Aged care residents live in one of two very different worlds. Those who can (for the moment) afford thousands of dollars to pay for rooms with ensuites and garden views and those who can’t.
If the nearly 40,000 Kiwis’ living in aged care facilities all lived in one place, the community would be about the size of Gisborne. Those residents would almost qualify for their own electorate and have the right to a Member of Parliament.
And, if like Gisborne, they faced upheavals and life-changing events they would have politicians paying attention and public services swinging in to restore damaged lives.
However, that is not the case. Instead, aged care residents live in one of two very different worlds. Those who can (for the moment) afford thousands of dollars to pay for rooms with ensuites and views and those who can’t. Moreover, some 57% of people in care facilities require high levels of care.
With nearly 80% of available beds now requiring some form of ‘premium’ payment and free care available only to those with assets of less than $239,930, continued expansion of ‘for profit’ providers contrasts dramatically with the diminishing number of ‘not-for-profits’.
Industry lobby group, the New Zealand Aged Care Association (ACA) states that nearly 1000 rest home beds have disappeared in the past 12 months, mostly in the not-for-profit sector or among small, stand-alone providers.
At the same time, the industry projects that 70% of new beds will have dual service roles (hospital and care) or be care suites with premium fees attached.
When the Arvida group’s Mary Doyle Rest Home in Hawkes Bay announced its sudden closure it left 22 residents with no obvious new home.
The closure reflected a pattern of acquisition and closure by corporate operators securing market share and profile for their property interests.
Corporate villages seem to be focused on growth with the likes of BUPA, Summerset, Metlifecare, Ryman and Oceania expanding their care suites and premium rooms with some offering only premium rooms. The brand may be ‘care’ but the business end appears to be property and sales.
How care corporates reacted to the covid pandemic was telling. Metlifecare, in the midst of what some directors saw as a hostile takeover from abroad, found itself in court. Its Baltic buyers sought to wipe millions off the purchase price as the country locked down. The matter was settled eventually.
Other groups expected their villa sales to plummet and accepted covid relief money, but then had to pay it back when sales rebounded. Some, but not all corporates, were savvy enough to lift staff pay for ‘essential workers’, only to cut the pay when covid ended.
Twelve months out from covid many corporates became focused on land banking ahead of new builds. They offer ‘licence to occupy’ apartments and villas knowing there are some care and hospital beds on site. The ratio of apartments to care beds fluctuates but appears to be about five to one.
Grey Power national secretary, Jo Millar is critical of those providers who see what was once a ‘care’ vocation as increasingly just another property market. She questions as to what extent aged care providers understand that the room they charge for is also someone’s home.
I told her about my mother’s experience of paying nearly $400 a day for a premium room where the shower floods the walk-in bathroom and how it took weeks to get her a TV remote which didn’t involve dozens of tiny buttons, so small that her shaky fingers could not operate the device.
Residents and families also share the stress and impact of ongoing, high staff turnover.
While ACA and media focus on the shortage of nurses, it seems the shortage of the numerically larger carers occupational group is just as bad.
With nurses benefitting from additional government funding earlier this year, tens of thousands of carers are still waiting on their claim.
What’s more, some corporate providers appear to have recently reported record incomes. For example, Ryman group, with an 18.4% increase in underlying profit; Summerset reporting a 21% increase and Oceania at 5%.
The ACA represents both the corporates (public and private) who control 53% of all beds and the small ‘mum and dad’ providers at 27%. Charities, once the sector backbone, are now just 20%.
With the sector ‘in crisis’ ACA’s pre-election lobbying included a domino image of beds falling towards a wheelchair bound child. “If we don’t do something there will be thousands of seniors in our public hospitals”, intones the voice-over.
It’s an emotive image which exemplifies what happens when a social good becomes a commercially driven public/private’ partnership.
Care of the elderly was once a social commitment, delivered by the State through hospital-run facilities alongside religious and welfare organisations.
It seems to me that corporates are focused on residents with money, offering premium rooms but only for those who can afford it. Yes, the public sector is underfunded and successive governments have failed to address approaches from employers, unions and Grey Power to remedy the situation.
During the 2023 election, party hoardings proclaimed, “In it for You” (Labour) and “Get NZ Back on Track” (National). Yet, it appears ‘Kiwis’ need the equivalent of an MP’s salary and savings to rest well in care. Many don’t have that kind of money.
(Abridged)
Related: Aged care sector under pressure
