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Disability care needs flexible workforces

Tuesday, May 14, 2013

An ICA member reflects that disability care requires flexible workforce arrangements, and people prepared to do the work! The ICA member says:

I am interested in the progress of the National Disability Insurance Scheme and admit self-interest.  I now have my 93-year-old, infirm mother living in my home and requiring a high level of care.

I am not flush with funds, not so physically strong as I once was, and my house not specifically designed for "assisted living".  This makes care for mother all the more difficult.
 
Mother has access to care from Department of Veterans Affairs (father was a WWII veteran but now deceased).  I suspect this DVA scheme operates somehow as the NDIS ought to operate.  My aged mother has requirements that I would find difficult to provide—items such as a hospital bed, a lifting device because she can no longer stand from a seated positions, special chairs and the like.  The need for this equipment is assessed by the DVA occupational therapist and the equipment arrives, no charge to me or mother.
 
There are daily matters such as bathing and dressing mother; these services are provided by nursing staff from a private provider, financed by DVA.  Neither my wife nor I could physically or psychologically provide the daily attention to these particular needs of my mother.
 
We do the washing of bed linen and clothing, the meals, arrange for simple thing such as her daily medication and communication with her GP, and we provide the assistance mother requires to move around the house and generally provide her with social interaction.  We complain about none of these things.
 
It requires that we pause and see how this DVA scheme would translate to the NDIS.  The provision of the hardware is pretty much a matter of money.  We would hope that wise consideration has gone into forecasting those costs.
 
But the imponderable is "where do the nurses come from?"  We don't seem to have enough personal carers, and the type of care that these true angels provide is not a career that would be chosen frequently by graduates of our tertiary system.
 
The ladies who provide the care for my mother tell me that their "case load" can be 20 to 30 patients per day.  If there are 400,000 persons likely to go onto the NDIS scheme, the top end calculation for new nursing care would be around 20,000.  For sure that is a "very top end" number, but it might give a view of the scope of the project.
 
Where are the carers coming from?  I would guess there might be 10,000 carers coming to Australia on 457 visas?
 
Further, many if not most of the nursing staff are hired on a casual basis.  None of these ladies seem to have great fears about insecure employment. In fact, one of the ladies has been working continuously as a casual employee for the same organisation for 19 years.
 
These ladies chose to work on this basis, and their rosters are arranged around their personal lives.  They could not conform to a rigid employment relationship that the unions seem to require.  The ladies are all members of the relevant union, so one assumes the union is comfortable an amenable to the work arrangements.
 
Some of the ladies work mainly on weekends, many are called in to cover an unplanned absence and, generally, they seem to work a flexible system of engagement, in terms of the hours worked per week and days on which they are on hire.
 
The employer has a management system based on iPhones. The carer's detailed itinerary, and patient care requirements are online for them.  The carers log in and log out at the street in front of my home, thus providing a pretty good system of billing and management (the iPhone knows the address from which the login-logout was made and the times at which they are made).
 
A final thought on the unions’ position in all this: there seems to be inconsistent attitudes across the union movement.  Those unions trying to foist permanent employment onto both the work force and employers would seem to have an agenda that aligns with neither the requirements of the employee nor those of the employer.
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