Fix funding, workforce issues first

CONGRATULATIONS on your respective appointments.

You have a big job ahead of you, not to mention some major expectations to meet.

I know you are both well-informed about the aged care system but, as the rubber hits the road, I want to pass on some of the sentiments I’m hearing out there on the ground.

• Labor, in election mode, made ‘aged care’ an election platform.

It is therefore disappointing there is no dedicated portfolio for aged care in cabinet and that aged care was not identified as a priority for the first 100 days of government.

Ministers, most do not doubt your commitment to fixing the broken system, but the reality is that this will only happen if the portfolio is prioritised.

• The aged care workforce was in a desperate situation before COVID and is in a full-blown crisis now.

Committee for Economic Development of Australia estimates we will need 17,000 new, direct aged care workers each year to meet the basic standard of care for our elderly.

You’ve said you will bring in foreign workers to bolster the sector and that Labor is making a submission to the Fair Work Commission in support of the case for raising wages (25 per cent).

These are good steps, but they won’t fix the problem on their own.

In terms of workforce issues, we need a coordinated approach at state and federal levels that interfaces with the health, community, childcare and disability sectors.

• Ministers, the writing is on the wall for the viability of the aged care sector.

Australia’s Aged Care Sector: Mid-Year Report (2021-22) by UTS Ageing Research Collaborative found that more than 60 per cent of residential aged care homes are operating at a loss.

This is a taxpayer-funded sector and we need full accountability and transparency from providers about where the money goes.

However, there is no chance we can address all the failings identified by the Aged Care Royal Commission on the back of a system that is not adequately funded.

In the short term, additional funding is required for current gaps in staffing, COVID prevention costs, the upcoming requirements for 200 mandatory minutes of care and 24/7 nursing, as well as needs[1]based allied health.

In the medium to long term? Frankly, we need to start talking about co-contributions by users, relaxation of controls around fees, incentivisation and sustainability of capital investment and, yes, even a levy.

• Soon, residential aged care providers will be required to provide a minimum of 200 care minutes per resident per day (average).

That is a big jump from the average 178 care minutes currently provided and one that won’t be made while there are workforce shortages and funding deficits.

It is deeply unfair that providers will be forced to front up to the regulator on matters they can’t control.

No-one is suggesting these measures shouldn’t be introduced, but let’s not set up the providers to fail at the first hurdle. In short, can we sort out workforce and funding issues first?

• The lessons being learned in the National Disability Insurance Scheme must be heeded in the development of the NDIS-style Support at Home program for aged care.

There are grave concerns about the use of ‘independent assessments’, inadequate assessment tools, and the chilling impact that individualised funding has on consumer advocacy.

There is much to love about individualised funding, but we should not lose sight of the fact that it has a shadow side, and we should absolutely leverage the lessons from the NDIS.

• We must stop looking at aged care services as a black hole in the budget and acknowledge that the sector has direct and meaningful social and economic impact in the form of jobs, infrastructure investment and productivity.

Every time we release a person from providing unpaid care and allow them back into the workforce, we create economic benefit.

Every time we fund care for a person, we create the jobs required to provide that care.

Every time we build a facility or a head office, we stimulate the local property and construction markets.

Over to you ministers.

Australia is facing one of the most profound changes of our time in the form of a rapidly ageing population.

The question of whether we can thrive in the face of this challenge will, in part, depend on your ability to deliver meaningful and impactful reform to the aged care system.

• Amber Crosthwaite is a commercial lawyer specialising in seniors living, aged care and disability.