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Phil Donato pushed for 24/7 nursing in aged care in 2017. He lost. Now he reckons victory is close
May 31, 2022
By Peter Holmes
Aged care facilities in Orange and surrounds could soon be subject to regulations ensuring registered nurses [RNs] are rostered on 24 hours a day, seven days a week.
After five years of pushing for RNs to be rostered on around the clock in aged care, state MP for Orange Phil Donato believes his Shooters, Fishers & Farmers party is very close to getting legislation passed in NSW that will make it mandatory.
The Orange News Examiner spoke to Phil Donato about the long journey.
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Q: You've been chipping away at this since 2017.
Yeah that's right. In 2017 I introduced a bill into the [NSW] lower house to make it a mandatory requirement for registered nurses [RN] to be in nursing homes 24/7.
That was a bill that originally began with my upper house colleague at the time Robert Brown. He got the bill through the upper house, then it came into the lower house, where I took carriage of it ... it was debated back then and it was narrowly defeated by the Liberal Nationals who voted against it.
We had overwhelming support by all the crossbenchers and also the opposition back then.
Now that the numbers are much tighter and the government is [in] minority, we've reintroduced it.
Mark Banasiak, my upper house colleague who replaced Robert Brown at the last state election, introduced it into the upper house first [earlier in May this year] where it passed, and I've taken carriage of it again in the lower house, and will be introducing it for debate hopefully in the next couple of weeks that we're sitting, in June.
Q: Given the mood around aged care since revelations about the standard of care in some facilities in Australia, are you more hopeful now?
Obviously we've seen the royal commission into aged care, we've heard the stories coming out of that ... a number of findings and recommendations in relation to that - one of those was looking at the staffing of RNs in nursing homes.
It used to be the law. Prior to 2014 it was legislated and was mandatory, but [there were] unintended consequences when the Commonwealth changed the definition of nursing homes, which meant that the mandatory requirement for a 24/7 nurse was removed.
This would put the status quo back in place.
Q: It seems extraordinary - not so much that the change in definition resulted in inadvertent consequences, but that it wasn't fixed when discovered. Was it politics? Business saying it didn't want to have to pay for nurses around the clock?
Yeah probably. You would've thought - it being an unintended consequence [of legislation] - the [Liberal National] federal government could have changed it back then to correct it.
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They didn't.
Maybe it was the corporates, the large aged care institutions that have some level of influence, I suspect, over government. It was certainly very disappointing that in 2017 the government chose not to support it.
That was pretty much politics. The government doesn't like supporting a private member's bill or a bill that's not their own. But now, with the makeup of the Legislative Assembly (lower house) the government do not have the numbers, they are in minority and rely on the crossbench to get legislation through.
I'm hopeful the crossbench will support this bill and also the opposition, who I'm pretty sure will support it.
In essence, it's looking after those most vulnerable people in our community, whether they be our relatives or family or friends in aged care facilities, where you're relying on and trusting those facilities to deliver the best level of care around the clock.
Enrolled nurses and assistants in nursing, who aren't as highly qualified and trained, can only administer Panadol.
They can't administer drugs more powerful; they can't intravenously administer drugs; they can't intubate; and they're limited in their medical skills.
To be able to ensure the best level of care is provided to our elderly residents of these facilities we want make it not discretionary, but a mandatory obligation.
Q: In parliament in 2018 you said that the Nationals MP Adam Marshall claimed your bill would lead to nursing homes having to close. Was that about the cost of meeting those requirements?
Yeah that was his point. I read the Hansard last week of the debate that took place back in 2017.
Certainly those were the concerns the government relied on - and it was mainly National members - that it would cause financial hardship on some of these facilities.
I say this - what value do you put on life and care of our elderly citizens?
This was a requirement before 2014 and I don't think it's an unreasonable burden to expect that these aged care facilities have at least one registered nurse on shift around the clock.
We've all heard the horror stories. And as a local member I've heard from constituents who have relatives and parents and people they know in aged care who have received pretty unsatisfactory levels of care, to be quite honest, and to be quite blunt.
If there was a registered nurse on shift available hopefully that wouldn't happen.
We'll see how serious the [state] government is. I think it's a bill they should support because it's the right thing to do.
People pay a lot of money to go into aged care, their families pay a lot of money, and there are ongoing costs, which aren't cheap either. If putting on a registered nurse is going to send these institutions broke then maybe they're in the wrong business.
Many of them are publicly-listed company, they're profit-driven, but at some point we can't just have the care of our elderly citizens put on the scrap heap because of the financial impost of employing a registered nurse. It is not satisfactory.
Q: What about resident to nurse ratios?
We're not legislating any ratios in terms of aged care. All we're saying is a minimum of one.
Q: How would this work with the new federal Labor government's pledge to have nurses 24/7 in aged care?
At the moment the Labor government, I know they've spoken about it, but they haven't designed a standard or drafted a bill. We don't know when that will happen.
It was a commitment, but this is a bill that is before the house, it's been before the house before, it could be easily passed in the next couple of months to become legislation fairly soon, and I think there is some level of urgency to get this done.
Governments make commitments in election campaigns all the time and we don't know when it's going to be delivered on. We have to take [federal Labor] at their word.
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