Everywhere you look, Scott Morrison and his ministers have a women problem. You see it even as he uses the media focus on allegations of sexual assault as cover for his efforts to convey the aged care royal commission’s damning report to the too-hard basket.
When you think about it, aged care is the ultimate women’s issue. Of those receiving aged care, women outnumber men two to one. Who does most of the worrying about how mum or dad are being treated – and probably most of the visiting? More likely to be daughters than sons.
The commission’s report found that the root cause of the common ill-treatment of people in aged care is the insufficient number, inadequate training and low pay of aged care workers. And who are these overworked, undertrained and woefully paid age care workers? Almost all of them are women.
Now do you see why aged care conditions have been low on the priorities of successive governments? Not enough rich white men jumping up and down.
Aged care is huge. Despite understaffing, it has 366,000 paid staff, 68,000 volunteers and 28,000 contractors – about 3 per cent of the whole workforce.
The report found that at least a third of people in residential and at-home care had experienced substandard care. It identified food and malnutrition, dementia care, use of physical and chemical restraints and palliative care as needing urgent improvement.
Aged care used to have prescribed staffing ratios, but they were removed as part of the push to get for-profit providers into the “industry”. The report found that what regulation of facilities exists isn’t enforced because the government knows it’s not paying enough to make quality care possible.
The providers will tell you there’s a shortage of properly qualified personal care workers and nurses. Probably true. But those who are qualified are less attractive because they have to be paid more. Registered nurses have more choice about the industry they work in, so they must be paid more and treated better.
Lack of trained workers is a two-sided problem. If there was more demand for qualified workers and they were offered better pay and conditions – permanency, for instance – more would go to the trouble and expense of acquiring qualifications to supply.
Providers complain of high rates of staff turnover. They don’t mention that when they overwork, underpay and give workers no guarantee of regular work – or delegate their responsibilities as employers to a labour-hire company - a lot of workers soon leave in search of something less terrible - say, picking fruit in the blazing sun at Woop Woop.
It’s a funny thing: workers who are given little loyalty don’t tend to give much back. You’ve no idea how selfish workers can be. Don’t they know I’m trying to increase profits? Next time I see a Coalition MP I’ll give him (the hims are more receptive) an earful about how the dole’s so cushy these young bludgers don’t want to work.
It takes a lot of dedication to deal with the bodily needs of elderly people you’re not related to. But if you can find the motherly types, surely they won’t mind if you pay them peanuts. The full-time award rate for base-level aged care workers is $21.09 an hour, a fraction less than for base-level cleaners and just $1.25 above the Australian minimum wage.
Much of the poor treatment of people arises from the use of casualisation to save on wages and the resulting high rate of staff turnover, which makes it hard for residents and their carers to develop relationships.
The report found that “older people get the best care from regular workers they know, who respect them and offer continuity of care as well as insights into their changing needs and health requirements”.
In contrast, casually employed carers can struggle to “provide continuity of care and form ongoing relationships with older people”.
Professor Kathy Eagar, of the University of Wollongong, has said that “the staff are so busy that all they get time to do is tasks, like helping with toileting, showering, dressing and feeding residents. A lot of residents report they’re relatively lonely because, even if there are staff, they don’t have the time to talk to them.”
“For people with dementia, it helps to have the same people every day. If I don’t know my name because I’ve forgotten it, but the care worker does know my name, that’s a whole different proposition to if I don’t know it and my carer doesn’t know either,” she said.
Morrison says he’s focused on getting more jobs in the economy. Eagar has estimated that implementing the report’s proposals on staffing would increase the aged care workforce by about 20 per cent.
