Aged care providers say the ongoing closure of aged residential care beds could accelerate.
Operators may be forced to take drastic measures if more realistic government funding for these services is not forthcoming, including for the critical issue of pay parity for aged care nurses. A number of members of the New Zealand Aged Care Association have come together to escalate attention on what industry leaders say is shameful and deliberate underfunding by the government of aged care services. They commissioned a survey of aged care providers across the whole sector to better understand the pressures facing the sector.
The leaders of small and large operators, rural and urban, have expressed significant concerns that the sector has reached a breaking point, with the closure of beds approaching 500 in the last six months alone.
The survey found that, if current levels of government funding continue, - 47 percent of respondents believe they would be very unlikely to build new ARRC-certified (Age-Related Residential Care) beds within the next year - 65 percent said over the next 12 months, it is very likely or likely they will have to cease or restrict taking admissions into their aged care facilities - 35 percent said that over the next 12 months, is it very likely or likely they will have to close aged care facilities.
The survey results underscore the extreme pressures faced by the sector and their likely implications. The results complement the work of the NZ Aged Care Association and others who have highlighted the critical importance of more realistic funding for aged residential care if the coming surge in the country’s older population is not to overwhelm the public health sector.
Not only does the survey highlight that existing beds will continue to be lost in the near future as a result of government underfunding of the aged care sector, but the provision of new beds will be adversely affected, despite a recent BERL report highlighting the need for 15,000 additional aged care beds before 2030. The country’s aged care sector currently has 41,097 aged residential care (ARC) beds1 compared to 14,000 beds in the public health system.
Carriann Hall, CEO of CHT Healthcare Trust, which operates aged care facilities in Auckland, Bay of Plenty and the Waikato, said the survey shows options for standard, affordable beds in aged care facilities are disappearing or have disappeared.
“I fear that those who are the most vulnerable will feel the impact the most,” Hall said.
“We are in a position right now where the operational choices we are having to make to reduce the risk of affecting the quality of care will have serious long-term consequences.
One aged care provider surveyed revealed the current funding model is of such grave concern that they expect they will be forced to reduce the beds available in metro areas across New Zealand by 30-40 percent unless action is taken. A hundred percent of respondents said, assuming current levels of government funding continue, their organisations will be negatively impacted (providing a range from moderately to extremely negatively).
Michael Parker, CEO of Presbyterian Support Southland, said the impacts were being felt across the board, with respondents noting the biggest impacts look likely to be felt in Auckland as well as in smaller non-metropolitan areas nationwide. Thames, Coromandel, the Waikato, Palmerston North, the Bay of Plenty, Invercargill, and Southland were all mentioned in the survey.
The majority said they feel “frustrated”, “distressed” or “sad” at the changes their organisations may have to make in the near future due to underfunding. One respondent said the changes they will have to make within their organisation over the next 12 months are “driven by necessity and effectively as a result of a crisis”. Another said it “breaks my heart that we are in a situation where we can't admit residents to some of our care homes - that's what we are here for - to care for people”.
The key risk arising from underfunding identified throughout the survey was overwhelmingly to do with staffing levels and associated impacts on care. The survey also identified that there are major staffing issues in at least nine of the aged care organisations represented, with several of the CEOs surveyed calling the situation ‘not viable’ and ‘unsustainable’.
“Underfunding impacts aged care facilities’ ability to attract and retain staff and it’s unfair for these workers who are providing vital services to give our nation’s elderly the impeccable quality of care they deserve,” said the co-owner of Ambridge Rose aged care organisation Allan Sargeant.
“Due to government decisions, at some levels, we’re paying them 20 percent less than DHB counterparts. Aged Care facilities relieve a huge amount of pressure from the public health system, but it is becoming increasingly difficult to carry it.
“The poll shows clearly the number one implication of insufficient government funding is an inability to retain registered nurses, which would compromise the ability to provide safe, quality care. Is this the value the government places on our old people?” said Sargeant.
Pay parity for aged care and DHB nurses, with levels currently set by the Government, is crucial. Nicola Turner, General Manager, for Presbyterian Support Central’s Enliven Services oversees 1,000 staff including over 100 registered nurses.
“We must be able to recruit and retain nurses to aged care. Without us, acute hospital beds will need to be used for those waiting for more appropriate care and the health system will come to its knees,” said Turner.
“Our nurses work extremely hard, they cover a huge range of clinical areas yet they are not being compensated to even the same rate as their DHB counterparts. It is unacceptable.
“It’s very disappointing and concerning that, the goals of the new Health Authority are silent on older people who have done so much throughout their lives are forgotten by successive governments.”
One survey respondent remarked that the Government first needs to “recognise what is needed moving forward and have changes implemented accordingly.”
Another agreed: “Government is not listening”.
Andrew Peskett, CEO of Radius Care which operates aged care facilities throughout the country, said, “the strain is showing on the industry”.
“Without a commitment by the Government to more realistically fund aged residential care across all providers, this sector that has served the country so well risks falling apart.
“The current government stance shows blatant and wilful neglect of our frail, older New Zealanders, which the government and New Zealanders should be ashamed of.
“A realistic funding model for the aged care sector can ensure that our main centres and our rural and provincial communities alike can continue to see the full range of aged care services our communities expect, delivered in caring yet cost-effective ways. A collapse of any part of the sector – be they community providers or not-for-profits or small, private providers – will see the public health system overwhelmed as demand for aged residential care, and in particular specialist and complex care, surges in the coming years.”
