11 April 2022
Article from April 2022 edition of INPractice
The coming federal election could deliver a lifeline … or a devastating knockout blow.
ANMF Federal Secretary Annie Butler has a blunt and somewhat chilling view of the Morrison Government’s attitude to aged care.
“The only conclusion I can draw is that older Australians, especially older Australians living in nursing homes, don’t matter to this Government,’’ she says.
The crisis in aged care has never been so dire. At the time of writing almost a quarter of aged care shifts nationally were going unfilled weekly, with about a third of the workforce lost to infection or isolation.
With Omicron rampant in aged care homes, hundreds of residents have died and thousands of staff and residents are infected. We have heard reports of COVID-infected carers being asked to work with residents, reports of widespread resignations and of massive staff shortages due to COVID outbreaks. These have all resulted in residents being isolated in their rooms and missing out on visitors, medication, meals and even water.
A parliamentary committee was told that, as at mid-February, 2022 has already been the deadliest year for aged care residents since the start of the pandemic. 691 residents have died this year due to COVID-19 outbreaks, compared with 282 deaths for the whole of 2021 and 685 in 2020.
Almost one-third of the country’s residential aged care homes were, at the time of writing, battling coronavirus outbreaks, with 915 of the country’s 2900 facilities affected.
And despite the enormous responsibility that comes with their job and the additional workloads and risks associated with COVID, aged care workers continue to be paid a pittance. Just $21.62 an hour on a level one wage – less than an adult fast-food worker, who earns $22.33 under the industry award.
We have also heard of staff being expected to work 30 minutes of unpaid time to have rapid antigen tests prior to starting their shifts and also having to battle their provider to get the right pay rates when they work double shifts.
May’s Federal Election is shaping up as make or break for the aged care crisis. The marginal South Australian seat of Boothby will inevitably be a key battleground. One which could very well decide the next government and the future of aged care in this country.
“Aged care urgently needs an overhaul. It needs more staff, staffing ratios, more skills and training and vastly improved wages to retain and attract nurses and care workers,’’ ANMF (SA Branch) CEO/ Secretary Adj Associate Professor Elizabeth Dabars AM said.
“Otherwise, we face the prospect of workforce numbers crashing even further than the current inadequate levels and the needs of the vulnerable elderly unable to be met.’’
“With the latest outbreak of COVID arriving at a time when staffing was already at breaking point, staff have been working regular additional hours, overtime and double shifts,’’ says one South Australian regional aged care nurse.
“Nursing staff are both physically and mentally drained with no end in sight as there are no Agency Nurses to come and help. Working sometimes in full PPE is not only exhausting but lonely, as you are told to take your breaks at different times. Where we were once there to support each other, you now sit alone.
“I’ve seen a lot of great nurses retire early due to the demands of the job, so sad their careers ended this way.’’
Sadly, this warning continues to fall on deaf ears. Even one of the Morrison Government’s key architects on aged care funding reforms has publicly criticised the Prime Minister, saying his Government “has not been interested in pursuing the real fundamental reforms that are required”.
“It’s impossible not to assume that this is a political decision to try to placate the sector,’’
said University of Wollongong Professor Kathy Eagar of the PM’s cynical pre-election bonus payments totalling $800 for aged care workers, announced in February.
Professor Eagar had led work on overhauling the Commonwealth’s Aged Care Funding Instrument. “Nobody should believe that two one-off payments in the lead-up to a federal election will actually do anything in the long run,’’ she told the InDaily online newspaper.
“It’s not going to go away. We knew the sector was in crisis before, it’s still in crisis and nothing the Government does of the short-term nature will actually have any systemic value.
“The current state of aged care I would describe as unsafe, unkind, uncaring but also unsustainable.’’
To quote the findings of the Royal Commission into Aged Care Quality and Safety: “The evidence is compelling that overall staffing levels in aged care are linked to quality of care, and that registered nurse numbers are particularly important’’.
When the Federal Government was handed the findings of the Royal Commission into Aged Care Quality and Safety on 1 March 2021, the ANMF was quick to urge the Morrison Government to act.
At the time, ANMF Federal Secretary Annie Butler said the Morrison Government and previous governments had done nothing to address ever-increasing shortages of registered nurses and qualified carers working in aged care.
“Without adequate staffing and skills mix, with minimum standards for care workers, nursing home residents have suffered terribly, as a result of inadequate levels of care,’’ she said.
“Every day the Government fails to address dangerous understaffing in nursing homes and community care, is another tragic day, that vulnerable residents will continue to receive inadequate levels of support and care.
“I cannot believe the level of disrespect and disregard they’ve shown and the way the Prime Minister, the Health Minister and the Aged Care Minister have been talking about the deaths in nursing homes,’’ Ms Butler said.
“People who, in the most astonishing display of heartlessness and lack of respect from our Prime Minister and Health Minister, were told that they were palliative, they were going to die anyway, that they didn’t really matter so much.
“People who should have been protected by their Government and people who could have been protected if the Government had acted responsibly.’’
THE AGED CARE ELECTION
The COVID-19 pandemic has shone on a huge torch on the failures of the Morrison Government in aged care.
The ANMF was dismayed that despite the tragedies in aged care during previous outbreaks, the Government stood-back and ‘let it rip’, without securing proper supplies and provision of vital booster shots, RATs and personal protective equipment (PPE) for nursing homes.
“The Morrison Government should have been more prepared. It’s like nothing has been learnt from the second wave in 2020 (when, tragically, 685 lives were lost),’’ ANMF Acting Federal Secretary, Lori-Anne Sharp, said in January.
In an affront to aged care workers, residents and their families, the Aged Care Services Minister Richard Colbeck chose to go to the Ashes cricket match instead of fronting a Senate Hearing on the Morrison Government’s handling of the Omicron wave earlier this year. He has twice this year declared that the aged care sector is not in crisis.
The Federal Government has completely failed to plan for adequate surge workforce capacity and invest in staff, despite knowing the chronic understaffing that has overwhelmed the sector for a decade and which has been further highlighted by the Royal Commission as well as the intense impact of the pandemic.
“The Royal Commission recommended, and the Government accepted our recommendation about staff ratios, but they don’t take effect until October 2023,” Professor Kathy Eagar said.
Note: The Government has in fact only agreed to the first phase of the recommended staffing levels with no commitment to the final staffing numbers and mix recommended by Prof. Eagar and the Royal Commission.
Professor Eagar went on to say that “We know the evidence is very clear, we need more staff, better skill mix. That is we need more registered nurses, more allied health staff, better continuity so we can’t have this situation with large pools of casual staff going from home to home taking COVID with them, which has been one of the systemic problems.
“We need incentives for staff to stay working in this sector and to develop relationships with their residents and unless we address those systemic issues we will never make aged care safe in the way that it needs to be safe,’’ Professor Eagar said.
“It’s 100 per cent the Federal Government’s responsibility,” she said.
“The Government needs to provide extra funding to pay for staff salary increases and when you’re a low paid worker and you’ll be paid more to work in a supermarket than you are putting yourself at exposed risk in an aged care sector it’s not surprising that workers have been leaving the sector in droves.’’
The ANMF, along with other unions, have put a case before the Fair Work Commission, calling for a 25 per cent pay rise for aged care workers in a bid to boost the attraction and retention of staff.
We have also called on the Government to mandate financial transparency, to ensure money is actually being spent on care.
Our battered aged care sector is on the ropes. And unless action is taken now the situation will get so much worse.
Australia is facing a shortage of at least 110,000 direct aged-care workers within the next decade unless urgent action is taken to boost the workforce, a report last August by the Committee for Economic Development Australia (CEDA) found.
The report, Duty of care: Meeting the aged care workforce challenge, finds the shortage will balloon to more than 400,000 workers by 2050 if nothing is done.
CEDA Chief Economist Jarrod Ball said Australia had failed to prepare for this challenge, despite multiple inquiries and our ageing demographic destiny being well understood for decades now.
“We will need at least 17,000 more direct aged-care workers each year in the next decade just to meet basic standards of care,” Mr Ball said.
“These projections are based on conservative assumptions, and the situation may prove to be even more dire than this.”
“The number one issue that we hear from our members across all sectors, but also in aged care, is workload, safe workload, being able to give safe care,’’ Ms Butler said. “If you legislate ratios, obviously we don’t find the workforce tomorrow, but they will return. So, we know that over two to three years when Victoria first legislated ratios, 10,000 nurses returned to the system.
“So, we know that we can stop the exodus. When they know that they’re going to be able to have not just safe workloads but be able to deliver the right type of care, the care people actually need, people will return to the system.
“Once you do the other things as well, increased wages and conditions, then you start to attract and start to retain people in the system.’’
AGED CARE AND THE SOUTH AUSTRALIAN FEDERAL FIGHT
Since September last year, the ANMF (SA Branch) has invited most SA Federal Members of Parliament, and Senators, to sign our Fix Aged Care pledge.
The Shadow Minister for Health and Ageing Mark Butler, ALP, not only signed the pledge, but also met with aged care representatives and workers to discuss issues they face on the frontline day in, day out.
Here in South Australia, there is one seat that could create real action on aged care and that is the marginal seat of Boothby.
In 2019, Boothby was a hotly contested seat with the Opposition and the Greens making inroads into the margin. What does this all mean? This is a seat that could result in a change of Government, and a seat that could result in real meaningful changes in aged care.
When the ANMF (SA Branch) first reached out to candidates in Boothby, the Australian Labor Party candidate Louise Miller-Frost accepted the invitation to meet as soon it was offered to her, immediately indicated her support for our campaign goals and signed the ANMF’s Fix Aged Care pledge.
The Greens’ Jeremy Carter and Independent Jo Dyer have also signed the pledge. However, the Liberal candidate for Boothby, Dr Rachel Swift, by contrast, cancelled one meeting with the ANMF (SA Branch), and no meeting was rescheduled despite our repeated requests. In a late development Dr Swift agreed to participate in our ‘virtual’ aged care forum in Boothby but still declined to sign our pledge.
And yet the same Dr Swift was quoted in The Advertiser last November saying: “Boothby is one the older electorates in the country, so if you haven’t had to deal with aged care for yourself in Boothby, you’ve had to deal with it for a family member,” she said. “Climate and aged care (are) the things that people continue to tell me are front of mind.”
Ms Dabars said at the time of Dr Swift’s appearance at the Boothby forum: “Now that she has once again declined to sign the pledge it calls into question her support for real reform in the sector.’’
“We have reached out to Liberal Party Senators and Members of Parliament in Federal Parliament, including Ministers in the Morrison Government, and not only have none of them signed our pledge, but several have also declined to meet with us altogether,’’ Ms Dabars said.
“This represents a continuing lack of commitment by the Morrison Government to respond to fully implement the recommendations of the Royal Commission that would improve the care they are able to provide to older Australians.’’
By contrast Federal Labor has committed to the ANMF pledge. Labor leader Anthony Albanese has gone on the record, saying “Fixing aged care will be a central priority of an Albanese Labor Government”. He told The Lamp: “We absolutely need minimum staffing ratios in residential aged care so that residents get the care they deserve’’.
What do we want?
When do we want it?
NOW!
Make no mistake -
aged care is in crisis.
The ANMF is calling on every federal politician to make aged care an election priority and deliver a system that respects staff and residents and keeps them safe.
Federally, the ANMF have called on every MP and Senator in the Parliament to sign our Fix Aged Care pledge. And what we have asked every politician to do is to commit to implement the recommendations from the Royal Commission into Aged Care Quality and Safety, support understaffed nurses and care workers and put an end to the unnecessary suffering of residents.
There are four key issues we are asking the federal politicians to commit to. They are:
- RN24/7 – at least one registered nurse on site at all times
- Mandated staffing ratios and the right skills mix
- Greater transparency of funding tied to care
- Improved wages and conditions
Aged care has suffered from chronic and widespread understaffing over many years and a lack of transparency in how funding has been spent, and next month’s Federal Election is a chance to have your say in changing the course of the aged care crisis.
You can see a full list of which MPs have signed the aged care pledge
here
Click here to read the April 2022 edition of INPractice