Lack of aged care planning 'unconscionable', aged care boss says

Friday, 28 July 2023

An aged care boss has called Te Whatu Ora unconscionable for doing nothing to prepare for the tsunami of need it knows is coming as beds are being closed across the country.

New Zealand Aged Care Association interim chief executive Katherine Rich made the comment referring to data from Te Whatu Ora’s aged residential care demand planner, available on its website, that showed New Zealand would need 80,000 beds by 2040.

The country was only on track to get to 33,000, she said.

Providers had closed 969 beds throughout the country since January 2021 as they struggled to make ends meet.

A Te Whatu Ora spokesperson said the agency was reconsidering the funding model for aged care.

Rich said fundamentally the aged care sector needed sustainable funding rates, to be able to retain staff and cover maintenance and repairs on ageing infrastructure.

While cities were the hardest hit by bed closures, the regions had not come out unscathed.

Since January 2021, 20 beds had been lost in Northland, 108 in Waitemata, 143 in Auckland, 37 in Waikato, 56 in Bay of Plenty, 44 in Taranaki, 67 in MidCentral, 107 in the Capital and Coast district, 112 in Wairarapa, 84 in Nelson Marlborough, 98* in Canterbury, and 98 beds in the Southern district.

The numbers included 21 facilities that had closed completely, but not those that have indicated they will close soon, beds that have been closed temporarily because of staffing shortages, or those that closed because of flood damage.

Elderly Kiwis typically moved into aged care after an incident or illness that required hospitalisation. When beds were closed in the community, it meant longer waits to discharge them, Rich said.

The result was blocked up emergency departments and surgery delays.

“The healthcare system is only as strong as its weakest link and at the moment, the aged care sector is the weakest link.”

About 59% of facilities were run by small operators or charities who couldn’t cross-subsidise with property developments, and there hadn’t been any new standard beds – the kind most Kiwis could afford – built in 10 years.

“There is this ingrained belief that aged care providers are making pots of money, but it’s because they confuse aged care with retirement villages,” Rich said.

Charity posts biggest loss

Earlier this week, Presbyterian Support Otago board chair Stephanie Pettigrew told the Otago Daily Times that the organisation was preparing to post its biggest lost ever.

Chief executive Jo O’Neill explained to Stuff that the organisation cared for those who did not have assets – like houses – that could go towards paying for their care.

Presbyterian Support had to come up with financial incentives to deter staff from moving to Te Whatu Ora and commercial providers, and when they could recruit from overseas, they needed to pay for immigration and accomodation costs, she said.

The cost of food and consumables had risen 30 to 40%, but funding received from the Government increased only 5%, O’Neill said.

“The Government must understand the seriousness of the situation and recognise the place charitable, not-for-profit providers like PSO have in aged care provision, and as such, the funding model needs to change.”

An independent report released by Aged Care Matters last year said government spending on aged care appeared to be low compared to other OECD countries, which prompted calls for the two-decade-old funding system to be reviewed.

In 2022, the cost for a day in aged residential care hospital-level care was $258, while the cost for a day in a public hospital was $1,592. Adequate aged residential care bed numbers could save the country $7.2 billion, the report found.

Health NZ plans to review funding model

A Te Whatu Ora spokesperson said reviewing the aged care, home and community support services models was one of the actions in the Interim New Zealand Health Plan.

The reconsideration of the funding model would examine whether the current funding rates were sustainable, the spokesperson said.

Interim director of primary, community and rural Emma Prestige acknowledged that a lack of aged care beds meant people would be in their own home for longer with higher demands on home support services or they remained in public hospital.

Te Whatu Ora had increased bed day prices from July 1, with the extra $30m per year expected to go straight to nurses’ pay, she said.

Immigration settings had been changed, financial support was being provided to help nurses to enter or return to practice, bonding schemes had been put in place, nurses were being supported to upskill, and the country had doubled the number of nurse practitioners it trained each year, Prestige said.

“Te Whatu Ora is developing the ability to nationally monitor the availability of beds in each area to get a clear national picture.”

The agency had also allocated $6m to districts to pay for initiatives that facilitate discharge from hospital.

* Correction: An earlier version of this article said Canterbury had lost 983 beds. The correct figure is 98. (August 4, 2023, 6pm)