Mandate aged care skill mix, says nurses union
The federal government is being called upon to prevent aged care providers replacing enrolled nurses with personal care workers.
The federal government is being called upon to prevent aged care providers replacing enrolled nurses with personal care workers.
In Tasmania, Southern Cross Care is making its ENs redundant and substituting them with extended care workers. Some providers in South Australia are also replacing ENs with a combination of registered nurses and personal care workers, whilst in New South Wales some ENs are reportedly being offered care worker contracts.
In response, the Australian Nursing and Midwifery Federation released a statement accusing “greedy” aged care providers of “gaming the system”.
The ANMF described the move as a “cynical cost-cutting exercise.” This was in spite of the fact that the sector has received a “significant funding increase” in government subsidies, said the ANMF.
“It’s unconscionable that these taxpayer-funded aged care providers are manipulating the government’s reforms to sack frontline ENs, especially given we’re in the midst of a rapidly-escalating Covid wave, and just a month before Christmas,” said ANMF federal secretary Annie Butler.
“ENs were among the healthcare workers lauded as heroes throughout the pandemic, but now they’re being disrespected and discarded by operators trying to boost their bottom line,” she added.
Noting that the royal commission recommended more qualified nurses in aged care, Ms Butler said: “The Albanese Government’s reforms aim to improve care in nursing homes by ensuring an appropriate mix of RNs and ENs and PCWs, but without mandated requirements specifying skill mix percentages, providers are gaming the system to dilute the skill mix.
“Our hard-working ENs are now on a slippery slope and unless the government intervenes and mandates a commitment regarding skill mix percentages or RN, EN, PCW care minutes, we fear there’ll be more sackings across the sector.”
Ultimately, said Ms Butler, it will be aged care residents who will suffer. “The ANMF and our members are urging the prime minister and minsters for health and aged care to intervene before even more nurses are lost from aged care.”
“ENs make a significant contribution to the care of older people.”
The Aged Care Workforce Industry Council also weighed in on the subject of ENs saying they played an “important role” in ensuring older Australians receive access to high-quality care.
“ENs make a significant contribution to the care of older people. It is an important role in its own right, so it’s incumbent on aged care providers to invest in the retention and attraction of enrolled nurses,” ACWIC said in a statement. “Anything less is short-sighted and only serves to hold back the critical reforms needed across the sector.”
The Department of Health & Aged Care released a statement strongly urging Southern Cross Care to “reconsider its decision”.
“Qualified and experienced enrolled nurses are a critical component of the aged care workforce as are those carers who provide direct care to some of the most vulnerable in Australia … It is unacceptable that after the findings and recommendations of the Royal Commission into Aged Care Quality and Safety that a small minority of providers are looking to lower the standard of care available to residents in aged care facilities.”
The statement continued: “The government has tasked the Department of Health and Aged Care to provide a response for government which will prevent this from happening.”
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This infuriates me…”greedy providers”…providers who carry more risk than most other industries and have to get by on 0-7% margin before tax…66% of the sector operating in the red and selling up to get out of the industry. We are retaining EENs in our business as we value them, but the gov’t doesn’t make it easy. A Gov’t who has not delivered “significantly” more money to the industry, they have fallen way short on their predicted “average increase”…typical Union bashing of providers. The Gov’t set the rules on who contributes to care minutes…EENs are treated as only “Care workers”, the providers did not define them this way, the Gov’t did. Keep calling the providers “greedy” and we will never resolve the critical staffing concerns the industry is suffering from. Disgraceful PR from the Union when they should be encouraging more people to the industry!
This is a typical reaction statement from the ANMF. The simple answer is for EN time to be included in the 40 minutes of specialist nursing time under the ANACC thereby recognising the fantastic professional contribution of EN’s, but the ANMF won’t want that because EN’s and Carers are simply cannon fodder for the union that thinks RN’s are the only “real nurses”. I’m so sick of hearing that there is all this new or extra funding. The ACRC stated that successive governments, [including the ALP with Mark Butler as Minister – he made an art form of it], reduced real funding to the industry by $10bn per annum. They have put back $3.4bn per annum with a massive amount of specific staffing requirements, as well as extra reporting and bureaucracy. Come on Annie Butler – “greedy providers”?? Can’t you do better than that old line? The total industry in 2020/21 made a consolidated loss of $850bn – data released by the DH&A which they’ll no doubt not release again. Here’s a novel idea – why not work with the industry to improve all aspects instead of making childish and sensational accusations.
Is the exclusion of EN’s from aged care the result of the ANMF telling the Royal Commission that only RN’s are needed in aged care and they never mentioned or advocated for EN’s with the Commission? If this is the case then this article could only be described as hypocritical. Why are the ANMF now back tracking and telling the government that a Nurse is a Nurse RN or EN ? Both should be included in the 24/7 requirement. That way all Nurses will be valued. The short sighted ANMF have only themselves to blame for this with residents and providers are now left with the consequences. What is that old saying – Those who have the least to lose meddle the most
This is not the fault of the providers. The Government are the ones that are forcing providers to change the Nursing staff by regulating RN’s in residential care. Also look at the Nursing bonus announced by the Government. It only applies to RN’s. EN’s do not meet the criteria for the bonus. Do you think the EN’s feel recognised for their work by the Government if they are not considered Nursing staff and worthy of the “Nursing Bonus”? EN’s do a great job working in the community all day every day. Yet the Government does not even mention them in their reforms.
This outcome can be completely laid at the feet of the Government and the ANMF. EN minutes should have been included in Registered Nurse minutes from the beginning, but they were not because the Government and the ANMF thought that this would then impact RNs because those ‘greedy’ providers would then sack the more expensive RNs and employ the less expensive ENs. The importance and value of ENs in RAC was never in question with Providers, they have been our life blood especially in regional areas. On the other hand the Government and the ANMF showed exactly what they thought about the value of ENs when they (a) equated the value of their caring work with that of a Care Worker, a person who has just completed a Cert 3, disregarding the fact that they are a nurse who is ‘Registered’; and (b) did not quality them to receive the substantial ‘nursing bonus’. The Government and ANMF own this one as they created this mess.
You can blame the government, unions or providers, the real culprit is common sense. Of course Southern Cross and others will look for the cheapest way to up their care minutes (their tricky plan to train GSOs as AINs to increase the tally is just nasty) all because some goose decided that quantity trumps quality. Mandating an obscure system of care minutes was a triumph for those really in charge of aged care…the accountants. No more tricky equations to determine full-time equivalents, now it’s just simple division. It’s only just begun. Let’s see how AN-ACC looks in 12 months: No more 4b claims? Ditch the physios! Blame whoever you like…we’re all just dumb. Once again, aged care is behaving like the embarrassing drunk uncle of the health care family. Every restructure over the past twenty years has either been unscrupulously gamed or just faded away until the next big idea took its place. It’s a tired old act that will keep repeating until aged care is integrated into the health system. (Sorry folks, but cite one instance where outsourcing community service obligations to private enterprise has actually worked well for the entire community)