2023 – a year in review: part 2

The year continued as a momentous one of change and major reform for the aged care sector.

Following on from part one in this series, the year continued to deliver the aged care sector plenty of change, along with some good news and more delays.

May

In a pre-budget announcement – and in line with the FWC’s ruling – the federal government confirmed the 15 per cent pay rise for 250,000 aged care workers was to be fully funded, representing an additional $11 billion for the sector over four years.

Describing the cash boost as “history making,” Minister for Health and Aged Care Mark Butler said in a statement: “Our commitment is long overdue recognition of the skilled work our workers deliver day in, day out.”

In an effort to boost staff numbers, the government created a new Aged Care Industry Labour Agreement enabling providers to sponsor direct care workers on skilled visas.

Negotiated directly between unions and employers, the agreement contains added incentives for providers to attract overseas workers to the sector – including an expedited two-year pathway to permanent residency.

The federal budget directed $36 billion into the aged care sector for 2023-24, including the already promised $11 billion to fund the 15 per cent pay rise. The Australian National Aged Care Classification starting price was raised by 17.6 per cent to $243.10 to pay for both the wage hikes and indexation.

Charles Moore

Providers welcomed the budget package.

“Facing an ageing population and workforce shortages, we know that smart and strategic investments are the best way forward to future-proof the industry and ensure quality care remains available to all ageing Australians,” said BaptistCare NSW & ACT CEO Charles Moore.

The government announced that the Support at Home program would be further postponed until 1 July 2025. Initially due to be implemented July this year, the revised program had already been pushed back to 1 July 2024 following provider concerns.

“For us to put the line in the sand and deliver it as is for 1 July 2024 didn’t seem like it was going to satisfy our critical stakeholders,” said Minister for Aged Care Anika Wells. It was also announced that an Aged Care Taskforce would be created to – among other things – inform the final design of the new scheme.

In another announcement, the government advised that a new food support unit would be established. Staffed by specialists, the Food, Nutrition and Dining Advisory Support Unit was created to help lift the quality and nutritiousness of food served in aged care facilities and to enhance the dining experience. The unit, providers were told, would offer education programs – including those run by accredited practicing dietitians.

June

Southern Cross Care Queensland CEO Jason Eldering (far left) with the nine PNG workers

The release of the Quarterly Financial Snapshot – October to December 2022 ­– held a glimmer of hope for the sector. Released by the Department of Health and Aged Care, the report showed that the proportion of aged care providers making a loss had fallen. The number of residential aged care providers operating in the red had reduced during the period from 66 per cent to 54 per cent.

Speaking at the National Press Club of Australia, Minister for Aged Care Anika Wells said the data was evidence that the Albanese Government’s aged care agenda was working. “Our reforms are making a tangible difference to providers,” she said.

A new global consortium formed to advocate for the wider adoption of small household models of residential aged care. Australia’s HammondCare, the United Kingdom’s Belong group and The Green House Project in the United States partnered as founding members of the Household Model International Consortium to promote the benefits for residents living in small-scale congregate settings.

As well as advocacy, the consortium will share research to deepen understanding of the household model of care and how it can be further developed and enhanced.

The first workers from Papua New Guinea drafted to help boost staff numbers in Australian aged care homes arrived in Queensland. Employed by Southern Cross Care Queensland under the Pacific Australia Labour Mobility scheme, the nine women were based in facilities in Chinchilla, Murgon and Taroom.

Jason Eldering

It’s the first time workers from PNG had been placed in Australian aged care facilities under the PALM scheme. SCCQ CEO Jason Eldering said he was delighted to welcome the new intake of workers.

“The arrival of these workers will be enormously beneficial, and they will be warmly welcomed by our residents, families and loved ones, staff and within the communities where they will live.”

The inaugural meeting of the aged care taskforce addressed long-term funding of the aged care sector on 16 June. Chaired by Minister for Aged Care Anika Wells – and attended by industry stakeholders – the taskforce also set out its remit.

Among the items on the agenda: considering mechanisms – such as co-contributions from those who can afford it – to develop a more equitable, sustainable and viable aged care sector.

July

The 1st of July was D-day for the aged care sector as a number of major changes came into play, including the 15 per cent wage increase for workers and around-the-clock nursing in residential care. In tandem with 24/7 RNs came a legal requirement for providers to report on their nursing coverage every month.

Other reforms that came into effect included the establishment of the:

Lori-Anne Sharp
  • Aged Care Volunteers Scheme
  • Food and Nutrition Advisory Support Unit 
  • Office of Inspector General of Aged Care. 

“The rebuilding of the aged care sector is just beginning,” said federal assistant secretary of the Australian Nursing and Midwifery Federation Lori-Anne Sharp.

The independent capability review of the Aged Care Quality and Safety Commission contained 32 recommendations to improve the regulatory body. Among them, a need for the commission to be more collaborative with providers and other stakeholders, and to utilise opportunities for codesign with consumers.

The review’s author David Tune also called for an urgent overhaul of the complaints system so that “the wider community gain trust that matters of concern to older Australians and their families are getting priority attention.”

August

Stage three of the FWC’s aged care work value case commenced in August. However, staff yet to receive a wage increase heard they’d have to wait until next year before they learn whether they too will be included in the deal. While 250,000 workers received a 15 per cent pay rise in July, many others in the industry didn’t – including administration, maintenance, laundry, cleaning, gardening and catering staff.

“The quick determination of final pay rises for all aged care workers that properly and equally reflect the value of the work is critical,” said the Aged Care Workforce Industry Council in a statement. “It is only fair that all workers are rewarded equitably for their efforts, to not do so will continue to  undermine team morale and productivity.”

Government statistics showed that RNs were in aged care homes 98 per cent of the time. As well, 86 per cent of Australia’s 2,600-or so facilities had an RN onsite 24/7.

Annie Butler

Acknowledging “there is much more work to be done,” federal secretary of the  Australian Nursing and Midwifery Federation Annie Butler said:

“The fact that there has been a significant uptake of 24/7 nursing in just the first month shows how we can achieve improved care outcomes for residents when unions, providers and our other stakeholders work together with the government to rollout these crucial reforms.”

Anika Wells, who attended the meeting remotely, said on social media: “The new Aged Care Act will respect and uphold the rights of older people in our aged care system. Today, a group of passionate advocates came together to provide feedback on the proposed foundational elements.”

Peak bodies and advocacy groups met to provide feedback to the aged care minister on the proposed framework of the new Aged Care Act. The redrafted rights-based Act – a recommendation of the royal commission – comes into effect from 1 July 2024.

The Treasury released the latest Intergenerational Report, which warned that Australia’s ageing population will place further pressures on the aged care system and, in turn, government finances.

The number of people 85-plus are projected to triple by 2062-63 to more than 3.5 million people while the number of people 65-plus is expected to more than double in 40 years. “This will exert considerable pressure on aged care spending,” said the report’s authors.

The report also showed life expectancies will rise in Australia with men living to 87 years of age and women to 89.5. As well, the population will swell to more than 40 million by 2062-63.

2023 – a year in review: part 3

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Tags: 24/7 RNs, aged care act, aged care quality and safety commission, aged care taskforce, budget, food and nutrition, FWC, Intergenerational Report, PALM, Quarterly Financial Snapshot, skilled visas, small household model, Support at Home,

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