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Aged care nurses are operating under virtual slave labour wages and being treated as the lowest-ranked professionals.

And as long as this appalling situation remains, the overall care of the elderly will remain inadequate.

This was the grim revelation recently of National Seniors chairman Everald Compton, who made a call for all aged care nurses to be given better professional recognition.

“At present aged care nurses suffer wages that are close to slave labour and they are treated as the lowest ranked professionals,” Mr Compton said.

Increased opportunities for further education and better working conditions for aged care nurses were key areas that needed to be addressed if more nurses were to be attracted to the profession, Mr Compton said.

With the aged care system experiencing rapid demand due to an increase in the ageing population it is estimated that the Australian Government spending on aged care will more than double relative to national income from 2010 to 2050, according to figures from National Seniors Australia (NSA).

NSA says their research has found that there is very little support for the existing fund structure.

“These findings suggest that consumers, including those not engaging with aged care services yet (baby boomers) are acutely aware of the impact of funding on quality care,” Mr Compton said.

Aged care providers are also experiencing challenges in providing the qualified staff needed to deliver high quality care to older Australians.

Mr Compton was basing his revelations on recent reports from Access Economics commissioned by the Australian Nursing Federation.


The report discovered that nurses working in residential aged care (RAC) were paid at least 10% less than their counterparts in acute care…with the wages gap worse in some locations.


The report also claimed that the work intensity for RAC nurses had increased – with 6.7 residents per nurse three years ago, up from 5.2 in just four years.


And this figure ratio was expected to double to 12.1% in the next decade on current trends.


“This means that each nurse is increasingly required to supervise more residents as well as more staff, sometimes across multiple locations,” the report found.


“Moreover, supply projections will not keep pace with demand growth (numbers

of residents) to 2020, plus there will be growing complexity of care as the

population of residents becomes older with more chronic needs,” the report continued.

It stated that data from the ANF indicated that the wage gap may have climbed to as high as 12‐13% across Australia, when comparing the aged care enterprise bargaining agreement (EBA) with EBAs in public sector nursing as a whole. (There is a further gap between RAC nurses on EBAs and those on the Award.)


As at 30 June 2008, there were 160,250 RAC residents in Australia, with around 70% receiving high level care, 55% aged 85 years or older, 71% females and 98% permanent residents.


“Projecting future RAC residents  – based on the current proportions of residents to

population by age‐gender group, applied to future demographic trends – suggests there will be

around 251,254 residents by 2020, up 56.8% on 2008.

 “The strongest growth (9.5% per annum) will be in the most complex needs group (aged 95+). Demand will grow strongly in (older) rural and remote Australia and it will also be important to appropriately cater for the care needs of growing numbers of culturally and linguistically diverse residents,” the report continued.


In other alarming key findings, the report found that associated with the changing RAC workforce, the quality of care will be potentially compromised.


“In acute care and RAC the evidence shows that a higher nurse ration in the staffing mix contributes to better quality outcomes (measured through indicators such as resident satisfaction, resident functionality, ulcers, infections, bleeding, weight loss and death).


“Better quality of care and health outcomes reflects the level of education, training

and ongoing professional development invested in skilling and equipping nurses

to meet the challenging and changing needs of aged care – particularly for the

now high proportion of residents with dementia.


“The combination of inequitable remuneration, increasing workloads and the frustration

of compromised quality outcomes is driving nurses from the sector.


“The tight market is reflected in recruitment and retention difficulties, rising

vacancy rates and exits to acute care or elsewhere,’’ the report outlined.


The report, quoted by Mr Compton, stressed that there was a pressing need for reform in aged care to address these areas.


Some of these crucial issues covered in the report are:


* Wage disparities must be corrected.


* If stipulated nurse ratios are to be avoided, then better quality outcomes should

be funded at higher levels, with the nursing requirement – as one evidence‐based

indicator of quality – linked to the Aged Care Funding Instrument (ACFI).


*Resident‐nurse ratios at each RAC facility should also be required to be regularly

made public, so consumers have access to this information in their decision making

between providers.


*University nursing training should be expanded, as there is excess demand for

places together with emerging workforce shortage.


*RAC providers should be required to provide acquittal of funds against the various

funding instruments.


*Long term RAC financing should be addressed, by streamlining the plethora of

current instruments and regulations, and investigating alternative future financing

mechanisms, such as the scope for potentially higher quantitative caps or healthy

ageing savings mechanisms akin to superannuation provisions for retirement



If the findings of this report and the revelations by Mr Compton don’t ring serious alarm bells in the newly-elected Federal Government, then more pressure must be brought to bear on the authorities.

There should be no way that nurses who devote themselves to aged care should be allowed to remain working under the existing appalling wage conditions.


It will be interesting to see how long it takes and what priority the new Government will give to these pressing issues.





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