Reti wants to ‘free up’ 200,000 hospital bed nights/year, which Costello may do by moving sick elderly into residential care & raising ‘fragility level’ for admittance; Good housing productivity news
Elderly either need hospital care or they don't. Substituting residential care just won't suffice. Residential care is substandard care. I worked in that sector long enough to know. Be afraid, elderly folk be very afraid! Residential care is death row.. changing the level will make it death row on steroids.
“Costello said one option under consideration was to contract the residential care sector to supply "recovery beds" for people who would often be stuck in hospital after an accident or illness because there was nowhere for them to go.”
Has she tried getting someone from Hospital into residential care or aged care recently?! They’re just as stretched, if not more so than the hospitals and already heading for a severe staffing crisis with an aging population and increasing demand without adding burden.
My sister just went into respite care..she took the only bed available in the Wellington area supposedly.. so how does that sector absorb 200000 hospital beds a year. ,? My own experience in that sector saw the elderly being moved regularly to hospital not from hospital.
It is not just Wellington, trying to find a respite facility with any vacancies at a suitable level of care is difficult everywhere. If Resthome-level care is removed then this is only going to get worse. This all means informal carers are unable to take a break; without respite breaks the carer burnout risk, and stress are increased.
Even a skeletal but professionally adequate social and economic evaluation would measure the full costs of burnout of carers for the poor, vulnerable and aged. Many of us could offer dramatic case studies. Rarely these surface through the complaints process
Then "flak-catcher" agencies like the Health & Disability Commission may investigate. It may then write letters asking overworked frontline staff to write letters of apology. See Gabor Maté (2022) "the Myth of the Normal : trauma, illness & healing in a toxic culture".
The Dementia Economic Impact Report (2020) by the University of Auckland "shows care partners of people living with dementia provide nearly 53 million hours per year of unpaid care, valued at $1.19 billion." Given dementia prevalence is increasing year on year, and costs increasing, I would expect this figure will have increased substantially.
Indeed. Makes lotsa sense to move frail old people out of hospitals but only if they fund an expansion of rest home care beds, not if they only make it harder for families to get into the same places.
Whilst I like the fact that the government is spreading the pain over its traditional voter base as well as the poor, I am concerned that what we are actually observing is political tactics of proposing something awful and then backtracking to look like heroes. At present they are still blaming the previous government (obvious nonsense based on the nature of money, but no one seems to care about this), and they can continue to make absurd and unpleasant solutions for another 12 months, before coming to the rescue and saving us all in time for the 2026 election.
Rather than live solely in a rage echo-chamber it might be worth assessing and understanding the political strategy of all of this otherwise I’d say there is every chance the national party will ride in on a white horse and save us from (itself) and canter to a 2026 victory.
Very insightful Sam. Are you following any partlcular political boffins (outside of Bernard) who have been discussing the coalition goverment at the strategic level? I'd be interested to read more.
When we focus on the daily headlines so much it can be hard to deduca what their 'final solution' is!
When the absurdly toxic Sam's Creek Mining Licence is submitted about right now, implying a Fast Track setting-aside of last year's Water (quality)Conservation Order to regulate pollution in the Takaka Valley aquifers, and the whole of Golden Bay business and community protest, the fast declining under the Fast Track Act would be touted as demonstrating its social and ecological responsiveness. But two factors diminish the need of "resource curse" regimes to account to 'voters': money (from royalties and construction-based lobbies) and authoritarian powers. There is a 'resource grab' mentality currently as the AUKUS military-industrial economy goes critical . NZ government has just announced its adoption of the Australian "critical minerals list". When concepts like "vital national interests" are used in America, as they were in the 1970s "Energy Crisis", money tends to migrate into markets for war materials. Tough on crime migrates to tough on protestors. So join me and the AUKUS war office to watch the Sams Creek Mining Licence Application in coming weeks.
Thank you Bernard. Your continued highlighting of this gumment's attack on previously intact accepted societal norms is showing how seriously we have been misled by pre election spin.
I'm beginning to see this lot as a multi headed hydra akin to the Trump triffid. In terms of immediate negative impacts this government is wrecking more damage than the 80s reforms.
Aside from personal physical violence are there any options for terminating the NatActNZF oligarchy ?
I'm reading Paul Lynch's Prophet Song, about a fascist government coming to power in the Republic of Ireland. Taking solace in sobering fiction might be small comfort.
Does Labour need to stand up now and declare that all these "climate denial" actions the government is taking will all be reversed in a Labour government's first hundred days?
Oh, what the heck. Throw in those other things that have gone against official advice. So, almost everything ACT ministers are doing, plus Casey Costello, Simeon Brown, etc.
"Costello said nothing had been presented to her, as it was "still in the review stage".
So we can rest assured this is exactly what is about to happen.
"The NZCTU said the changes will lead to more workers being misclassified as contractors and denied annual leave and holiday pay."
Which is exactly what they want. Can't have those pesky workers demanding rights and taking profits away from hard working multinational corporations' huge profits.
Moving by expressway past the matter of reduced recovery in hospital for the elderly (or slower, avoiding O2NL's proposed 27km charging users a potential $1000 p.a. toll: a lot more respite beds will be required in rest homes to cope with that - so privatisation by stealth, yes?)
... and on to Shane's critical minerals list, which is topped by "Aggregate and sand" needed for "roading". Well, just dig everything up will ya. There are so many things on the list that they might as well have announced 'open slather'. Come one, come all, and conservation be dammed.
As far as I know aged care facilities do have beds for people coming out of hospital before people go home. The number of these beds may be reducing as numbers of people needing hospital level care permanently increases. Casey Costello seems to be unaware of this.
Gosh, everything here (except the upzoning news) is deeply depressing and/or infuriating! This is the second time the Nats scrapped the carbon neutral public service targets. I worked on them in 2004-07, and we were well on track to become the world’s first carbon neutral public service by 2012. Huge cost efficiencies as well as better working conditions (especially around energy efficiency and indoor air quality) too. Total win-win-win but Joyce scrapped every government policy or strategy with the word sustainability in it as soon as they got in, in 2008. Now we’re further away from achieving the same goals by 2025! The National government does nothing but send us backwards every time they get in power.
The model I've seen is that they will use 'restoratiive' techniques to have these people out of public hospital beds into their home. The unsaid expectation was informal carers ( Family, friends, neighbours) will do the care giving, supported by Home and Community Support Service organisations (Who already are overstretched, and aren't always available in parts of NZ ).
Likewise, it seems they are tinkering with the Needs Assessment process so that needs assessors will have to show higher needs to get the previous levels of home and communitycare. Needs include all activities of daily living, not just the particular illness or condition that got them to hospital in the first place. That is, not just the short-term care needs, but also the long-term care needs are on the line.
But, because Te Whatu Ora aren't being transparent we are having to connect dots on limited info. Therefore the more pressure applied by media and associations, then we might be able to have a clearer idea.
The next public meeting of the Health Committee Inquiry starts at 9 am on Wednesday 18th September. I'll be listening in with a keen interest if anyone can add more dots of info to what was revealed at the previous public meeting where Tracey Martin, Aged Care Association said she had the documents that were previously denied as existing. It seems RNZ also has them. So, there could be some interesting comments and questions on Wednesday
Inquiry into the aged care sector’s current and future capacity to provide support services for people experiencing neurological cognitive disorders open to the public is on Wednesday 18th September from 09:00 to 10:45 at Room 1, Bowen House. A livestream will be available from the NZ Parliament, Health Committee website
It looks like this meeting will be concentrating on aged care provision to include supporting people with early onset conditions and what asset thresholds are appropriate. This government is becoming very adept at moving goal posts to suit their agenda.
I agree, the Health Committee Inquiry seems to be heading into a set of recommendations in the report to support some of the draconian ideas into aged care models and funding being reported as existing but denied by Te Whatu Ora and Minister Costello.
The pushback from submitters at the first public meeting was huge as to these 'non-existent' proposals. I've read most of the submissions, and like my own, they raise serious issues around not just aged care, but early-onset neurological conditions support and services and underfunding (Not just by this government but decades) of support and service organisations like Dementia NZ and Alzhemiers NZ. But, I not expecting much to be done on the initial inquiry focus on those with early-onset neurological conditions due to the changed focus of the inquiry.
Since the National - NZ First Coalition Agreement and then the May 2022 press release from the Health Committee chair Sam Uffindale the focus was to be very much on people with early-onset (A more accepted term now is young-onset) neurological conditions. This is neurological conditions in those under 65 years old; for example Young-onset Dementia.
However, after a private Health Committee meeting, when announcing the scope and terms of reference, I saw much more focus on Aged Care funding and services review currently being done by Te Whatu Ora. This has meant less emphasis now on those with Young-onset conditions, and we are getting much more into aged care, and especially aged care for those frail older people. I'm not saying this isn't important, because it is. Just that it is disappointing that we in the Young-onset Dementia community, and other young-onset neurological condition have had our messages and submissions diluted.
I have a meeting scheduled with Simeon Brown. I have been following all your media.
I am a school principal and keen to promote electrification of NZ over gas and coal and wonder if you have people(more knowledgeable than myself)in Auckland that would be free to accompany me when I get a date for this meeting
Why don't you ask Professor Alistair Woodward, Uni of Auck, who understands the connections between health and transport, and has written extensively about bikes, electric bikes, SUVs, and other transport modes.
Fragility Threshold is definitely one of the scariest terms I’ve yet heard especially in connection with hospitals and the elderly
I think whenever you include statements from Minister Costello you should include a warning stating “may not contain facts”
Elderly either need hospital care or they don't. Substituting residential care just won't suffice. Residential care is substandard care. I worked in that sector long enough to know. Be afraid, elderly folk be very afraid! Residential care is death row.. changing the level will make it death row on steroids.
“Costello said one option under consideration was to contract the residential care sector to supply "recovery beds" for people who would often be stuck in hospital after an accident or illness because there was nowhere for them to go.”
Has she tried getting someone from Hospital into residential care or aged care recently?! They’re just as stretched, if not more so than the hospitals and already heading for a severe staffing crisis with an aging population and increasing demand without adding burden.
My sister just went into respite care..she took the only bed available in the Wellington area supposedly.. so how does that sector absorb 200000 hospital beds a year. ,? My own experience in that sector saw the elderly being moved regularly to hospital not from hospital.
It is not just Wellington, trying to find a respite facility with any vacancies at a suitable level of care is difficult everywhere. If Resthome-level care is removed then this is only going to get worse. This all means informal carers are unable to take a break; without respite breaks the carer burnout risk, and stress are increased.
Even a skeletal but professionally adequate social and economic evaluation would measure the full costs of burnout of carers for the poor, vulnerable and aged. Many of us could offer dramatic case studies. Rarely these surface through the complaints process
Then "flak-catcher" agencies like the Health & Disability Commission may investigate. It may then write letters asking overworked frontline staff to write letters of apology. See Gabor Maté (2022) "the Myth of the Normal : trauma, illness & healing in a toxic culture".
There already have been evaluations both of economic and social impacts of caring. You can find links for many via the Alzhemiers NZ website here: https://alzheimers.org.nz/explore/research/#:~:text=Each%20year%2C%20The%20annual%20economic,than%20those%20of%20non%2Dcarers.
The Dementia Economic Impact Report (2020) by the University of Auckland "shows care partners of people living with dementia provide nearly 53 million hours per year of unpaid care, valued at $1.19 billion." Given dementia prevalence is increasing year on year, and costs increasing, I would expect this figure will have increased substantially.
And that's when it becomes dangerous for all concerned
Indeed. Makes lotsa sense to move frail old people out of hospitals but only if they fund an expansion of rest home care beds, not if they only make it harder for families to get into the same places.
Is she suggesting they go home with the bed - as if a bed alone is all that is needed?
Whilst I like the fact that the government is spreading the pain over its traditional voter base as well as the poor, I am concerned that what we are actually observing is political tactics of proposing something awful and then backtracking to look like heroes. At present they are still blaming the previous government (obvious nonsense based on the nature of money, but no one seems to care about this), and they can continue to make absurd and unpleasant solutions for another 12 months, before coming to the rescue and saving us all in time for the 2026 election.
Rather than live solely in a rage echo-chamber it might be worth assessing and understanding the political strategy of all of this otherwise I’d say there is every chance the national party will ride in on a white horse and save us from (itself) and canter to a 2026 victory.
Very insightful Sam. Are you following any partlcular political boffins (outside of Bernard) who have been discussing the coalition goverment at the strategic level? I'd be interested to read more.
When we focus on the daily headlines so much it can be hard to deduca what their 'final solution' is!
Not especially, mainly talking to economists and political commentators in my work
I was thinking much the same.Make life bloody awful and then start ‘fixing’ what it broke.
When the absurdly toxic Sam's Creek Mining Licence is submitted about right now, implying a Fast Track setting-aside of last year's Water (quality)Conservation Order to regulate pollution in the Takaka Valley aquifers, and the whole of Golden Bay business and community protest, the fast declining under the Fast Track Act would be touted as demonstrating its social and ecological responsiveness. But two factors diminish the need of "resource curse" regimes to account to 'voters': money (from royalties and construction-based lobbies) and authoritarian powers. There is a 'resource grab' mentality currently as the AUKUS military-industrial economy goes critical . NZ government has just announced its adoption of the Australian "critical minerals list". When concepts like "vital national interests" are used in America, as they were in the 1970s "Energy Crisis", money tends to migrate into markets for war materials. Tough on crime migrates to tough on protestors. So join me and the AUKUS war office to watch the Sams Creek Mining Licence Application in coming weeks.
Good observation, Sam. It's all dressage at the moment!
Dressage! Fantastic word.
I take a degree of extremely cold comfort from the fact that Simeon Brown is young enough that he will live to see the results of his policy changes.
Thank goodness for TKP.
As for kicking the elderly out of hospitals; I wonder how many of these elderly, or their adult children voted for this result?
Thank God this lot weren't in charge during the pandemic.
Climate Simeon Brown pushed emissions standards to meet industry's deadline….
How does this type on blunt corruption is acceptable? Guns, Tobacco and Car lobbyists become Ministers? Is just so wrong
Thank you Bernard. Your continued highlighting of this gumment's attack on previously intact accepted societal norms is showing how seriously we have been misled by pre election spin.
I'm beginning to see this lot as a multi headed hydra akin to the Trump triffid. In terms of immediate negative impacts this government is wrecking more damage than the 80s reforms.
Aside from personal physical violence are there any options for terminating the NatActNZF oligarchy ?
I prefer voting to the alternatives.
I'm reading Paul Lynch's Prophet Song, about a fascist government coming to power in the Republic of Ireland. Taking solace in sobering fiction might be small comfort.
Does Labour need to stand up now and declare that all these "climate denial" actions the government is taking will all be reversed in a Labour government's first hundred days?
Oh, what the heck. Throw in those other things that have gone against official advice. So, almost everything ACT ministers are doing, plus Casey Costello, Simeon Brown, etc.
"Costello said nothing had been presented to her, as it was "still in the review stage".
So we can rest assured this is exactly what is about to happen.
"The NZCTU said the changes will lead to more workers being misclassified as contractors and denied annual leave and holiday pay."
Which is exactly what they want. Can't have those pesky workers demanding rights and taking profits away from hard working multinational corporations' huge profits.
Moving by expressway past the matter of reduced recovery in hospital for the elderly (or slower, avoiding O2NL's proposed 27km charging users a potential $1000 p.a. toll: a lot more respite beds will be required in rest homes to cope with that - so privatisation by stealth, yes?)
... and on to Shane's critical minerals list, which is topped by "Aggregate and sand" needed for "roading". Well, just dig everything up will ya. There are so many things on the list that they might as well have announced 'open slather'. Come one, come all, and conservation be dammed.
As far as I know aged care facilities do have beds for people coming out of hospital before people go home. The number of these beds may be reducing as numbers of people needing hospital level care permanently increases. Casey Costello seems to be unaware of this.
We couldn't count all the things Costello appears or prefers to be unaware of on our collective fingers.
Gosh, everything here (except the upzoning news) is deeply depressing and/or infuriating! This is the second time the Nats scrapped the carbon neutral public service targets. I worked on them in 2004-07, and we were well on track to become the world’s first carbon neutral public service by 2012. Huge cost efficiencies as well as better working conditions (especially around energy efficiency and indoor air quality) too. Total win-win-win but Joyce scrapped every government policy or strategy with the word sustainability in it as soon as they got in, in 2008. Now we’re further away from achieving the same goals by 2025! The National government does nothing but send us backwards every time they get in power.
Please ask this Minister where she intends these patients to go without serious investment in suitable facilities? Frightening changes yet again.
The model I've seen is that they will use 'restoratiive' techniques to have these people out of public hospital beds into their home. The unsaid expectation was informal carers ( Family, friends, neighbours) will do the care giving, supported by Home and Community Support Service organisations (Who already are overstretched, and aren't always available in parts of NZ ).
Likewise, it seems they are tinkering with the Needs Assessment process so that needs assessors will have to show higher needs to get the previous levels of home and communitycare. Needs include all activities of daily living, not just the particular illness or condition that got them to hospital in the first place. That is, not just the short-term care needs, but also the long-term care needs are on the line.
But, because Te Whatu Ora aren't being transparent we are having to connect dots on limited info. Therefore the more pressure applied by media and associations, then we might be able to have a clearer idea.
The next public meeting of the Health Committee Inquiry starts at 9 am on Wednesday 18th September. I'll be listening in with a keen interest if anyone can add more dots of info to what was revealed at the previous public meeting where Tracey Martin, Aged Care Association said she had the documents that were previously denied as existing. It seems RNZ also has them. So, there could be some interesting comments and questions on Wednesday
Hello Paul fabulous for us you are following this. When and where is this meeting to take place please?
Hi Gloria,
The public part of the Health Committee
Inquiry into the aged care sector’s current and future capacity to provide support services for people experiencing neurological cognitive disorders open to the public is on Wednesday 18th September from 09:00 to 10:45 at Room 1, Bowen House. A livestream will be available from the NZ Parliament, Health Committee website
Many thanks. Surely will be interesting.
Great points Paul. Cheers.
It looks like this meeting will be concentrating on aged care provision to include supporting people with early onset conditions and what asset thresholds are appropriate. This government is becoming very adept at moving goal posts to suit their agenda.
I agree, the Health Committee Inquiry seems to be heading into a set of recommendations in the report to support some of the draconian ideas into aged care models and funding being reported as existing but denied by Te Whatu Ora and Minister Costello.
The pushback from submitters at the first public meeting was huge as to these 'non-existent' proposals. I've read most of the submissions, and like my own, they raise serious issues around not just aged care, but early-onset neurological conditions support and services and underfunding (Not just by this government but decades) of support and service organisations like Dementia NZ and Alzhemiers NZ. But, I not expecting much to be done on the initial inquiry focus on those with early-onset neurological conditions due to the changed focus of the inquiry.
Since the National - NZ First Coalition Agreement and then the May 2022 press release from the Health Committee chair Sam Uffindale the focus was to be very much on people with early-onset (A more accepted term now is young-onset) neurological conditions. This is neurological conditions in those under 65 years old; for example Young-onset Dementia.
However, after a private Health Committee meeting, when announcing the scope and terms of reference, I saw much more focus on Aged Care funding and services review currently being done by Te Whatu Ora. This has meant less emphasis now on those with Young-onset conditions, and we are getting much more into aged care, and especially aged care for those frail older people. I'm not saying this isn't important, because it is. Just that it is disappointing that we in the Young-onset Dementia community, and other young-onset neurological condition have had our messages and submissions diluted.
Hi Bernard,
I have a meeting scheduled with Simeon Brown. I have been following all your media.
I am a school principal and keen to promote electrification of NZ over gas and coal and wonder if you have people(more knowledgeable than myself)in Auckland that would be free to accompany me when I get a date for this meeting
Regards
Donal McLean
I would try the cycling activist community and the Electric vehicle campaign groups.
Why don't you ask Professor Alistair Woodward, Uni of Auck, who understands the connections between health and transport, and has written extensively about bikes, electric bikes, SUVs, and other transport modes.