Article from ANMJ Jan-Mar 2019 Volume 26, No.5
In 2019, the Australian Nursing and Midwifery Federation (ANMF) will lead the way on a wide range of issues facing nursing, midwifery and the broader community.
An impending federal election will see the ANMF ramp up pressure on federal politicians to legislate minimum staffing ratios in aged care through its national public awareness campaign – Ratios for Aged Care – Make Them Law Now.
Last September, the Morrison Government announced it would establish a Royal Commission into Aged Care Quality and Safety examining the crisis facing the sector.
With growing research showing chronic understaffing is contributing to inadequate care in nursing homes, ANMF Federal Secretary Annie Butler says the sector cannot wait at least two years for a Royal Commission as it continues to decline.
“All political parties must make a commitment to protect residents and support legislative change to introduce minimum staffing levels and hours of care for all residents,” Ms Butler says.
“Vulnerable elderly residents deserve access to affordable and high-quality aged care services delivered by a professionally trained and dedicated workforce.”
As the country’s largest union, the year ahead once again presents the ANMF with an opportunity to use its influential voice to lead the way on important issues facing the professions and the Australian population.
The 2019 priorities include:
- Aged Care
- Change the Rules
- Climate Change
- Nursing Now
As aged care comes under the microscope during the Royal Commission into Aged Care Quality and Safety, the ANMF will increase pressure on federal politicians to support aged care ratios in law in the leadup to the federal election.
The ANMF’s campaign – Ratios for Aged Care – Make Them Law Now – moves onto its next phase where it will continue building alliances with politicians, key stakeholders and supporters through on the ground lobbying.
Backers of the ANMF’s push for mandatory minimum staffing ratios in aged care include Federal Senator Derryn Hinch, who introduced a Private Member’s Bill seeking to amend the Aged Care Act and mandate aged care ratios, the Australian Medical Association (AMA), who is calling for regulated nurse-to-resident ratios in aged care and a registered nurse on duty around the clock, and numerous pledges of support from politicians such as Wentworth MP Dr Kerryn Phelps and Longman MP Susan Lamb.
Last month, a report tabled by The Standing Committee on Health, Aged Care and Sport investigating Australian residential aged care facilities recommended Parliament pass the Aged Care Amendment (Staffing Ratio Disclosure) Bill 2018 introduced by Mayo MP Rebekha Sharkie that would force aged care providers to publicly disclose their staffing ratios.
The committee also recommended the government legislate to ensure that residential aged care facilities provide a minimum of one registered nurse on site at all times, and that it specifically monitor and report on the correlation between standards of care, including complaints and findings of elder abuse, and staffing mixes to help shape future decisions in relation to staffing requirements.
“New evidence is emerging by the day demonstrating the link between an appropriate level of staffing and the delivery of quality aged care,” Ms Butler says.
“This report marks another step in the right direction and adds momentum to our campaign as we move forward and intensify our action.”
Building on growing evidence reinforcing why minimum staffing ratios in aged care are vital, the ANMF commissioned Flinders University to undertake an independent economic analysis of its 2016 National Aged Care Staffing and Skills Mix Project Report.
Findings showed the benefits of implementing minimum staffing hours outweigh the costs and warn there would be significant costs in not implementing the report’s recommendations.
Further, the ANMF has developed a plan to implement an ideal staffing and skills mix it believes can ensure proper care of Australia’s elderly residents and have a positive impact on overworked aged care staff.
“The only way we can ensure elderly Australians have access to safe and quality care is to legislate minimum staffing ratios in aged care immediately,” Ms Butler says.
“They do not deserve the chronic understaffing currently plaguing the sector. The Royal Commission into aged care is an important step but it cannot mean a delay in urgently needed reforms and another 18 months of pain and suffering for the elderly.”
Ms Butler maintains the ANMF will work cooperatively with the Royal Commission as it unfolds to provide accurate and important information relevant to the investigation.
The ANMF has informed its members about their rights during the aged care Royal Commission and called on them to contact the union for further advice at any stage.
The union has also penned an open letter to Prime Minister Scott Morrison detailing why older Australians are entitled to safe and quality care delivered by a dedicated and qualified workforce.
“We know fixing the crisis in aged care will take time and requires significant investment,” Ms Butler said.
“But our plan for minimum staffing ratios in aged care is achievable and gives Australia the opportunity to lead the way globally in the delivery of aged care just as it does with healthcare.”
CHANGE THE RULES
In 2019, the ANMF will continue to stand in solidarity with the Australian Council of Trade Unions’ (ACTU) national Change the Rules campaign aiming to restore workers’ rights and ensure people receive pay rises that keep up with the cost of living.
Launched in 2017, key objectives of the campaign include increasing Australia’s minimum wage, protecting penalty rates and driving a number of amendments to the Fair Work Act in a bid to shift power back to working people.
Last October, ANMF members were among hundreds of thousands of protestors who took to the streets in a show of support during nationwide rallies held across capital cities and selected regional towns.
“We know that the cost of living is spiralling out of control yet wages are just not keeping up. ‘Trickle down’ economics does not work and inequality is at a 70 year high,” Ms Butler points out.
Change the Rules is broadly seeking to fix widespread inequality, a broken tax system that rewards big business, the underpayment of workers, weak industrial rights, increasingly insecure work arrangements and restrictive rules surrounding enterprise bargaining.
The movement’s significance to nursing and midwifery is widespread and felt across a variety of workplace settings.
Areas of focus for the ANMF include calling on the incoming Australian government to support policies that give nurses, midwives and carers on casual contracts greater control over their employment and the option of moving to permanent employment.
Due to a growing ‘gig economy’ typified by organisations temporarily employing independent or freelance workers infiltrating health and aged care, the ANMF is also seeking support for policies that give this group equal protection, rights, entitlements and a minimum living wage.
Similarly, responding to agency nurses working under labour hire arrangements who face potentially poorer job security, working conditions and entitlements than those in permanent positions, the
ANMF is calling for a national labour hire system that would guarantee companies do not cut wages or impose poorer working conditions.
The ANMF will also draw attention to the need for the next Australian government to stop employers from unreasonably terminating enterprise agreements, support equal pay and rights for women workers, increase access to vocational education and training in aged care, and safeguard equal rights, entitlements and pay for staff working under temporary visas in the health system.
The ANMF is also supporting greater recognition for nurses and carers working in the aged care sector that experience a vast wage disparity of between five and 17% less when compared to their counterparts in the acute sector.
To this end, the union is asking for pay to include a minimum living wage that improves over time, that penalty rates are protected, and that workers have access to a fair bargaining system.
“Care provided in aged care and hospitals is frequently comparable and should merit equal pay,” Ms Butler argues.
“Installing pay levels that respect and value the work being carried out will help improve recruitment and retention across Australia’s aged care sector.
“The ANMF encourages all nurses, midwives and carers to band together with other unions to change the rules and achieve better pay and conditions for everyday working Australians.”
The growing negative health impacts of climate change presents a defining challenge of our time and the ANMF believes everyone has a role to play in tackling the global issue.
Australia and the South Pacific region are both vulnerable to the effects of climate change, which range from adverse impacts to physical and mental health due to air pollution and illness and injury or death triggered by more frequent natural disasters.
One of the ANMF’s longstanding climate change interventions has involved helping its neighbours in the South Pacific region tackle and respond to the issue.
While the South Pacific region emits well below 1% of total global greenhouse gases responsible for climate change, its island nations remain among the most exposed globally to its negative impacts.
“Hundreds and thousands of people around the world are already dying directly from the effects of climate change,” Ms Butler says.
“Unfortunately, many of those experiencing the worst of the effects of climate change, such as the South Pacific region, have not caused it.”
In high-risk regions like the South Pacific, climate change now poses a real threat to the survival of future generations and is likely to cause ripple effects on economic and social development, Ms Butler adds.
“In addition to the physical effects of climate change in the Pacific – that is, villages disappearing under water, there are mental and psychological effects on culture that need to be taken into consideration as well.
“The ANMF is committed to working collaboratively with nurses from these nations to address the problem.” From an overall picture, the ANMF will continue actively tackling climate change at a national level.
The union believes governments have unduly focused their attention on the impacts of climate change on the economy and industry and failed to acknowledge what it means for the health and wellbeing of the population.
It argues the energy, mining, agriculture and transport sectors should form a key target for policy interventions because they produce the greatest amount of emissions in the country.
In 2019, the ANMF is calling on the incoming Australian government to commit to some of the following:
- Developing a standalone policy on climate change that includes a key focus on health and wellbeing.
- Reducing greenhouse gas emissions that exceed the current 2030 Paris carbon emissions target of 26-28%.
- Implementing a fair and effective carbon tax during stages that does not adversely affect Australian households.
- Developing an energy policy to transition from fossil fuels to at least 50% renewable, zero-emission sources by 2030.
- Increased government funding for climate-resilient health systems and climate change research.
The ANMF has long recognised the importance of developing an international network of affiliations to advance the interests of the professions and safeguard the health of communities worldwide.
In 2019, one of the ANMF’s key partnerships involves getting behind landmark threeyear global campaign Nursing Now.
Launched in February last year, Nursing Now is aiming to improve health and raise the profile and status of nursing worldwide.
“The campaign aims to highlight the contribution nurses make to improving health outcomes so the profession can be empowered to work to its full scope and help push for universal health coverage,” Ms Butler says.
Nursing Now evolved from a global nursing review undertaken by the UK’s All Party Parliamentary Group on Global Health that produced a report in 2016 titled Triple Impact, which argued strengthening nursing would trigger a threefold effect – improving health, promoting gender equality and supporting economic development.
The campaign includes backing from the International Council of Nurses (ICN) and the World Health Organization (WHO).
According to WHO, nurses represent nearly one-half of the total number of health workers worldwide and an additional nine million nurses would be required by 2030 for all countries to reach the Sustainable Development Goal 3 to ensure health and wellbeing at all ages.
Nursing Now encourages health leaders to invest in nursing and introduce new models of care that maximise nurses’ contributions to achieving universal health coverage, which would guarantee everyone the right to quality healthcare without financial hardship.
Since the campaign’s launch, the ANMF has been actively working together with key national nursing organisations to formulate Australia’s contribution. The strategy is likely to focus on encouraging nurses to promote the contribution of nursing and midwifery to health, and enhancing access and equity to healthcare for all Australians.
“We have a wonderful universal health insurance scheme in Australia, the problem is unequal access,” Ms Butler says.
“If you are an Indigenous person, live in rural or remote Australia, are disabled, have a mental illness or are below the poverty line, you can expect much worse health outcomes.
“We need to see the expansion of nurse-led models of care that are innovative, increase access and lead to better health outcomes for communities.”