Budget fails aged-care workers and older people: this year's budget was a huge disappointment for those working in aged care. There's no money for training and no money to ensure those who work in the sector are paid the same as in the public sector.

Last month's Budget failed to deliver the funding increases for the aged-care sector essential to achieve equity and provide quality care. But the failure of the Budget and the Government to deliver adequate funding to aged care will not stop NZNO in its determination to ensure fairness for the nurses and other workers in this sector, and quality care for older people.

Nonetheless, it is reasonable to ask what it will take to get equity for the aged-care workforce. In its own reports, the Ministry of Health records the drastic situation of this workforce. (1,2) Even the Associate Minister of Health, Pete Hodgson, in his press statement made the point: "The provision of better pay and conditions and more training are key elements in improving staff retention and the overall quality of services. The new money announced today should enable workers, providers and the contracting OHB more scope to make such improvements." (3)

Despite the Minister's words, the allocation of money in last month's Budget meets neither needs nor expectations. A $71 million increase in funding sounds impressive at first. A closer analysis provokes a different response. Of the $71 million increase for the sector, $32.5 million goes to district health boards (DHBs) for the recognised short-fall in funding when health services for aged peoples' services were devolved from the Ministry of Health to DHBs last year. This leaves $38.4 million of additional funding. However, this allocation has to take into account inflation, as well the growing elderly population and subsequent increasing demand for residential aged-care beds.

NZNO negotiators and delegates at upcoming negotiations will battle hard for their "fair share" of that money. But the extra funding will not achieve NZNO's goals of establishing pay parity with DHB rates and of implementing a comprehensive training package for caregivers.

The budget announcements confirm that an industrial response in aged care is critical to success and change. NZNO's "Grow to Win" strategy is an industrial campaign, based on the successful campaign in the DHBs that resulted in significant wage increases for NZNO nurses, midwives and health care assistants. The lack of a meaningful funding increase for aged care in the budget means NZNO's strategy for the sector will increase in intensity.

To win fair pay in the sector we will need to build membership, so we can deliver a significant industrial campaign over the next three years. Our "grow to win" strategy is on the right track and a delegate activist in Auckland, Eddie Haines, has just been appointed to begin this work in earnest. He will be working with Auckland aged-care sector organisers in selected workplaces, focusing on recruitment. Central and Southern regions are developing proposals to employ three more delegate activists.

For more than four years now NZNO, the Service and Food Workers' Union and the Council of Trade Unions have highlighted the parlous state of the workforce in aged care. We realistically expected this Budget to recognise that training was a priority for the aged-care workforce and that a strategy would be outlined and a government-funded training programme commenced. These expectations were not met and hopes have been dashed yet again.

Meanwhile, evidence of the gaps in service provision continues to grow. Research commissioned by the Ministry of Health was recently published in the New Zealand Medical Journal. The research results showed that training health care assistants made a difference to the quality of care for older people living in residential care. (4)

The Government knows nurses and other health care workers outside the public sector expect a flow-on effect following the fair pay settlement in the DHBs.

The primary health care sector faces similar issues to aged-care workers. Concerted NZNO action will be needed to achieve pay parity for all nurses and health care workers. This is not beyond our ability or our determination, as has been shown in many struggles fought and won by NZNO members.

Other health-related budget announcements contained fews surprises--all had been flagged in pre-budget press releases. The extension of the lower cost primary health visits to 18-24-year-olds is welcomed, along with the intention to extend this to the entire population in the longer term. The public and health care workers will welcome the upgrading of public hospitals throughout the country.

Home-based services get increase

Home-based health services for older people got a real increase in funding of $12.4 million. But no money was allocated to stop the unacceptable practice of home care workers paying for their own travel expenses, even between clients. Consequently, these workers--mostly women--remain on rates of pay well below the minimum wage rate. Something is rotten in the state of New Zealand health care for this practice to be allowed to continue.

The Budget has failed to meet the needs of elderly people in need of care and of those who care for them. it is now up to NZNO and those who work in aged care to fight for the basics--decent wages, workforce training and quality care.

References

(1) Chal, J. (2004) Disability Support Service in New Zealand. Pert I, Service Provider Survey. Auckland: Auckland University Services Ltd.

(2) Ministry of Health (2004) Report of the Quality and Safety Project. Wellington: Ministry of Health.

(3) Hodgson, P. (2005) $71 million boost for residential cure. Budget press release, May 19, 2005.

(4) Smith, B. & Parsons, N. (2005) Quality of Residential care for Older People: Does education of health care assistants make a difference? New Zealand Medical Journal; 118: 1214.