Cash crunch hits services for elderly

Support services for the elderly and disabled are chronically under-funded, suffer huge workforce turnover and many are providing inadequate care, a new report says.

Hundreds of millions of dollars may be required to address the problem, compounding yearly as the aged population continues to grow, the Government-commissioned working party report on the issue finds.

The report was completed in February, but released by Associate Health Minister Pete Hodgson yesterday with a Cabinet paper outlining plans for Budget increases for the aged-care sector.

The amount of the funding increase was blanked out, and will be unveiled on Budget day, Thursday May 19.

But the damning report reveals the sector is now in considerable trouble and anticipates deepening problems as low unemployment and pay rises for nurses worsen its staffing problems.

An estimated 45,000 support workers, or caregivers, work in residential and home-based care for older people and those with disabilities.

Annual staff turnover for home-based support workers is 39 per cent and 29 per cent for residential care workers - and those figures are rising, the report says.

Unlike aged residential care, home support providers are not covered by the Health and Disability Services (Safety) Act 2001.

While a standard has been developed, it is not compulsory and "many providers" would not meet requirements - a high priority issue which needs to be changed, the report finds.

The devolution of funding for support services for the elderly is placing particular pressures on District Health Boards facing limited funding growth, it says.

While some boards are coping by extracting resources from existing services, others are increasingly relying on family caregivers as they cut their own home-based services.

Modelling carried out by the Private Hospitals Association estimates the full cost of addressing the funding pressures would be in the hundreds of millions of dollars - a figure that government officials dispute, the report says.

But in its recommendations, the working party finds that in the medium-term, that amount of money "and/or some changes in policy settings or some modes of service delivery will almost certainly be required".

In the short-term, the working party agreed "funding is required to address the safety of services".

"In addition providers, unions and consumers consider that short-term funding is required to minimise the risk of service cuts and to maintain timely access to needed services."

The lack of staff training was a significant issue, it found.

The working party was formed after a meeting between ministers and the Nurses Organisation, the Council of Christian Social Services and the Service and Food Workers Union last November.

Age-old problem

* Government health expenditure was $9.6 billion in 2003/04.
* $1.5 billion of it went on elderly and disabled support services. That group also used additional primary and hospital care.
* Kiwis aged over 65 set to increase from 461,000 in 2001 to 800,000 in 2021.