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Make aged care count

Along with many NZNO and SFWU members, senior NZNO delegate and activist Grant Brookes  attended the second Caring Counts summit in Wellington last week. Here are his thoughts about progress to date and possibilities for the future.

Slow progress and a determination to keep pressing ahead were the two themes which emerged at the Pre-Election Summit of the Caring Counts Coalition, held in Wellington last week.

The Coalition was formed to promote the recommendations for aged care in the Caring Counts report, published by the Human Rights Commission in 2012. The Coalition includes NZNO and the Service & Food Workers Union Ngā Ringa Tota (SFWU), along with government officials, community groups, aged care providers and their industry umbrella group, the Aged Care Association.

I was there to show the support of the NZNO National Delegates Committee for the DHB Sector.

The venue was St Andrew’s Church. Opening the Summit, SFWU aged care spokesperson Alastair Duncan said it was appropriate it was being held in a place associated with miracles. “The miracle is that the Coalition has continued”, he joked.

The Summit was held as Kristine Bartlett’s historic case for Pay Equity in aged care winds its way through the courts, supported by NZNO and SFWU but opposed by Terranova Homes and the Aged Care Association. This case has attracted much media attention, including feature stories on Campbell Live.

Of the ten recommendations in the Caring Counts report, Summit participants heard that progress has been made towards the goal that “all new staff achieve a Level 2 Foundation Skills qualification within six months of starting and that all existing staff achieve this qualification in the next two years”.

The number of staff achieving Level 2 qualifications has doubled since 2012, from 6,000 to 12,000 people a year. The Careerforce Industry Training Organisation has a goal of 30,000 staff enrolled by the end of 2016.

But it was acknowledged this still wouldn’t be enough to maintain the proportion of qualified staff, assuming staff turnover of 20 percent each year. Actual turnover is probably higher.

Progress on other key recommendations around pay and safe staffing, however, is even slower.

No significant movement has been made towards “pay parity between health care assistants working in DHBs and carers working in home support and residential facilities”.

And there is no sign that the voluntary standards, including minimum staffing ratios, will “become compulsory to ensure the protection of both carers and older people”.

Kristine Bartlett captured the essence of the day when she said, “Every day we delay respect for the carers is a day less respect for the men and women in care.”

She also talked about her case, now before the Court of Appeal.

“Earlier this year the Service Workers and the Nurses Union made a video talking about the equal pay case and the need for other women to join the case”, she said.

“Five months later nearly 3000 women have filled out authorities to join. So if we made another video and got everyone together you wouldn’t see me. I’d be one of thousands, which is of course who I have been all along.”

Kristine also shared her own “scorecard”, about how aged care is progressing towards some other Caring Counts goals.

“Leadership. This is the one directed at the Prime Minister. Of all the recommendations, it was probably the easiest to enact and the one that could have sent the strongest message about government intentions.

“Putting the Minister with responsibilities for older persons into the top ten cabinet positions would have been politically smart and easy to do.

“Instead what did we see from the government? Having ensured the Ministry of Health was not in the Employment Court they then sought to intervene at the Court of Appeal – opposing the Employment Court decision.

“Not that I expect them to be listening to either my union or NZNO, but having been told by the Aged Care Association that the sector needed five or even six percent to stand still they funded a miserable one percent.

“Invited to attend the Careerforce conference earlier this year, the Government didn’t turn up and prevented Ministry of Health officials from attending.

“The only real leadership we’ve seen from this government in aged care has been in the wrong direction”.

Kristine concluded by reminding us of the upcoming general election.

After morning tea, participants broke into groups and came up with questions for the politicians who were joining the Summit after lunch.

Labour’s associate health spokesperson, Iain Lees-Galloway, said “the time for debating the merits of the recommendations is past. The time for implementing them is now.”

He said a Labour led government would provide enough funding to cover inflation and population growth, year on year.

Green health spokesperson Kevin Hague pledged to make DHBs pass on all the aged care funding increases to the sector.

“But the industry must also pass through the funding they receive”, he added. In 2006-7, employers took the DHBs to court to avoid paying government-funded wage increases. He said that even in the depth of the Global Financial Crisis, the government had enough money to fully fund health, but chose to spend it instead on tax cuts and Roads of National Significance.

NZ First health spokesperson Barbara Stewart said, “In 2012, the government said they would do something about aged care when they’re back in surplus. They’re in surplus now, and in the latest Budget we saw absolutely nothing for aged care.”

The National Party was also invited, but did not attend.

Summing up the day Dr Jackie Blue, EEO Commissioner at the Human Rights Commission, commended the Caring Counts Coalition partners for their ongoing commitment to aged care.

An abridged version of this article is appearing in the August issue of Kai Tiaki Nursing New Zealand


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Update on the Caring Counts report recommendations

FinalReport2012_web_Page_001David Wait is NZNO’s industrial adviser for the aged care sector. This week he attended the Careerforce and Health Workforce New Zealand Workforce Development conference. Here are a few of his thoughts on the first day.

A highlight of the first day of the conference was a presentation by Dr Judy McGregor. Dr McGregor was the Human Rights Commissioner who investigated the aged care sector and wrote the report “Caring counts: Report of the Inquiry into the Aged Care Workforce”.  The report set out a number of recommendations, particularly around mandatory staffing levels, pay and mandatory training.

Since the report was published a coalition of unions, employers and national leaders and decision-makers in the aged care sector has been formed to advance the recommendations. One summit has been held and another is planned for later this year.

Here’s what Dr McGregor had to say about progress on the recommendations.

Pay parity – not achieved.

The Caring Counts report recommended that the Minister of Health directs District Health Boards (DHBs) to develop a mechanism to achieve pay parity between health care assistants working in DHBs and carers working in home support and residential facilities. And that DHBs and residential care and home support providers implement pay parity for carers across the government-funded health sector within three years.

Pay parity has not been achieved, although Dr McGregor states that there is momentum with the equal pay case, being led by Kristine Bartlett. The case is complex and may go all the way to the Supreme Court.  Regardless of what happens in the courts the issue is not that we cannot afford equal pay, but that we cannot afford discrimination.

(I enjoyed Dr McGregor’s idea to have Kristine Bartlett feature on our next new bank note!)

Training – partly achieved.

The report recommends providers in the aged care sector and the ITO (Careerforce) commit to ensuring all new staff achieve a Level 2 Foundation Skills qualification within six months of starting and that all existing staff achieve this qualification in the next two years. Within five years, Level 3 should become the normal level of qualification for all staff with 18 months service or more.

At the first Caring Counts summit, Careerforce announced it would incentivise training with payments to providers, since then there has been increase to training of approximately 68% and the number of people completing training has also risen.

Consumer information – some progress to date.

The recommendation is that a five star system of quality assurance comparing residential facilities, with the aim of improving consumer choice and public accountability, is developed and adopted for use in New Zealand by the Ministry of Health and DHBs with input from the Auditor-General (A-G).

Full audits have been made publicly available with 2500 downloads and 6500 visits to the site. However, audits do not include follow up on how issues identified in audits have been addressed. You can find the audits here:https://www.health.govt.nz/your-health/services-and-support/health-care-services/services-older-people/rest-home-certification-and-audits/rest-home-audits-full-reports. Importantly, the public availability of these audits is a trail. We will watch with interest to see whether the Ministry of Health continues its commitment to transparency.

Staffing

The “Indicators for safe aged and dementia care” was not discussed. The other recommendation was achieved. What we know is that staffing is often far from adequate, with care hour reviews frequently showing staffing levels lower than those set out by the standards document. We also know that these standards are out of date and that the acuity of residents has increased, requiring higher staffing levels than were needed in 2004.

Valuing carers

The recommendation is that the Human Rights Commission hosts a stakeholder summit with government agencies, peak bodies, providers, Age Concern and Grey Power, trade unions and community groups to enhance sector cooperation and to promote and celebrate the paid aged care workforce.

We have a way to go yet. It is particularly important to get more money into the pay packets of carers.

The Caring counts report says,

“The reliance of New Zealand, of all of us, on the emotional umbilical cord between women working as carers and the older people they care for at $13-14 an hour is a form of modern day slavery. It exploits the goodwill of women, it is a knowing exploitation. We can claim neither ignorance nor amnesia.”

Dr McGregor reiterated how important it is for everybody involved in the aged care sector to work together to find a solution.

It is really good to hear that there has been progress made on the recommendations and that Dr McGregor is still a passionate advocate for the cause. We are equally pleased that Jackie Blue, who has taken on the role of Equal Employment Opportunities Commissioner, is similarly committed to Caring Counts. We look forward to working with her on this issue.

Dr McGregor said she still receives heartfelt letters from families, thanking her for her work to improve conditions for workers in the aged care sector. And she told a story that really illustrates how important this work is for all New Zealanders.

There have only been three times that the phone lines have jammed at the Human Rights Commission during her time. The first was in response to something Hone Harawira said, the second time was in response to something Paul Henry said, and the third time was a massive outpouring of hope and support for the Caring counts report and the potential it has to achieve justice in an undervalued workforce.

That about sums it up for me! Together, we will reach our goal.

You can find the report here: http://www.hrc.co.nz/eeo/caring-counts-report-of-the-inquiry-into-the-aged-care-workforce/

And the full list of recommendations here: http://www.hrc.co.nz/eeo/caring-counts-report-of-the-inquiry-into-the-aged-care-workforce/caring-counts-recommendations/