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FEATURE: Defining the future
Defining the future
Workforce pressures, lessons learned from COVID, and the aged care reform agenda will be among the hot topics centre stage at this year’s ACSA National Summit.
There will be much to discuss at the upcoming Aged and Community Services Australia National Summit. Not least of all – amid the COVID pandemic and the implementation of the reform agenda – what the future holds for Australia’s beleaguered aged care sector.
Titled Aged Care 2.0: Getting it Right, ACSA’s 34th National Summit aims to find solutions to ensure older Australians receive quality care in the years and decades to come, says ACSA chief executive Paul Sadler. “Our starting point of the whole program is to have a look at the five key areas that the Government has identified for the aged care reforms,” Sadler tells Australian Ageing Agenda.
They are home care, residential aged care services and sustainability, residential aged care quality and safety, workforce and governance. ACSA has added a sixth pillar for discussion, says Sadler – retirement living and housing. A major focus of the summit is to analyse how the reform agenda is going. “The intention is for the Department of Health to bring us up to date on some of their key reform initiatives and for us to engage with them about those initiatives,” he says.
From ACSA’s point of view – and the views of other aged care representatives it has surveyed – the reform agenda hasn’t got off to a particularly good start, says Sadler. “There have been questions about how effective the engagement with the sector has been, providers are very dubious about how effective the Government’s reforms have been to date, and there are real questions about whether we’ve got the long-term solutions to maintain the sustainability of the sector,” he says.
Paul Sadler
The misgivings don’t end there. “We don’t feel the workforce initiatives are adequate,” says Sadler. “There’s also real concern among many providers that the types of measures we’re putting in place for quality involve more staff doing more paperwork but not necessarily improving the quality of life of older people.”
ACSA’s National Summit – held at the National Convention Centre in Canberra from 3-5 May – won’t be short of industry experts opining on the best way to proceed with the royal commission’s reforms. Sector leaders, experts, workers, fellow aged care providers and allied professionals will gather in the nation’s capital and online. Speakers include:
• New South Wales Ageing and Disability Commissioner Robert Fitzgerald
• CEO of Aboriginal Community Services Graham Aitken
• Former aged care peak CEO Maureen Lyster
• Professor Joseph Ibrahim of Monash University’s Health, Law and Ageing Research Unit
• Mercy Health chair Virginia Bourke
• HammondCare CEO Mike Baird.
Mike Baird
For Baird, the two main issues facing the sector are underfunding and understaffing, which he describes as “the outcome of two decades of neglect.” But while Baird acknowledges that it is an incredibly challenging time for the sector, he also sees it as one of opportunity. “That’s what I’m most excited about,” Baird tells AAA. The reforms will “not only put the onus on providers to try and give the best possible care but also give customers choice,” he says.
While the reform agenda may be daunting, Sadler also views it as an exciting opportunity for the sector. “If we get it right and we implement some of the vision of the royal commission, we will be able to have an affordable aged care system where older Australians receive the services they need, and we’ll have a workforce that can actually provide that care when and where it’s needed,” says Sadler.
It’s about creating an aged care system that works for everyone, he says. “The royal commission exposed long-term systemic issues. Big changes are required to ensure the system can deliver for older people, their families and the workers who care for them.”
Workers who are largely female. According to the 2020 Aged Care Workforce Census, 86 per cent of the residential aged care workforce is made up of women. And it’s a workforce that is woefully undervalued, says Libby Lyons, chair of the Aged Care Workforce Industry Council and a panellist at the ACSA summit. “We need to absolutely address that issue,” Lyons tells AAA. The caring professions have always been undervalued in the community, she says. “This is something that has been a problem in most developed countries for a long time — those that care are underpaid,” says Lyons.
Libby Lyons
It’s historical, she says. “Women always did the caring. Most of the time it was unpaid.” If there is an upside to the pandemic, says Lyons, it’s that it has emphasised the importance of those who care in our community. “It shone a light on the essential work that they do,” she says. “[Care workers] are the backbone of our community, and without these people who provide the care, our system as we know it, our society as we know it, will fall apart.”
Baird echoes this sentiment. “We need to understand people are doing work that is incredible, that is life-changing and that is purpose-filled,” he says. “Anyone who loses a loved one and sees the impact that a care worker has had, can’t put into words how important and significant that is.” There needs to be a national conversation about the value of the work on offer in aged care, says Baird. “We have to lift them up.”
The issue for Lyons is that caring is perceived as women’s work. “As a community we have to challenge our thinking around that and say, ‘Do all women and men want to be cared for by one gender?’ We need choice. And we’re not going to get choice until we challenge the stereotypes of our professions. We have to encourage young men in particular into thinking about careers in aged care – careers as carers. They are, for the right people, the most rewarding careers that they can have.”
How to attract young people into the aged care sector is one of the many topics covered at the summit. The four-day event consists of forums, panels, plenaries and presentations. Expect much talk of the pandemic and its devastating effect on the industry. “More than 75 per cent of aged care homes in Australia have experienced an outbreak,” says Sadler. Of course, the sector had challenges that predated the pandemic, but with COVID, “those challenges accentuated into a full-on crisis,” he says.
The ACSA summit will provide delegates with a platform upon which to reflect on the lessons learned. “Being prepared for events like COVID is something that will be there for future leaders,” says Baird. “If we embed some of those learnings in future leaders, we’ll create better, stronger leaders in the future.”
The National Summit will hear insights into how the pandemic was managed and the lessons for future COVID outbreaks or similar stresses on the system. “One thing we know already is that the resilience of the system was inadequate,” says Sadler.
Unlike the resilience of staff. For the past two years or more, aged care workers have gone “above and beyond” to deliver quality care, says Sadler. “They have been on the frontline of the response, keeping people as safe as they could in unprecedented times.”
Lyons agrees: “Had it not been for the amazing workforce, many older Australians would have suffered far more than they have already. There is so much negativity thrown at the sector which really distresses me because the workforce over the last two years has been exceptional,” she says. “Day in day out these people are doing an incredible job.”
And for that, says Sadler, they should be getting the pay they deserve. “The royal commission recognised this. It called for higher wages, better qualifications and more time for workers to spend with older people.”
But as Sadler points out, when the Government responded to the royal commission’s recommendations it failed to adequately address workforce pressures. “Workers and the people they care for are paying the price,” he says. “Unfair pay is forcing them to make difficult decisions, with many leaving aged care altogether.”
Fixing the aged care pay gap is the key to solving the staffing crisis, says Sadler. “Nurses and care workers in aged care are paid much less than if they worked in the disability or health sector,” he says. “This is the number one reason that workers give for leaving the sector.”
A call for fair pay will be one of many demands ACSA will be making of politicians in the lead up to this year’s federal election. For the aged care sector, it will be a landmark election, says Sadler. “For the first time in living memory aged care is going to be one of the major items in the election campaign,” he says.
“We foresee this as a great opportunity for the aged care sector to really prosecute the case for better funding, better support for our workforce and for measures that truly improve the quality of life for older people.”
Along with other members of the Australian Aged Care Collaboration, ACSA is asking all parties and independent candidates to join representatives of older people and their carers, providers, unions and health professionals in supporting a National Aged Care Workforce Partnership.
As laid out in an election statement, the workforce partnership rallies around three calls to action. Firstly, there needs to be a workforce supplement for providers to spend immediately on increasing wages, training, minutes of care, 24-hour nursing and COVID prevention costs.
At the moment, prevention costs are unfunded unless there happens to be an outbreak. Sadler says this is akin to closing the barn door once the horse has bolted. “That seems like a pretty crazy way to do business where you wait for something dreadful to happen before you fund the response,” he says.
The second call to action is a minimum wage increase for aged care workers. This involves funding the Fair Work Commission work value case and awarding wage increases from July 2022.
Thirdly, there needs to be a commitment to a multidisciplinary workforce by putting into place an allied health needs assessment and funding model by 2024 “at the latest,” says Sadler. “Government funding is nowhere near what is required to implement the recommendations of the royal commission,” he says.
“With COVID outbreaks and rising costs the funding crisis is spiralling, and a majority of providers are operating at a loss.”
Sadler acknowledges the Government’s $18.3 billion investment in aged care in 2021. But modelling for the royal commission shows this commitment will fall short, “especially after so many years of underfunding,” he says.
“If the Government agrees that quality aged care can only be delivered by a fit-for-purpose workforce, then it must come to the table with the funding to make it happen.” After all, says Sadler, “fixing aged care means fixing aged care funding – this is the only way that providers can invest in quality care for older people.”
Fixing the future of aged care for the future of all Australians will be top of the agenda at the 34th ACSA National Summit, he says.
