better for those within the system and for those desperate to access home care as an alternative to facilities that, in many cases, have been exposed as poorly managed, understaffed, and not fit for purpose.
These include increasing the number of home care packages in line with the commission's recommendations, mandating standards of care in line with the commission's recommendations, providing alternatives for the many young people living in aged care, mandating at least a Certificate III in aged care for people working in the sector, and mandating wage levels sufficient to make the sector attractive to qualified staff.
While these are baby steps in terms of the total challenge they would make a world of difference to the more than 200,000 people living in residential aged care right now.
The time to act is now. There is no time to waste.
Sign up for our newsletter to stay up to date.