Unions: Aged care system needs radical overhaul

March 4, 2021
Photo: Sabine Vanerp / Pixabay

The Australian Nursing and Midwifery Federation (ANMF) reiterated its call for adequate staffing levels in nursing homes as the Royal Commission into Aged Care Quality and Safety Final Report was handed down on March 1.

The report identified “serious systemic problems” and “recurrent issues that stem from problems inherent in the design and operation of the aged care system”. 

Specifically, the commissioners pointed to “inadequate funding, variable provider governance and behaviour, absence of system leadership and governance, and poor access to health care”. 

ANMF federal secretary Annie Butler said on March 1 that a succession of federal governments have “done nothing” to address the ever-increasing shortages of registered nurses and qualified carers working in the sector. She said this means that elderly residents have been “made to suffer”.

The ANMF said the government’s “immediate response” of $452 million in public funds to be tied to providing better care. Given the billions of taxpayer dollars aged-care providers receive annually, the lack of transparency must be rectified, it said.

After a two-year inquiry, involving more than 10,000 submissions and 23 public hearings, the commission produced a 1000-page final report.

Distressing evidence from overwhelmed nurses, carers, elderly residents and their families exposed that a root cause of so much of the residents’ neglect in private centres is understaffing.

The commission summarised the problem as “substandard care and abuse”. Two commissioners made 148 recommendations, although they differed on 43. The lack of unanimity will no doubt allow the government some wriggle room on which proposals it will support.

Unions covering the aged care sector, together with the Australian Council of Trade Unions, have put forward a comprehensive plan involving four key measures: mandated minimum staffing levels and a required mix of skills and qualifications in every residential facility; transparency and accountability for government funds; mandated training requirements (including infection control and ongoing professional development) accessible to all staff and paid by the employer; and government funding to be increased and linked to care and employment of permanent staff on decent wages.

The Health Services Union (HSU) said the sector needs “transformation” not “tinkering”. HSU national president Gerard Hayes said workers need a substantial pay rise and called for an extra $5 an hour in all major aged care classifications.

HSU aged care workers spoke to the union about their work.

Karen said: “Sometimes I finish my shift and I’m in tears because I knew I couldn’t provide the support the residents needed. It’s a production line.”

Chrissy said: “Where’s the money going? Residents are paying thousands of dollars a month and there’s lots of taxpayer funding. Where’s it all going?” 

Rachel said: “Residents are told to pick their two days a week they want a shower. There’s a lady who likes her hair blow dried just once a week. That’s it. But I just don’t have the time to do it and I feel awful.”

Honorine said: “Not having enough time to spend on each resident’s care is heartbreaking. Everyone does the best they can but there is only so much we can do in this broken system.”

“We also need a sustainable funding model,” Hayes said. “Research we commissioned for the royal commission shows we could fund a pay rise, an additional 59,000 aged care jobs and close to 90 minutes of additional resident care per day, through a 0.65% increase in the Medicare levy.”

An extra $8 billion a year in government funding is necessary to tackle the crisis in the aged care system, the union said. 

The Australia Institute supports a new Medicare-style levy to pay for essential aged care changes. “Increasing the Medicare levy by at least 1%, or a new progressive Aged Care levy, is a rare opportunity to shore up Australia’s dwindling revenue base,” Ben Oquist, executive director of the Australia Institute, said on March 1.

Socialist Alliance Moreland City councillor Sue Bolton said the way the pandemic took hold in residential aged-care homes in Victoria and New South Wales was “waiting to happen” because the system has been left to private corporations to run.

“The privatisation of this essential health service must end,” she told Green Left last year.

The deregulation of the aged care sector began after the Aged Care Act allowed mandatory staffing ratios to be removed and the workforce to be casualised. This led to insufficient pay, with no entitlement to paid sick leave for the largely casual work force.

Bupa and Estia Health are not specialists in aged care, yet they receive $1 billion each year from the federal government. Neither are these profit-gouging companies required to employ a registered nurse to be on-site 24 hours a day, Bolton said.

The commissioners said their examination of the sector “cannot help but paint a gloomy picture … The delivery of aged care in Australia is not intended to be cruel or uncaring.”

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