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2016-2017
THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA
SENATE
Aged Care Amendment (Ratio of Skilled Staff to Care Recipients) Bill 2017
EXPLANATORY MEMORANDUM
(Circulated by authority of Senator Derryn Hinch)
OUTLINE
The Aged Care Act 1997 fails to prescribe a minimum staffing standard for Australian
Government funded aged care residential facilities, and does not specify what constitutes
'appropriately skilled and qualified staff' for the purpose of providing care.
International research suggests that higher Registered Nurse staffing levels, higher total
staffing levels and a high skills mix (ratio of Registered Nurses to other nursing staff) are
associated with better quality care. This amendment will enhance the level of care provided
by aged care facilities nation-wide. The majority of aged care staff in Australia are personal
care attendants (PCAs) or community care workers (CCWs), with a declining share of
registered nurses (RNs) over the last decade or more. In 2016 the average total care hours
worked per resident per day were 2.9 hours.
This Bill introduces the concept of a mandated ratio of skilled staff to care recipients in
Australia's aged care residential facilities. The task of calculating a safe and specific ratio,
including for variables such as day and night shifts, higher and lower care residents, and for
metropolitan, rural and regional areas, should be undertaken by the Department of Health in
consultation with the aged care sector, and included in the Quality of Care Principles.
The passage of this Bill would require the Quality of Care Principles to mandate a minimum
adequate and safe ratio of appropriately skilled staff to care recipients. This ratio should take
into account the number of care recipients receiving care through the aged care service at that
time, the type of care and level of care provided.
NOTES ON CLAUSES
Clause 1: Short Title
1. Clause 1 is a formal provision specifying the short title of the Bill.
Clause 2: Commencement
2. The Bill will commence on the day it receives Royal Assent.
Schedule 1 - Amendments
Aged Care Act 1997
Item 1 - Paragraph 54-1(1)(b)
Item 1 substitutes paragraph 54-1(1)(b) to introduce the concept of a mandated ratio of skilled
staff to care recipients.
Item 2 - At the end of section 54-1
Item 2 amends section 54-1 of the Act to mandate an adequate and safe ratio of skilled staff
to care recipients is specified by the Quality of Care Principles.
Item 3 - At the end of Division 54 of Part 4.1
Item 3 adds the criteria to be considered when implementing the ratio of skilled staff to care
recipients by the Quality of Care Principles.
Statement of Compatibility with Human Rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary
Scrutiny) Act 2011
Aged Care Amendment (Ratio of Skilled Staff to Care Recipients) Bill 2017
This Bill is compatible with the human rights and freedoms recognised or
declared in the international instruments listed in section 3 of the Human Rights
(Parliamentary Scrutiny) Act 2011.
Overview of the Bill
This Bill introduces the concept of a mandated ratio of skilled staff to care
recipients in Australia's aged care residential facilities.
The majority of aged care staff in Australia are personal care attendants (PCAs)
or community care workers (CCWs), with a declining share of registered nurses
(RNs) over the last decade or more.
The average ratio of residential direct care workers to operational places (beds)
was 0.78 in 2016. Average total care hours worked per resident per day were
2.9 hours in 2016.
The Aged Care Act 1997 does not prescribe a minimum staffing standard for
Australian Government funded aged care services. New South Wales,
Queensland and Victoria prescribe staffing requirements for some residential
aged care facilities, but all elderly Australians deserve the best level of care
when they can no longer live independently, and instead rely on aged care
residential facilities for their health and wellbeing.
The Australian Government is the primary funder of aged care in Australia, and
as such is the most appropriate regulator of ratios of skilled care givers to care
recipients. The minor change introduced in this Bill - the introduction of
mandated ratios which would be determined by the Department of Health -
would be an important step in moving towards an aged care system that is more
focussed on the protection of the elderly, than on profit margins of aged care
facilities.
Human rights implications
The Bill engages the following human rights:
the right to the enjoyment of the highest attainable standard of physical
and mental health;
the rights of equality and non-discrimination.
The Bill promotes the right of everyone, including the elderly, to the enjoyment
of the highest attainable standard of physical and mental health as set out in
Article 12 of the International Covenant on Economic, Social and Cultural
Rights, as well as the right to equality and freedom from discrimination for
older persons.
International research suggests that higher Registered Nurse staffing levels,
higher total staffing levels and a high skills mix (ratio of Registered Nurses to
other nursing staff) are associated with better quality care. Legislated ratios of
appropriately skilled care givers to care recipients have long existed in hospitals
and child care centres, and this Bill seeks to extend the same protection to the
elderly.
Conclusion
The Bill is compatible with human rights as it promotes the human rights to the
highest attainable standard of physical and mental health and the right to
equality and freedom from discrimination.
[Senator Derryn Hinch]