Aged Care Reform Now’s (ACRN) Budget submission was decided on as part of our lobbying for systemic reform. The change of government raised concerns regarding the progress of aged care reforms and the direction such reforms will take. Members were particularly concerned about the continually worsening staffing and skills crisis in residential aged care.
Treasurer Jim Chalmers stated the October 2022 Budget would be a “bread and butter budget” which would find cost savings and deal with basic needs. Although Government is determined to progress its 5 basic aged care reforms, including 24/7 Registered Nurses, members were concerned that ongoing reforms at the aged care recipient level would not progress in the near term.
To that end, ACRN has suggested that aged care funding immediately deals with first principles, improvements in the direct care of our frail elders, particularly the most vulnerable in residential care.
The ACRN budget submission was aimed at ensuring that aged care staffing, staff re-skilling, and medical support networks for facilities are funded in the immediate term and into the future.
ACRN believes that immediate attention to the fundamentals of clinical care such as legislating registration of carers and a revision of carer and nurse qualification criteria, problems identified by the Aged Care Royal Commission report should continue.
The Budget submission flags that training in gerontology, palliative care and behaviour management of neurological morbidities such as Dementia needs urgent funding on a nationwide basis.
Relying on individuals to initiate the uptake of scholarships and free TAFE alone will not bring the needed rapid expansion of the workforce to meet acute staffing deficits. Expanding the numbers and role of nurse practitioners in aged care to provide mentoring, clinical leadership and ongoing training is necessary to improve care in view of the increased morbidity and mortality of residents. (Nurse practitioners have limited prescribing rights).
In rural, regional, and remote areas the Doctor shortage is already acute. Only 1:8 medical graduates elect to train as general practitioners currently, there is a worldwide and nationwide shortage and the General Practitioner (GP) cohort is rapidly ageing, particularly in rural areas. We have suggested that the existing Rural Doctor scheme be expanded and refined and that this scheme, designed originally for rural & remote QLD and NSW, be revisited. Doctors would undertake a bonded period of service in rural areas of 2 years post attaining their GP fellowship in return for having their HECS debt paid.
We have also suggested that the Government fund advanced GP training to meet regional needs. Without GP supports, particularly in palliative care and dementia/mental health, the clinical supports will remain inadequate.
To rely solely on funding and expansion of Telehealth will only solve a small part of aged care needs.
ACRN members have engaged extensively with the Department of Health and other advocacy groups but much of the engagement is provider-centric not focussed on responding to the immediate and ongoing needs assessment of aged care clients.
Our submission has an unapologetic clinical needs focus as we believe meeting frail elder needs must be the foundation of lasting and successful reforms.
Humane, impeccable care available to all, is an inalienable human right.