Linda Hardman was beginning to feel that time was running out. An assistant in nursing (AIN) in an aged care home for over 20 years, she had never experienced such major advances in pay and working conditions as in the last two years.

Pay increases and recognition for a profession long undervalued by Australia’s highest authorities have been achieved. The skies finally seem to be clearing for Hardman, and her profession as a whole, after many years of struggle. “We’d had the normal wage increases that we get with our enterprise bargaining, but we were still far behind,” she explains.

In March 2024, the Fair Work Commission, Australia’s workplace relations tribunal, made a landmark decision for assistants in nursing and other aged care workers. Acknowledging that all the jobs in the sector were undervalued, the commission ordered basic pay rises of up to 28.5 per cent. The increases take into account a 15 per cent rise already announced by the Australian government at the end of 2022.

The decision is a victory for the various unions that brought the case before the Fair Work Commission, the Health Services Union (HSU) and the Australian Nursing and Midwifery Federation (ANMF), but above all for the many employees in this predominantly female sector.

Inflation and low pay

The situation had become unbearable over the last few years. Between the Covid-19 pandemic, the rising living costs in Australia and the serious decline in working conditions, Hardman warmly welcomes the decisions taken by the Fair Work Commission and the government.

“I’m on my own, I’m a widow, I’ve got three grown-up children and five grandchildren, and I rent. And because of the cost of living at the moment, when I do get the increase, it is going to improve my quality of life,” says the care worker.

Inflation in Australia reached 7.8 per cent at its peak in December 2022. At the same time, the country’s major cities have been hit by a massive housing crisis. The Illawarra region, south of Sydney, where Hardman lives, has not been spared.

“When you have two rent increases in a row, then you’ve really got to crunch your numbers and think about what you’re doing and be a bit more careful. So the pay rises will make a big difference,” says the union delegate, who is due to retire in three years.

For as long as she can remember, Jocelyn Hofman cannot recall such a significant victory ever having been achieved. Yet she has long been fighting for better working conditions with the New South Wales Nurses and Midwives’ Association (NSWNMA), the main union for nurses and assistants in nursing in the state.

A registered nurse, originally from the Philippines, she has been working in the care sector since 1987. When asked if she had ever received a pay rise like this during her 37 years in the profession, she lets out an indignant laugh and says, “God, no, nothing this decent.”

She also welcomes the recent decisions. “We just weren’t catching up with the expenses of life,” she says. Still, she is well aware that the pay rises will not be enough. “It’s more of a correction really. Because we were paid 10 to 15 per cent less than in the public health system.” For Hofman, a member of the NSWNMA Council, this victory is by no means the final goal, but “it’s a start”.

Aged care: a complex yet undervalued profession

The aged care sector is in tatters, having been undermined for too many years, according to the various people interviewed. Since 1997, and the deregulation introduced by the conservative politicians then in power, aged care has fallen into the hands of the private sector.

“One of the big issues is we have relied on the private market and for-profit institutions to deliver aged care under this neoliberal fantasy that competition produces quality care and somehow produces quality work,” says Sara Charlesworth, emeritus professor at the Royal Melbourne Institute of Technology (RMIT) University. Her research over the past few years has focused on gender inequalities in employment and the low pay in feminised sectors of the labour market.

She closely follows the situation of workers in the aged care sector and has provided her expertise on the subject on several occasions in cases such as the Royal Commission of Inquiry, launched in 2018 by the government of conservative prime minister Scott Morrison following revelations of neglect and abuse within the elderly care system, or the recent proceedings of the Fair Work Commission.

“I brought evidence on how the work is so profoundly undervalued and underpaid and has poorer conditions than even many other feminised sectors.”

It is a sector that is undervalued, despite its essential nature, and reflects, as the Fair Work Commission has recognised, assumptions based on gender. “In simple terms, it’s because care work looks like the work women do for free,” explains Sara Charlesworth. “For a long time, we just assumed that these workers did this work out of the goodness of their heart, because they liked old people and that’s how it was. That they’d grown up somehow naturally being imbued with caring qualities. A lot of employers used to refer to these as attributes, not skills.”

So when Hofman and Hardman appeared before Australian legal authorities to justify the demand for better pay, they had to detail the realities of a complex and exacting job that requires specific skills.

Both were called upon to testify before the Fair Work Commission. “It’s a very complex job. It’s very physical and it can be very mentally straining at times, because you have to really be adaptable. Every shift is different, because sometimes someone might have a stroke or they could have a fall,” says Hardman, who feels honoured to have been able to represent her profession before the commission.

Emerging from the shadows

In addition to the testimonies provided by Hofman, Hardman and Charlesworth, the last few years have also seen the profession emerge from the shadows. The Australian Nursing & Midwifery Federation (ANMF), the national umbrella organisation for the unions in the various states, has seen the “value of nurses and carers” highlighted during the Covid-19 pandemic. “There was absolutely lots of community support for nurses and care workers,” says Julie Reeves, a nurse working as a strategic lead in aged care for the ANMF.

“We have shown how resilient we are. We continued to care for our residents even though it was quite scary in those times, because we didn’t know what was going on. It’s ironic that it took a Covid pandemic for them [the authorities] to realize how valuable we are.”

For Lloyd Williams, national secretary of the Health Services Union, although the Fair Work Commission’s decision on pay rises is minimal compensation, it nonetheless recognises, at last, the importance of the elderly care sector. “The HSU work value case was a watershed moment for the aged care sector. This was more than just a pay rise – it was about recognising the invaluable contribution of aged care workers who have long been the unsung heroes of our nation.”

For the care workers interviewed, there is still a long way to go to achieve fair recognition. Firstly, because the government has staggered the pay rises, which will not be fully received by the sector’s employees until 2025. As Lori-Ann Sharp, assistant federal secretary of the Australian Nursing & Midwifery Federation, explains by telephone, the increases will be received in stages, in January and October of next year.

Also, the increase of up to 28.5 per cent, depending on the employee’s level of qualification and experience, does not apply to all staff, only AINs, personal care workers and other workers in nursing homes.

“At the moment, as we speak, we also got a 15 per cent interim increase for registered nurses in the aged care sector,” says Sharp.

The phasing in of the pay rise is a minor concern for Hardman, who is relieved at the prospect of seeing the pressures of everyday living costs eased. “It doesn’t matter. Eventually we’re going to get it, so I think it helps inspire you and helps you keep the faith.”

Hope. This is what the Fair Work Commission’s decision is really about: the hope that the authorities will take action, at last, to address the growing pressures on the sector.

Staff shortages: an ongoing reality

The hope is that better pay will attract more workers. “The main issue is the staff shortages. Because if you haven’t got enough staff on the floor, you can’t provide the quality of care that you want to provide.”

Hofman, who works as a registered nurse in a aged care home in western Sydney, says she often has 80 residents under her watch when she works nights. “On night duty there’s only one personal care worker for 20 residents,” adds the nurse, who often finds herself being the only person there that is qualified to provide advanced care.

Many aged care workers and assistants in nursing report the absence of a registered nurse during their shifts on the Aged Care Watch platform, a tool developed by the main trade unions.

“Aged care should be a human right, not just a market transaction,” insists Hofman. “That’s why I started fighting for having registered nurses 24/7 on the floor in nursing homes. Our residents can deteriorate at any time.”

According to Professor Charlesworth, some improvement has been seen since the initial pay rises. “The staff shortages are very real but after the first 15 per cent wage increase there has been some increased retention and recruitment,” she explains, at the same time as denouncing private aged care providers for not “addressing the elephant in the room”. “They could start offering full-time jobs instead of very short hours, part-time contracts,” points out the professor.

The Australian government, for its part, seems determined to make a difference. In 2022, the Labour Party was elected on the promise of a sweeping reform of the aged care system, promising better pay for workers in the sector, as well as more staff, to ensure that all residents have more time with care workers and nurses.

On 12 September 2024, Prime Minister Anthony Albanese’s government tabled a bill to this end, pledging to invest 5.6 billion Australian dollars (around €3.46 billion). It is a step forward that has been welcomed by those in the sector but has not fully satisfied them. “The Act doesn’t go far enough in the accountability and transparency of the taxpayer funds,” says Sharp. “The people running the nursing homes aren’t properly held accountable for how that money is spent and distributed on care.”

Charlesworth also points to “the lack of transparency about the funding that aged care providers receive” and is “very concerned” about it still being “profit-driven”.

For the women working in the sector, the historic year that has just unfolded and the prospect of this reform, which could take effect in July 2025, do not spell the end of their worries or their struggle. “The thing is we’ve never had anything like this before. But we’re keeping the pressure on Anika Wells [minister for aged care and sport]” says Hardman. “There’s an election next year, so we want to make sure that the politicians are accountable as well.”