Media Releases

The E tū union is either being deliberately mischievous or is seriously misinformed about how aged residential care works in New Zealand, says Aged Care Association Chief Executive Hon. Tracey Martin.

The Post published a story last week based on a report titled Transparency and Corporate Tax Reforms to Improve the Efficiency of Aged Residential Care Funding, which has not been made public.

“To level public accusations based on an unreleased document, one that neither the targeted provider nor the public can scrutinise, is not only duplicitous but unethical.” says Ms Martin.

It is disappointing that E tū has chosen to spend time and money on what appears to be a flawed report, in an attempt to bully a particular provider into ceasing a change consultation process with their staff.

Without access to the full report, the Association can only respond to the comments attributed to the report’s authors and the union.

The claim that aged care providers may not be using government money appropriately is either a complete misunderstanding of how aged residential care is funded or a deliberate manipulation of the facts to push an alternative agenda.

Aged care is a complex environment, but at its core, the financial relationship is between the government agency, Health New Zealand, and the individual New Zealander who needs care.

Providers meet rigorous standards to be eligible to deliver aged residential care services to New Zealanders who are funded directly by the Crown.

The Aged Care Association had hoped for a more constructive relationship with E tū for the benefit of their members and ours, based on shared recognition that the funding model for the provision of aged care to senior New Zealanders is fundamentally broken and must be addressed with urgency.

The time and resource spent on this report would have been better directed toward advocating for an independent, cross-party taskforce (including union representation), to design a fit-for-purpose aged care funding model that delivers greater transparency for all, including everyday taxpayers.

Note to editors:

Funding for aged residential care is allocated as follows:

• Aged care providers are certified by government agency HealthCert as meeting criteria to deliver specific levels of care – e.g. Rest Home, Hospital, Dementia, or Psychogeriatric care.
• Certification does not entitle providers to any guaranteed funding. It simply confirms that they meet the required standards to deliver care, such as the required staff and facilities.
• Providers are subject to regular audits (both scheduled and unannounced) by independent auditors approved by HealthCert.
• Many of the standards audited relate directly to staffing levels, and the sector overwhelmingly respects and adheres to the voluntary safe staffing levels agreed with Government.

When a New Zealand senior is assessed by a NASC (Needs Assessment and Service Coordination) team as needing residential care, the Ministry of Social Development reviews their financial situation. If they qualify for support:

• They must first contribute their own income (e.g. superannuation or assets).
• The Government then tops up the difference between what they can afford and a capped amount that can be charged by any residential care provider for the provision of that care, with the capped amount set by the Director-General of Health.
• The individual and their whānau choose the care provider they wish to deliver that care to them.
• All financial agreements around the provision of care are between the government and the New Zealander needing care. None of our members receive a bulk grant from government or have a direct financial contract with government.

Trans-Tasman knowledge of the aged care sector received a major boost in Parliament this week, as Health Select Committee Chair Sam Uffindell partnered with New Zealand Aged Care Association to host Tom Symondson, Chief Executive of the Australian Aged & Community Care Providers Association (ACCPA). Valuable insights were shared with a broad range of Members of Parliament as part of wider visit, where Mr Symondson shared his extensive experience in Australian aged care reforms.

ACA Chief Executive Tracey Martin acknowledged the importance of the visit, emphasising that Mr. Symondson has been central to advancing aged care planning in Australia.

“Tom has played a key role in the recent developments around aged care planning in Australia, both for home and community providers and residential care facilities. We believe New Zealand has much to learn from these outcomes and should consider adapting similar approaches to address the shared challenges our aged care sectors face,” Ms Martin said.

“The reform package in Australia is set to see a $5.6 billion investment, projected to save $12.6 billion over the next 11 years, highlighting that if evidence-based investment is made now, long term savings without compromising health outcomes is possible.”

During his four-day visit, Mr. Symondson engaged with a diverse range of stakeholders, including government agencies, community and residential care providers, retirement and aged care commissioners and Members of Parliament. These meetings provided insights into Australian aged care reforms and explored their relevance to New Zealand’s aged care landscape.

“It’s been an honour and a great privilege to meet with parliamentarians, providers and others from across New Zealand’s aged care and retirement living sectors,” Mr Symondson said. “In some ways aged care in Australia is very similar to New Zealand but there are important differences which means there is so much we can learn from each other.

“Both countries share a common goal of improving the lives of older people and continuing to do so, as we embark on a journey of significant reform, to prepare for our populations to age over the coming decades.”

MP for Tauranga and Health Select Committee Chair Sam Uffindell agrees.

“Strengthening trans-Tasman collaboration for the benefit of the aged care sector makes sense. More than a million New Zealanders will be aged over 65 years in the next four years or about 20 per cent of the population. This is predicted to increase further so it is imperative that we ensure we are doing the best we can for our older generation. This is why the Government is undertaking a Select Committee inquiry into Aged Care and is continuing with a review of aged care funding” Mr Uffindell said.

The Aged Care Association (ACA) is expressing serious concerns about the future of palliative care on the West Coast following comments from palliative care doctor Wendy Pattemore regarding the region’s new Korowai programme. Dr. Pattemore highlighted that while the programme currently focuses on palliative care patients, it may be expanded to include chronic disease patients due to the lack of residential care beds on the Coast.

The ACA is urging Te Whatu Ora to engage more meaningfully with residential care providers to address these critical gaps and ensure comprehensive palliative care options are available for families in need.

“Is this a sign that Te Whatu Ora has given up on working with residential care providers on the West Coast to enhance and expand the much-needed provision?” asks ACA Chief Executive Tracey Martin. “While we strongly advocate for more support for palliative care education and services, we are deeply concerned that the system is abdicating its responsibilities to ensure West Coast families have access to the best supports for them and their loved ones at end of life.”

Martin emphasised the importance of giving families realistic options that consider their physical, mental, and emotional abilities, rather than relying solely on home-based care solutions.

“The ACA has articulated on a number of occasions the issue of palliative care being absent from key discussions on the Funding and Delivery Review of Aged Care currently being undertaken by Te Whatu Ora. One thing we all know for certain is that 100% of us will eventually die. However, our members are reporting instances around the country where families try to care for their loved ones at home, only to find the physical and emotional pressure too great. These families often turn to our members in desperation, requesting urgent admissions for their loved ones in their final days or even hours. Many of these families then have to add guilt to their grief.”

Martin stresses that residential care providers must be part of the future design of aged care services, with palliative care integrated as a standard offering, whether in the home, community, or aged residential care settings.

“We continue to ask to be part of the design of future aged care provision, with palliative care to be a natural inclusion alongside home and community support, and aged residential care,” Martin said.

Like the rest of the country, the aged residential care (ARC) sector found out from media on 26 September that there would be no more free Covid-19 rapid antigen tests from 1 October.

ACA Chief Executive Hon. Tracey Martin says, “This is yet another example of hasty, poorly thought-out cost-cutting that unfairly shifts both the costs and the risks – without consultation or compensation – squarely onto aged care providers and the people they care for.

Aged care residents are among the most vulnerable to Covid-19, and protecting their safety means we must continue testing as we have been – on the presentation of symptoms, and cohort testing based on exposure risks. Testing is vital to establish whether antiviral agents should be used to reduce the symptoms and improve the outcomes for the people we care for.”

Martin continued, “Not only is this the compassionate thing to do to protect our elders, but it is in fact the recommended practice for effective infection prevention and control.

Our calculations estimate that discontinuing free Covid-19 RAT tests will transfer an additional cost of at least $4 million a year to the front line of aged residential care, potentially reaching upwards of $6 million annually. While some larger providers may be able to bulk source tests at $1.82 per test, smaller providers will have to pay the retail rate of approximately $4 per test.”

We continue to urge Te Whatu Ora to work with us before making these arbitrary decisions in an effort to meet the government’s required cost cutting. We have no confidence that those who made this decision were even aware of the consequences for our elders and those that care for them.

We call on Te Whatu Ora to reconsider the decision, and to continue to fully cover costs of Covid-19 tests in aged residential care. Additionally, we call for greater involvement of affected communities in future decision-making processes.

The Minister for Disability Issues, Hon. Louise Upston, has confirmed that there will be no funding increase for disabled adults in aged care, but has asked the Aged Care Association to be involved in a solution for the sector.

Over 1,000 people with disabilities live in aged residential care facilities. The funding freeze announced recently by the Minister poses challenges for those people and the providers who care for them.

We expect our members will be seriously considering whether they can continue providing care for adults with disabilities. Aged residential care facilities are already on a knife edge, and this funding freeze makes a difficult environment even worse.

The more positive news is that Minister Upston has moved swiftly to address our concerns by establishing an internal taskforce to review disability support service funding models and the commitment to developing an engagement program where we will have the opportunity to participate. The ACA is ready to collaborate with the Taskforce to ensure that the voices of our members are heard in this important process.

We strongly urge the Minister of Health to take similar steps, by establishing a Ministerial Taskforce to work alongside us in addressing broader challenges in the aged care sector. Collaborative solutions are essential for creating a sustainable aged care system that can effectively meet the needs of our communities.

The Aged Care Association is calling on the Government to follow the lead of Australia’s Minister for Aged Care and immediately create a taskforce from the aged care sector to assist them in addressing the immediate need to release pressure on hospital beds.

“The Government’s Nation-wide Service and Campus Planning report shows that without changes to the way we deliver safe and sustainable support to our growing senior community, by 2043, 9 out of 10 hospital beds will be filled by someone aged 65 or over,” says Aged Care Association CE Tracey Martin. “If the Government would work with those of us in the sector currently delivering care, we can help them develop a practical, workable and sustainable care continuum that will release some of this pressure. However, to date our offers to co-design have been ignored or dismissed.”

Ms Martin points to the work done by the Australian Minister for Aged Care, Anika Wells, who not only formed an Aged Care Taskforce but personally chaired it herself. “That is a Minister who has taken the bull by the horns, and working with those on the frontline of community and residential care, delivered their report in March this year to the Australian Government. That report means that once again the Australians are a step ahead of us towards delivering a sustainable aged care system that provides high quality care to all Australians now and into the future.”

“We were very disappointed when the Associate Minister of Health with delegations for Aged Care declined our offer to travel to Australia in a cross-party delegation to gain a greater understanding of the changes implemented over the last two years by our Aussie neighbours,” Tracey continues. “We know the government is cash-strapped so our Association had offered to finance the visit, because our members are passionate about ensuring that the seniors of today and tomorrow are not left without the appropriate level of care or support just because this government wants to keep them out of a hospital bed.”

“We reiterate our concerns that Te Whatu Ora is designing a new care delivery model behind closed doors, with no provision for co-design.” Ms Martin points out “The Ageing Well Team has been instructed to save 200,000 bed nights per year in our hospitals. We join with our home and community colleagues to once again offer to work collaboratively with the Minister to ensure that we design a system that works for our seniors and communities, not just for Te Whatu Ora and cost savings.”

The recent decision by Te Whatu Ora Health New Zealand to decommission the four flexi-beds used for respite care at the Rangiora Health Hub is deeply concerning for aged care providers and the community. The decision to reallocate the space at Rangiora Health Hub for other purposes should not come at the expense of essential respite care services.

The claim that there is adequate capacity within aged residential care facilities to absorb the demand for respite care is misleading. While North Canterbury does have several ARC facilities, only one of these says it has a single bed dedicated to respite care. Many of these providers are already operating at or near full capacity, and the availability of respite care is always conditional to beds being vacant between long-term residents.

We would also point out to Te Whatu Ora that Aged Residential Care providers are not compensated for the additional costs incurred in admitting and caring for short term, as compared to long term, residents. Additionally, providers are not funded to offer respite capacity, and so most providers must prioritise providing a bed to a long-term resident over respite requests.

The Aged Care Association strongly refutes the comments that Aged Residential Care facilities in North Canterbury have sufficient capacity to allow Te Whatu Ora to relieve itself of respite care responsibilities. Statements such as these continue to ignore the reality being faced daily by our members, and the removal of respite care services without ensuring there is long term sustainable alternative provision will instead place more pressure on already stretched families, whanau and caregivers.

It is essential to recognise the unique needs of those requiring respite care, and the vital support these services offer to maintain the wellbeing of both the caregivers and care recipients.

The Aged Care Association calls on Te Whatu Ora Health New Zealand and the Associate Health Minister Matt Doocey to work more collaboratively with the aged care sector to find sustainable solutions that address the real needs of the families and community.

Respite care is a critical service that provides temporary relief to caregivers, ensuring that individuals with complex health needs receive appropriate care in a supportive environment. This level of care often requires specialised staff and resources, which may not be readily available in all aged care facilities.

In Minister Bishop’s speech announcing future development and growth requirements for councils, he articulated his belief that a well-functioning housing market that delivers thriving cities, growing productivity, and super-charged industry will create a future that is bright for everyone. At the Aged Care Association, we want to ensure that the Government, both local and central, ensures that the future they envision creating is just as bright for New Zealand seniors.

Last year, the Retirement Commission reported a doubling of the number of retirees who will be forced to rent over the next 25 years. The 2023 review identified that 20 percent of those aged over 65 do not own their own homes. This figure is expected to jump to 40 percent, or 600,000 people, within the next 24 years.

“We would like to see some thought put into ‘circular house planning,’” said Aged Care Association CE, Tracey Martin. “What we mean by that is when councils are zoning for and consenting these new apartments proposed by the Minister, let’s ensure they can deliver for young couples just starting out on their lives together, starting their family; perhaps before they move into their next more spacious property. But these dwellings also need to acknowledge that one day those young, vibrant couples will also be aged and could need to return to a low maintenance, public-transport-accessible living place. As a country, let’s be smart about this and ensure that these smaller-sized homes are accessible for all, with wider doorways, wet rooms, and no steps – to name just a few design points.

“We also need local government and councils to ensure that their 30-year growth plans include development land earmarked for aged residential care,” said Ms. Martin. “This must include lifestyle provision for all sections of our society. Not all seniors can, will, or want to buy into a large, well-appointed retirement village. Not-for-profit and charitable village, rest home, and residential care facilities must be included in 30-year development and growth planning.”

Over the next 30 years, Aotearoa New Zealand’s population of seniors will grow from around 850,000 (17 percent of the population) to around 1.5 million (24 percent of the population), so any failure to plan for these New Zealanders when considering housing and health care delivery would be an unforgivable omission.