Fast Tracking a National Care Service

We face the immediate future burdened with an out-of-hospital care workforce that is poorly paid, insufficiently skilled and understaffed to meet the caring needs of vulnerable people throughout the life span from infancy and childhood to old age.

At the same time we have a bloated income support and unemployment benefits system structured round punitive governance that discourages job seeking by capable youth and adults.

But this conjunction actually opens up an opportunity to create a joined-up National Care Service that can widen access to jobs in the caring professions. And by deploying funds already committed to our inefficient welfare system, it can be done quickly and not all that expensively.

As Professor Stephen Leeder wrote in 2018:

‘An Aged Care Commission should be introduced to streamline the aged care system, and should include a role that ensures there is an adequate supply of appropriate, well-trained staff to meet the demand of holistic care to a multicultural, ageing population, and also to ensure the aged care workforce has clear roles and responsibilities.’

A National Care Service would offer voluntary and fair-waged roles funded out of a combination of some of the money currently available for job-seekers, unemployment and other income support and benefits. These funds could be combined with the community health and social care budgets in a de-privatised care economy together with means-tested fees for some services beyond a reasonable threshold of income. Since the wages would be fair, most employees of the NCS would be taxpayers.

Training would be offered in blended programmes of online modules and workplace/work experience placements.

The training would begin in middle secondary school and progress to Further Education and Higher Education, building on present vocational pathways and apprenticeship models.

The training would focus on core care knowledge, skills and attitudes to generate transferable competences to enhance employ-ability within and beyond the care economy.

Placement opportunities would be articulated within the formation of a de-privatised care economy and would help to provide auxiliary staff prior to completion of training in this labour-intensive sector.

The pre and post hospital training scheme would be a ‘ladder’ to entrance to fully ‘professionalised’ health care education and training programmes.

The involvement of secondary school, FE and HE sectors in developing and delivering the skills modules would be an important element in the reconfiguration and deployment of their capacity in the context of pandemic futures with fewer overseas students.

With the predictions of demographic changes and the prevalence demographics of Covid19 type outbreaks, participation in a National Care Service workforce should be available through all age groups to provide a ‘currency of caring and sharing’ that they too may need to call on for themselves or their families.

We need not only a monetised care economy but an additional, new currency of caring and sharing. Participation in the National Care Service workforce can be incentivised by a range of rewards including fair wages, training bursaries, grants for further education and training, and earning entitlements to future care for self or family scaled by the level of one’s own service.

There are models of the earning of entitlements such as Military Service Benefits ranging from the US GI Bill [pp.23-24] to educational bursaries offered by the Australian Armed Forces.

The proposed alignment of education, training, work experience and apprenticeships to clearly identified needs of a sector of the national workforce would overcome many of the failings of unfocused youth training and job seeker initiatives. As in US New Deal job creation programmes, there would be focused alignment with social and economic needs, in this case in the care sector.

For example, during its eight-year existence, the Works Progress Administration [WPA] put some 8.5 million people to work (over 11 million were unemployed in 1934) at a cost to the federal government of approximately $11 billion. The agency’s construction projects produced more than 650,000 miles (1,046,000 km) of roads; 125,000 public buildings; 75,000 bridges; 8,000 parks; and 800 airports.

The Civilian Conservation Corps [CCC](1933–42)provided national national work primarily for young unmarried men. Projects included planting trees, building flood barriers, fighting forest fires, and maintaining forest roads and trails. The CCC at its largest employed 500,000 men, provided work for a total of 3,000,000 during its existence

Over the past thirty years I have worked in the design, delivery and accreditation of health professions training at university level.

I know that the educational basis of credentialing for out- of hospital care has begun at the lower vocational level, but it needs to be be articulated with formal workforce frameworks and governance in order to attract and protect workers, particularly in the complex health economy that we now have to build so urgently.

It basically requires a fast track alignment of the educational/training ladder and job seeking benefits frameworks. The post-secondary sector may well have considerable spare capacity that can quickly be repurposed to the fast track building of the educational framework outlined here. The government seems to have the capacity to quickly change the legislative basis of the income support system,

When the Fates hand us lemons we should make lemonade. Here we have an opportunity to build a new career ladder in the caring professions financed in part with monies that  are being spent on unfocused preparation for job seeking by people of all ages who were left out of the pre-Covid-19 economy and those who are newly out of work. And it can be done in a matter of months.

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Sue Rabbitt Roff grew up in Melbourne during the British testing period. Her studies of the long term health effects on military participants in the tests have supported more than sixty successful appeals against denial of pensions in Australia, the UK and New Zealand.

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