July 5, 2022

privatisation

Time to rein in “Wild West” aged care operators

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Vulture private equity firms prioritise profit over care.

A BBC investigation has exposed sharp practices among Britain’s largest aged care providers leading to calls for accountability – even from a former Conservative health minister.

The BBC exposé was based on a financial analysis by Australian campaigner Jason Ward – from the Centre for International Corporate Tax Accountability and Research (CICTAR) – who has done similar work in Australia for the ANMF and NSWNMA.

Jason used forensic accounting techniques to show that three of Britain’s biggest care home groups owned by private equity firms, with intricate corporate structures based in the Cayman Islands, were saddled with massive amounts of debt.

He found that a significant amount of the revenue that came out of the pockets of the vulnerable aged or from subsidies from cash-strapped local authorities ended up in this tax haven, or in outsized dividends, or were used to pay off this debt rather than being spent on care.

Jason said it is a “a common private equity tactic” to move “money out of the operating companies and to the ultimate investors in a way that maximises their profit”. Former health minister Jeremy Hunt described the sector to the BBC as “the Wild West” and “the unacceptable face of capitalism”.

Government signals privatisation of aged care assessments

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Aged Care Assessment Teams (ACAT) have been under the threat of privatisation for years to no avail. Despite the many failed attempts, the government is again pushing forward towards a tendering process as early as next month.

The many failed attempts to privatise

In December, 2019, the federal government, which funds ACAT, tried to push through a tender to privatise. This was met with strong opposition from unions, workers, aged care advocates, medical peak bodies and even the NSW Minister for Health, who said: “it seems pre-emptive and unreasonable to be effectively privatising health aged-care services while the royal commission into aged care is still under way… not a lot of logic there”.

The government’s decision to withdraw the tender was announced on 28 February via a Council of Australian Governments Health Council (CHC) communique released following a meeting of state and territory health ministers, stating:

‘The Commonwealth has agreed to work with the States and Territories to have a consistent, uniform, efficient and integrated aged care assessment process that meets the needs of senior Australians and their families.

‘The Commonwealth has confirmed that it is not proceeding with the current tender process.’

The current situation

In May, this year, the Morrison Government again signaled its intention to privatise aged care assessment teams (ACAT) in its response to the aged care royal commission recommendations.

The decision to put the recruitment of the workforce out to tender is a clear misinterpretation of the commissioners’ advice to ‘replace the Aged Care Assessment Program and the Regional Assessment Services with one assessment process’.

Last week, during Senate estimates, Aged Care Services Minister, Richard Colbeck, reiterated the government’s plans to put the tender to market.

Under the proposed arrangements, organisations will be contracted to provide these government funded services. State public health providers will have an opportunity to win these contracts, however this approach will likely result in a significant (if not total) privatisation.

“These services are far too valuable and integrated with the health and care needs of older Australians to leave it to a ‘procurement approach’,” NSW Nurses and Midwives’ Association General Secretary Brett Holmes said.

“Quality services need to be maintained, not reduced through the introduction of a profit motive”.

The NSW Nurses and Midwives’ Association is campaigning against any privatisation of ACAT. Assessment services are expertly delivered by a skilled NSW public health workforce of registered nurses, social workers and others. Privatisation would jeopardise the jobs of hundreds of skilled practitioners.

Public health promise was broken

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Healthscope has failed to live up to its commitments to the community served by Northern Beaches Hospital, said NSWNMA General Secretary, Brett Holmes.

He said the Berejiklian government promised locals their new hospital would offer the same level of care as any equivalent public hospital in NSW.

“The Berejiklian government’s claims have turned out to be false,” he said.

“Healthscope is shifting away from the government’s promise, just two years into their 20-year contract.

“It wants to remove minimum staffing requirements inside the hospital, pulling the rug out from under nurses and midwives who transferred across from the publicly run former Manly and Mona Vale hospitals.

“This means removing the protections of minimum nursing care numbers from the local community, which all other NSW residents receive.”

Brett said Healthscope was also refusing a 10-hour break between shifts, which aims to keep patients safe by reducing fatigue among the staff.

“Our members have also told us they’re constantly missing breaks within their shifts now that elective surgery is returning to pre-COVID-19 levels.

“Healthscope also wants to strip back a host of other working conditions, including maternity and carers leave.

“The nurses and midwives at Northern Beaches Hospital want to continue providing a safe level of care to their community, but Healthscope’s plans will only make that harder.

“Research clearly tells us that reducing the numbers of qualified nursing hours leads to poorer patient outcomes.”

Public health promise to Northern Beaches locals broken

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As activity returns to pre-pandemic levels inside Sydney’s Northern Beaches Hospital, concerns are rife that private operator, Healthscope, is not living up to its commitments to the local community.

Despite the Berejiklian Government promising locals their new hospital would offer the same level of care as any equivalent public hospital in NSW, Healthscope is shifting away from the government’s promise, just two years into their 20-year contract.

NSW Nurses and Midwives’ Association (NSWNMA) General Secretary, Brett Holmes, said the Berejiklian Government’s claims have turned out to be false, with Healthscope attempting to remove the protections of minimum nursing care numbers from the local community, which all other NSW residents receive.

“When Northern Beaches Hospital opened its doors in late 2018, patients and their families were assured access to equivalent public health care and private health services. Now, Healthscope is breaking that promise by cutting the legal requirement for minimum nursing hours and other important conditions” said Mr Holmes.

“Healthscope wants to remove minimum staffing requirements inside the hospital, pulling the rug out from under nurses and midwives who transferred across from the publicly-run former Manly and Mona Vale hospitals.

“Healthscope is refusing a ten-hour break between shifts for nurses and midwives, which aims to keep patients safe by reducing fatigue among the staff.

“Our members have also told us they’re constantly missing breaks within their shifts now that elective surgery is returning to pre-COVID-19 levels.

“Healthscope will also strip back a host of other working conditions, including maternity and carers leave.

“The nurses and midwives at Northern Beaches Hospital want to continue providing a safe level of care to their community, but Healthscope’s plan will only make that harder.

“Research clearly tells us that reducing the numbers of qualified nursing hours leads to poorer patient outcomes.

“This could mean less nurses, working more fatigued across the hospital,” Mr Holmes concluded.

The NSWNMA is in talks over a new enterprise agreement with Healthscope, including members working at Northern Beaches Hospital. The NSWNMA is calling on Healthscope to live up to its promises to the government and the Northern Beaches community.

“COVID has illustrated the overwhelming importance of public services”

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COVID-19 has confirmed that well-resourced public health systems are the best defence against any public health crisis, Public Services International‘s Rosa Pavanelli writes.

The COVID-19 pandemic has illustrated, more than ever, the overwhelming importance of public services and the devastating consequences of under-funding and privatising public services.

The workers who deliver public services: healthcare workers, child, disability and elderly care workers, workers who make sure we have access to energy, to water and sanitation, emergency service workers, teachers and workers supporting public education, waste sector workers and workers who keep local, provincial and federal government services and administration working, are calling on governments to commit to COVID Recovery Plans that deliver a new era of public services for all.

Governments are now seeking to stimulate economic activity. They can and must take the opportunity to leave a lasting legacy for future generations and facilitate the largest delivery of public goods in a lifetime.

COVID-19 has confirmed that well-resourced public health systems are the best defence against any public health crisis. Similarly, well-resourced public services are the best defence against economic and social crises. Countries that have invested in quality public services will weather this crisis, and any future crisis, far better than those who have embraced the corrosive ideology of neoliberalism.

Many governments are now lifting restrictions and seeking to stimulate economic activity. They can and must take the opportunity to leave a lasting legacy for future generations and facilitate the largest delivery of public goods in a lifetime.

COVID-19 Recovery Plans must reorganise our societies around the capacity to care for all people and the environments we depend on, and to eliminate gender, wealth and social inequalities. Recoveries following previous crises – like the Great Depression and the Second World War – demonstrate that with political will, it is possible to secure a vast array of new public goods and services.

We can recover and inoculate ourselves against future crisis by building new public health infrastructure, health training and research, new universities, new public broadcasters and data systems, new public clean, renewable energy, new public spaces and guaranteed universal social protection.

What we cannot afford is to go back to the broken ‘business as usual’. We cannot accept the enticing discourse that is emerging in global circles, where corporates are not only promising a prosperous future for all – after having been bailed out by governments during the emergency – but also demanding even more power to define the rules of the new order.

The NSW Nurses and Midwives’ Association is proudly affiliated with Public Services International.

Hospitals – put people before profit  

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The Liberal–National Coalition and Labor approach the 23 March election with public hospital policies as different as night and day.

The Liberal-National Coalition claims its “partnerships” with private operators will deliver a more “efficient” health system.

It tried to sell five NSW public hospitals – Wyong, Goulburn, Shellharbour, Bowral and Maitland – but fierce public opposition forced it to backtrack.

In northern Sydney, residents lost two public hospitals – Manly and Mona Vale – in return for the Healthscope-operated Northern Beaches Hospital.

As the media widely reported, its opening weeks were a shambles.

NSWNMA members have campaigned strongly against privatisation in their communities. They have made it clear they did not want their local public hospital turned into a profit-making operation.

Labor and the NSW Greens strongly oppose hospital privatisation.

Labor leader Michael Daley has promised: “Under Labor, the sell-offs will stop. There will be 
no privatisation of NSW hospitals, water, electricity or public 
transport services.”

Since elected in 2011 the Liberal–National government has sold off electricity services, bus services, ports, housing, land and property information, recreation facilities, museums and court operations – to name a few.

In health care, privatisation has even extended to residential disability services and palliative care. Ignoring the pleas of staff and families the government flogged off services provided to some of the state’s most vulnerable citizens.

On the Northern Beaches fiasco, NSWNMA General Secretary Brett Holmes wrote:

“The privatisation of the Northern Beaches Hospital was undertaken without any serious public debate. The tendering process was shrouded in secrecy. The public was lied to about what it would cost. Now the hospital has opened in a state of chaos due to completely inadequate planning and preparation.

“This is largely due to a failure to engage with staff and a management that lacks experience in running public hospitals. It was arrogant to think that private corporations would do a better job of running a public hospital.

“The government responsible for this debacle deserves to be made accountable.”

The Liberal-National Coalition tried to sell five regional NSW public hospitals but fierce opposition by nurses, midwives and their local communities forced it to backtrack.

Where the parties stand on PRIVATISATION

 NSW GREENS

  • Oppose Public–Private Partnerships in provision of public hospital services.
  • Support keeping all current and future public hospital developments and land in public ownership.

 NSW LABOR

Labor leader Michael Daley says: “Under Labor, the sell-offs will stop. There will be no privatisation of NSW hospitals, water, electricity or public transport services.”

LIBERAL-NATIONAL COALITION

Privatised the Northern Beaches Hospital and tried to sell six regional public hospitals.

Why we oppose the Liberal–National Coalition’s hospital privatisation

  • Private operators have a duty to reward their shareholders by making a profit on their investment.
  • They can only do that through cuts to staffing and resources.
  • Privatisation of public health care has never delivered better services.
  • Privatisation will starve our public hospitals when nurses and the public want to see them grow.