Elderly people could struggle to get adequate care in the coming years, according to an Auditor-General report that says there is no sufficient plan to deal with growing demand.
Presenting the report to a parliamentary social services committee today, Office of the Auditor-General manager Gary Emery said that while home-based services for older people appeared to be adequate at the moment, there was considerable concern about the future.
The biggest risk raised by District Health Boards was the issue of spending.
"Money is going to become tighter, demand is going to increase, but nobody seemed to be taking a strategic approach and saying 'well okay, we know this is going to happen, how are we going to tackle that?'," Mr Emery said.
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"There needs to be a collaborative approach between the Ministry, the DHBs and providers, and that was the bit we're saying wasn't being planned for, we knew that this train was coming down the track."
Mr Emery said the groups had to go back to the beginning and ensure good quality services were in place to set a benchmark and plan properly for the future.
Already there were difficulties providing home-based care in some places, particularly in rural areas, and there were also inconsistencies across the country in what level of support people received, and how their needs were assessed.
Mr Emery also raised concern about a lack of mandatory standards in the industry, and recommended the Government consider setting them.
While there were very few official complaints about home-based care, Mr Emery said the lack of standards meant it was hard to judge what support people should expect from the care, and said the complaints system was hard to access.
"Our qualified view does not give us assurance that services are effective in all cases," he said.
Along with considering mandatory standards, the report made several other recommendations, including having DHBs work collaboratively to improve the complaints system, and collecting further information to ensure ongoing value for money and service quality.