Elderly care costs need review

The quality of the care available to the elderly rarely gets on to the political radar.

Yet according to a 2010 estimate, there are about 42,000 people receiving care in more than 700 aged residential care facilities in New Zealand, with a further 75,000 elderly people receiving some level of state support to enable them to remain in their own homes.

Those bald numbers are due to increase, sharply.

The population aged over 65 will grow from 13 per cent in 2010 to a predicted 19 per cent by 2026 and 25 per cent by 2051.

The number of people older than 85 will also increase, from 58,000 in 2006 to 127,000 in 2026.

Meanwhile, the wages and working conditions for the rest home workers we entrust with the care of the elderly have been a scandal for years.

Most of the workers involved are women, a significant proportion are migrants, and many are receiving little more than the minimum wage.

Last week, a report by Judy Mcgregor of the Human Rights Commission issued a scathing indictment of the situation.

‘‘ It offends against human decency,’’ Dr Mcgregor reportedly said. ‘‘ The reliance on the emotional umbilical cord between women working as carers and the older people they care for at $13 to $14 an hour is a form of modernday slavery.

‘‘ It exploits the goodwill of women. It is a knowing exploitation. We can claim neither ignorance, nor amnesia.’’

For many people, how the agedcare industry functions is something of a mystery.

Increasingly, chains of major private providers (some owned in Australia, some in Britain) are displacing or taking over the former not-for-profit church-run facilities and the small-scale local providers.

Therein lies the puzzle. How can the owners continue to rack up large annual profits and yet receive public money, at the same time as the working conditions and the career prospects for the staff on the front lines remain so poor? The short answer is there is no auditing of how the public money involved is being spent.

Note this exchange, from parliamentary question 11435 in 2010:

Sue Kedgley to the Minister of Health (Jun 17 2010): ‘‘ Is any financial auditing of aged care facilities carried out, to ensure that all government funding is directly spent on the provision of care for the elderly; if so, how, and by whom?’’

Hon Tony Ryall (Minister of Health): ‘‘The auditing of aged care facilities does not extend to monitoring how government funding is spent. Private providers are expected to supply contracted care services that meet the assessed need of all the residents and this has been the case under the previous government.’’

In other words, there is no way of tracking if any additional funds would be used for the purpose intended, such as boosting wages, or providing additional staff or better building maintenance, rather than going straight into the pockets of shareholders.

Dr Mcgregor urges a sweeping revamp of the sector – complete with ministerial responsibility, strict targets, enhanced training etc to bring standards up to the levels found elsewhere in the health sector.

However, in the current climate there seems little will at Cabinet level for giving rest home workers anything more substantial than a big round of applause.