Unmasking the True Costs of Quality Care

The views expressed in this article are solely my own.

Last Thursday in Parliament, the government asked itself ‘Dorothy Dixers’ in reference to the success on delivering their aged care platform, in particular the mandate to provide round-the-clock nursing care in residential facilities by 1 July 2023.

A ‘Dixer’ occurs when the government poses a question to itself during Question Time and then provides a scripted answer. This exercise serves to allow the Minister or Prime Minister to highlight their policies, achievements, or to articulate a specific point, such as countering an opposition stance.

The term is derived from the pen name ‘Dorothy Dix’, used by Elizabeth Meriwether Gilmer, a famous American journalist and advice columnist in the early to mid-20th century. There’s a popular belief that Gilmer sometimes crafted the questions she would then answer in her column, leading to the adoption of the term ‘Dorothy Dixer’ as a colloquialism in Australian politics.

While the government can justifiably take pride in many of its aged care achievements since coming to office, it was the question to the Minister for Employment and Workplace Relations that caught my attention.

The Minister contrasted the approaches between his and the previous government in supporting and implementing wage increases for aged care workers. Some of the Minister's remarks included:

“…. if you don't have enough staff you end up with residents who need more significant treatment. Per day in aged care costs $200 to $300. Per day in hospital costs $2,000.”

I have seen similar figures used before but mainly to underscore how poorly aged care is funded.

While complexity of care can explain some of the difference between the two settings, does anyone genuinely believe that with similar resourcing requirements it is ten times cheaper to deliver quality care in a residential setting?

Setting that aside and focusing on the Minister’s primary point, the government’s intervention in the aged care work value case was well-received. Furthermore, the significant $11.3 billion boost in funding the government is now providing to cover the additional costs of the Fair Work Commission’s (FWC) wage adjustments is commendable. The sting in the tail, however, is that not all aged care workers received an increase.

The FWC is still deliberating on whether workers who are not in direct care roles should receive a similar increase in award rates as well as other potential modifications to classification definitions and structures in the relevant awards.

We are not expecting a decision until early 2024 and the people who missed out are those who typically keep things running behind the scenes but are still just as essential in ensuring that older Australians receive quality care.

If the government truly believes that better staffing equates to better care and there is a cost benefit in keeping older Australians out of hospital as their answer would suggest, why not fund a pay increase for those who missed out now and thereby ensuring the sector can attract and retain these key people?

There is no hard and fast rule that says the government must wait for the FWC decision and apart from being the right thing to do, it would be transformative in helping the sector combat the labour shortages it currently faces.

It might mean that the next time the Minister stands up in Parliament, he will need to say that a day in aged care now costs $300 to $400. However, I believe this is an investment in the wellbeing of older Australians that we all would applaud!

The full government questions and answers can be found on the Parliament of Australia website.