Simon Wallace: Aged care sector needs ministerial responsibility

COMMENT:

New Zealand's aged care sector welcomes measures that help improve the quality of care for our most vulnerable citizens, but renewed calls to establish an Aged Care Commissioner are misinformed and do not address the fundamental challenges facing the industry.

Associate Health Minister Jenny Salesa has revealed she has asked the Ministry of Health for advice on establishing an Aged Care Commission. Minister Salesa's revelations follow Grey Power's recent call for Labour and the Greens to honour their pre-election promises to establish a Commission, with "legal powers and powers of enforcement".

Minister Salesa will know that New Zealand's aged care sector is already heavily regulated and numerous Government agencies have plenty of legal clout to enforce good standards of care.

Operators of aged care facilities must meet vigorous audit and reporting systems - including the Ministry of Health's HealthCERT and the local district health boards (DHBs), both of which have authority to investigate rest homes at a very high level. And all of the reports they produce are publicly available.

And there's a complaints process in place that residents are very aware of, with complaints made firstly to the facility itself, then if necessary elevated to the DHB or Ministry of Health and also to the Health and Disability Commissioner (HDC).

According to the latest statistics from the HDC, out of nearly 38,000 available beds, they received 100 complaints about rest homes of which 20 were taken to full investigation. Whilst one instance of poor care is one too many, this does demonstrate that such cases are rare.

The Government's emphasis should not be on establishing another watchdog in the form of an Aged Care Commission, but rather to hasten and streamline the complaints resolution process.

What the Government really needs to do is establish a Minister for Aged Care elevating ageing and aged care to an issue of national importance with policy, regulatory, fiscal and operational responsibilities. Not only would this recognise the issue of a growing population, a dedicated Minister for Aged Care could demand accountability across a range of functions.

A Ministerial portfolio could bring together the existing disparate parts of aged care across government – from the Ministry of Health, DHBs, the Ministry of Social Development to Immigration amongst others – into coherence and to work proactively with the sector to address the big issues and make a real difference.

We have the Minister for Seniors Tracey Martin, a staunch advocate for the sector, but this role is limited in scope and does not have the important policy and fiscal responsibilities as part of the job.

The reality is that our aged care providers have an enormous responsibility in caring for the growing numbers of older Kiwis in our communities, who are living longer and presenting with more complex care needs.

We have repeatedly told government that New Zealand's aged care funding and governance have not kept pace with the increase in demand for care and services.

Despite the significant challenges around workforce shortages, partly driven by immigration policy, the vast majority of New Zealand's rest home providers are doing an extremely good job of caring for the more than 38,000 elderly citizens living in some 600 certified aged residential care facilities around the country.

Rest home care is also delivering value to the lives of older people. Our recent report Caring for our older Kiwis: The right place, at the right time, anonymously analysed more than 300,000 interRAI assessments, interRAI being the clinical tool used to assess people before and after going into care.

It shows that 82 per cent of older people report they no longer feel lonely when they move into care, 74.5 per cent had improved health stability and 62.6 per cent had improved levels of pain.

But it also raises serious concerns about the ability of many elderly people to access care when they need it. Over half of the country's DHBs are delaying access to rest homes for older people who need it, and this can have serious consequences for their health.
Ultimately, we are all striving for the same outcome – the ability to give our older people quality care where and when they need it.

Adding another ambulance at the bottom of the cliff in the form of an Aged Care Commissioner is not going to address the fundamental policy and fiscal issues that are undermining our ability to achieve that outcome.

It is time to see a shift in our political and social ethos toward ageing and caring for our older citizens and establish a Minister for Aged Care.

• Simon Wallace is the chief executive of New Zealand Aged Care Association