Aged care reforms are welcome – but must go further
The Morrison government’s aged care package is a step in the right direction, but falls well short of royal commission recommendations.
The federal government has made a positive start to fixing the broken aged care system. But it has failed to deliver the “once in a generation” reform promised by Prime Minister Scott Morrison.
The Aged Care Royal Commission’s recommendations were aimed at repairing a system it described as “inadequate and inhumane”.
In its May Budget, the government responded by injecting an extra $17.7 billion into aged care over five years.
The Australian Nursing and Midwifery Federation (ANMF), which represents state-based nursing unions including the NSWNMA, said the government’s package included some “very positive” measures.
However, the ANMF said the package ignored too many of the commission’s recommendations.
“It simply won’t go far enough to guarantee safe, quality care for all older Australians,” said ANMF Federal Secretary, Annie Butler.
On the vital issue of staffing, the government committed to a mandatory minimum care time for aged care residents.
From October 2023, nursing homes will be required to provide at least 200 minutes of care per day to each resident, including 40 minutes of care delivered by a registered nurse.
October 2023 is more than a year later than the start time – July 2022 – recommended by the commission.
Also, the budget measures do not include any subsequent increase in minimum staff time as recommended by the commission.
The commission called for at least 215 minutes per resident per day from July 2024, with at least 44 minutes provided by an RN.
Most critically, the reforms don’t include any requirement for a registered nurse to be on site 24/7, as the commission also recommended.
The government will only require an RN to be on duty for 16 hours per day.
Annie Butler said this means care is likely to remain at an “adequate 3-star level” rather than reaching a level of high-quality care across the sector.
“Elderly residents will continue to be denied round-the-clock nursing care,” she said.
“The effect of this could be that residents may be forced to go without pain relief or be transported to hospital for a minor incident, because the care workers on duty don’t have the support of a nurse’s clinical expertise.”
Annie said the government has done little to bridge the pay gap for aged care RNs, which is as much as 15 per cent below hospital pay.
Instead, the government promised a retention bonus for RNs who stay with their employer for at least a year.
The bonus is $3700 for full-time RNs, or $2700 for part-time RNs.
Annie said money should go to lifting wages throughout the sector, improving conditions and putting proper career structures in place.
“What RNs need to come into the aged care workforce is safe staffing and safe workloads.
“In particular, young, newly graduated nurses need to feel supported.
“That’s why having nurses 24 hours a day is critical.”
The royal commission concluded that inadequate staffing levels, skills mix and training were the principal causes of substandard care.
“The royal commission made it absolutely clear that until you get the staffing right, none of the other stuff really matters,” Annie said.
“You can tinker around the edges, but quality care won’t be delivered until you get the staffing right. That means enough care time with the right mix of skills.
“This budget will not guarantee high-quality and safe aged care. It’s particularly disappointing because this package is the government’s full response to the royal commission, which is simply not enough.”