Hal Swerissen

Aged care providers can’t get staff. Reports indicate there are about 60,000 vacancies and this will rise to over 100,000 by the end of the decade if nothing is done. In particular, it will be increasingly difficult to attract low paid workers like kitchen hands and garderners. This is a major and continuing problem for access and quality of aged care.

About 1.4 million older people receive aged care services, including basic and more intensive home care, care in residential institutions and short term respite care. These services employ around 420,000 people employed across residential aged care, home care, and various support programs. This includes registered nurses, personal care workers, allied health professionals, and support staff.

Aged care providers routinely report that it is difficult to attract staff with the result that they can’t meet the growing demand for services from older people.

The Committee for Economic Development Australia has estimated that an additional 110,000 additional full-time equivalent workers will be needed by 2030. That is around a 25 per cent increase in the current workforce. This massive gap is driven by several factors. Firstly, Australia’s population is aging rapidly, with the number of people aged 80 and over projected to double by 2050. This translates to a rising demand for aged care services, outpacing workforce growth.

Secondly, despite recent wage increases, the sector struggles to retain existing staff. Low wages, compared to the broader healthcare sector, and demanding workloads contribute to high turnover rates. Long hours, shift work, and emotional challenges associated with caring for older people can take a toll on morale and lead to burnout.

Furthermore, the training landscape within the aged care workforce presents a mixed picture. While some roles, like registered nurses, require university degrees, there are no minimum qualifications for entry level support workers . A significant portion of the workforce relies on Certificate III qualifications and around 30 per cent of direct care workers have no formal qualifications in aged care support. Nor are there well established supervision, professional development and career progression pathways for staff. This limits workforce development, satisfaction and the quality of the services provided. Increasing levels of privatisation and fragmentation, particularly in the home care sector make this more problematic.

The recent Royal Commission on Aged Care Quality and Safety highlighted the need for a more skilled workforce, emphasizing the importance of ongoing professional development for all staff. To date the Commonwealth’s training initiatives have been anemic.

While initiatives like the Aged Care Transition to Practice Program supports nurses entering the sector, much broader investment in upskilling the entire workforce is necessary. Demand for aged care training, particularly in vocational education is low. Much more systematic incentives, including scholarships and traineeships for aged care, are needed to provide incentives for training.

Skilled migration may meet a proportion of the workforce shortages, but it is unlikely to be a major part of the solution. Progress to bring in skilled aged care workers has been glacial. Initiatives to establish agreements to bring in staff from overseas currently involve only about 1 per cent of providers and will meet only 10 per cent of the workforce shortfall at best.

The consequences of an understaffed and under-trained aged care workforce are severe. Agencies struggle to get staff and then have to run at below capacity or at reduced quality. That means older people either don’t get care or they are increased risk of neglect, malnutrition, avoidable hospital admissions and a poorer quality of life.

Better pay and conditions is part of the story, but unless aged care becomes a career that the community recognises, values and supports it will continue to be difficult to train, attract and retain staff.

Addressing these challenges requires a multifaceted approach. Australia will need a massive increase in the number of aged care workers and the quality of the care they provide. Wages have to be competitive to attract and retain staff. Training for direct care work has to become mandatory to make sure care standards are met, much more significant and systematic incentives and support for training will be needed and supervision, career progression and staff development will have to be dramatically improved if we are to attract and retain the workforce that is needed.

Hal Swerissen is emeritus professor of public health at La Trobe University