A road map forward
The Royal Commission into Aged Care final report is not perfect but there are strong recommendations in key areas such as workforce and governance that can drive the sector to a much better place.
There is much to digest in the commission’s final report which runs to eight hard-copy volumes and has an executive summary of over 120 pages.
There are some in the sector who are disappointed by the report but a close analysis reveals a vision for the aged care workforce that is underpinned by values and policy recommendations that the ANMF and the NSWNMA have been advocating for more than a decade.
The commissioners, Tony Pagone and Lynelle Briggs, recognise that the 1997 Aged Care Act introduced by the Howard government, which is the foundation stone that has shaped the profit-driven sector we now have, has failed.
That legislation allowed providers to decide for themselves what staffing numbers were adequate and how taxpayers’ funding was used. It was from this moment that the replacement of nursing staff with unregulated care workers began.
The consequences of this have been dire and the commissioners have identified key issues that need to be addressed if the sector is to be salvaged.
They point out that there are not enough workers to provide high quality and safe, person-centred care and that the proportion of qualified staff, such as registered nurses and allied health workers is too low.
This is in circumstances where the acuity of people receiving care has increased.
The commissioners agree that the aged care workforce is poorly paid for difficult and important work. They also observe that some staff are untrained or insufficiently trained for the work they do.
Current staffing levels are unacceptable
They accept the evidence that there is a link between staffing levels and care outcomes and observe that currently, staffing levels within large parts of residential aged care, fall well short of acceptable practice standards.
To remedy these deficiencies in the workforce the report recommends that the sector needs:
- the right number of staff with the right mix of staff and skills
- a greater proportion of registered nurses, nurse practitioners, and allied health professionals
- better education and training to achieve a more highly professional workforce
- registered personal care workers/AiNs
- minimum qualifications for personal care workers/AiNs
- improved pay and conditions.
These recommendations match the key objectives of our long, hard-fought campaign for a better and viable aged care sector.
The commissioners recognise that the aged care workforce needs to be professionalised which will require improvements to education, wages and conditions.
They agree that there is a wages gap between aged care workers and workers performing equivalent functions in the public health sector. They are in no doubt that a registration scheme is needed for personal care workers/AiNs.
The commissioners see a clear link between more staff, safety of care, a safe work environment and attraction and retention of staff.
The federal government’s integrity is on the line
The responsibility for implementing the commission’s recommendations now falls to the federal government.
The ball is now in Scott Morrison’s court and it is not an understatement to say the integrity of his government is on the line.
The testimonies and revelations in the lead up and during the course of the commission’s inquiry about the way many aged care residents have been neglected in a sector whose reason-for-being is care of our elders have been heart-rending.
The commission’s report clearly shows that the problems of the sector are deeply structural. The commissioners leave no space for excuses by the federal government to abdicate its responsibility for the governance of the system.
There have been many commissions, inquiries, analyses and reports about aged care in the past that have resulted in absolutely zero change.
We cannot allow that to happen with this pivotal report. Despite its flaws it is a significant step in the right direction.
The NSWNMA and the ANMF will campaign hard to have the commission’s recommendations implemented including through a paid advertising campaign.