Gordon Campbell on aged care, local v central Govt

The Greens/Labour Party investigation of conditions in the aged care sector in New Zealand paints a hair-raising picture of this country’s quality of care for the elderly. To date, the greying of our population and the care of the aged has been seen as a profit opportunity for the private sector, and not as a planning priority for central government The result has been unrelenting pressure to drive down wages and defer investment in staff training – both of which have been reflected in high staff turnover. While some carers do provide excellent care regardless, many submissions to the report highlighted the substandard care in a sector that has no mandatory staffing levels, and no regulations that govern the care and handling of residents.

As the report found, the horror stories about inadequate staffing resulting in massive time pressures, residents’ calls for help going unanswered, medication or diagnosis errors, overcrowding and terrible cases of neglect were all too common. Such findings come hard on the heels of the Auditor-General’s report last year that slammed the inadequate monitoring of levels of care in the nation’s 715 rest homes.

Clearly, a significant boost in funding for the aged care sector is essential. Yet as the report indicates, aged care hardly featured in budget increases this year with just 1.73% going into residential care, and this neglect followed on from last year’s cuts to home support services. Internationally, the most recent data available confirms how badly New Zealand fares in global comparisons with respect to its treatment of the elderly. According to the OECD Social Expenditure Database, spending on old age (which comprises pensions, early retirement pensions, home-help and residential services for the elderly) has steadily reduced from 5.2% of the GDP in 1998 to 4.2% in 2005. This is below the OECD average of 7.0% for 2005, as well as falling behind Australia’s 4.4%, the UK’s 6.1% and is even below the 5.3% average for the United States.

Given the Auditor-General’s findings though, there would be little point in shovelling more funds into aged care until we have adequate audits and oversight in place for the funds we are already spending. That’s why the Greens/Labour team’s leading recommendations focus on providing a fresh regulatory framework for the sector. Plainly, the care of the elderly cannot be left to unbridled market forces. The private providers need to be regularly monitored by the state, to ensure they are meeting adequate standards of care, and providing adequate wages and working conditions for the workers giving that care. This sector totally invalidates Health Minister Tony Ryall’s bogus distinction between health bureaucrats and front line workers : plainly, both are essential or the system will fail in its duty of care.

As the report recommends , successful reform will require government to :

Establish an independent Aged Care Commission and Commissioner (as is currently in the UK and Australia) which would operate along similar lines to the Mental Health Commission with an advocacy service and an 0800 number. A National Quality Manager, based within the Commission, would work with aged care facilities to encourage organisations to carry out quality improvements and measure progress.

As part of the Aged Care Commissioner’s initial term, a technical working party would be established (made up of experts from industry – including providers and the unions – and aged care specialists) to investigate the issues raised in our report, including auditing processes, developing a national Aged Care Strategy and Action Plan, and looking into the issues facing family carers, including respite care.

The Aged Care Commissioner would be tasked with developing and trialling new models of caring for people in aged residential care, based on a more person-centred care approach.

This would be a good start, and increased funding should then follow hard on its heels. All credit to the Greens, the Labour Party and Grey Power for shining the spotlight on the conditions in this sector – which is currently a national disgrace. Given the demographic realities, standards of care for the elderly are certain to deteriorate further unless this report is acted upon.

Central vs Local Government

The Key government now seems to feel it has a vested interest in the failure of both Len Brown in Auckland, and Celia Wade-Brown in Wellington. The battle lines over central government funding of the CBD rail loop in Auckland are already being drawn up. Key starting his press conference last Monday for instance, with a list of how much his government was already spending on roads and rail in Auckland, In his view, Aucklanders would need to temper their expectations of how much more central government would provide. How different the tone would have been if John Banks had triumphed. No effort would have been spared to ensure his success.

In Parliament this week, Transport Minister Stephen Joyce kept up with the same Scrooge-like responses when questioned by Greens Co-Leader Russel Norman about central government funding for the CBD Loop.

Plainly, the aim is to take the lustre of Brown’s election by starving his council of funds – thereby throwing the costs of the CBD Loop and other Auckland urban transport needs directly onto ratepayers. So much for all the rhetoric about Supercity Auckland. Clearly, if it can’t have its minions running the show, central government won’t be funding it. No matter that this recent report into the upcoming oil shocks makes a sensible case for less investment in roading, and for more investment in public transport.
http://www.parliament.nz/en-NZ/ParlSupport/ResearchPapers/4/6/a/00PLEco10041-The-next-oil-shock.htm
All of which applies to Wellington as well, and totally validates Celia Wade-Brown’s programme for light rail, walking and cycling. Again, Joyce is not likely to stump up funds for her, either. For the foreseeable, central government is now on a mission to frustrate and overturn the public will, as it applies to local government.

The other fascinating aspect of the local government results has been that voters have finally buried the 1980s model of political leadership. All around the country, voters rejected the combo of alpha male leadership, highly centralised decision making, council amalgamation and the corporatisation of public services. The Supercity model was judged, and found to be unsafe for export.

Lest anyone try though, to depict the voter trends in local government purely in left/right terms it should be recalled that the model for fuzzy, warmly inclusive political leadership has been set by John Key. In Auckland, Len Brown won out as the warmer, more credibly inclusive candidate. All along, what Banks needed was a third party candidate on the left to split the Brown vote – yet thanks to a combination of personal failings and a virulent campaign to discredit him, North Shore mayor Andrew Williams could never credibly play a splitter role. The crucial miscalculation of the Banks campaign was to treat Williams - and not Brown – as the more serious threat. Whaleoil’s Cameron Slater helped Brown no end in that respect.

In Wellington, voters rejected the corporatisation of services and roading projects that the aloof and autocratic Kerry Prendergast embodied - in favour of a more inclusive, grassroots campaigner committed to the public provision of services. In Christchurch, the earthquake enabled even Bob Parker to project a caring and inclusive style of leadership – while temporarily burying those inconvenient past dealings with property developers that had formerly dogged his campaign. As mentioned, New Zealand has had it with alpha male leaders making ‘bold’ decisions that have only elite support. Key need only point to these results to silence those on the right of his party who want him to move further, faster.

For the next few months, the nation’s bellwether politician will be Len Brown. That’s why central government has such a keen interest in ensuring that he fails, and that the Supercity mayoralty becomes a poisoned chalice, For any number of reasons, Brown will need to ensure that any blame for Auckland’s problems gets sheeted home to where it truly belongs. He may well end up needing to campaign directly to the people (in public meetings and via social media) right over the heads of central government and the mainstream media to do so.

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