‘Unholy set of interests’ to blame for ‘deskilled’ workforce: Royal Commission

The Royal Commission into Aged Care Quality and Safety has sat for 55 days so far, calling 296 witnesses. Of those, 85 per cent have given testimony on issues concerning the aged care workforce, with 113 witnesses providing their perspective on working day-to-day in aged care.
The third Melbourne hearing got underway with a video montage of some of these witness' testimonies:
We need more people on the floor and we want those people to be trainedā¦ā
"I would look after 20ā60 residents ⦠so we canāt give the time and attention that each person deservesā¦ā
"Half the time I would go and visit dad and thereās no one to be seen ā¦ā
"She used the diaper and I said, āmum why didnāt you ring the bell?ā and she said āI did ring the bell, but nobody cameāā
"For the work that we do, the pay doesnāt reflect that, at all.ā
"All the duties that we had to do in the time that was allocated, there wasnāt time and we were discouraged from developing relationshipsā¦ā
Counsel assisting Peter Rozen told those attending that the aged care workforce ā which stands at 366,000 ā has seen a declining number of nurses in the ranks.
āIn 2003, as can be seen, 35.8 per cent of the workforce were nurses. By 2016, this had declined to 24.2 per cent. So, from over a third to under a quarter,ā he said.
This point was backed up by Professor Kathy Eager, director at the Australian Health Services Research Institute. She believes that due to economic pressures the industry has been ādeskilledā.
āI think itās a combination, but I think it has been an unholy set of interests that have come together to have a deskilled workforce,ā she said.
āI think the reduction in health professionals has been largely economic.ā
Eager also told the commission that due to this skills shortage, residents are often moved to hospital emergency departments rather than be cared for at the facility. She also went further on her comments about the economics of the sector, suggesting that the care side of aged care should not be profited from.
āI would make two remarks. The first is that the ACFI is no longer fit for purpose and so maintaining the current funding model but just throw a bit more money at the problem will not solve the problem,ā she said.
āThe second issue is that one of the things that is missing in this sector is a policy on the relationship between cost and price. And by that, I mean if you think about the way residential aged care is funded, thereās an accommodation stream and thereās a hotel stream and thereās a care stream. It would be quite reasonable to argue that government funding for care should actually be invested in care, and that care is not a profit stream.
āIf we had a system that ensured that all care funding was actually invested in care, it would be a very different sector,ā she said.
Chair of the aged care workforce strategy taskforce, John Pollaers, spoke about a number of reasons for workforce issues, including the fragmented nature of the various bodies representing the sector.
āThere are very many peak bodies that lay some claim to representing this sector⦠thereās more peaks in this industry than there is in a small mountain range,ā he said.
āAt the outset ... there was lots of different groups that didnāt have a lot of time for each other, hadnāt taken the time to listen to each otherās opinions and points of view so ā and in many ways locked into a contest between government, industry and the unions, without really involving the community or the residents and the consumers themselves.ā
Pollaers was less than complimentary of the way government chose to engage with the industry ā which he describes as āadolescentā ā telling the commission that he felt the ādepartment or the ministerās officeā would do things to keep the industry fragmented and ādividedā so it was āeasierā to deal with.
Pollaers also told the commission that attraction and retention were key to any workforce strategy going forward, and the responsibility for this task lies with government, the community and the industry as a whole.
āThere has to be a very proactive approach to a social change campaign around ageing in Australia,ā he said.
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