5. Sue Bradford (Green) to the Minister for Disability Issues: Does she accept that "Home help for the frail and elderly is under threat as caregivers quit because of low pay and long hours.", as reported in the Press on 6 November 2004; if so, how and when will the Government address the urgent issues of recruitment and retention in the home-help industry?
Hon Ruth Dyson (Minister for Disability Issues): Yes, I am aware of a number of longstanding and interlinking caregiver workforce issues, including recruitment and retention, which is why last year the Ministry of Health received an additional $1 million to undertake policy work, in collaboration with the sector, to enable the issues to be addressed in a sustainable way. That work has just been completed, and I am considering the recommendations now.
Sue Bradford: Does her reply, when asked by the Press "if she would wipe bums for $10.50 an hour", that: "That's not a relevant question to ask me. I'm not applying for a job as a caregiver." mean that the Minister considers such a pay rate is acceptable?
Hon Ruth Dyson: I do not have ministerial responsibility for wage negotiations or for fee-setting for the caregiver workforce.
Darren Hughes: What approach will the Government take to improve the status of the caregiver workforce, given the Minister's statement that she is aware of the issues in that area?
Hon Ruth Dyson: As part of the work done to date, a national training qualification has been developed for that workforce. I am considering recommendations that I have just received from the Ministry of Health on the best way to make that training accessible to the workforce, and the best way to link qualifications with pay rates.
Sandra Goudie: How many reports does the Minister need before she takes action, given that there have been at least six reports in the last 5 years, including a 1999 report by the Ministry of Women's Affairs called Homecare Workers?
Hon Ruth Dyson: Just one — the one that I referred to in answer to the primary and the supplementary question. The Quality and Safety Project is the first comprehensive look into the issues surrounding caregivers, and I will be considering its recommendations soon.
Sue Bradford: What is the Government doing to end the ridiculously wide variation in wage levels between different providers and different parts of the country, and to ensure that we move to a situation in which home-care workers are employed on a well-paid and permanent basis, rather than in an endlessly casual and low-paid way?
Hon Ruth Dyson: That is one of the many issues that is being addressed through the work of the Quality and Safety Project to which I referred in my reply to the previous supplementary question. The other issues are having a career path into nursing and social services, security of hours, fair remuneration, including consideration of travel time and costs, the nature of the contracts being on a fee-for-service rather than a bulk-funded basis, the quality of services received, recruitment and retention issues, and the consistency of standards between the three funding agencies.
Marc Alexander: Does the Minister agree that an aim of the Health of Older People Strategy is to: "Enable older people, and people with disabilities, to live with independence and dignity in the community" as stated in the project update for home-based services; and if so, how does this Government's current underfunding, and consequent demoralisation, of caregivers promote that?
Hon Ruth Dyson: Yes, I certainly do support that aim. I agree that the sector is underfunded, but as I said in the report in the Press referred to by Sue Bradford in her primary question, more funding on its own is not the answer to the situation, at all. What we need to do is to have a comprehensive approach that addresses all the issues on a sustainable basis.
Rod Donald: Does the Minister agree with Rural Women New Zealand that the home-care sector is in crisis, illustrated by the fact that that organisation is turning away 12 clients a day, on average; and exactly when will the Government take action to ensure that home-care workers do not have to pay their own travel costs out of their very minimal wages — and I am talking about the often considerable travel costs between clients, which is particularly a problem in rural areas?
Hon Ruth Dyson: The member may be interested to know that some providers, despite the fact that they are given exactly the same funding rate as other providers, are able both to pay petrol expenses and some to even offer remuneration for the time between clients. Those issues are part of the Quality and Safety Project work. It is a priority for my ministerial work programme.
Sue Kedgley: What is the Government doing to address the warning that there could be a meltdown in home care in 6 weeks time, over the Christmas period, putting at risk the health and safety of elderly and disabled people who depend on that service, because home-care staff are leaving the sector in droves because of low wages, with a turnover of 90 percent in some areas, and with services already refusing referrals because of the lack of staff?
Hon Ruth Dyson: A shortage of caregivers is certainly one of the few unfortunate consequences of our having the lowest unemployment rate in New Zealand for nearly two decades. As I indicated to another member in my answer to a previous supplementary question, there is a comprehensive work programme to address that very issue.
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