The hapless politics of our aged care catastrophe

The politics, as Glady Berejilkian noted in her text exchange with an unnamed federal minister during the Black Summer fires two years ago, is the first thing Morrison thinks of. But he does eventually get around to policy. Which is why the word games on aged care this week are worth unpacking for what they reveal about the thing that matters most: the safety and dignity of some of our most vulnerable Australians.


In Morrison’s telling of the Omicron wave, the virus has simply added a layer of tragedy to the routine of death in the aged care system. “In the normal course of events, around a thousand people pass away in aged care facilities every week,” he told the media on Monday. “That’s what happens year round, even when there’s not a pandemic and when there is. And over the course of particularly Omicron, around less than 10 per cent of those who passed away in our aged care facilities have passed away with having COVID.”

It was, on paper, a callous thing to say. Does he really think that the electorate can be convinced to accept the death of up to 100 of people each week as a trade-off for the rest of us living with the virus? Or was he trying to reassure himself that he has done his best?

There was, in fact, a hint of genuine humility as he brought his answer to a close. He acknowledged that he can’t fix the systemic problems in aged care when “you have large numbers of people taken out of the workforce” in a pandemic. He can only “seek to mitigate them as best you can, but that doesn’t mean you can mitigate them all”.

What is clear is that the crisis in aged care can now be described as a catastrophe. You can see it in the dirty secret behind Morrison’s superficial observation about the workforce. The problem in aged care begins not with the treatment of the residents, but the pay and conditions of aged care staff.

This is work that Australians prefer to avoid. It can be seen in the official jobs data. The Australian economy, as we know, employs more people today than it did before the pandemic started. It remains the government’s last great boast.

Here’s the rub. The nation’s largest employer, health care and social assistance, has added 120,000 jobs over the past two years, an increase of almost 7 per cent, according to the Australian Bureau of Statistics. Encouragingly, 70,000 of those new positions have been taken up by men.

But break down the three main types of work in the sector – in hospitals, medical and other health care services, and residential care – and guess who missed out? Employment jumped by almost 7 per cent in hospitals and by more than 11 per cent in medical and other health care services. But in residential care, the total number of jobs actually shrank by 29,000, or almost 11 per cent. And this was before Omicron put thousands more into isolation.

This is the hidden cost of a closed international border. We received 232,000 migrants from overseas per year in net terms between 2004-5 and 2018-19, while 13,000 more Australians left the country each year than came the other way. In the past financial year, 96,500 migrants left the country in net terms, while just under 8000 Australians came home. The labour shortage in aged care can be found in that gap.

The system did try to cope by allowing some groups to continue coming to Australia. The most notable ethnic community to defy the trend for departure was from the Philippines. We received an additional 1000 migrants from there in 2020-21. But the average intake per year before lockdown had been almost 12,000.

It is already too late for the government to buy itself a reprieve before the election. As Victoria showed us in 2020, once the virus gets into aged care, it takes at least three months to suppress it. On that score, we are only half through this wave.

Let’s assume the best case and the death toll halves from here on. We are still looking at another 600 lives lost between now and a May election. And then we face the perfect storm for whoever forms the next government. Chief medical officer Paul Kelly has already warned of another COVID wave in winter, combined with the return of the flu.

The crisis in aged care has been decades in the making, and may take a decade to fix. The tragedy is that neither side can contemplate the true cost of boosting the workforce to meet the demand of an ageing population until well after the election.

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