Hon Tony Ryall
Minister of Health
29 June 2011 Speech
Winara Rest Home and Hospital Wing Opening – Waikanae

Opening

Thank you for the opportunity to join you at the opening of your new 24 bed hospital wing here in Waikanae.

Today Winara Rest Home and Hospital is about to add a significant part to the continuum of services older people may need.

I'd like to acknowledge Bupa Care Services who've made a significant capital investment particularly in this region - with the opening of this much anticipated hospital wing today.

I'd also like to acknowledge:
• Hon Nathan Guy
• Jenny Rowan, Mayor of Kapiti Coast District Council
• Lorraine Pollock, Manager, Winara Rest Home and Hospital.
• Staff from Capital and Coast District Health Board
• Winara residents and your family and friends.
•
The Challenges Ahead
Fifty years ago, New Zealand built numerous schools, hospitals and houses to meet the needs of a new generation we now know as "the baby boomers".
As this generation enters retirement, New Zealand faces a new, yet similar, challenge: we do not have the facilities or services to care for these ageing people.
The care needs - or acuity - of older New Zealanders in aged-residential care is getting higher and higher.
And this is changing the services you offer older New Zealanders. Providers are expanding hospital and dementia care, much more so than rest home beds.
Hence, why your new hospital wing - and earlier investment in dementia care - are completely aligned with the future needs of your community.
There’s no getting away from the reality our population is ageing.
In New Zealand in 1950 children under the age of five made up ten per cent of The population, and people over eighty were just one per cent.
Since then the number of 80 year olds has quadrupled to 153,000 in 2010.
And that number will double again by 2030 to 300,000.
In just twenty years' time, it is predicted the two generational groups will be neck and neck - one adult over eighty for every child under five. The so-called population pyramid is becoming a rectangular block.
The old are not so old anymore
The conventional wisdom is the older we get the more likely we are to suffer aged related illness or disability. And that coupled with more of us ageing will crash public health systems around the globe.
But there is increasing evidence that the so-called burden of an ageing population may not be as dramatic as people fear.
A report published in Science magazine late last year argues that rising life expectancy and improved health means while there will be increasing numbers of older people, physically, they will age more slowly.
The American and Austrian authors say that the current methods of predicting the impact of an ageing population are wrong because they are based on chronological age... and consider people as being "old" when they are 65.
The authors say people are living longer healthier lives and, basically, "the old are not so old anymore".
People are fitter, healthier and more active, longer.
In 2006, one in six New Zealanders aged 65 and over was in paid employment.
That’s a big jump up from less than one in ten over 65 year olds working in 1986.
The Science report is saying people can look forward to fewer years of ill-health, much later in life and possibly for a shorter period.
They argue the expected tidal wave of older people dependent on expensive health and welfare services may actually be more of a ripple – for some time to come.
The two effects of getting older and healthier for longer offset one another.
This suggests that there may not be unmanageable pressure due to ageing or end of life expenditure in the medium term.
Don’t blame the elderly for rising health costs
It’s very fashionable to blame the elderly for the increasing cost of health care in New Zealand and around the world.
And while there’s no doubt the cost of health care rises with age, ageing is not the main driver of cost in the health service. So don’t blame the elderly for rising health costs.
Research by the Treasury[1] looked at the causes of real growth in health spending from 1951-2002.
For the decade 1991-2002 real growth in health spending was around 3.6%. This consisted of: 1.34% for population growth, 1.85% for cost of new technology, wider access and staff salaries, and only 0.45% related to ageing of the population.
A similar analysis in Canada also concluded that increased utilisation is driving health costs rather than ageing[2]. New medicines, new technology, more doctors, more nurses, higher salaries are having much more impact.
Taking aged care seriously
This Government inherited a mess in the quality monitoring of aged residential care.

The Office of Auditor General issued a damning report panning Labour's neglect of rest home monitoring.

This government has moved rapidly to deal with aged care issues
In our first budget we increased the subsidies for rest home care by $72 million over four years ($18 million per year) to improve nursing quality and supervision.
Last year we invested another $64m over 4 years in increased subsidies for aged care.
And in this year’s budget we’ve increased subsidies by $100 million over 4 years including a 9% boost in subsidies for dementia beds
We've introduced spot audits, - surprise checks – not the old kind where they used to ring up the rest home to tell them they were on their way.

And we are auditing the auditors to make sure they do their job properly.

Good information is critical to older New Zealanders and their families planning which rest home to choose.

That's why we now publish colour-coded summaries of rest home audits on the Ministry of Health website.

…blue is good, red is not good.

At a glance, older New Zealanders and their families can find out about different rest homes, and make better informed choices about residential care.

Closing

With the opening of this new hospital wing today you have shown that you are ready and able to respond to the needs of your residents and the local population on the beautiful Kapiti Coast.

Today we're opening a keenly awaited 24 bed hospital wing which will increase the provision of aged care here to 82 beds: 24 hospital beds, 29 dementia beds and 29 rest home beds.

There's been a shortage of hospital beds for rest home residents on the Kapiti Coast.

And that's caused considerable disruption for rest home residents who need hospital care – and their families.

I understand from Winara's manager Lorraine Pollock, there's one ninety year old lady who doesn't live her anymore but who's been telling her new caregivers every day that she's coming back to Winara.

This resident had to leave here when she reached a stage where she needed hospital level care.

Since Winara couldn't provide it, she was forced literally to "leave home".

Just like the 59 other former residents who've found themselves in the same boat over the past three and a half years.

Now there are 33 people on a waiting list for this 24 bed hospital wing – and ten of them, including our ninety year old, are ex residents keen to come home.

That is I’m told likely to be very soon.

So I'd like to say welcome home to those residents returning, and congratulations to all of you here now.

This is an exciting time for both you and for the Kapiti Coast District as I know these beds are urgently needed for local older people.

Caring for older people is a rewarding and sometimes challenging field and your new development will provide rewards and challenges in an already busy work environment.

It is a pleasure for me to be here to join you in celebrating this occasion.

ENDS

[1] John Bryant et al., Population Ageing and Government Health Expenditure: New Zealand
Treasury Policy Perspectives Paper 05/01 (The Treasury, 2005), 6.
[2] British Columbia’s Health Care System and Our Aging Population, Urban Futures Institute June 2010

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