Interview with Stephen Cenatiempo
24 May 2023
Subjects: Aged care home closures, Labor’s rushed aged care requirements
CENATIEMPO: Now, I mentioned yesterday that 23 aged care homes have shut their doors since September last year. This is in the wake of - well, they're trying to grapple with stringent reforms that have been brought in by the current Government off the back of the Aged Care Royal Commission. Senator Anne Ruston is the Shadow Minister for Health and Aged Care and joins us now. Senator, good morning.
SENATOR RUSTON: Hey Stephen, how are you?
CENATIEMPO: Good morning, Senator.
SENATOR RUSTON: Good morning.
CENATIEMPO: There we are. This is a real concern. I mean, the object of the Royal Commission was obviously to improve the aged care situation. But if we've got 23 facilities closing their doors, that's only going to put more pressure on a system that's already bursting at the seams?
SENATOR RUSTON: Well, look, absolutely. And I think the thing that's worth mentioning right upfront is the fact that the Royal Commission made the recommendation that they have registered nurses on site 24 hours a day, seven days a week, and the reforms needed to be brought in by the middle of 2024. This government went to the election, promised to bring them in by 2023, in the middle of a workforce crisis, and have rigidly refused to accept the fact that in many instances this is not going to be possible. So, these closures have occurred as a direct result of this government's refusal to actually address the workforce shortages and from bringing forward, by an entire year, a recommendation of the Royal Commission. This did not need to happen.
CENATIEMPO: But how do they address the workforce shortages? It's not as easy as snapping your fingers together and creating these registered nurses and an aged care workforce. I mean, I know there's some tinkering around the edges that could be done with allowing retirees to, you know, earn more before they lose parts of their pensions and those kind of things. But it's only going to be sort of stopgap measures, isn't it?
SENATOR RUSTON: Well, I think what we have to realise is, first of all, the Royal Commission made a recommendation to stage it in over a longer period of time, recognising - even at the time of the Royal Commission's recommendations - that we had challenges with workforce. Those challenges have only got worse post the recommendations, because of course the impacts around COVID. So, we had a landscape that we knew was really challenged around the care workforce and particularly around registered nurses, and yet we still saw the Government refuse to accept the fact that there was a challenge and, hell for leather, went on this pursuit of 24/7 by the end of next month. I was going to say - what we have to realise is that if you are constrained by workforce, you have to put in models of care that will actually reflect that. I mean, this government could have made the exemptions wider, they could have deferred the timelines, they could have looked at alternative models of care, particularly in rural, regional and remote Australia, where we know workforce is even more shallow than it is in the city. But they refused to look at anything and just said it has to be put in place, and as a result we've seen 23 aged care homes closed and potentially many more.
CENATIEMPO: It's interesting you talk about rural and regional areas because the Minister says, well, it's only rural and regional areas that are struggling to meet the new rules, like that's some sort of consolation.
SENATOR RUSTON: Well, it's also not right. We know that we have got workforce challenges right across the country, whether it starts in inner cities right out to remote communities. Yes, they are much more acute the further you get away from a metropolitan area because we have got shallow markets, but it's happening in the cities as well. But the problem we've got is that there's just no flexibility. They've sort of applied this one-size-fits-all city-centric, you know, 'you have to do this by now, by this particular time', taking no regard for nuances in different areas. I mean, even within city areas, there are different places where we have - in some areas, we've got lots and lots of nurses, and in other areas we've got none. But overall, we've still got a massive shortage - in excess of 20,000 short, right now, of registered nurses to support Australia.
CENATIEMPO: Having said that, though, the Minister says that there's more aged care places nationally than there were back in 2019. 6500 more places. That's got to be a positive?
SENATOR RUSTON: Well, first of all, if you have a look at their budget papers, you'll see that they've taken $2.2 billion out of residential aged care in this budget, citing the fact that they think that there will be less people in residential aged care going forward. So this idea that somehow we are expanding beds, when we've just taken $2.2 billion out of the aged care budget for residential care, does not add up. Also, the bed numbers that we're talking about all were put in place under the previous Government's watch. This minister has done nothing, absolutely nothing to improve the numbers of residential aged care beds or done anything to deal with the overwhelming workforce crisis that we're facing in aged care. So, I think, the Minister needs to be very careful that some of the things that she's saying right now aren't true, and she needs to check some of the facts before she opens her mouth.
CENATIEMPO: The broader problem here is that the quarterly financial snapshot says that 66% of private providers are operating at a loss. That says there's a broader structural problem with the overall aged care system that we need to address.
SENATOR RUSTON: Look, absolutely. We've known that aged care has been under a lot of pressure. And of course the findings of the Royal Commission, that clearly needed to be dealt with, were going to put on additional financial pressure. But right now, because of the workforce challenges, many of these facilities are paying well above award. A lot of them are paying locums or agency staff, which means that their staffing bills are much, much higher than they would be under normal circumstances. So, there's so many pressures. There's so much reform that's been forced on them. They're having a whole heap of paperwork and regulations forced on them. We're seeing an aged care sector that looked after older Australians during the pandemic, under extreme stress and fatigue, constantly being forced by this government to just do more and more and more. I think it's time to actually sit down and talk to the aged care sector and work out how we can help them deliver the best possible care to older Australians, within the constraints that currently exist in our market, instead of just having this ideological bent that we've just got to do this, even though it's not possible.
CENATIEMPO: It's certainly something that needs to be addressed and something that's been a problem for many, many years. Senator, I really appreciate your time this morning.
SENATOR RUSTON: My pleasure as always.