The Meaning of Purpose in the Aged Care Sector

What is the meaning of ‘purpose’ for faith based, community and charitable providers in the aged care sector, asks the new CEO of the Aged and Community Services Australia (ACSA), Adj Prof John Kelly.

Adj Prof Kelly made the following (edited) Keynote Address to the ACS State Conference on the topic of “A Strong Partner in Church, Charitable & Not for Profit Aged Care”.

It is with a great deal of honour and privilege that I recently assumed the leadership of ACSA at this critical time for our sector; a sector that has been my passion for 35 years.

In a forum such as this, it may seem a little curious for me to quote a famous American playwright, but when I came across the following, it crystallised for me the very essence of what ACSA is, what it was always destined to become and why the recent turn of events have been such a tremendous opportunity to consolidate our status as the national peak body representing mission based community and residential aged care providers.

The great Arthur Miller once said – “Don't be seduced into thinking that that which does not make a profit is without value”.

And for our most vital sector, such a statement could not have more resonance.

Given the Federal Government’s intention to establish an Australian Charities and Not-for-Profits Commission, it would have been counter-intuitive to diminish ACSA’s NFP voice at such a critical time for the sector.

The unique requirements of faith based, community and charitable providers in the aged care sector must be articulated precisely and not be overshadowed by matters that concern the industry in its entirety.

Those most disadvantaged in our community require extra consideration to enable appropriate care solutions. The charitable and Not for Profit sector, or as I prefer to call it, the mission-based providers, must lead the way here.

To this end, it is critical that ACSA underlines the distinguishing responsibilities of our members as custodians of values, leaders of innovation, champions of volunteerism and proponents of wholesale community benefit.

It is essential that our members become more visible Not for Profit leaders in service and activism to merit the public’s confidence in our missions, as expressed by tax exempt status and philanthropic support.

ACSA and its members must continue to foster an environment that promotes innovation and ensures that effective programs and practices are implemented.

We must advocate for prevention, wellness, palliative care and models of service that improve health and address cost; we must partner with new organisations that are aligned with our mission, values and imperatives and we must support research with particular emphasis on the needs of rural, remote and disadvantaged older populations.

ACSA must continue to lead the way in supporting initiatives that entice, develop and retain those staff responsible for service provision and governance within our organisations. A highly skilled, stable workforce underpinned by healthy cultures and principled leadership is essential for quality care delivery.

Competent boards are essential for accountability; and talented professional leaders are essential for success.

As the respected Not for Profit leader Reverend Tim Costello recently said, “Our organisations may not be for profit, but we are for purpose.”

And let’s not underestimate what that’s worth.

“Purpose” is not some nebulous concept that has no substantive meaning or consequence.
It is PURPOSE that gives leaders in our sector their unique sense of duty.

It’s that PURPOSE that lies at the very heart of devising organisational strategy, the manner in which our vital work is undertaken, and the way we hold ourselves accountable to our consumers, our patrons and society as a whole.

When purpose is complex – and encompasses a holistic approach to care that respects each individual’s dignity and promotes the physical, emotional and spiritual well-being of all older Australians – irrespective of their means – then it necessarily comes with long term goals that require commitment, courageous innovation and continuous improvement to achieve.

Granted, Not for Profits have boards and governance structures, external regulatory frameworks, contractual obligations, a multiplicity of reporting requirements, micro management, significant compliance burdens, as well as internal risk management frameworks such as codes of conduct to keep us circumscribed.

But our raison d'être is never purely financial or governance focused.

Yes, it’s definitely in the best interests of aged care that we do everything possible to maintain and improve community confidence in the quality and integrity of our organisations.

Accountability and transparency is something to be embraced and our sector must set the standard. But equally it’s important to remember what we should be accountable for.

Accountability in the mission based sector is more than just looking after the bottom line – that is too simplistic a measure and does not reflect the multi-dimensional complexity and intangible, albeit profound, impact and effectiveness of our programs and initiatives.

Being able to manage and govern an organisation to make a profit or surplus is a necessary business imperative, but for us, this is not sufficient to achieve our far more complex and valued mission.

Our member organisations proudly exist to serve all older Australians requiring our services, and our true bottom line rises and falls with that.

Our purpose is to deliver services predominantly to individuals who find it difficult or are excluded from the marketplace.

Any surplus is reinvested in improving services, keeping people actively connected in civil society; delivering unprofitable services in unviable markets, and operating where there is no capacity for the disadvantaged in our society to make purchases in existing markets.

The Gillard/Butler announcements of a reform agenda that identifies a 10 year plan and pathway is most welcome, but of course, in the detail creates some considerable and critical concerns for us as providers.

This again highlights the essential issue that mission based providers must be able to directly articulate our unique concerns to government to ensure supportive policies are put in place to enable us to deliver services that achieve community benefit.

As a society, it is incumbent upon us to offer older Australians a continuum of opportunity, a seamless provision of services if you will, that inspires and facilitates active retirement; that harnesses the depth of talents and experiences of older Australians, and in time, affords them the right to age in place and access excellent care options, be that community or residentially based.

I am confident, however, that the Government’s track record and goodwill has demonstrated a genuine commitment to work through the detail and the potential negative effects of some of the announcements that might uniquely present themselves to providers – particularly mission based providers – who need to examine policy platforms carefully to ensure they support the provision of services to disadvantaged Australians.

Friends and Colleagues, this is a most exciting time for the community and residential aged care sector in Australia.

Never before has there been an opportunity for providers, consumers, industrial associations and governments to work together from an informed baseline to achieve sensible and positive policy change and implementation in the sector.

In terms of “on the ground” effects in the shortest period of time, the sensible commitment to – and creation of – social policy in 2012 in this sector, may well be heralded in hindsight as the greatest contribution this current Federal Government has made to the community.

That is the challenge for government and our opportunity to ensure they understand this.