The lack of attention given to aged care is yet another example of politicians kicking the can down the road. But there is an urgent and deep need for a sustainable funding model now
Opinion: It is pretty hard to avoid knowing there is an election coming up. Just about as hard, among the big arguments over potholes and dual language road signs, to understand how that election will affect the major issues affecting our future.
It's a sort of Barbie election where the choice is between two middle-aged pākehā men named Chris wearing suits. Essentially identikit dolls with different gear for whatever the occasion. Each seems to have an equal desire to avoid real issues in favour of a vague cost of living concern which, given that living is not free, appeals to most of us whether the cost that worries us is rent and food or tax and overseas travel.
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Even a genuine cost of living problem such as aged care, real now and certain to become worse in coming years, has had no attention. Sorry, not sorry, to break in to the Mr Congeniality contest, guys, but you really should be tackling this.
Right now aged care is a pressing problem for those directly affected and their family, those who will be and their family, those who work in aged care and those who fund it. Yes, that is the “middle” you pretend to be competing over.
Let me just remind you, Chris:
* Chronic underfunding by successive governments has meant there has not been enough capital or operational investment in aged care facilities (your predecessors are both to blame). This is despite known growing demand.
* Last year 1260 previously available beds closed and the sector is short of more than 1200 nurses.
* Even the retirement village businesses that do provide aged care services are now building fewer beds, focused on their own residents, because of these funding problems.
Looking forward the prospects without a changed approach are grim. More of us are getting old, living longer with various health problems, and fewer of us own property to afford the retirement village model. Not all of us will fit an “ageing in place” model even if there were adequate funded services to support that. So let's just recall what we know about this future for aged care unless old people start conveniently dying much younger.
* The best estimate seems to be that by 2040 there will be 230,000 people over 85 and that on current trends there will be about half or less the aged care beds available to meet demand.
* Aged residential care at hospital level costs about $270 a day to provide against about six times that for the same service in a hospital bed.
I don’t imagine either of you, Chris, intend building and staffing to meet this demand in the hospital context. I hear that they might have a few of their own problems.
Te Whatu Ora and the aged care sector have been haggling about funding. They did manage to agree on some additional funding this year. But they both knew that in making this arrangement it was nothing like a solution. They know it, the ministry knows it, and we should hope that the minister, Cabinet and opposition spokespeople know it. They must know this amount went only part of the way towards pay parity for aged care staff. That it is nowhere near solving even that problem, let alone dealing with the training and retention needs.
It is simply what the sector could get, and yet another example of politicians kicking the aged care can down the road and hoping to postpone the reckoning needed. I guess no one saw any votes in facing the real problem which is that there is an urgent and deep need for a sustainable funding model for aged care.
The recent increase in funding did nothing at all to support the built environment in a sector short of facilities, bound to get shorter, and for which the facilities which are there have an average age over 30 years – often built for an era of different expectations.
We do have a structure that can provide not only village residential lifestyle but, assuming staffing issues are funded properly, aged care for the aged population who own enough property. The other half or more of people will fall back on family and an already overloaded hospital system unless a solution is found.
There is no solution to health system issues which does not produce a new model for aged care.
So there you go, Chris, why not actually face a genuine cost of living problem? Engage with the service providers, with those already needing decent aged care and those who will, and solve something other than your next job.
