Ratios: an argument against privatisation of aged care

31 May 2014
Peter Carter

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.


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