Plenty of beds, but where are the nurses?

Extra hospital and nursing home beds alone won't improve health care, according to the nursing profession.

More beds without more nurses makes no sense and will do nothing to improve the health of the aging population.

But it could make a bad situation worse, said nurses in response to the federal government’s proposal to fund extra hospital and nursing home beds as part of its agreement with the states to hand over part of their GST.

As part of it’s health reform plans, the government will provide $300 million in zero interest loans for aged care providers to build 2500 new beds. The states will be handed $280 million for up to 2000 hospital places for elderly people who should be in nursing homes but can’t find places.

At no stage of the health reform proposal has it been indicated how nursing care for patients in these extra beds will be provided, said Tracey Osmond, College of Nursing chief executive.

“Problems we are facing in the health system as a whole, not just in hospitals, can’t be solved simply by proving more beds or places,” Osmond said.

“I have seen many beautiful new wings opened that don’t see the light of day because there is not enough staff. Beds can’t be delivered in isolation – without extra nurses, who is going to care for the patients in these beds?”

More zero-interest loans to fund not ‘new’, bed licenses will not fix the problem, said Dr John Ballard, Mercy Health CEO.

“Aged care struggles with a Commonwealth pricing system that does not reflect the real cost of operations or capital required to provide and staff settings of care. Nor has the government responded to the multiple studies forecasting a critical shortage in skilled workforce,” Ballard said.

“Australia’s frail aged deserves more than to be treated as bargaining chips in a health reform negotiation that increasingly appears to be more about politics than it is about people or health outcomes.”

Funding has been allocated for increased GP visits to aged care facilities, but this will only provide a fraction of care needed which is largely carried out by nurses, Osmond said.

“Even if GPs start visiting facilities more often, residents need ongoing management of care. And this is provided by nurses, not doctors,” she said.

“It has been said time and time again, but it is crucial to increase funding for experienced enrolled and registered aged care nurses.”

There has been a lot of criticism from health professionals and experts on the government “drip-feeding” information about reform plans. By only releasing components, Osmond said the cracks between the issues were being skipped over.

“These cracks, such as transition of care from acute care to the community of facilities, need to be part of the discussion,” she said.

Reducing hospitals admissions is also central to health reform. According to government figures there are around 670,000 preventable hospital admissions every year.

“The focus on funding hospitals ignores the need for greater funding for community nurses, who are essential to keeping patients at home and out of hospitals. Nurses working in primary care are invisible when it comes to funding,” Osmond said.

“The government and policy makers’ only look at what nurses cost the system, not what they save the system by keeping people out of hospital.”