It is well established that the quality of care and support is linked to the quality of jobs for workers.29 Not only do there need to be enough workers, but those workers need to be suitably skilled and enabled to do their jobs well. Then, they need enough time to deliver services effectively, in a dignified way and with enough training to do their jobs well. These jobs need to be decently paid and secure jobs, enabling workers to stay in the workforce and provide continuity of care and support.
Current workforce shortages are driving poor outcomes for individuals with care and support needs. It contributes to burnout of existing staff, who have limited time to provide sufficient care and support and leads to a lack of availability of services for those who need them.
Having enough workers is the predominant concern for providers across the care and support economy. Despite the recent growth in the number of workers, workforce shortages remain. Worse, these shortages are projected to increase. For instance, worker shortages are projected to increase to around 285,000 people by 2049-50, primarily for aged and disabled carers, nursing support and personal care workers.30
There are a range of jobs across the care and support economy, with different skills required in different sectors. However, there are also similarities between sectors. For example, these workforces have a similar demographic composition and require similar skill levels. As a result, competition for workers between care and support services itself is a source of pressure. Strategies to attract workers to one sector, such as disability support, risks exacerbating workforce shortages in aged care, veterans’ care or ECEC. Solutions therefore need to focus on growing the total care and support economy workforce, rather than focusing on one sector within it.
Making jobs more attractive
The attraction and retention of workers is the most impactful and long-lasting way to ensure a sufficient workforce.
The result of high workloads, low pay and poor conditions is high turnover. For example, one in every four aged care and disability support workers spend less than one year in the profession.31 Staff turnover severs relationships with those receiving care and support. It means a loss of the skills and knowledge that has accumulated in a staff member and results in time and resources being invested into recruiting, training and inducting new staff.
Improving the quality of jobs will also support the attraction and retention of workers to the system. Opportunities to improve the quality of jobs in the care and support economy are explored further under Goal 2: Decent jobs.
Getting the right mix of skilled workers
The care and support workforce has a range of qualification levels. While not mandatory in aged care and disability support, most personal care and support workers have a relevant qualification. Overall, the skills profile of the care and support economy shows workers possess a range of skills levels, with the majority of workers holding a relevant qualification.
However, there also needs to be a range of workers with different skills within a sector, or even within one facility, such as in residential aged care. Unsuitable skill mix has been identified as one of the principal causes of substandard care and support in the current aged care system.33
Of course, no sector remains static. As the needs of those receiving care and support change, the skills of the sector’s workers must also adapt. For example, as life expectancy increases, aged care workers will require more specialised skillsets to deliver quality care and support to people with complex comorbidities and acute health conditions. Matching workers to the roles that best use their skills and expertise can drive improved outcomes, worker satisfaction and productivity.
The newly established Jobs and Skills Council (JSC) for early childhood educators, health and human services will identify skills and workforce needs for these sectors and develop contemporary vocational education and training (VET) products. The JSC will also play a role in: working with industry to ensure training delivery meets stakeholder needs; mapping and promoting career pathways; and in providing strategic advice on workforce challenges for both industry and government. The JSC is a mechanism to ensure VET training is responsive to employer and learner needs and current and emerging skills gaps.
In addition to formal qualifications, the increasingly diverse Australian population also requires a workforce that is culturally competent for First Nations peoples, people from culturally and linguistically diverse backgrounds and lesbian, gay, bisexual, transgender and intersex people.34
Governments can also support a suitably skilled workforce by examining the funding arrangements that either incentivise or discourage workforce training. For example, when funding is provided for specific services and the pricing is set only for the time taken to deliver those services, this can result in insufficient funding to cover training. Addressing this issue requires a broader consideration of funding models and pricing, discussed further under Goal 3: Productive and sustainable.
Growing the First Nations care and support workforce
First Nations peoples should enjoy long, healthy lives centred in culture with access to culturally safe and responsive care and support services. To enable this, there needs to be a sustainable First Nations care and support workforce, especially in regional, rural and remote areas where workforce shortages are more acute. Care and support services for First Nations peoples should be delivered through community-controlled organisations that are based in communities wherever possible.
The number of community-controlled organisations providing care and support services will need to increase to meet the growing needs of First Nations communities and ensure culturally safe services are available. Streamlining regulation across the care and support system could help to support community-controlled organisations to expand current and more flexible service provision across each of the sectors within it.
Access to qualifications is a barrier for expanding the First Nations care and support workforce, and completing training away from Country can be an additional barrier for First Nations students. Community-controlled training organisations are well placed to deliver a mix of accredited and non-accredited training for First Nations peoples. They deliver tailored training in a culturally safe environment and often provide wrap around assistance for students to ensure they are able to successfully complete their program of study.
All Australian Government actions should align with the National Agreement for Closing the Gap. Specifically, they should be developed in genuine partnership with First Nations organisations; support the growth of the community-controlled sector; and ensure government organisations are culturally safe, responsive to the needs of First Nations peoples and free from racism.
The Australian Government has committed to replacing the Community Development Program (CDP) with a new program that delivers good jobs, better pay and decent conditions. These reforms offer an opportunity to support the rapid development of a care and support workforce and realise economic benefits for First Nations communities.
The role of migration in the care and support workforce
Migrants make up a significant proportion of the care and support workforce.
Given Australia’s current tight labour market, migration is likely to continue to be part of the solution to workforce shortages. Currently, the skilled migration pathway is an avenue to help fill roles such as ECEC Centre Managers, teachers, nurses and allied health professionals. However, this is not suitable for filling roles at lower skill and income levels such as personal care workers or early childhood educators.
While skilled migration offers some solutions, other migration pathways are available to help employers meet workforce needs through temporary migration. For example, employers may apply for a Labour Agreement to engage migrant workers where there is a need that cannot be met by the local labour market. The Australian Government has worked with employers and unions to streamline this process in the aged care sector. On 5 May 2023, the Government announced the establishment of an Aged Care Industry Labour Agreement. It will provide a streamlined pathway for aged care providers to access direct care workers from overseas, where standard visa programs are not available, whilst ensuring providers continue to support existing domestic workers. In addition, the Pacific Australia Labour Mobility Scheme is a pathway to engage migrant workers from Pacific Island countries and Timor-Leste on a temporary basis. This is currently being trialled in aged care.
It is important to factor in that over-reliance on migrants in lower skill and lower-paid roles risks embedding low wages across the care and support economy. This would make attracting domestic workers more challenging. Additionally, there is likely to be greater competition for migrant workers in the future as all nations grapple with declining dependency ratios. Migration is also vulnerable to global disruptions, as was evident during the COVID-19 pandemic.
Objectives
1.2 The workforce has the right skills and training to deliver quality care and support
1.3 Workforce supply meets demand
How will we get there?
The Priority Workforce Initiatives Action Plan will outline initial steps towards ensuring there are sufficient workers and that those workers have suitable skills and training.
Among these steps will be the establishment of a governance function to coordinate workforce planning across the care and support economy. This includes leveraging the work of the relevant Jobs and Skills Council; developing and overseeing a data strategy; identifying workforce gaps and work across governments to develop targeted policy responses; monitoring and evaluating actions; and disseminating ongoing learnings.
Consideration of migration pathways for lower-skilled workers will form part of the solution in the short term. This will be complemented by actions to make jobs in care and support more attractive as part of a longer-term approach to workforce shortages.
These actions will build upon work to date including:
- The Australian Government commitment to funding (jointly with states and territories) 480,000 fee-free TAFE places over 4 years to address skill shortages, including in care and support.
- The Australian Government is providing 20,000 extra university places, including 1,469 for early childhood teachers across 2023-24.
- The Closing the Gap Disability Sector Strengthening Plan, and Early Childhood Care and Development Sector Strengthening Plans, endorsed by all levels of government. These plans provide a framework for a national and coordinated approach to strengthening the disability and early childhood community-controlled sectors, and include dedicated actions to strengthen the workforce.
- The Australian Government commitment to replace CDP with a new program with real jobs, proper wages and decent conditions – developed in partnership with First Nations peoples.
- I Arends, C Prinz, and F Abma, ‘Job Quality, Health and At-Work Productivity,’ OECD Social, Employment and Migration Working Papers No. 195, Organisation for Economic Co-operation and Development, 14 June 2017.Return to footnote 29 ↩
- NSC (National Skills Commission), ‘Care Workforce Labour Market Study: Final Report,’ NSC, 30 September 2021, [13].Return to footnote 30 ↩
- NSC, ‘Care Workforce Labour Market Study.’ [13] Return to footnote 31 ↩
- PM&C analysis of 2021 Census data.Return to footnote 32 ↩
- Royal Commission into Aged Care Quality and Safety, ‘Final Report: Volume One,’ Royal Commission, March 2021 [16]. Return to footnote 33 ↩
- Senate Community Affairs References Committee, ‘Future of Australia’s Aged Care Sector Workforce,’ Senate Printing Unit, Parliament House, June 2017 [89-100].Return to footnote 34 ↩
- PM&C analysis of 2021 Census dataReturn to footnote 35 ↩