Saturday, July 20, 2024

Nursing shortages

Grey Power’s Lobby Visit to Wellington - BY JAN PENTECOST National President Grey Power NZ Federation INC

In addition to the issues around the need to increase community care facilities, raised in our cover story, our lobby visit also raised the underfunding and chronic nursing shortages in aged care facilities.

Our objective was to repeatedly emphasise this issue to persuade politicians that action is urgently required. We frequently hear that the dire nursing shortages in rest homes threatens the viability of the sector. This means that we could be witnessing a potential sector collapse partially because of lack of funding, insufficient places in nurses’ training, lack of upskilling nurses in the aged residential care (ARC), and sector pay discrepancies between aged care nurses and DHB nurses.

Our members and other older people and their families are intensely concerned about this issue, which has occurred because of on-going critical Government underfunding of the aged residential care services and latterly the failure of budget 2022 to deliver desperately needed funding for the aged care sector which means that the loss of beds and closure of aged care facilities will continue.

The sector is in crisis and almost at the point of no return where much needed aged care services will disappear and our older people will bear the brunt of Government underfunding (from Aged Care Matters – media fact sheet May 4 2022).

The background

This year’s budget provided no financial assistance to address the issue of pay parity, with DHB nurses currently earning anywhere from $20,000 to $30,000 a year more than aged care nurses. The pay levels are currently set by the Government and pay parity would help alleviate stressed, overworked nurses and other care-givers.

New Zealand Aged Care Association Chief Executive Simon Wallace says “We have lost more than 1,000 nurses; around 20 percent of the total nursing workforce and mostly to District Health Boards (DHBs) [now Health NZ] that are actively recruiting from rest homes offering remuneration often $15,000 per annum above what rest homes are able to pay – and are not funded to match.”

He has also predicted that 15,000 additional aged care beds are required before 2030, but the sector is at breaking point now with the closure of facilities resulting in the loss of around 800-1000 beds in the last six months alone.

The aged care sector provides 40,000 care beds, more than half of which are catering for residents receiving hospital, dementia or psychogeriatric care. The cost of this provision with the Government funding a hospital level ARC bed is a maximum of $250 a day, compared to over $1,000 a day in a Health NZ setting.   (S. Wallace CEO New Zealand Aged Care Association).

Our evidence

Grey Power’s evidence  has been gathered from our members’ stories, from many media articles and from our work with The Coalition on Fair Pay for Aged Care Nurses, which is made up of nine organisations with a shared interest in the care of older New Zealanders: New Zealand Aged Care Association (NZACA) and its Nursing Leadership Group, Age Concern New Zealand, Alzheimer’s New Zealand, Care Association of New Zealand (CANZ), Grey Power New Zealand, Home and Community Health Association (HCHA), New Zealand Council of Christian Social Services (NZCCSS), New Zealand Nurses Organisation (NZNO), and the Retirement Villages Association (RVA).

“We are pleased that some money is now available for our nurses. They deserve every cent, and more. The aged residential care sector is nurse-led and, as a nation, we couldn’t care for older New Zealanders without them.” – Aged Care Association deputy chair, Warwick Dunn

And the ‘Tipping Point Report’ released in April showed 35 percent of the 17 sector leaders polled would be forced to make closures in the next six months if the Government did not provide additional funding. That could represent the loss of 7,827 beds.

The Government’s failure to address the $425 million deficit across the system of aged residential care in New Zealand shows neglect for New Zealand’s ageing population and their wellbeing and we hear from numerous members mutterings of blatant age discrimination and abuse.

Also, despite the former Minister of Health’s promise of pay parity for aged care nurses, what has been paid is less than half of what’s required.

But it appears that the government has not honoured its promise. On March 8th 2023 we were told that: “Aged care nurses are being paid up to $20,000 less than nurses who are employed by Te Whatu Ora in public hospitals, and that is the leading cause of nurse shortages and subsequent bed closures.

“More than 1,200 aged care beds have closed in the last year due to this severe shortage of registered nurses.

“This massive pay disparity was caused by government underfunding in the first place. The least it should do is fix it,” says Warwick Dunn

“The funding that has been allocated will not stop the flow of aged care nurses to higher paying jobs in public hospitals, and it will not stop disruptions in the health care sector. It’s traumatic for older New Zealanders who are displaced from closed care homes or not able to enter care. Many end up in public hospitals, unable to be discharged until an aged care bed becomes available, which causes flow on effects to the entire system.”

Dunn says, “This funding does not provide equity of access to health care for vulnerable older New Zealanders. The association is calling on the government to create the thriving and sustainable health care system it says it wants by funding pay parity.”

Our recommendations

We recommend that the government take note of the Australian reforms and supply the funding necessary to return to or embrace the basic reforms to provide older people with respect, care and dignity, real  choice and control, safe and high quality care, easy, consistent and equitable access, care and support that contributes to quality of life.

Grey Power concludes that we are in a vicious circle. Home & Community Support Services have been drastically reduced – this lack of care can lead to health issues which require hospitalisation but at discharge time if the client is no longer able to manage at home there are insufficient beds in age care facilities; what is to happen to older people in need?

Where do the residents go? What happens to those that do not have family back-up? What happens to those who cannot be discharged from hospital because there is nowhere for them to go? And what about others who need hospital attention and the hospital is cluttered up with oldies with no care?

The government and their Ministry of Health responses do not provide any assurances that there will be any action. We believe this situation has reached crisis point now – older people are suffering – we are scared for ourselves and others.

If we were old, sick farm animals or domestic pets the kindest action would be to euthanise us to put us out of our misery and reduce the pressure on the health system/aged care sector.

Our question to those politicians considering this is: what would your party do to fix the underfunding and chronic staff shortages in aged care facilities?

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