Aged care dirty work done dirt cheap

The Federal Government's $1.2 billion plan to lift the wages of aged care workers from July is in danger of collapsing. This is due to employer dissatisfaction with an increased role for unions, and frustration that the package falls short of the Productivity Commission's recommendations for aged care reform.

The ageing of the population will require the size of the notoriously underpaid workforce to treble by 2050, and the Labor Government is offering to contribute towards pay rises above the award wage. But the industry is unhappy with the condition that employers sign up to enterprise bargaining agreements, which is deemed necessary to ensure that employers do not pocket the funds. 

An industry body argues that the plan discriminates against the 65 per cent of the aged-care sector that are small and standalone providers, with nearly half the large Catholic component of the sector unlikely to sign up. But inaction that leads to failure to reach an agreement to secure the earmarked funds amounts to discrimination against one of the most vulnerable groups of the population.

What is often regarded as 'basic' nursing care is actually a demanding and complex role, dependent upon both an often unrecognised level of skill and discretion on the part of the worker. As Sydney University health educator Professor Mary Chiarella argues, these workers are invariably the ones who make or break the dignity of a person in aged care, by how sensitively they choose to perform their role.

Despite what those who don't do this work might think, it is not basic — it is extremely psychologically complex. Cleaning patients who are soiled with excreta, blood, or vomitus, who feel ashamed of themselves for being 'dirty' or for 'losing control, and restoring both their hygiene and their sense of self worth in the process, requires the highest order of skill.

Chiarella describes much of what nurses do as 'invisible', performing the most private of functions for a patient, such as washing genitalia. Nurses do things which have the potential to strip patients of their dignity, but most of the time they choose to enhance it. Managing sensitive issues to do with the body is not given the same status as a psychiatrist handling sensitive issues of the mind, because it is considered 'dirty' menial or domestic work.

As is the case in many workplaces, there is an important link between pay and performance. If the workers are treated with dignity, they are more likely to treat the patients with dignity, which is what aged care is all about.

It's time to step up negotiations. Wage increases for aged care workers should not be allowed to become yet another laudable but failed Gillard Government initiative that an incoming Coalition government refuses to countenance because of its stated commitment to fiscal responsibility.

The dignity of older Australians is not expendable.