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Turia: How to enhance well-being of our elderly

Social Security (Long-Term Residential Care) Amendment Bill

Second Reading; Tuesday 7 November 2006; 7.30pm

Tariana Turia; Co-leader of the Maori Party

There is a whakatauki which I think will assist this House in understanding the issues associated with the Social Security (Long-Term Residential Care) Amendment Bill.

He whiringa takitahi ka hunahuna
He whiringa ngatahi, ka raranga, ka mau

If you plait the strands, one strand at a time, the ends will fray and fragment. If you weave them together, they will hold.

In this Bill, the Government’s policy goals of long-term residential care are being realized.
Changes are made to the Social Security Act 1964 to amend the income and asset testing regime for older people.
But those changes on their own, will be insufficient to enhance the well-being of our elderly people, if the package is not supported with additional measures.

As a nation, we must accord value and respect to our senior citizens.
Promoting health and well-being throughout the life stages is an important strategy for improving the health of the older population.

Mr Speaker, the Maori Party comes to this Bill aware that the Maori population is aging faster than the population as a whole.

Statistics New Zealand’s expectation is that there will be eight times as many Maori over 65 in 2051 (that is 129,000 people).

We also know that although the majority of Maori over 65 years remain in whanau homes, 2% of that population are currently in rest-homes, and 3% in long-term hospital care, so the issues are becoming increasingly relevant.

The demographics indicate that there will be an increased need for culturally appropriate residential care to meet the needs of Maori.

Indeed, as befitting of the wisdom and strategic outlook of the late Sir Hugh Kawharu, one of the consequences of the return of Takaparawhau Park, including Bastion Point, which emerged from the 1991 Orakei Act, was that Ngati Whatua established a retirement village and rest home as part of their long term strategy.

A strategy which maximized commercial opportunity and incentives to create a sustainable capital base for future descendants, but a strategy also which took into account the increasing numbers of older Maori, including older Ngati Whatua.

A recent study of some 468 residential care facilities, published in the New Zealand Medical Association journal, describes the evolving needs of our aging Maori.

The study by Liz Kiata, Ngaire Kerse and Robyn Dixon, identified that while Maori are highly represented amongst the workforce, the numbers of elders in long-term residential care is more variable.

Over 50% of the facilities in Northland, Waikato and Hawkes Bay had Maori residents in their facilities.
But other centres suggest that there may still be problems regarding the way facilities respond to cultural concepts of elder care, which act as barriers.

This issue will become more pertinent as the Maori population ages, and as the ‘middle’ generation attempts to juggle caring for tamariki and mokopuna, with caring for elderly whanau members.

So how does this Bill address the growing needs for our kaumatua?
The Bill ensures that those requiring long-term residential care in a facility that has a contract with a DHB, will pay no more than the maximum contribution for care – whether or not they are subsidized.

In essence, the Maori Party supports the changes to the means-testing policies, because it is consistent with our desire to care for our Pakeke, a commitment to manaakitanga.

But we were, however, very interested in the arguments presented to the select committee by Susan St John who believed that the opportunity to consider appropriate funding of long term care has been lost.

It was Ms St John’s contention that there is not enough transparency in discussions regarding the funding of long-term care. She suggests that without a proper consultative process and serious effort to define the upstream effects of the aging of the baby-boomer generation, the policy will be a fragmented one.

Weaving only one strand at a time, makes the policy changes vulnerable to pressures of other factors.
Susan St John also raised the issue that the aggressive use of trusts to evade asset testing has been ignored in this legislation. As such, the incentive for the affluent to set up trusts and obscure their wealth still remains.

The submission from St John stated that in a society where students are laden with student debt and child poverty is rampant, partial removal of asset testing poses huge inter-generational equity questions.

And I want, today, to warmly congratulate Susan St John and the Child Poverty Action Group in the historic decision by the High Court yesterday, asserting the right of that group to act on behalf of children affected by discriminatory government policies.

The Maori Party supports the work CPAG has done in raising the issue of the worsened inequalities for a whole generation of children. And we believe the analysis Susan St John lay in front of the select committee for this Bill has also been very useful.

Another set of issues that came to the Select Committee from Althorp Private Hospital also bears further discussion. They were concerned that the cost to the Government of raising the asset-testing threshold would be at the expense of funding the provision of services and care to older people.

And in the study referred to earlier, the researchers concluded that the turnover of the residential care workforce suggests that the industry continues to be under threat from staffing shortages.

The study found that the majority of facilities, indeed 63% of all studied, employed Maori healthcare workers; while 15% (70 in number) had Maori enrolled and registered nurses on their staff.

Of even more interest was the fact that one quarter of all facilities surveyed, stated that they had employees who were speakers of te reo Maori as their first language.

Yet staff turnover was 22% annually. Reasons for staff dis-satisfaction included low rates of pay, no involvement in care planning, and low job security.

Poor funding for quality rest-home care for the elderly will inevitably restrict the opportunity for older New Zealanders to be given the attention they require in a timely and effective manner.

Retention of staff; inability to provide culturally responsive care; refusal to give due attention to the vexed issue of trusts; lack of consultation, are all strands which threaten the strength and viability of the proposals contained in this Bill.

Mr Speaker, the roles played by kaumatua in community decision making and in the inter-generational transfer of language, knowledge and culture, are essential to our well-being as whanau, hapu and iwi.

Kaumatua play a strong role in formal leadership, whether in tribal strategic planning or in ‘leading from the back’ through the guidance that continues to sustain marae, hui and other institutions.

To attain the status of kaumatua is a respected position within the Maori community.
In the current climate, where New Zealanders are living longer, we must make every effort possible to ensure that increased longevity is matched by improved health status and enhanced wellbeing.

The Maori Party will support the Social Security (Long-Term Residential Care) Amendment Bill in the understanding that it does contribute to supporting the long-term prospects for our aged.

But we were disappointed that the Select Committee chose to overlook the opportunity provided by the wealth of submissions, to address some of the issues that I have raised tonight.

In particular, we remain interested in the notion of the Royal Commission of Inquiry into long-term care proposed by Susan St John; and believe this to be an idea which may benefit from further discussion in this House.

No reira, tena koutou, tena koutou, tena tatou


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