Budgetary pressures associated with an ageing population, increasing demand for community services, and a shrinking tax-base are all impacting on the sustainability of healthcare services, writes Rod Cooke.
Take note Australia: an economic warning has been sounded.
Thanks to the National Commission of Audit, the nation is set to have the conversation it ‘needs to have’ about the increased healthcare costs associated with our ageing population and expected level of future healthcare services.
It has directed the spotlight onto our current health system and associated expenditure. And, as planned, the Abbott Government will soon re-examine its healthcare costs, make compromises and hopefully, also make informed choices about how to best to spend the taxpayer dollar to deliver a healthy and equitable Australia.
The first 2014 sitting date of federal parliament is only a few weeks away and there’s no time to waste. We believe Australians need to start talking about the realities of the healthcare system, how it is delivered and who delivers it. And the government needs to ramp up community-wide discussion about what will happen if we don’t act now to examine how the healthcare dollar can be better spent in order to preserve the standard of living to which we have grown accustomed.
According to our federal Treasurer, Joe Hockey, last month’s Mid-Year Economic Financial Outlook (MYEFO) showed that Australia’s living standards will be “at risk if action is not taken now” because our spending outweighs economic growth by 1.5 per cent in real terms.
A Grattan Institute report from April 2013 also estimates that over 40 per cent of Australia’s total budget is spent on direct health and welfare payments. Add to that the national cost of providing aged care, disability care and community services and it’s estimated that the national total will come to 50 per cent of the total annual budget spend.
Budgetary pressures associated with an ageing population, increasing demand for our quality community and health services, and a shrinking tax-base due to demographic imbalances and underemployment are all having an impact on the sustainability of delivering quality healthcare and community services.
Let’s not forget the community services and health workforce is also ageing. By 2030, 65 per cent of all current community services and health workers will have reached retirement age. And by 2050, these workers will become high-need aged care clients. No other industry faces the challenge of having its workforce add to its service demands.
We need to start a national conversation about what is really happening in terms of costs and expenditure; evaluate the risk of doing nothing and keeping the current status quo; look at how we can better spend existing funds and alternative community services and health workforce models; and consider the cost savings if funding was redirected into preventative healthcare.
Re-examining investment flows and workforce models in the future of community services and health industry is not only the right thing for a government to do; it is the only thing it can do to reduce expected budgetary costs associated with welfare, unemployment, aged and healthcare blowouts.
The responsibility of action falls not only on governments. It falls on the community and industry to rethink workforce solutions and consider achievable productivity increases. It is also the responsibility of industry and community to petition governments and to raise awareness of the issues nationwide.
What does action look like?
The Productivity Commission has estimated that a 5 per cent improvement in health service productivity, nationally, could generate close to $3 billion in resources for the Federal Government which could be redirected into client care annually.
CS&HISC believes that Australia needs to develop a new innovative, holistic community services and health workforce model that not only looks at doctors and nurses, but the assistant VET-qualified workforce. That’s because it is the assistant worker who makes up the bulk of the community services and health workforce.
We need to identify how many vocationally educated and trained workers will be needed to implement this model. If as a country we don’t know what the workforce shortages are and the skills required, then we won’t be able to forge ahead.
We need an evidenced-based understanding of what productivity actually means and looks like in a social and healthcare and support context, where caring skills are commonly undervalued and under-priced. And, we need to know how to measure it.
Employers must ensure that workers have or are able to achieve the right qualifications (whether it is a VET or university qualification) and skills for the right job that exists because it is demanded by Australians. There should also be clear VET and higher education pathways for students to progress and encourage productivity in the community services and health sector.
And finally, industry and government needs to band together to run an awareness and recruitment campaign to attract qualified workers to the community services and health assistant sector who will stick around for the long-haul. Too often the focus is on the negatives (low wages, unglamorous surroundings, physically and emotionally taxing work). But what if the focus was on the positive side to this work? What if the upside was showcased? What if the benefits of flexible working hours, opportunity to work close to home, the ability to literally change someone’s life, were reported? Workforce growth could also be achieved by creating opportunities for under-employed and skilled unemployed adults suited to working in the care and support industry.
Seize the moment
It’s time to act. We thank Mr Hockey for his MYEFO comment and agree with him wholeheartedly: our living standards – predominantly the current quality of our health and community services – will be at risk if action is not taken now. We’ve been saying this for a while. It was, in fact, the premise of our key 2013 call to action document Time for Action is Now.
But what needs to be determined and supported by industry, media, government and community is what form action should take. And hopefully, CS&HISC, Mr Hockey, the Federal Government and Opposition will all agree on the desired action’s look and feel.
The cost of inaction will mean you will no longer be able to access aged care accommodation because the waiting list is triple today’s length, child care costs will be unaffordable to all but the elite, and allied healthcare costs will exceed beyond control.
We urge you to make your 2014 commitment one that matters to the nation and to each individual’s future sense of community, family and wellbeing.
Rod Cooke is CEO of the Community Services and Health Industry Skills Council.