HOW DID AUSTRALIAN aged care reach its current nadir? Countless inquiries and reviews have probed this question; postmortem after post­mortem has dissected the policy and regulatory failures that have wrought the present abysmal state of affairs; a surfeit of recommendations have been handed down; revised guidelines and principles adopted; advisory committees formed; stakeholders consulted – yet here we are, a prosperous nation with one of the worst aged-­care systems in the developed world. And in spite of the scorching spotlight of the Royal Commission into Aged Care Quality and Safety – the final findings of which are due in November 2020 – there is seemingly little political will or vision for change, and no clear road map ahead.

The more I think about the aged-­care impasse, the more I have come to see the sector’s seemingly intractable issues as symptomatic of a more fundamental failure: one that underpins the litany of ineffectual policy reforms, deficient regulation, negligent provider practices and lamentable outcomes experienced by many aged-­care recipients. This failure is not unique to politicians or aged-­care providers – but their failure in this respect is more consequential. It is a collective failure that implicates us all. Fundamentally, the failure of Australian aged care is a failure of imagination.