PG #77: Royal Commissions are systems thinking in practice

The last few weeks have seen the release of two landmark reports out of multi-year Royal Commissions – the first into Aged Care, the second into Mental Health.

It’s rare that we get two reports released more or less concurrently, and I found myself drawing some natural comparisons between them. While it’s impossible to summarise both reports, they do detail common policy failures, chronic underfunding and the consequence of deliberate deskilling of workforces.

Both of them show:

• Funding models that are completely mismatched with the desired human outcomes; incentivising care providers for the wrong things, with little regulation or oversight to ensure care goals are met
• Undertrained and unprepared staff, stressed and stretched themselves, unable to deliver the care they want to (but, also, sometimes actively abusing those in their care)
• The systemic overuse of sedation as a coping mechanism for care providers, who chose to keep people in comatose states because care is easier
• A lack of respect for the agency of those people in care – human rights being ignored to meet logistical and financial constraints

Together, they paint a bleak picture of how Australian society cares for some of its most vulnerable. They also contain hopeful, clear recommendations for improving these systems outcomes.

Up until the 2017 Royal Commission into the treatment of children in custody in the Northern Territory, I’d never read the actual reports. I’d only seen the news coverage, or maybe read an article about the political appetite (or lack thereof) for acting on recommendations.

Over the last few years though, I’ve made sure to read as much of them as I can in between work and life commitments. I’ve come to recognise them as touchstones, both as snapshots of a system in time, but also as our society’s best attempt to compel itself to change.

As objects, they combine economic analysis and quantitative lag measures of various kinds with multi-year community engagement and witness testimony to paint a holistic picture of a system and its leverage points. They make recommendations, often hundreds of them, and these recommendations themselves are consulted around and vetted by experts.

In fact, they’re fairly similar to what we produce as research reports and design roadmaps, except at a far larger scale.

Like much of the best research and design work, however, they are often ignored.

As designers, we’ve all got examples of our best work falling on deaf ears. If Royal Commissions are the best tools we have as a society to influence systems, then why is their impact so limited?