At rallies across the country on 12 May, the nurses’ union kicked off a national campaign to win nurse-resident ratios in aged care. While ratios currently set minimum staffing levels in Australia’s childcare centres and public hospitals, there are no minimum staff-resident ratios in most of the aged care sector. 
In Victoria, public aged care facilities have legislated ratios of a maximum of seven residents per nurse. Queensland has similar laws. These ratios were won by nurses’ struggles, beginning with the 1986 Victorian nurses’ strike. 
However, public nursing homes make up only a small fraction of the sector. In Victoria, there are only a few dozen facilities run by the state, compared to more than 700 for-profit facilities. The majority of Australia’s aged care residents live in homes owned by companies subject to no minimum staffing rules.
Aged care has undergone a marked transformation in the last decade. While the number of private operators – and their profits – has soared, so to0 has the number of aged care residents classified as requiring “high care”. 
At the same time, the proportion of aged care staff with nursing qualifications has dropped drastically. Personal care assistants – often on half the salary of a registered nurse – make up nearly 70 percent of the workforce. PCAs are increasingly performing tasks once undertaken by nurses. At numerous inquiries into the sector, nurses report working at homes where one nurse can be responsible for 100 residents. 
The Australian Nurses and Midwifery Federation, which represents nurses and PCAs, points out that the huge profits made in the aged care sector largely come from government subsidies. Nursing ratios would ensure that more of this public money is directed to resident care and less to corporate balance sheets. 
So far it appears that the ANMF strategy for achieving nursing ratios will largely be focused on lobbying. The union has purchased billboard advertising to be displayed in Canberra. Industrial action must also be part of our strategy. Every upcoming enterprise agreement campaign must have nursing ratios as part of its log of claims.

Peter Carter

Union launches national campaign for minimum ratios in aged care

After a long fight, Victorian aged care nurses and carers have notched a solid win in their dispute with health industry multinational BUPA. In September, union members across BUPA’s 26 Victorian aged care facilities started a campaign of industrial action over the terms of a new enterprise agreement. Significantly, the nurses and carers carried out a number of full shift stoppages over the course of the dispute.
As a result, in early 2018, after holding out since the agreement expired in 2016, the company was forced to make an offer that the Australian Nurses and Midwifery Federation could recommend to members. The central victories contained in the deal are an 11.25 percent wage rise over three years and an increase in Sunday penalty rates from 150 percent to 175 percent of the standard hourly rate. Workers will also get access to a dispute resolution procedure to raise workload complaints.
The pay rise is a marked improvement on BUPA’s initial offer of 2.1 percent over one year, with no other changes. In particular, the increase to penalty rates puts BUPA workers ahead of Victorian public sector nurses and highlights how an industrial strategy can protect penalty rates.
The BUPA workers’ success should serve as an inspiration to others in the aged care sector, where a reluctance to stage entire shift walk-offs has limited workers’ ability to win industrial disputes.

BUPA aged care workers strike and win increases

Aged care nurses and personal carers at one of the country’s most profitable aged care providers are taking action for improved wages and conditions. Bupa workers across the health industry giant’s 26 Victorian aged care centres have been fighting for a new enterprise agreement since 2016.
While the Bupa Australia group last year reported profits of nearly $600 million, its aged care nurses and carers are among the lowest paid in the sector. They haven’t had a pay rise since April 2016. Aged care is just one part of BUPA’s private health empire. It also has large insurance, optical and dental care interests.
The workers, who are represented by the Australian Nursing and Midwifery Federation, are demanding wages comparable to those paid by other providers. But an improvement to staff-resident ratios is an equal priority for overworked staff. Federal laws do not prescribe minimum staffing levels in aged care facilities. Private homes are notorious for operating with skeleton staffing levels.
For example, the night staff at Bupa’s Ballarat facility are one nurse and four carers. These five workers are responsible for the care of 144 residents. “Bupa are terrible with staffing. If someone is sick, they just don’t replace them”, one Bupa worker told Red Flag. “The union is right not to give up until they do something about this.”
Bupa workers’ industrial action began on 27 September with workers wearing union shirts and handing out leaflets to the families of residents. From 9 October, they escalated the campaign to include a ban on completing aged care funding documentation, delaying Bupa’s receipt of government funding. Two-hour stoppages have also been implemented on a facility by facility basis.
Industrial action has achieved some results. Bupa’s opening offer was a one-year agreement with a 2.1 percent wage increase. Immediately prior to industrial action, it was up to a two-year deal with a 2.5 percent increase per year, and a week after the action started, the offer was lifted to 11.25 percent over three years, with back pay. It has refused to agree to any staffing improvements. The union says that it will not support an agreement that ignores nurses and carers’ workload concerns.
Aged care workers are a growing section of the working class. The Productivity Commission recently forecast that by 2050 the aged care workforce will be 1 million strong. The Bupa nurses and carers’ campaign is an important example of the sort of fight that is needed to win decent standards for staff and residents alike.
ANMF members and supporters are protesting outside Bupa’s Melbourne office on 25 October.

Bupa aged care workers take action over wages and workload

Victorian public sector nurses are gearing up for their 2016 enterprise agreement campaign. A statewide meeting of around 1,000 delegates on 23 March heard reports on the progress of negotiations with the Victorian Hospitals’ Industrial Association.
The nurses union, the Australian Nursing and Midwifery Federation, served a log of claims on the employers in January. Central to the nurses’ claims are the maintenance of current conditions and an improvement in pay.
Victorian nurses are paid less than the national average pay rates for nurses. For division one nurses, the union is seeking at least a 3 percent per year pay rise on base rates of pay, plus an additional catch-up amount to bring Victorian nurses into line with other states.
There are plans for a ballot to authorise protected industrial action as part of the campaign. The next mass meeting is planned for 20 April.

Vic nurses’ pay campaign kicks off

Federal government funding changes have abolished the distinction between high care and low care nursing home residents. NSW is currently the only Australian state with legislation requiring that nursing homes with high care residents have a registered nurse (division 1) on site 24 hours a day. Scrapping the demarcation between high and low care residents makes this requirement meaningless. 
The Baird state government initially passed interim legislation maintaining the registered nurse requirement in high care nursing homes but is now considering letting the laws lapse. 
The nursing home industry is run by some very large companies. Many of these see staffing standards as an unwanted restriction on their business practice. Charles Wurf, CEO of Leading Age Services NSW-ACT, a peak industry body, is for scrapping the registered nurse requirements, saying, “The slow measured retreat from regulating nursing homes in NSW in favour of a national aged care system is both sound and appropriate”.
However, the federal aged care framework says only that staffing levels must be “appropriate”. 
Nationally, the best standards for nursing home staffing levels are in Victorian public aged care facilities. These standards are not legislated but have been won and defended by union activity.
A large nurses’ strike in 1986 set the scene for staff to patient ratios to be implemented. In 2000, nurses took further action to get their workload under control. In 2011, nurses again defended ratios with industrial action that was at times illegal under industrial laws. The pressure to lower staffing levels is constant.
The next challenge for the Australian Nurses and Midwifery Federation is to launch a national campaign to win ratios in the rapidly expanding private and not-for-profit aged care sector.

Campaign needed for aged care standards

For five years I’ve worked as an endorsed enrolled nurse. For most of that time, I’ve worked in private aged care facilities. A few weeks ago I moved to the public sector. The difference between the two is like night and day. 
In a private aged care facility I was responsible for 40 residents – and I had to provide two rounds of medication each shift. On my last night, at the start of the second medication round, I found a resident lying face down in the bathroom bleeding profusely. I stopped the bleeding, cleaned her wounds and with the help of a personal care assistant lifted her back onto her bed. 
While most other residents were still waiting for their medication, I had to arrange a visit from a locum doctor, contact her family, conduct neurological observations and complete paperwork related to her fall. My rostered shift was finished before I could continue the medication round. I stayed an extra hour after my shift, for which I wasn’t paid.
There was nothing particularly remarkable about that night. When caring for people with limited mobility, dementia and chronic conditions, emergencies often arise. The problem is that, in the private sector, staffing levels are set at management’s discretion. They generally allow for only as many workers as it takes to get the bare minimum done – and then only if nothing goes wrong. It is a system that encourages shortcuts.
By contrast, the public sector operates with a ratio of one nurse for every five residents. Ratios allow nurses time to care for the residents far more effectively. The need to take shortcuts is diminished. In the public sector, part of my responsibility is to ensure that residents don’t fall and end up bleeding on the floor.
Last week in the tea room I had a discussion with my new workmates about workloads in the public and private sector. Most had worked in both and recognised the importance of ratios. Most supported the industrial action, taken during the last enterprise agreement negotiations, to defend public sector ratios from encroachment by a cost-cutting Victorian state government.
Most were against the Liberal government’s plans to privatise public aged care facilities across Victoria. They know that this means an end to ratios in aged care.
It should be a priority for our union, the Australian Nurses and Midwifery Federation, to organise a serious and sustained campaign for the defence of these facilities.

Ratios: an argument against privatisation of aged care

It has recently come to light that in 2011 a young worker at an aged care facility in Maidstone, Victoria, was sacked for refusing to lie about the death of a resident.
The Melbourne Herald Sun reported that Susan Mutami, a newly arrived Zimbabwean immigrant, was directed by her boss to report that the resident had collapsed in a corridor and died of a heart attack.
In fact, Susan had seen the resident lying motionless in a pool. She courageously reported what she had seen to the coroner. On appearing for her next shift, Susan was sacked on the spot.
This incident is an example of the sort of intimidation applied to the largely immigrant workforce in the aged care sector. The facility in question is run by Arcare Pty Ltd, a for-profit company.
The Victorian government is about to sell 1,000 aged care beds to private providers like Arcare. Government-run facilities operate with a one nurse to five residents ratio. This will go when these beds are sold to the private sector. In aged care, low staff numbers are a disaster waiting to happen.

Union launches national campaign for minimum ratios in aged care

BUPA aged care workers strike and win increases

Bupa aged care workers take action over wages and workload

Vic nurses’ pay campaign kicks off

Campaign needed for aged care standards

Ratios: an argument against privatisation of aged care

Aged care cover-up

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