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| A dinner of chicken nuggets and chips at an aged care home IMAGE: The Age, 1 March 2022] |
The federal government does not know how much of almost half-a-billion dollars it paid aged care providers to improve nutrition was spent on meals, as families report residents are still being served “disgusting” food.
The $10 basic daily supplement was a key part of the government’s response to the Aged Care Royal Commission final report a year ago. It has so far handed over more than $460 million to about 2700 homes, without an effective system to ensure it is spent on food....The royal commission heard evidence that two-thirds of aged care residents were malnourished and recommended funding earmarked for food be lifted by $10 a day for each resident. [The Age, 1 March 2022]
Even though residential aged care has been increasing privatised for the last twenty-five years - until commercial delivery of residential aged care dominates what is now an industry - the Australian Government remains the primary funder and regulator of the aged care system. Thus it has many avenues to influence the quality of aged care.
The aged care sector has a troubled history and many older people fear being admitted to nursing homes once they become frail or chronically ill. There have been 18 inquiries and reviews of aged care in Australia since 1997.
The most recent investigation, the Royal Commission into Aged Care Quality and Safety was established on 8 October 2018 and The Honourable Tony Pagone QC and Ms Lynelle Briggs AO were appointed Royal Commissioners.
The Commissioners' eight volume Final Report titled “Care, Dignity and Respect” was handed down on 26 February 2021 and made 148 detailed recommendations.
In May 2021 the Morrison Government on paper accepted roughly half the recommendations and, rejected outright or offered up a workaround of the other half.
Thus far it appears that only 16 aspects of those 148 Royal Commission recommendations have been acted upon by federal government and, at least one in a way which might not have been expected by the Commissioners.
One of the recommendations which was not readily agreed to and is yet to be acted on is:
Recommendation 87: Employment status and related labour standards as enforceable standards.
1. By 1 January 2022, the Australian Government should require as an ongoing condition of holding an approval to provide aged care services that
a. approved providers: have policies and procedures that preference the direct employment of workers engaged to provide personal care and nursing services on their behalf
b. where personal care or nursing work is contracted to another entity, that entity has policies and procedures that preference direct employment of workers for work performed under that contract.
2. From 1 January 2022, quality reviews conducted by the Quality Regulator must include assessing compliance with those policies and procedures and record the extent of use of independent contractors.
Almost two months past the Royal Commission deadline to demonstrate an increase in direct employment of those providing personal care and nursing care to aged care facility residents, the Australian Treasurer & Liberal MP for Kooyong Josh Frydenberg announces that Productivity Commission would undertake a study of employment models in aged care, and the effects that policies and procedures to preference the direct employment of aged care workers would have on the sector.
Thus kicking ensuring provision of adequate personal and nursing care for aged care residents, further down the road and past the May 2022 federal general election.
One might suspect from the wording of the directive to the Productivity Commission, that Mr. Frydenberg is less concerned about how nursing home staff are employed and more concerned that corporate owners of nursing homes retain their ability to pay low wages to much of their workforce.
Australian Productivity Commission, retrieved 1 March 2022:
Terms of reference
I, the Hon Josh Frydenberg MP, Treasurer, pursuant to Parts 2 and 4 of the Productivity Commission Act 1998, hereby request that the Productivity Commission (the Commission) undertake a Study to examine:
employment models in aged care, and the effects that policies and procedures to preference the direct employment of aged care workers would have on the sector.
Background
The Royal Commission into Aged Care Quality and Safety (the Royal Commission) was established on 8 October 2018 and the Final Report: Care, Dignity and Respect was released on 1 March 2021.
The Australian aged care system provides subsidised care and support to older people. It is a large and complex system that includes a range of programs and policies. In response to the Royal Commission there will be significant reform to the aged care system. These reforms will be underpinned by a new Aged Care Act, which is intended to commence from 1 July 2023, subject to parliamentary processes.
The Royal Commission noted a trend in recent years has been the increased use of ‘independent contractors’ in aged care.
The Royal Commission’s Final Report noted numerous submissions over the course of the Royal Commission inquiry had made the claim that quality care was more likely to be delivered by direct employees than by contractors. However, some stakeholders consider these subcontracting models deliver better consumer choice and flexibility, which is also desired by the sector.
Scope of the study
The Commission will undertake a study to examine employment models in aged care, and the effects that policies and procedures to preference the direct employment of aged care workers would have on the sector.
When examining these issues, the Commission should also consider recommendation 87, as well as submissions and evidence provided to, the Royal Commission.
In undertaking this Study, the Commission should:
examine the extent of the aged care personal care and nursing workforce who are not directly employed by aged care providers
taking into account the wide scope of duties within the aged care sector, ranging from low level care such as grocery shopping and gardening through to high level personal and medical care, examine how different employment arrangements might impact on:
- quality of care
- consumer choice
- job creation and availability of workforce
- employment conditions for the workforce
- worker preferences
- flexible and innovative models of care
- accountability of aged care providers for care delivered on their behalf
- costs of providing care
- viability of aged care providers
explore any preconditions in personal care and nursing workforce supply that would be required prior to any potential policies and procedures to preference direct employment
consider whether new policies and procedures would impact other care sectors, such as disability and childcare.
The Commission should support analysis with modelling using quantitative and qualitative data.
Process
The Commission should undertake broad consultation with consumers, the aged care workforce, unions and aged care providers.
The Commission could release a draft report in June 2022, and provide a final report to the Australian Government in September 2022.
The Hon Josh Frydenberg MP
Treasurer
[Received 23 February 2022]
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