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

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