2022 Platform: Aged Care

Please note that this is the ‘Aged Care’ platform we took to the 2022 Election. Please refer to our current platform for our plans for the upcoming election.

The Royal Commission into Aged Care has found significant fault in the aged care system as a whole and uncovered neglect, abuse, indifference, and poor leadership. It says one-third of aged care residents received substandard care .

While money alone does not solve these problems, current expenditure on aged care is about half that of the average spent by OECD countries with Denmark and Sweden’s expenditure at 4% of GDP, funded by a universal tax base.

The inescapable challenge is that Australia spends less than half of what comparable countries do on aged care, at 1.2% of GDP versus an OECD average of 2.5%.

More staff, more training, higher wages, and better oversight are needed for this. The Royal Commission concluded that an extra $10 billion a year would be required.

The Federal Government responded to the Royal Commission’s final report on the day the 2021-22 budget was handed down. See here for our take on the budget for aged care.

Aged care can also be substantially improved by:

HomeCare

There are ~ 120,000 people currently on waitlists for home-based care. This is a disgraceful lack of services. It also results in people being forced into residential care prematurely and is arguably a significant factor in Australia’s disproportionately high ratio of people in residential care.

There is a current shortage of home care support staff and monitoring and oversight of home care has been found wanting. After years of neglect, addressing this shortcoming should be a high priority for Government.

Low wages and Covid

Personal care workers make up 70% of the aged care workforce and are paid barely above the minimum wage. 29% of the personal care workforce have no formal qualifications. Nurses are paid less than their counterparts in other health sectors.

Due in large part to low wages, the aged care sector relies heavily on migrants and international students on temporary and bridging visas . The Covid disruption made their migration status precarious and led to a ban on working at more than one home and shortages of staff in residential aged care.

Staff and residents in aged care were disproportionately affected. 682 residents died in aged care, 75% of all Covid-related deaths in Australia . More than 2,000 staff were infected. Lack of infection control, PPE, and training in its use were key factors and experts agreed the pandemic exposed systemic weaknesses.

Navigating the system

A Victorian Parliament research paper on residential aged care in Victoria, in response to an interim report of the Commission, said the system was difficult to navigate and confronting for older citizens, there was a lack of accessible public information about how to choose a home or identify those that are substandard, there is a lack of transparency and the workforce is under pressure where intense, task-driven regimes govern the lives of both those receiving care and those delivering it. There is severe difficulty recruiting and retaining staff, poor pay conditions, stymied innovation, patchy education and training, no defined career path for staff, and deficient leadership.

Diversity

Over 30,000 Australians were born in non-English-speaking countries, one in eight residents in aged care has a preferred language other than English and these numbers are set to increase. Little is known about how well their needs are met in aged care.

Profit and loss

The residential aged care sector is dominated by private not-for-profit providers – mostly church-related – followed by a growing number of large private for-profit companies and a small number run by state governments. 60% of providers now report operating in deficit and the Commission found a steady decline in reported profits from 2017 to 2019 . That said, profits were substantially higher in the for-profit sector. This could be due to the generally larger scale of residential aged care developments, however, critics say deregulation and encouragement of private sector investment have led to ‘dumbed down care’ . State government operations are significant loss-makers with higher staff numbers.