Why Australia needs a national registration and education scheme for Care Workers
Aged Care Reform Now (ACRN) has presented a staunch case for a nationally mandated, harmonised, and legislated registration and education scheme for personal care workers across Australia’s aged care, disability, and veterans’ care sectors. This was a submission to the Federal Government’s Department of Health, Disability, and Ageing invitation for consultation on the design of a national registration scheme for personal care workers in aged care.
The submission, titled “The case for a nationally mandated, harmonised, and legislated registration & education scheme for the Australian Care Workforce” argues that now is the time to rectify the damage done to the care workforce and the sector as a whole. Decades of deregulation, inadequate training standards, and widespread systemic failures were starkly exposed during the Royal Commission into Aged Care Quality and Safety and the COVID-19 pandemic. ACRN believes that a professional, regulated, and educated care workforce is absolutely essential to ensuring high-quality, person-centred care for vulnerable Australians.
A sector in crisis
ACRN points to the 1997 Aged Care Act as a significant turning point, describing it as the “road to neglect”. This Act encouraged private, for-profit operators and essentially deregulated aged care delivery, leaving staffing levels and design to ‘market forces’. The consequence over 20 years was a workforce reduced to minimal numbers of registered nurses, a diminished enrolled nurse cohort, and up to 83% of staff being poorly trained or unqualified. This occurred while pay increases in the public sector were not matched in aged care, boosting provider profits but resulting in diminished levels of clinical care. The pay differential and heavy workloads led to nursing staff losses to other sectors. At the time of writing the submission, there was no mandate for care staff to have even the minimum Certificate 3 in personal care to obtain work in residential or community aged care.
The COVID-19 pandemic further highlighted the severe failures, revealing training deficits, understaffing, and a general lack of knowledge regarding the needs of frail elders. By contrast, publicly run aged care facilities in Victoria, with mandated minimum staffing levels under the Safe Patient Care Act 2015, demonstrated significantly better management of the pandemic, with fewer outbreaks and deaths.
ACRN asserts that the ill-conceived 1997 Aged Care Act, based on the marketisation of care for vulnerable people, was a national shame and an abrogation of government responsibilities. The “abuse and neglect” that followed was foreseen by nurses in the sector. The Royal Commission’s final report itself highlighted systemic issues including a shortage of workers, skills not matching complex needs, and quality of care being inextricably linked to job quality.
Registration and professionalisation is the solution
ACRN firmly believes that an enforceable Care Workforce registration is crucial to facilitate and empower the current aged care reform process and rebuild trust. They maintain that aged care is a social good intrinsically linked with health care and must be recognised as such, aligned with other health and social care contexts like the acute sector.
Key recommendations put forth by ACRN include:
- Mandatory Registration under AHPRA: All care workers should be mandated to be registered and regulated under a separate registration board administered by the Australian Health Practitioner Regulation Agency (AHPRA). This system is already in place for most other health practitioner groups.
- Public Register: There should be a public register via the AHPRA system so people can easily see that a personal care worker has met their registration requirements, ensuring accountability and transparency.
- Minimum Education Standards: The proposed Aged Care Act 2025 must mandate a Certificate 3 in Personal Care as the minimum qualification for employment in direct care roles in Aged Care. For existing staff, a timeframe (e.g., 12 months or shorter, ideally 6-12 months) should be set to achieve the required standards, supported by paid leave and government funding for training upgrades.
- Nationally Harmonised Training and CPD: There should be nationally harmonised first registration entry training competencies. Yearly re-registration must be dependent on completing ongoing Continuing Professional Development (CPD), with a suggested minimum of 20 hours per year (10 mandatory hours in safety/compliance and 10 hours in specialist areas). ACRN proposes a range of specific training areas including palliative care, dementia care, infection control, OH&S, and behaviour management.
- Professionalisation and Career Pathways: The sector needs structures that provide a clear career path with commensurate pay scales. Formalising career structures based on education and training is vital. ACRN aligns strongly with the National Aged Care Alliance’s view that professionalisation requires culture change and improvements to education, training, wages, and labour conditions.
- Addressing Barriers for Diverse Workers: The scheme must address specific barriers faced by First Nations workers, migrant/CALD workers, workers with disability, and those from low socioeconomic backgrounds. This includes ensuring accessibility, providing culturally safe training, addressing language barriers (while maintaining English proficiency requirements), supporting recognition of overseas qualifications, and offering financial/technological support for training. Co-design with older people and diverse groups is also essential.
- Mandated Staffing Levels: ACRN believes mandated minimum nurse ratios must apply to aged care, similar to the public sector, and that these ratios are a demonstration of safety in care. They advocate for minimum staffing levels over and above the confusing “care minutes”.
- Integrating Values: Training must go beyond technical knowledge to cultivate compassion, patience, respect, and a deep commitment to person-centred care through values-based learning, reflective practice, and ethical standards.
Why this matters
A robust and enforceable registration process supported by a code of conduct, ethics, and harmonised education will facilitate high-quality, accountable care. It helps workers understand their Duty of Care and their obligations when in contact with vulnerable people. Such a system changes the power imbalance and leads to a more respected, supported, and engaged workforce. This, in turn, is expected to increase job satisfaction, improve workforce retention, and enhance continuity of care, ultimately lifting the quality of care provided.
ACRN stresses that the workforce is the linchpin of the Care sector; without a consistent, effectively educated, engaged, and empowered workforce, reform will not succeed in preventing “neglect and abuse” or providing the highest quality care. They reiterate that political will is needed to urgently advance workforce reform under the new Aged Care Act 2025.