(Image: Mitchell Squire/Private Media)

Australia’s aged care system is again in crisis — or, more correctly, an ongoing crisis in aged care has sharpened into potential tragedy as the system attempts to balance the need for staff in a sector struggling to find enough workers with the need to keep residents safe as COVID outbreaks spread in what may soon be 50% of facilities nationwide.

With aged care beset by a continuing shortage of workers, the industry and the government are on the horns of a horrible dilemma: in a sector where staff shortages are seriously affecting resident care, how do you prevent widespread infection rates from keeping staff at home, knowing that one infectious staff member could set off an outbreak in a facility that could claim lives even among the double-vaccinated?

The government claims the rollout of booster shots is “ahead of schedule” and will be completed by the end of the month.

Its solution for staffing shortages while Omicron tears through the community was announced on January 7 — the isolation rules for workers identified as close contacts were amended for large groups of workers, including aged care staff. If asymptomatic, they could keep working provided they undertook a rapid antigen test every day for seven days. Most states have ratified that.

Plainly that assumes availability of rapid antigen tests, which were initially not available. Providers sought to access the federal government’s stockpile but “they weren’t getting them at all, or not promptly”, says Paul Sadler, CEO of the non-profit sector peak body Aged & Community Services Australia.

Moreover, the government was prioritising providers who had experienced outbreaks — currently between 40% and 50% — which inevitably meant no preventive measures in aged care facilities that had yet to suffer outbreaks.

The Health Services Union’s Gerard Hayes told Crikey that members are reporting RATs are starting to flow through to workplaces — it’s “slowly moving in the right direction”, he says — but they’re arriving only after services have been seriously degraded due to staff shortages.

“Some residents are going without showering due to competing priorities for staff, there are reports of low or inadequate supplies of food — this isn’t food you can go down to Woolies to get,” said Hayes. “And there’s little if any agency staff to call on. When the government talks about a ‘surge workforce’, I’d like to know where it is.”

An inevitable consequence, he points out, is providers having to send residents to hospitals.

Both Hayes and Sadler agree the overarching problem is the lack of appropriate pay for aged care workers. “There are two big workforce problems,” says Sadler. “One, wages. Two, the need for career paths and training.”

Hayes says aged care workers can find higher-paying jobs in desperate sectors like hospitality — and the stress is lower.

The Morrison government didn’t create the crisis in aged care — it’s been decades in the making. But it has been strangely dilatory in doing anything about increasing the pay of aged care workers. The aged care royal commission recommended the government supports unions and providers in the Fair Work Commission (FWC) application to significantly increase sector wages, reflecting a reappraisal of the value of aged care work. While there may be some differences around the margin, it’s likely unions and employers, for once, will be on the same page in terms of urging higher wages.

The Commonwealth, however, would fund any potential wage increase via increased payments to providers. And it has been silent on whether it will do so at all. Despite the other parties requesting it make its position clear and the commission seeking the Commonwealth’s response, the Morrison government has insisted it will make a decision only after the FWC has made a decision on increasing wages.

This leaves the sector in the catch 22 situation that a key input to the FWC decision on increasing wages — how much the key funding source will provide — won’t be available until after the decision is made. No money has been allocated by the government for increased aged care funding.

In the meantime, indexation of grants to providers last year was just 1.1% — less than a third of inflation — and well below wages growth in the broader health and social care sector from which the aged care sector draws its primary workforce.

With the FWC case unlikely to be decided before late this year or early 2023, a funding decision may not be made until the 2023 budget — unless announcing a big pay rise for aged care workers occupies the bulk of Morrison’s $16 billion secret fund of election campaign measures.

So aged care residents will continue to face indignity and lower standards of care in an overwhelmed industry.

This morning, all major aged care unions and key provider groups issued a joint statement calling for the government to deploy the Australian Defence Force to aged care facilities and to immediately provide a wage boost to aged care workers. The current crisis “exposes unresolved systemic funding and workforce issues”, the group said. Is the government listening?

Have you or a loved one been affected by the latest crisis in aged care? Let us know your thoughts by writing to letters@crikey.com.au. Please include your full name if you would like to be considered for publication in Crikey’s Your Say column. We reserve the right to edit for length and clarity.