Aged care CEOs and other stakeholders welcome the aged care funding in the budget but raise concerns over wages and the availability of staff to meet new care requirements.
A consultant calls the government’s deferral to the Fair Work Commission for responsibility over wage increases a joke while an academic says there are insufficient nurses to meet the new standard because government policy has depleted the industry.
This week’s Federal Budget includes almost $18 billion in additional funding for the aged care sector with big ticket items including almost $4 billion to mandate a minimum 200 care minutes including 40 minutes with a registered nurse daily for aged care residents from October 2023 and $6 billion for 80,000 more home care packages.
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There’s also $136 million to provide $3,700 and $2,700 incentive payments over two years for full-time and part-time registered nurses respectively who work for the same aged care provider for 12 months.
There’s additional money available for nurses working in rural and remote areas, holding post-graduate qualifications and taking on additional training responsibilities but no financial support for personal care workers.
Marcus Riley, executive chairman of aged care and retirement living provider BallyCara, said the aged care budget provided more than he was expecting.
“The Federal Budget certainly contained some positive steps from the Government and fair to say exceeded expectations in terms of the commitments made, noting though that expectations were understandably low,” Mr Riley told Australian Ageing Agenda.
However, he said key questions remained over important issues such as long-term funding certainty and guaranteed access for people needing services and system-wide quality.
“The main gaps from the budget announcements include addressing wage rates, which is fundamental to ensuring a sustainable aged care workforce, and a demonstrated commitment to fostering a wellbeing approach inclusive of preventative and restorative initiatives for people using services,” Mr Riley said.
More needed to attract nurses
The CEO of fellow aged care provider Benetas, Sandra Hills called the Federal Budget a significant milestone for the aged care sector but also raised the issue of wages as well as availability of workers.
“Additional funding will still be required however to attract nurses to work in the sector. A key response going forward will be to increase salaries commensurate with the public sector,” Ms Hills told AAA.
“With the much needed commitment to an additional 80,000 Home Care packages we are mindful of the need to have skilled and available staff to support these clients. We do not want to be in a position where we are unable to provide the services required or meet their needs,” Ms Hills said.
HammondCare CEO Mike Baird also welcomed the funding boost and measures in the budget as “a step in the right direction” but noted the need to lift wages.
“These new budget measures, together with a commitment to increase wages if recommended by the Fair Work Commission, would provide a pathway of hope for improved aged care quality,” Mr Baird said in a statement.
No committment to lift wages
The royal commission recommended the Australian Government collaborate with unions and employers to apply for increases in three awards for aged care workers and nurses.
In its response to the recommendations, the government said it noted the matter was being considered by the Fair Work Commission (FWC) and offered to provide information but nothing more.
“The Health Services Union has made claims to the FWC for increased wages for aged care workers covered by the Aged Care Award 2010. Decisions made by the FWC are independent of Government. The Government will provide information and data to the FWC as required,” the government said.
Aged care consultant Mark Sheldon-Stemm said the Government’s response here was “a joke” and lack of funding in the budget for wage increases showed the government was not committed to lifting wages if the FWC says no.
And the FWC will reject the application, said Mr Sheldon-Stemm, principal at Research Analytics.
“Because as soon as you give one part of the community an increase in salaries, then the others go and put up their hand and say, ‘what about us? Our jobs just as important,’” Mr Sheldon-Stemm told AAA.
Trying to entice people to enter the sector with no changes in pay rates or conditions is aslo a joke, he said.
Not enough nurses to meet standard
Mr Sheldon-Stemm said the government’s budget initiative to mandate care minutes with registered nurses would be hard to achieve due to a lack of qualified people.
The budget’s $3.9 billion commitment to fund and mandate a minimum of 200 minutes of care to all aged care and respite residents each day from October 2023 includes 40 minutes with a registered nurse.
“You need $6.4 billion because you’re doubling the number of nurses and then the best of luck in getting those nurses because it is impossible to get an RN.”
He said most facilities would have the 200 care minutes covered as standard but they would not have access to enough registered nurses.
A 64-bed facility would need to provide 42 hours of care with a registered nurse per day, which is effectively six or seven registered nurses on, Mr Sheldon-Stemm said.
“That is just a nonsense and then rural areas and regional areas it just won’t happen,” he said. “It is actually physically impossible to meet that requirement unless you bring 50,000 nurses out from [overseas].”
Govt policy depleted aged care nursing
Associate Professor Maree Bernoth in the Charles Sturt School of Nursing, Midwifery and Indigenous Health agrees there are not enough registered nurses to meet the proposed care minutes.
“It’s not possible because the workforce has been allowed to be depleted over time. In the late 90s when I worked as a clinician, there were a plethora of registered nurses.
“But government policy has depleted the industry. It’s going to take a while then to build that back up and to attract registered nurses,” Dr Bernoth told AAA.
“We need to address those issues around wages because we’re in competition with all the other industries and especially with nurses,” Associate Professor Bernoth said.
Like Ms Hills, she said aged care nurses need pay parity with the acute sector in addition to the incentive payments. There also needs to be more specific incentives to bring registered nurses out to rural and remote areas, Dr Bernoth said.
The other important thing is registered nurses working in aged care also have to work to their scope of practice, she said.
“And organisations need to put in place policies and procedures to allow that to happen so that registered nurses aren’t seen as a nuisance that they have to have and someone they stick out in the back room doing the funding tool or the documentation for the standards monitoring.”
Some facilities might already be meeting the proposed care standard but others won’t be and many will be “hard pressed to do it,” Dr Bernoth said.
“It’s going to take time. It is like turning around the Titanic,” she said. “We’re going to have get there.”