Aged care workers are being assaulted at an alarming rate when they could earn more as supermarket checkout operators, a royal commission has been told.
Unions and a peak industry body want the federal government to provide increased funding to boost staff numbers in aged care, and increase the wages and skills of its undervalued workers.
Health Workers Union representative Lisa Alcock said a workforce that was "working poor" could not be expected to provide high quality care.
"You can't expect a high quality of care from workers on $21 an hour," she told the aged care royal commission on Wednesday.
Ms Alcock said there was a culture that accepted people who worked in the industry should be prepared to be physically or sexually assaulted on a weekly basis.
"The two most critical pieces of feedback that we receive from members on a daily basis is the alarming rate of occupational violence and that is just something you have to accept when you work in aged care," she said.
"The second is that the incredibly low rate of pay is something that you have to similarly accept."
The commissioners heard aged care nurses earn up to 10 or 15 per cent less than those in the acute health sector, while minimum award rates of pay for full-time personal care staff are set at $20-$25 an hour.
Australian Nursing and Midwifery Federation representative Paul Gilbert said carers questioned why their job was viewed as less worthy than a supermarket position paying $24-$26 an hour.
"The comment I hear is 'I could get paid more working on the checkout of Aldi' and it's technically true," Mr Gilbert told the Melbourne hearing.
Industry body Aged and Community Services Australia's Darren Mathewson said providers agreed the workforce was generally not paid at an appropriate level, but they faced financial constraints.
"Our members for some time have been indicating they would like a greater injection of funding into the system by the Commonwealth to ensure that they can undertake the sort of improvements that they needed to do," he said.
Mr Mathewson noted increases in federal government subsidies to aged care were running at about half the rate of annual award pay rises, which were generally about three per cent.
Mr Gilbert said the federal government had increased taxpayer subsidies to aged care to improve nurses' wages three times over recent decades.
But he said without the ties requiring the funding be used for that purpose, it did not deliver a dollar in improved wages.
Ms Alcock also argued increased funding had to be directly linked to wage rises and increases in staffing.
Mr Gilbert said it was "time to stop kicking the can down the road" after 20 reviews in 20 years.
"We know what needs to be put in place and we need to make it unambiguously uncomfortable for the Commonwealth to put those things in place."
Australian Associated Press