Editorial

Abstract

In the 1960s the Australian government established the aged care programme to provide subsidies to residential aged care providers. Within a couple of decades, Australia had one of the highest proportions in the world of its older citizens in residential care. In the mid-1980s, to remedy this overdependence on residential care, the Australian government introduced the home and community care (HACC) programme. The HACC programme provided care to the frail aged and disabled; and funded the establishment of many small, stand-alone, non-government service providers. Community care developed separately from residential aged care. The legacy of these policy decisions is two sectors that together constitute one large aged care sector providing complementary and sometimes overlapping services but with separate cultures and workforce traditions. Aged care workers are currently employed by a mix of public, private-for-profit and not-for-profit service providers and, compared with the acute care sector, are distributed across a large number of mostly small to medium sized services, operated by small to large organisations, with most having little individual capacity for workforce planning and development. Over recent years the sector has developed a reputation for staffing shortages and high staffturnover. This diversity of settings, variety of ownership types, range of sizes of services and organisations, and reported workforce issues are, arguably, the outcomes of past government policy. The Living Longer Living Better reforms to the aged care sector announced by the Australian government in 2012 introduce a period of reform in aged care and it is timely to examine the similarities and differences across these sectors and to identify the policies and management practices that are likely to enable the industry to develop the resilient and sustainable workforce needed to meet the predicted demand.The Productivity Commission (2011) has predicted that by 2027 there will be a need for 287,000 residential aged care beds (up from 167,000 in 2007) and about 976,000 HACC individual client services (up from 518,000 in 2007). If current ratios of staffto residents and clients remain constant, this will require a 72% increase in residential aged care staffand an 88% growth in community care staff. In 2012, within the aged care programme, there were approximately 5,300 separate funded services operated by about 1,400 providers. There are approximately 3,300 agencies providing HACC services and seven in 10 HACC organisations employ fewer than 20 workers. Collectively the industry employs approximately 133,000 care staffin residential facilities and an additional 74,000 in community care (Australian Institute of Health and Welfare, 2011). This workforce is predominantly female, a majority work part-time with a quarter employed casually or on contract. They have been paid less than other industries and have a lower level of education than the overall Australian workforce (Australian Institute of Health and Welfare, 2011). Considering this workplace profile and low salaries, it is not surprising that reported workforce issues include a claim of continuing shortages of skilled staff, difficulty in recruitment and high turnover. There is also a continuing discussion on the appropriate staffing mix and arguably a poorly coordinated approach to workforce planning. These workforce claims and the potential strategies to address them are worth examining during this period of aged care reform.The most recent list of skills shortages published by the Australian Government Department of Employment, Education and Workplace Relations (DEEWR) (2012b) suggests that in 2011/2012 the 'social and welfare professions' had the second highest rate (across all occupations surveyed that year) of 'proportion of vacancies filled' (83%; and second only to school teachers at 89%) and nurses and midwives had a vacancy fill rate of 75% (an increase of 12% over the previous year and well above the mean of all occupations listed in the report). …