Heather Roy's Diary
The Old and the Restless
The election campaign was long and hard fought but I am now experiencing the lull following the storm - the last week
has been surprisingly calm. ACT continues to occupy the eighth floor of Bowen House opposite the Beehive as we have
since 1996 although our parliamentary representation this term only justifies a smaller office allocation. Parliamentary
Service is responsible for allocating office space to parties but they have a problem. No-one knows who is going to be
in government and which parties will therefore be prepared to share floor space and which will be opposing each other.
Negotiations between Labour on one hand and the Greens, New Zealand First, United Future and the Maori Party on the
other continue although the nature of the new government remains guesswork. I regret to say that I have no insight into
the nature of the negotiations and, for the moment I am just an observer getting information from media outlets like
everyone else.
So, with a little extra time on my hands I have been visiting Internet web logs commonly known as blogs. Long may they
flourish as a medium for political debate. Most have a declared political stand and that makes a refreshing change from
traditional media outlets, which claim neutrality. I particularly enjoyed one article on David Farrar's blog this week.
It gave the average age of MP's of each political party. According to David the averages were as follows:
ACT : 44.5 years National : 49.8 years Labour : 50.8 years Greens : 52.3 years United Future : 56.5 years Maori Party :
58.3 years New Zealand First : 58.8 years Progressives : 67.0 years
By these calculations the touted coalition is likely to be one of extreme antiquity. As the younger MP in the youngest
party I enjoyed the joke.
Aging Politicians and Aged Care
One of the problems with caretaker governments preoccupied with coalition negotiations is that the real world rolls on
with all of its attendant problems. Given their average ages the MPs should be a little more concerned about the
problems being faced by the elderly requiring care. During the election campaign some billboards surfaced asking voters
to take the plight of aged care into consideration. Unfortunately an opinion as to which party had the best policies was
never ventured so I doubt that the billboards made much difference to the result.
The problems are numerous - poorly paid caregivers both in the community and those working in residential units,
registered nurses paid significantly less than those in District Health Board run hospitals resulting in widespread
staff shortages to name just a couple. The main problem is price control by government, which holds rest home fees for
subsidised patients at a fixed amount imposing a loss on many rest homes. The end result is that rest homes are closing
up shop as waiting lists rise and rise.
For example, the Salvation Army, earlier this year put all 12 of its residential aged care centres on the market after
70 years in the business. There have also been residential care facilities and private hospital closures in Dunedin and
Christchurch. One might expect that if there was a shortage of places then residential facilities should be opening, not
closing. When things appear to be happening back to front it is wise to look for government involvement.
However, the government price for residential aged care is fixed. Any charge to the government subsidised patient for
services such as doctors visits, medicines, medical supplies and other treatments such as physiotherapy can't be passed
on but are the liability of the rest home. The Labour government has for the past six years stuck stubbornly to a
rigidly controlled price although the history of price controls is one of unmitigated disaster in every sector and in
every economy in which it has been tried.
Labour fears that if it allows additional charges to be made to residents or if it increases the payment then that will
allow profiteering by the residential homes. Indeed Labour Ministers have been known to accuse aged care facilities of
doing exactly that. My own feeling is that these fears are misplaced. Religious organisations like the Salvation Army
are not known for their avarice and it is simply unrealistic to expect anyone, no matter how committed, to take a loss
on their business year in and year out.
The rest home industry was thriving at one stage but things are going downhill fast. The worst-case scenario is this -
as residential homes try to operate on a fixed income in the face of rising costs financial disaster is inevitable.
There is already an under-capacity and it is beginning to get difficult to find a place for patients. I predict that the
queues will get worse while rest homes and hospitals for the elderly close down by the score. The public will look on
bewildered as demand of residential homes rises and supply of rest homes plummets.
NZNO Report
Earlier this week the NZ Nurses Organisation released a report on a 'snapshot study' they carried out on 40 aged care
facilities. Concerned by comments in a Ministry of Health handbook outlining 'indicators' of safe staffing levels and
standards of care and particularly the assumption that these indicators were largely being met, the NZNO carried out its
own survey. The results confirmed what those working in the area already knew - staff shortages are rife. Staffing
levels for caregivers in rest homes were at 56% of expected levels, and for nursing staff at rest homes 53% of expected
levels. In many settings Enrolled Nurses, recently prohibited by the Nursing Council from working in any area other than
that with 'stable outcomes', are being used to substitute for Registered Nurses. As the NZNO report states, "the
findings of this study are important, and offer an important series of findings about staffing trends". Unfortunately
the report has been largely ignored. Until there is political will for change aged care will remain the poor cousin in
the medical arena. The report is available at www.nzno.org.nz/Site/Campaigns/aged_care.aspx. So while negotiations for
the next government occupy the minds of those involved the real problems continue to escalate unattended.
ENDS