Australia's aged care system is overly complex with reforms over the past 30 years too often addressing issues in isolation rather than the system as a whole, the royal commission into the sector has been told.
At the first hearing to take evidence in Adelaide on Monday, counsel assisting Peter Gray said the aged care system has been subject to many reviews and inquiries.
But he said where they were limited in scope, they had not been able to address the bigger picture.
"The sheer number and frequency of reviews shows that there are many issues in aged care which have not been resolved to the community's satisfaction," Mr Gray said.
Commissioner Lynelle Briggs says the aged care inquiry will be held amid a 'torrent' of concern. Source: AAP
'Harrowing experiences'
He also told the commission that many people who had received care, were family members or who worked in the sector, had approached the commission to tell their stories.
"Some have had harrowing experiences," he said.
"We are grateful to them for their courage in being willing to bear witness to the effects that the aged care system has had on them."
Among those are Barb Spriggs and her son Clive who will be the first to give evidence.
Mrs Spriggs' husband Bob was overmedicated and mistreated before his death in Adelaide's infamous Oakden nursing home, where the abuse of dementia patients in part sparked the royal commission.
Aged Care Minister warns of more harrowing stories to come
Aged Care Minister Ken Wyatt said the inquiry came amid a 177 per cent increase in findings of serious risk against service providers in the past year.
"Over the coming days and weeks the stories and events told before the commission will not be easy to hear, but they are necessary," Mr Wyatt said.
"Our senior Australians are among our greatest treasures. They deserve the highest quality aged care possible."
Minister for Aged Care Ken Wyatt. Source: AAP
Mr Wyatt said the federal government remained committed to providing senior Australians with access to care which supported their dignity.
He said the opening of the royal commission would be remembered as a highly significant day for aged care in Australia.
1700 submissions received
In his opening address, Mr Gray revealed that the investigation had now received responses from about 900 of Australia's 2000 approved aged care providers along with more than 800 submissions from the public.
Many of the public submissions directly related to substandard or unsafe aged care services.
He also provided an update on future hearings, with sittings in Adelaide in March to focus on home care and those in May to focus on the care of dementia patients, amid estimates about 900,000 Australians will be living with the condition by 2050. Currently, Mr Gray said 376,000 Australians have dementia.
Shining a light on issues in aged care
Ahead of Monday's hearing, industry group Aged and Community Services Australia said the investigation would shine a light on many complex challenges and issues within the system that had long gone undiscussed.
Chief executive Patricia Sparrow said it was hard for many people to talk about ageing.
"But that's what we need to do as a nation if we are going to improve the system and make it sustainable into the future," she said.
"The royal commission will be important in going right back to the beginning and examining what kind of system we need and how to make that possible."
The inquiry's initial focus will be on how aged care has been operated, monitored and regulated and how that may change under the Aged Care Quality and Safety Commission.
The commission will also consider the changing demographics of the Australian population and the implications this has for the system.
Advocacy and medical groups will detail the current state of the aged care system along with the clinical issues affecting elderly people and general challenges in meeting clinical needs.
The hearings in Adelaide will continue over the next fortnight.
