User Pays Trumps Quality Of Care in Productivity Commission Report

The interim Productivity Commission Report into aged care warns that the current system cannot withstand the challenges facing the sector but fails to address critical workforce issues.

The Productivity commission has released its interim report into aged care, with recommendations for older Australians to fund their own aged care needs through a wider use of bonds or daily fees for their accommodation. It also advocates a roll back of regulation in the sector.

The interim report was welcomed by many aged care providers but the ANF has identified some weaknesses.

The report bluntly states that the sector, as it is now, cannot withstand the challenges confronting it.

The challenges identified in the report include a significant increase in the number of older people, rising expectations about the care they receive, community concerns about the quality of care, a relative decline in ‘informal’ carers and a need for significantly more nurses and aged care workers.

Workforce issues barely get a mention

The Productivity commission concedes there is a workforce shortage exacerbated by uncompetitive wages but, according to the ANF, it has failed to link this to the impact on quality of care.

‘Wage disparity has led to a staffing crisis. Ignoring this issue means the problem of attracting nurses and assistants in nursing to aged care will continue long into the future,’ said ANF Federal Secretary Lee Thomas.

‘Nurses and aiNs are not just the backbone of the sector. They are keeping the system going day in and day out. The Productivity commission has ignored their call for urgent workforce reform. They have also let down the residents and their families because the key issue of care barely features in the lengthy document.’

Residents are not getting enough care

According to figures compiled by Bentley surveyors, NSW aged care residents on average receive just two hours and 26 minutes of care per day. Only 25 minutes of this care per day is from a registered Nurse.

NSWNA General Secretary Brett Holmes says the Productivity Commission failed to deal with this key issue of care delivery.

‘Two hours and 26 minutes is not good enough. NSW aged care residents deserve the right number of staff with an adequate skill mix to look after their health and care needs,’ he said.

‘Workforce issues are having a real impact on the level of care residents receive. We support the Federal Government stepping in to reform aged care and a high priority must be given to fixing workforce issues.’

Australian level of funding very poor

The combined Pensioners and Superannuants Association claims the interim report ingenuously suggests Australia has a funding crisis. ‘The Productivity Vommission’s draft report on aged care Caring for Older Australians makes aged care sound like a funding time bomb and it couldn’t be further from the truth,’ says CPSA Policy Coordinator Charmaine Crowe.

‘The Australian Government spends 0.8% of GDP on aged care – whereas Norway spends 2%, the Netherlands spends 3.5% and Sweden spends 3.6%. By 2050, Treasury predicts Australia’s aged care expenditure will be 1.8% of GDP – half of Sweden’s current aged care expenditure.

‘The Productivity commission is scaring older people into believing that unless they cough up their family home, care in nursing homes will not improve.’

Other proposals in the report include a new regulatory body – the Australian aged care regulation commission – to oversee the sector. It would be separate from the Department of health and ageing and would oversee the aged care accreditation Standards agency and the complaints scheme.

The report proposes abolishing the aged care commissioner and reducing mandatory reporting obligations.


A recent survey by the ANF found that:

  • 93% of AiNs and nurses in aged care say their workloads have increased over the past two years.
  • 95% say they don’t have the time to complete the job load that is expected of them.
  • 98.5% say the Federal Government needs to fund the necessary aged care reforms.
  • The survey identified the key issues nurses believe need to be addressed in the sector:
  • Staffing and skill mix (76% of respondents).
  • More money for resident care (61%).
  • Wages (59%).


‘The Productivity Commission and providers claim that these recommendations will give older people “choice” about selling the home. The choice is this: you either sell the home; or take out a reverse mortgage.’

Charmaine Crowe, Combined Pensioners and Superannuants Association

‘Failing to fully engage in debate on the critical issue of aged care staffing detracts greatly from this influential report.’

Aged Care Crisis group

‘It is disappointing that the report does not support licensing for AiNs and care staff. It also removes the delineation between high care and low care. While low care or hostel care might be a choice, high care is almost always a health need and should be treated as such.’

Quality Aged Care Action group (QACAG)


  • Write a submission emphasising the importance of staffing and quality of care. The Commission is receiving final written submissions up until Monday, 21 March 2011.
  • Join other nurses and supporters in a rally outside the Commission when it has its final hearing in Sydney on Monday, 28 March. Contact Stella Topaz stopaz@ for more details.
  • Write to your Federal MP and urge them to support our campaign to improve aged care.
  • Email Julia Gillard and tell her to show some love towards older Australians. Visit www. for more information.