Squaring the care circle? Increasing the quality of jobs and the quantity of services in community care Gabrielle Meagher Faculty of Education and Social Work University of Sydney

Disability support will no longer be based on the number of places in a limited number of programs. With people vying to get in the queue. With people shut out because of how they acquired their disability, and other unfair rules. And with too many missing out altogether. (Minister Macklin’s speech to the DisabilityCare Australia Conference, June 2013)

A gender equality issue: correlation between resources for aged and disability care and middle aged women’s employment rates Thanks to Marta Szebehely, Stockholm University, for this chart

Source: Brandt, M., Haberkern, K. & Szydlik, M. 2009, ‘Intergenerational help and care in Europe’, European Sociological Review, 25(5): More formal care does not drive out informal support

More services means more care workers Based on estimated demand projections and assuming models of care are maintained, there will need to be approximately 827,100 aged care workers by 2050 (up from 304,000 in 2010). Living longer, living better (2012, p. 15) … the current system is … characterised by a high level of unmet demand with many people with a disability unable to get adequate access to specialised disability supports. The introduction of the NDIS and NIIS to address this unmet need will require a large increase in the supply of disability workers. Disability Care and Support (PC 2011, p )

Non-managerial adult hourly ordinary time cash earnings by occupation, 2012

The care and support ‘workforce’ – linking unmet need to existing ‘capacity’

Better jobs and better services Employment conditions Staff skills Work organisation

The policy challenge More services Contain costs Better jobs

More services Contain costs Better jobs

More services Contain costs Better jobs

More services Contain costs Better jobs

Can individualised funding ‘square the care circle’?

Workforce risks of consumer-directed care Different employment forms: employed by an organisation contracted to provide a service directly employed by service user Risks for workers’ service continuity and job security income security opportunities to gain, use and retain skills right to work in a healthy and safe work environment right to voice and representation

Promoting service quality and workforce capacity improve government funding ensure the sustainability of service provider organisations minimise the role of cash payments avoid and manage direct employment avoid and manage contracting arrangements avoid employment of family members manage demands for flexibility sound workforce planning and development build alliances between workers, service users and providers involve support workers in research and evaluation