- by Anna Pha
- The Guardian
- Issue #2057
The Australian Nursing and Midwifery Federation (ANMF) held a rally in 2018 to demand making nursing ratios law. Photo: Matt Hrkac / matthrkac.com.au – flickr.com (CC BY 2.0).
The aged care system is in crisis. Successive governments have seen old people as a “problem” that costs ever-increasing amounts of money. Once someone is past their working life, they are seen as surplus to the requirements of the profit-driven capitalist system and as a burden by governments bent on privatisation and profits-first.
Profits can be made out of aged care services. Big business is rapidly expanding in the area, taking advantage of vulnerable Australians and government subsidies to syphon off millions of dollars of profits. All at the expense of quality care.
So it is that the Albanese Labor government has launched a taskforce to advise it on funding arrangements for aged care. Its aims are clear: to cut costs and make users of the system pay more.
Government reviews and inquiries are notoriously designed to come up with the recommendations that government itself wants. The aim of this review is to justify the cost-cutting and profit raising.
Its terms of reference are couched in the language of the sales pitch:
“The Government has committed to delivering aged care reform that restores dignity to aged care and ensures that older Australians are treated with the respect that they deserve. This includes reforming the in-home aged care system so that it better responds to the changing needs of older people and is simpler to understand and navigate.”
“The Taskforce provides an opportunity for targeted and thorough consideration of system funding arrangements to ensure that they are equitable, embed innovation, and include a future focus that adjusts to the changing pattern of demographics, needs and circumstances of older Australians …”
“Targeted” suggests a tightening of means testing and the possibility of assets testing, including the family home, resulting in higher costs for the aged.
There is also a reference to “a robust safety net that properly recognises financial capacity at different levels of income and/or life circumstances” – spin for the introduction of tighter means and possibly asset testing.
The report says care must be “affordable … with arrangements that balance equity and fairness between older and working-aged Australians.”
In other words, recipients of aged care should pay more for care. It pits one group of Australians against another based on age and work status, a favourite neoliberal strategy.
The May federal budget allocated $36 billion for 2023-24 for aged care with an estimate of just over $40 billion in 2026-27. This includes $11.3 billion over the next four years to cover an interim 15 per cent wage rise for aged care workers. With baby boomers soon to hit their late 70s the Treasurer is setting out to cut future spending on aged care.
This is the same government that finds it affordable to spend $368 billion plus on nuclear submarines, more than a quarter of a trillion dollars on tax cuts for the rich and to hand out billions of dollars in fossil fuel subsidies.
The taskforce is also asked to consider the recommendations of the Royal Commission into Aged Care Quality and Safety. “The Royal Commission made a number of recommendations on funding and contribution approaches for aged care, including means testing and the possibility of a levy, the Commissioners had differing views.”
The possibility of a levy such as the Medicare levy paid on personal (not corporate) taxable incomes appears to be high on the agenda.
Transparency and accountability are not on the agenda. There is no suggestion that the taskforce look into how care providers spend their subsidies and user contributions. Yet there are numerous examples of private providers, including church and non-profits, syphoning off millions at the expense of care quality. (See Guardian, #2021, 29-08-2022, “Profiteering & neglect: the aged care crisis.”)
The taskforce is directed to reach a unanimous position but to offer options for consideration by government.
It is chaired by Aged Care Minister Anika Wells. The deputy chair, Nigel Ray, has served as an executive director of the World Bank and the International Monetary Fund, as well as having had a career at Treasury. Another member of the Taskforce is Rosemary Huxtable, a former Secretary of the Department of Finance under the Coalition.
Other members come from more diverse backgrounds including Indigenous, seniors, ethnic and academic, as well as a trade union representative and former Liberal NSW state Premier Michael Baird.
The Royal Commission estimated that one in three residents in aged care facilities have experienced substandard care. It revealed a litany of issues including the failure to meet personal and clinical care requirements, staffing shortages, undervaluing of staff, casualised and low-waged workforce, substandard food, preventable deaths and injuries, drugging of residents, abuse of residents, lack of accountability and transparency, and poor management.
These critical issues will not be addressed by making users pay more or by a levy. The present system of private providers, outsourcing and complex company structures will continue to result in lack of transparency and accountability as to how funding is spent.
The 15 per cent rise in the award wage for aged care workers is a step in the right direction but will not solve the staffing shortage.
The private sector is incapable of delivering aged care that treats people with dignity and ensures that older Australians are treated with the respect that they deserve or the care that they need.
To achieve these basic human rights, we need, at a minimum:
- Equal pay for work of equal value for staff
- Permanent work become the standard
- Staff-to-resident ratios to reduce workloads and enable quality care
- Funding of registered nurses on every shift
- Improved working conditions negotiated through union industry bargaining
- Appropriate training of all staff.
- Abolition of university and TAFE fees, and adequate income support while training
- Staff, residents and their families to have greater involvement and say in the running of centres
- Regulation for higher standards, including measures to inspect and enforce them
- Full accountability and transparency
- More home care packages
- Construction by governments of more residential aged care centres
- Centralised funding through a progressive tax system.
These necessary and urgent reforms can only be achieved by a nationalised system with universal access, the abolition of deposits and hefty daily or weekly payments, in a system based on care, not a “care economy” for big business.
There is NOT a shortage of money to fund these reforms. It is a question of political will and priorities.
The taskforce is to report by December 2023 with an interim report in October.