Source: Aged Care Association
The Aged Care Association says recent Health New Zealand contracting decisions affecting established home and community support providers raise a much bigger question about how New Zealand intends to deliver the significant expansion of in-home aged care that will be needed in the years ahead.
Aged Care Association Chief Executive Hon Tracey Martin says New Zealand needs to increase the capacity of its aged care system, not risk reducing it.
“If we want substantially more older New Zealanders to remain safely and independently in their own homes, we are going to need more care capacity, more workforce and more choice, not less.
“At a time when the care workforce is already under significant pressure, we should be very cautious about a commissioning model where a procurement decision can remove established providers, experienced workers, community relationships and service infrastructure from the system.
“Those things have taken years to build. If that capability disappears and we subsequently discover we need it again, it cannot simply be recreated overnight.”
Martin says the Association is also concerned about the prospect of long-term contracting arrangements being put in place while the Government is considering significant reform of aged care following the Ministerial Advisory Group report, A Place to Grow Old: Securing the Future of Aged Care.
“The Ministerial Advisory Group has recommended a significant expansion of care and support in people’s homes. The Government has yet to determine its response to those recommendations.
“We therefore need to be very careful about locking in commissioning arrangements for many years that could constrain the choices available to government, providers and, most importantly, older New Zealanders as that new system is developed.
“This is not an argument that every existing provider has an automatic right to a government contract. It is a question about whether limiting publicly funded care to a relatively small number of contracted providers is the best way to build the capacity, workforce and choice New Zealand is going to need.”
The Aged Care Association has been advocating for a different approach.
Under the Association’s proposed model, government would assess what care and support an individual needs and determine the publicly funded entitlement available to them.
Providers wanting to deliver that care would have to meet robust national certification, quality, safety and audit requirements. Once certified, however, they would be able to provide publicly funded services to eligible older New Zealanders, rather than having to win a regional contract before they could participate.
Funding would follow the person and their assessed level of need, with the provider invoicing the responsible government agency directly for the approved services delivered.
Martin says this would give older people genuine choice about who enters their home and provides what can be very personal care.
“Government should set the standards, determine eligibility and fund the care appropriately. Providers should have to demonstrate that they meet those standards. But once those safeguards are in place, why shouldn’t an older New Zealander be able to choose the certified provider they know, trust and want providing their care?
“Choice also creates an incentive for providers to maintain quality. If people can choose between certified providers, providers have to earn and retain their trust through the quality, reliability and professionalism of the services they deliver.”
Martin says opening the system to certified providers would also allow a wider range of organisations, including aged residential care providers, to contribute to meeting increasing demand for support at home.
“We already have aged care providers throughout New Zealand with clinical expertise, trained workforces, infrastructure and deep relationships within their communities. Where they can meet the required standards, we should be asking how we enable that capacity to support older people at home, rather than designing a system that restricts who can participate.
“The challenge facing New Zealand is not that we are going to have too much aged care capacity. Everything we know about our ageing population tells us the opposite.
“If the policy objective is to support more older New Zealanders at home for longer, then we need a strong, diverse and sustainable network of providers capable of delivering that care.
“The question should not simply be who wins the next contract. The question is whether the contracting model itself will deliver the aged care system New Zealand is going to need.
“We have an opportunity through the Government’s response to the Ministerial Advisory Group to redesign this properly: assess what a person needs, fund that care appropriately, certify providers against strong national standards, and then give older New Zealanders genuine choice over who they trust to provide their care.
“For something as personal as care in your own home, that choice matters.”