Not far enough
The Federal Budget won ’ t solve aged care nursing problems .
By Joanne Travaglia
The Federal Government ’ s $ 17.7 billion of funding to the aged care sector is a significant start to improving outcomes for aged Australians , but it does not go far enough to solve the problems in aged care which are deep and cultural . It will require more than just money , but careful planning and a determination by all stakeholders to solve the problems .
The Federal Budget revealed the sector will receive $ 17.7 billion over five years . The Royal Commission into Aged Care Quality and Safety suggested the sector needs an injection of $ 10 billion a year . The implication of this can be seen in some of the targets : for example , the reduction in the home care waiting list which the government has targeted to reduce by 80,000 over the next two years . However , that is not likely given that the Royal Commission found that , as of June 2020 , almost 103,000 older people were waiting for a package .
Other Budget measures include staffing requirements for residential care , where every aged care resident will receive three hours and 20 minutes of care a day . Of that , at least 40 minutes will need to be spent with a registered nurse . From July next year , at least one registered nurse will need to be on shift at every aged
10 agedcareinsite . com . au care facility , for a minimum of 16 hours a day . But the Royal Commission recommended a nurse be on site 24 hours a day to ensure a better standard of safety and care .
Again , the Government should have gone further and mandated minimum staffing levels in aged care homes right now , and insisted on a registered nurse on-site 24 hours a day in all aged care facilities .
We also need to draw more skilled workers to the sector . The Royal Commission found that there are simply not enough skilled workers , particularly nurses , to care for the nation ’ s aged . The mix of staff who provide aged care is often not matched to the needs of older people . Along with inadequate staffing levels and a lack of skills and training , these are the principal causes of substandard care .
The Budget does not address the need for more nurses to work in aged care . The Royal Commission found that registered nurses comprised 21 per cent of the residential direct care workforce in 2003 , but by 2016 , this had dropped to around 15 per cent . The proportion of enrolled nurses also dropped , to 10 per cent from 13 per cent . The Budget funding will not reverse this trend as it does not create clear enough career pathways for nurses .
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Many registered nurses are simply not happy working in aged care , and no amount of money can fix that .
The Government will provide $ 216.7 million over three years to upskill staff , including making specialist aged care nursing scholarships available . This will also fund a retention bonus of $ 3700 for nurses who work for the same aged care provider for 12 months . But with so many nurses having left the sector in search of more rewarding workplaces , this will not lure them back .
It is still not clear where the extra staff will come from , particularly as COVID-19 continues to disrupt the flow of people into Australia . It is also not clear if the $ 3,700 one-off payment for nurses staying in aged care for at least a year will actually help keep them in the sector – especially as the sector as a whole is not just underpaid but undervalued as well . Many registered nurses are simply not happy working in aged care and no amount of money can fix that .
We need not just more workers , but better trained workers and better managed and governed ( including scrutinised ) services . The Budget does not do enough to address this urgent need for skills upgrading and training and the auditing of aged care services .
Dementia , including Alzheimer ’ s disease , overtook lung cancer as the second leading cause of death for men and was the leading cause for women in 2019 , according to the ABS . The
Royal Commission found that nurses and general practitioners do not have a full understanding of the needs of people living with dementia . It is therefore of crucial importance to train workers to better care for those with dementia .
The Australian Government , the aged care sector and unions must work together to professionalise the personal care workforce . This will require cultural change and improvements to developing career pathways for nurses , training and improving labour conditions for nurses – and even more funding . ■
Professor Joanne Travaglia is Professor of the Master of Health Services Management , director of the Centre for Health Services Management , and discipline lead ( Health Services Management ) in the Faculty of Health , UTS .