How have Labor’s aged care promises been tracking

The aged care sector has been subject to "ambitious" reforms some of which have been achieved, while others have stalled along the way or are in progress.

Following waves of the Covid-19 outbreaks and a confronting royal commission, the aged care sector was a major focus during the 2022 election campaigns.

The final Aged Care Royal Commission report found "unacceptably high levels of substandard care" across the system, with residential facilities failing to deliver adequate routine care.

"Too often there are not enough staff members, particularly nurses in home and residential aged care."

Taking data from RMIT ABC Fact Check, Aged Care Insite decided to see how the Albanese government policy commitments for the aged care sector panned out since Labor's election last year.

At the year-end, two promises have been delivered, four are in progress, and one has been broken.

Achieved

PBS co-payment
Four months into the Labor Party's term, legislation for lowering the PBS general co-payment to $30 per script was introduced.

At the time of the election in May, the maximum co-payment was $42.50.

The legislation was passed and enacted on 1 January 2023, lowering the cost by $12.50.

24/7 registered nurses
Labor promised to improve standards by introducing a new requirement for residential facilities to have a minimum of one registered nurse working on site 24 hours a day, seven days a week.

"This will save thousands of stressful, expensive and ultimately unnecessary trips to hospital Emergency Departments, for issues a nurse could solve on the spot," the policy stated.

The registered nurse mandate was a recommendation from the Royal Commission; however, the report also noted that there should be certain circumstances in which exemptions could be made.

Labor Leader Anthony Albanese issued a statement clarifying Labor's policy to reiterate that aged care providers would be able to be flexible enough to ensure they were "not unfairly penalised where workforce supply issues limit their ability to meet the standard".

The bill was introduced to parliament two months after Labor's election and was passed in October of that year, with the 24/7 mandate starting from 1 July 2023.

Workforce shortages were a huge issue for facilities, and with the mandate enacted in July, pressure was added to much of the sector.

A month after the requirement, multiple aged care facilities were forced to close due to workforce shortages.

Aged Care Minister Anika Wells reported in October that registered nurses were on site 98 per cent of the time, up from 81 per cent in March.

However, another report found that 71 per cent of aged carers struggled to meet 24/7 care.

Deputy chief of Whiddon Alyson Jarrett told Aged Care Insite staffing was especially difficult for Whiddon's rural and regional facilities.

Ms Jarrett said 95 per cent of Whiddon facilities met the 24/7 registered nurse mandate, with two being exempt due to their size. However, recruitment in rural and regional locations posed a challenge.

"In the last 12 months, the average time to recruit a registered nurse was more than six weeks, and this average is much longer in our regional locations," she said.

In progress

Investigative powers
Following the Royal Commission, Labor went into the election with a policy that would give aged care regulators "stronger investigative powers".

"Give stronger investigative powers to the Aged Care Quality and Safety Commission, including powers to enter and remain in an aged care facility at any time to ensure the safety of residents, as well as full access to documents and records," a joint media release promised.

Before the election, the Aged Care Quality and Safety Commission (ACQSC) had some powers to investigate, which were set out in legislation, such as entering a premises under a warrant or with consent from the provider.

As outlined in the final Royal Commission report, this was a problem as "it did not have the power to enter premises without the consent of the provider".

The final report added that unannounced visits were important in assessing the care providers gave, as occupiers of the premises could "simply refuse consent to entry of the premises and any person to whom questions are directed can simply refuse to answer".

In June of this year, Minister Wells released a road map for reform, which included a plan to replace the current Aged Care Act with a more "statement of rights" centred act in 2024.

In July, the federal government released a review of aged-care regulators made by senior public servant David Tune.

The review found that the existing aged-care legislative framework was not "fit for purpose and is too complicated and rules bound".

The promise is in progress as the government has not delivered stronger powers for regulators, allowing them to enter and remain on premises at any time and gain full access to their documents and records.

Meeting the minutes
Minimum minutes of care for residents were also a problem, and recommendations for a minimum standard were made in the report.

The former Coalition committed to an initial standard of 200 minutes of care per resident, including 40 minutes with a registered nurse, which would commence in October 2023.

Labor went to the election promising to mandate "every Australian living in aged care receives an average of 215 minutes of care per day, including 44 minutes with a registered nurse" by 1 October 2024.

Ms Wells made care minutes mandatory in September 2023, where providers had to ensure the daily average amount of direct care provided by direct care staff members corresponded with the table.

With workforce shortages and the 24/7 mandate, care minutes put more pressure on providers, with chief of Whiddon Aged Care Chris Mamarelis stating 200 minutes was not the magic number to improve care.

"I think we need more, and I think it's one piece of the puzzle; there's many reform items we're waiting to come to fruition," Mr Mamarelis told Aged Care Insite.

Increased pay
Before the election, aged care workers were calling for pay rates to be increased for three awards.

Labor pledged to support the case to lift industry rates and, if successful, to fund the outcome of the case.

In July, 250,000 aged care workers received a 15 per cent wage increase after the government allocated $11.3bn to fund the pay rise.

The promise will be achieved if the government factors into its aged care subsidies the full cost of any wage increases mandated by the Fair Work Commission and provides funding from when any increases take effect.

Financial transparency
During their election, Labour had also promised greater financial transparency from residential aged care providers.

In a media release following his 2022 budget reply speech, Mr Albanese pledged providers would be required to publicly report their expenditures for "full transparency for Australian taxpayers and aged care recipients".

Ms Wells introduced a new quarterly reporting for providers in August 2022, where providers would be required to report whatever information was requested in an "approved form" by the secretary.

These reports, however, are indicative as a broad summary of the provider's financial position, income, equity, cash flow, and accounting policies instead of a breakdown.

Fact Check said they would consider this promise delivered once the department publishes information about a provider's expenditure online before January 2024, as stated by a Health and Aged Care Department spokesperson.

Food and nutrition
Improving food and nutrition standards was another recommendation from the Royal Commission following the report.

The Commission found that approximately 68 per cent of residents in Australia's aged-care facilities were susceptible to malnutrition or were already experiencing malnutrition.

Some aged care facilities spent less than $6 daily on food per resident.

In April 2022, Labor promised to "work with the aged care sector and other stakeholders to develop and implement standards for aged care homes to ensure every resident receives sufficient, tasty, nutritious and safe food which respects cultural, religious and dietary requirements".

"Labor will also implement mandatory reporting rules to make sure the Basic Daily Fee paid to providers is used for care and nutrition."

In August of this year, the federal government teamed up with Maggie Beer to unveil a free program called Improving Food in Aged Care through Education and Training.

The promise will be delivered if Labor implements mandatory nutrition standards for aged care providers.

Stalled but got there

Urgent Care Clinics
In an early campaign speech to nurses, Albanese promised to "roll out 50 GP-led enhanced Medicare Urgent Care Clinics (UCC)" to help take pressure off hospital ED.

Medical services would include "important and time-critical treatments that don't need a hospital ED", such as treating burns, wounds and broken bones.

The Australian Institute of Health and Welfare found that among Australians aged 65 and over, fractures were the most common hospitalised fall injury at 50 per cent, followed by open wounds at 14 per cent.

"No appointment will be needed," the policy stated.

"All patients will need is their Medicare Card.

"Medicare UCC will be open during extended business hours – at least 8am to 10pm – seven days a week."

In an interview with ABC in April 2022, the then Shadow Health Minister Mark Butler said an Albanese Government would have "all 50" clinics "up and running" in 2023.

"We want to see them up and running in the next financial year commencing 1 July 2023."

Five months after winning the election, funding of $235m over four years was allocated from the first budget.

Three days later, the first UCC was opened in Cessnock, NSW.

The promise was stalled in March of this year when a statement by the Department of Health to Fact Check provided a list of 40 planned UCC locations across Australia.

"Some Medicare UCCs will be open by July this year [2023], with all 50 to be established this year," the statement read.

Fact Check labelled the promise as 'stalled' because only "some" clinics will be up and running by 1 July.

A statement by the Minister of Health said, "all 58 would be open by the end of 2023".

As of the end of 2023, 51 UCCs have been opened, surpassing the original promise of 50.

Do you have an idea for a story?
Email [email protected]