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Q平成21年度4月の介護報酬改定の特徴と介護職員処遇改善との関係はどうなっているのでしょうか?

A介護労働者の処遇改善を目的にして、3%介護報酬を上げるのですから、「介護労働者の給与を一律3%上げる」。のが普通ですが、改定内容はそうなっていません。
介護報酬は、基本報酬(介護保険サービスの単位)と加算(付加価値サービス)から構成されています。介護業界全体の処遇を良くするためには、介護報酬全体の底上げを図る必要性がありますが、今回の改定では、多くの加算を創設し加算等による報酬配分をおこなっています。負担の大きな業務や有資格者を評価するという趣旨で加算すれば、経営者は介護福祉士の資格を取得させるために、労働者を研修にも行かせるだろうし、長く働くように引き留めるだろう、と考えているのです。つまり、加算によって、誘導しているのです。
加算はオプションなので、加算をとらないと事業者だと賃上げの原資を十分確保できない状態です。加算なしで、十分な賃金引上げは困難です。ただし、加算ばかりになることで、事務作業が極めて煩雑になります。今までも、提出書類が多くて、それが、介護労働者が職場を辞めていく大きな理由でした。にもかかわらず、またもや書類が増えてしまうことになります。
しかも、負担や専門性、キャリアを加算等によって「評価」するといっても、個々の労働者の賃金とは直接関係がありませんから、介護労働者の低賃金問題を解決することは全くできない仕組みとなっています。

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