Aged care in Northland at breaking point

Rest-home operators in Northland are calling on local Members of Parliament to ensure that the country’s “broken” system of funding for aged care is addressed in the 2022 Budget to be announced on Thursday next week. They have warned that the government’s decision to pay nurses working in hospitals over $22,000 a year more than those working in rest-homes is creating “dire” staffing shortages, and that care facilities are choosing to close their doors rather than compromise quality standards.

Kerikeri Retirement Village chief executive Hilary Sumpter described the two-tier pay-scale for nursing staff as “lunacy” that could easily be rectified if officials at the Ministry of Health would only listen to cries for help from aged care operators across the country.

“I’m convinced that the damage these people are doing is not purposeful,” she said. “Because who would be so callous as to deliberately destroy the country’s aged care infrastructure? But if it’s unintentional why are they not taking immediate steps to fix the problem?”

An ever-increasing number of elderly people need the care only an aged care provider can offer. At the same time, these facilities are finding it difficult to keep the trained nursing staff they need to keep existing care facilities open, let alone increase the number of beds available. There is a worldwide shortage of nurses but Ms Sumpter says New Zealand’s aged care funding mechanism worsens the problem.

“Nurses in rest-homes do exactly the same work as those in hospitals and, in fact, are expert at being able to do everything rather than specialise. What could possibly be the Ministry’s justification for valuing their work any differently?” she said.

“Government is effectively outsourcing care for the elderly, then doing everything it can to ensure that we can’t get the staff to provide that care. It’s lunacy. And how does this speak to how our nation values its elders?”

There are currently not enough care beds in the Mid and Far North to meet demand. Kerikeri Retirement Village has a waiting list of 120 people for its 66-bed care facility.

“This is not how a First World country should work,” Ms Sumpter said. “And the situation will only get worse if operators have to close off even more beds because they can’t find or keep the qualified and valuable staff they need to operate safely. With or without COVID.”

The government currently pays aged care operators like Kerikeri Retirement Village a flat rate for every bed occupied in a care facility. But that rate does not cover the costs involved in keeping those beds open and the shortfall is increasing every year.

This funding gap means that the starting rate for a Registered Nurse within DHBs is now $22,500 a year more than an aged care Registered Nurse, with the gap widening to over $30,000 for more senior positions. It is therefore not surprising that recent analysis by the New Zealand Aged Care Association found a turnover rate for aged care Registered Nurses of 48%.

“We already subsidise our Care Facility with the money we earn from our ‘independent living’ retirement accommodation,” Ms Sumpter said. “We simply can’t afford to keep doing this while also keeping our retirement accommodation affordable.”

Kerikeri Retirement Village would have to earn more than half a million dollars extra each year from its 66 care beds and 190 independent living residents just to pay its nursing and care staff what they could earn if they worked at Kawakawa or Whangarei hospitals.

“There’s just no way we can do this,” Ms Sumpter said. “Government needs to value the work of care staff properly and stop the insensitive destruction of this country’s aged care infrastructure. We are fast approaching Third World levels of care for our elderly.”

Aged Care Matters, a movement of members of the New Zealand Aged Care Association to escalate a national dialogue on the crisis in the aged care sector, recently commissioned research to highlight the stress the crisis is causing the aged care sector. The survey, overseen by Talbot Mills research, represents around 50 percent of all aged care beds in New Zealand. The results are sobering and underscore the need for immediate and urgent action:

About a third (35%) said assuming current levels of government funding continue over the next 12 months, is it very likely or likely they will have to close aged care facilities.

Around two thirds (65%) of respondents said that assuming current levels of government funding continues 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.

Almost half (47%) of providers interviewed said that assuming current levels of government funding continue, they would be very unlikely to build any new beds within the next year.

The biggest underfunding risks identified were overwhelmingly to do with staffing levels and associated impacts on care.

Most respondents said that at current funding levels admission restrictions in the next year are likely. Around a third said that closing facilities is a possibility.

Expectations are for very strong negative impacts on the public health system as a result.

“Time is running out if we are to halt this crisis and protect aged care for future generations of older New Zealanders and their families,” Ms Sumpter said. “We are at a tipping point. Around 500 beds have gone from the sector in the past six months alone and around 20 facilities have closed hospital-level beds. Once local aged care providers decide to close beds, it is hard to bring them back.”

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