Time to take a fresh look at aged care

Upper Hutt Leader - - CONVERSATIONS -

The clo­sure of Wes­ley­haven Re­tire­ment Vil­lage is symp­to­matic of the head­winds fac­ing New Zealand’s aged res­i­den­tial care sec­tor, with un­prece­dented de­mand, work­force short­ages and a sys­tem and fund­ing model that is out­dated and in­ad­e­quate.

We have more peo­ple age­ing and liv­ing longer than ever be­fore in our his­tory – and the older we get the more com­plex are our care needs.

Yet, at a time when we need more care­givers, we’re see­ing im­mi­gra­tion poli­cies that will re­duce the abil­ity of em­ploy­ers to re­cruit and re­tain much-needed and val­ued mi­grant work­ers.

And, at a time when we need more beds, we’re see­ing rest homes forced to close or un­der the fi­nan­cial strain of the pay eq­uity set­tle­ment.

Don’t get me wrong – the New Zealand Aged Care As­so­ci­a­tion fought long and hard for an up­lift in care­giver wages. We ad­vised Gov­ern­ment of what would hap­pen if the set­tle­ment was not fully funded. And it’s hap­pen­ing, with more than 100 NZACA mem­bers fac­ing pos­si­ble clo­sure or re­struc­tur­ing and re­dun­dan­cies in the months ahead.

Those most im­pacted are the smaller fa­cil­i­ties like Wes­ley­haven, and the ru­ral, faith and wel­fare-based and not-for­profit fa­cil­i­ties. These op­er­a­tors are stal­warts of our com­mu­ni­ties, crit­i­cal to pro­vid­ing care for old peo­ple where op­tions might not other­wise ex­ist. We can­not see any fur­ther clo­sures.

We’re work­ing ur­gently with Gov­ern­ment on a tran­si­tional fund­ing pack­age to sup­port these providers through the next six to 12 months.

We’re also see­ing an in­ten­si­fi­ca­tion of dis­trict health boards favour­ing home-based care over aged res­i­den­tial care. Our sec­tor is not against peo­ple stay­ing at home, but where the per­son’s acu­ity is such that aged res­i­den­tial care will en­hance their health and well-be­ing and where res­i­dents and fam­i­lies sup­port this, we don’t be­lieve that DHBs should be putting up bar­ri­ers.

Then there’s the is­sue of care­giver short­ages. Even with the up­lift in care­giver wages, ex­ist­ing work­force short­ages are go­ing to con­tinue. Over the next decade, we’ll need an ex­tra 1000 care­givers a year to care for up to 20,000 ad­di­tional res­i­dents ex­pected to be liv­ing in aged care fa­cil­i­ties by 2026.

Cur­rently, around a third of New Zealand’s aged care work­force hold some form of work or res­i­dence visa. Given the fu­ture de­mand fore­casts, this pro­por­tion isn’t likely to de­crease.

As we head into the election, rather than fo­cus­ing on re­duc­ing im­mi­gra­tion we need poli­cies that en­able our aged res­i­den­tial care sec­tor to re­cruit and re­tain mi­grant care­givers – and have cer­tainty of sup­ply.

The Gov­ern­ment’s re­cent im­mi­gra­tion changes, in­clud­ing in­tro­duc­ing re­mu­ner­a­tion thresh­olds as a proxy for skill and a three-year stand-down pe­riod for Es­sen­tial Skills visa hold­ers – do not do that. They will see trained and com­mit­ted care­givers hav­ing to leave New Zealand af­ter three years as well as go­ing through an an­nual re­newal process.

The NZACA wel­comes a re­view of the com­pletely out­dated Aus­tralian and New Zealand Stan­dard Clas­si­fi­ca­tion of Oc­cu­pa­tions (ANZSCO) that have been sig­nalled for a phase two of tem­po­rary mi­gra­tion set­tings, but the re­view can’t come soon enough.

Cur­rently care­givers are clas­si­fied as ANZSCO Level 4, which ex­cludes these skilled and val­ued work­ers from the Gov­ern­ment’s re­cent changes. How­ever, for Pay Eq­uity Set­tle­ment pur­poses, the Gov­ern­ment recog­nises many care­givers as NZQA Level 4, which is the equiv­a­lent to ANZSCO Level 3.

We un­der­stand that im­mi­gra­tion pol­icy is premised on a New Zealan­ders-first ap­proach and that em­ploy­ers must do all they can to em­ploy and train New Zealan­ders.

Our 600 mem­bers across the aged res­i­den­tial care sec­tor ex­plore all pos­si­ble op­tions to em­ploy New Zealan­ders but there just isn’t the pool of Kiwi tal­ent avail­able to do the work.

As an ex­am­ple, at a re­cent job expo run by the Min­istry of So­cial De­vel­op­ment, one NZACA mem­ber re­ceived a to­tal of 249 queries fol­lowed by 138 ex­pres­sions of in­ter­est, but re­sult­ing in just one suit­able Kiwi be­ing em­ployed.

The Gov­ern­ment has val­ued care­givers to the tune of $2 bil­lion with a well-de­served in­crease in care­giver wages and this work­force in­cludes many mi­grant work­ers.

Ul­ti­mately, the is­sues fac­ing the sec­tor are broader than im­mi­gra­tion and pay eq­uity fund­ing.

We are fac­ing an un­prece­dented de­mand sit­u­a­tion and we need to take a fresh look at how we man­age and de­liver care to our vul­ner­a­ble older peo­ple now and into the fu­ture.

Si­mon Wal­lace is CEO of the New Zealand Aged Care As­so­ci­a­tion (NZACA)

PHOTO: JOHN NI­CHOL­SON/STUFF

At a time when we need more beds, we’re see­ing rest homes such as West­ley­haven forced to close.

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