Liberals face real test on aged care this budget

Opinion piece on the 2021 Federal Budget published in The Age on 9 May, 2021.

On Tuesday the Liberals will hand down their eighth federal budget. Already we are hearing the usual noises about how they will “fix” aged care. They’ll throw some money at it, based on years of underspending to make it look “big”. Photo ops will follow.

But I’m convinced the Liberals have no idea how to actually fix aged care.

I’m a nurse first, politician second. I spent 20 years nursing and then ran the nurses’ union. I’ve been campaigning for aged care reform for 30 years.

I’ve been saying the same thing the whole time – aged care reform means:

1) Fixing the workforce issues;

2) Making sure taxpayer funds are actually spent on quality care.

Even after the incredible work of the aged care royal commission, it still shocks people when I tell them that in mum or dad’s nursing home, there is NO legislative requirement dictating how many staff are on duty.

Under Howard’s government, the 1997 Aged Care Act removed prescriptive reference to staffing requirements and nursing care in residential aged care facilities and didn’t set any minimum standards.

The following year, the requirement that one registered nurse had to be on duty in a home at all times was removed.

After that, providers could choose how many workers they had on a shift under a concept of “safe staffing”. It became a nefarious issue driven by costs, and often profits, not quality care.

So-called “consumer-driven” choice which was supposed to drive quality through competition only drove the advent of fancy accommodation for those who could afford it, with little attention to the care required to keep our elderly safe and well.

Now, it means that one registered nurse can be responsible for 30 or 40 residents. Carers are literally run off their feet. One worker I spoke to recently said she had to shower, dress, and feed eight residents in three hours. You do the maths. And that is a good level by today’s standards.

Aged care workers are the most dedicated workforce I know but they do not have the time to provide the care they want and need to.

And because the Liberals hate ‘regulation’, I doubt they will rein in the rogue providers who choose to spend their share of the $13 billion per year of taxpayer funds on Maseratis or luxury homes, give it to churches to fund luxury lifestyles or funnel it into offshore tax-free accounts.

Competition without regulation, compliance and accountability led us to one of the greatest tragedies in modern Australian – a royal commission report titled Neglect.

It led to maggots in wounds. To two-thirds of aged care home residents being malnourished or at risk of being malnourished.

It should never, ever have gotten to this point.

While we on both sides agree that the aged care system needs serious investment, when the Liberals announce more money for aged care on Tuesday, ask yourself, will this mean guaranteed minimum staffing levels with the right skill mix of health professionals? Will it mean minimum qualifications and better training for workers?

Will it mean a crackdown on unscrupulous providers who put their financial comfort above the interests of older Australians in their care?

Will it include comprehensive reform with ongoing transparency and a ratings system so all Australians can make informed decisions about where their loved ones go for care?

Labor understands the need for this and Anthony Albanese has committed to real reform in aged care.

So don’t be fooled by flashy announcements of more dollars. Fixing aged care takes so much more than that.

Ged Kearney is federal Member for Cooper.