From John Ray's shorter notes

15 April 2023

Aged care rules ‘to set off collapses’

This is typical of Leftist thinking.  They think they can just pass a law and make something happen that they want to happen. That is rarely so.

The problem is that they do not first do the hard work of understanding how or why the existing situation exists.  It will almost always be the result of several interacting pressures and failing to account for those pressures will cause "unexpected" results.

The situation discussed below is a simple example of that.  We would probably all agree that nursing homes for the aged would ideally have a large, well-trained staff to give individual attention to each resident when required.  And the ALP is trying to make that happen by legislation.  But it won't happen

To understand why you need to look at the existing situation, where a small staff of not mostly not very bright people are all that are available in such homes.  And why is that so?

Cost.  Employing staff is expensive and the normal way of coping with that is to pay only minimal wages.  And the only people who will accept such wages are people who do not have much to offer in the way of skills and abilities

So mandate that staff must be paid more?  You can do that but what will be its effect?  The care offered by the home will be so expensive that few elderly will be able to afford it.  It would cast many frail elderly onto the streets.  You just can't do that.

And the proposal most discussed below is an example of that.  A qualified nurse gets wages well above the minimum so where are you going to get the money to pay her?  Short of government subsidy you cannot do it.  The home could well go broke trying.

So the nurse "shortage" is mainly a shortage of nurses who will accept nursing home pay.  There will be such a shortage for a long time.  The mandate will be largely unenforceable and will mainly result in a REDUCED availability of nursing home care.  Nursing home care will become the preserve of rich families only

It's a devil and the deep blue sea phenomenon. To get assured good care, you have to pay a lot. But not everyone can pay that much so you get the distressingly poor treatment of some residents that we often read about

The chief of the peak nursing professional body says it could take five to 10 years for the sector to ­recruit enough staff to meet ­Anthony Albanese’s target for 24/7 nurses in residential aged care facilities, warning there is “absolutely no way” the industry will meet Labor’s July 1 deadline.

Australian College of Nursing chief executive Kylie Ward also expressed concern that providers would be forced to shut down under the legislated requirement to have at least one registered nurse on site at all times.

The warnings come as the Aged & Community Care Providers Association, the overarching body representing residential, home and community care, said the government needed to ensure the pace of change was manageable for aged care providers and did not “exacerbate an already challenging situation”.

The sector is scrambling to ­implement a suite of reforms including mandated minutes of care per resident, quality and safety standards, and full-time nursing requirements as it adjusts to a new funding model bought in last October as recommended by the Aged Care Royal Commission.

The overhaul comes as financial troubles plague the sector, with the latest figures from the Quarterly Financial Snapshot of the Aged Care Sector revealing 66 per cent of private providers are operating at a loss, with facilities losing an average of $28 per resident each day.

For-profit and not-for-profit providers, which represent 90 per cent of all homes, returned a collective net loss before tax of $465.3m for the September 2022 quarter, off revenues of $5.3bn.

As the sector grapples with a major shortfall of workers and ­a deteriorating financial outlook, a number of aged care facilities have been forced to close their doors. Aged care provider Wesley Mission was the latest facility to close, announcing on Thursday the shutdown of all Sydney homes, citing difficulties in attracting and retaining staff.

The closure, to take effect next month, will displace about 200 residents but the facility said it was committed to ensuring the elderly had other suitable accommodation.

Professor Ward said the aged care sector was facing a shortfall of 10,000 nurses ahead of Labor’s July 1 deadline, and urged the government to invest in attracting overseas-trained nurses to ensure a sustainable supply of workers to help meet targets. She said the college, which had been fighting for facilities to have a registered nurse to be on site for years – had told the government of the projected staffing shortfalls ahead of the deadline.

“There is absolutely no way the sector is going to meet its legislated target by July 1,” Professor Ward said. “We needed a minimum of 10,000 workers before this came into place … where are the nurses coming from?

“If the government doesn’t start looking at developing skilled migration, or a broader approach to developing a new workforce then you’re never going to meet that target.”

Professor Ward said providers were fearful they may have to close their doors if they were unable to meet the legislated targets.

“I can guarantee you they will close. I have spoken to CEOs who are distressed and say they won’t be able to meet the requirement … the modelling of care needs to be considered as we transition to these reforms but we can’t just pluck these people out of thin air,” she said.

Aged Care Minister Anika Wells said the government would not force the closure of facilities that were unable to meet nursing targets and would work with providers to help them meet new standards. Last month, Ms Wells conceded about one in 20 aged care homes would not meet Labor’s July 1 deadline, but said about 80 per cent had already achieved the target.

Ms Wells said the “vast majority” of residential facilities would meet 24/7 nursing requirements and that around the clock nursing was needed to properly care for some of the nation’s most vulnerable. Exemptions would be available for a small number of facilities in regional and remote areas if they were unable to fulfil the requirements.

Opposition aged care spokeswoman Anne Ruston attacked Labor for failing to consider the challenging circumstances the sector faced due to severe ­workforce shortages “in their rush to tick and flick election commitments” after the Prime Minister promised to “fix the crisis in aged care”.

Senator Ruston seized on the closure of Wesley Mission’s homes, arguing residential facilities were not adequately supported during the transitional period.

Sue McLean Bolter, whose 98-year-old mother Moira McLean has been a resident of the Wesley Mission home in Narrabeen since 2019, was first informed of the provider’s closure on Tuesday.

She has been scrambling to find suitable accommodation for her mother, having recently flown in from the US to celebrate Ms McLean’s birthday. So far she has been unsuccessful.

“It’s been very stressful … it’s just been horrible … my sister who lives here has been furious,” Ms McLean Bolter said.

“Had (Wesley) even notified the government that they had been planning to close and why were we given just six weeks ­notice?

“This is the northern beaches where people have their families, doctors and hospitals so to send them over to the other side of Sydney is almost unthinkable. You can’t just drop by to meet your mum, you might have to drive two hours across Sydney in traffic.”

Wesley Mission chief executive Reverend Stu Cameron said Labor’s new national staffing requirements had created challenges for the home as a smaller provider. “The aged care sector is experiencing challenges to workforce and flow-on impacts from the national reforms to aged care,” Reverend Cameron said.

“Wesley Mission supports these once-in-a-generation reforms, improving quality for all care users. It is, however, a challenging environment to be a smaller provider.’

Aged care provider Whiddon chief executive Chris Mamarelis said the Wesley closure was “unsurprising” given the financial pressures many providers were under and forecast more failures.



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