Budget must confront care crisis
Aged care, particularly for seniors with hospital-level needs, is among the most shameful public policy planning failures in New Zealand. Longstanding reliance on privatisation without sufficient standards for minimum staffing levels, amid decades of underinvestment in health, was bad enough.
Horribly worsened, now, by recruitment and retention problems.
So here we are in Southland, where only four of the community aged care facilities that offer hospital-level care have resources to take on new patients.
In fact, amid a sharply increasing need from the ageing of the baby boomer generation, more than 100 beds have closed in Southland and Otago during the past six months.
Southern patients who need to move into hospital-level care in the community are instead lingering in Southland Hospital, reducing its already severely stretched capacity.
Demand rising, capacity shrinking – it’s an area the May 19 Budget must address.
Aged Care Association chief executive Simon Wallace warns closures and displacements will continue unless the Government steps up by delivering registered nurses working in aged-care facilities pay parity with their peers in public hospitals.
As things stand, he says the present gap between $10,000 and $15,000 would more than double under the pay offer between health boards and the New Zealand Nurses Organisation.
The private healthcare sector relies heavily on internationally qualified nurses and, although immigration rules have been set to encourage migrants with these skill sets, the cry has gone up that we need to make it easier for their families to come too.
The campaign for the introduction of legislated mandatory minimum staff levels across the sector has typically depicted such compulsion as necessary for safe staffing levels.
In the absence of anything more than recommended staffing levels, and many say outdated ones at that, we have been seeing the industry reacting to a problem it declares itself unable to remedy.
It’s been applying its own minimum standards by closing down beds, and entire facilities.
In 2010, the Labour Party recommended making minimum staffing guidelines compulsory and referred to the aged care sector as ‘‘desperate for a revolution’’.
More than a decade later, that desperation persists.
Clearly, compulsion to meet staffing levels that are in real terms unattainable with present resourcing would be futile.
That said, the state does need vigilance to keep this industry honest, and the nurses have plenty of reproach for some private players making large profits while lamenting recruitment and retention problems.
But this shouldn’t blind us to the fact that some 70 percent of rest homes are standalone providers run by not-for-profit religious and welfare organisations.
As Presbyterian Support Southland chief executive Michael Parker says, ‘‘We can’t live off promises’’.
In mid-February the Government attracted some sniffy criticisms for setting up the position of an Aged Care Commissioner to lead systematic change in that sector.
It’s a position lacking the resources to be fairly regarded as a lumbering new bureaucracy.
Carolyn Cooper has now taken up the job and has – it cannot have been difficult – correctly identified staff vacancy rates of 20% across the aged care sector as unsustainable, and that nurses could hardly be blamed for taking better-paid jobs with DHBs.
She won’t be alone, nor should she be, in seeking seriously improvements in these areas when Grant Robertson delivers his Budget.