Aotearoa’s aged care sector is facing a defining moment, with Aged Care Association chief executive Tracey Martin saying the country needs to confront how it will care for a rapidly growing older population.
The warning follows the release of the Aged Care Ministerial Advisory Group’s independent report, A Place to Grow Old: Securing the Future of Aged Care, which proposes one of the most significant overhauls of the sector in decades.
The report, chaired by former Labour finance minister David Cunliffe, contains 40 recommendations aimed at replacing what the group describes as a fragmented and increasingly unsustainable system.
At the centre of the challenge is demographics.
New Zealand’s population is ageing, demand for care is increasing and providers are already grappling with shortages of residential beds, service closures, workforce pressures and rising operating costs.
The advisory group warns the cost of aged care could nearly double over the next 20 years if the country continues with its existing model.
Martin, a former New Zealand First minister, now heads the Aged Care Association, the national organisation representing aged residential care providers across Aotearoa.
For providers, the report puts longstanding concerns about the sustainability of residential care firmly in front of the Government.
One of the major recommendations is targeted funding to increase the number of aged residential care beds, particularly in communities where shortages are expected to become most severe.
But the report also argues that simply building more beds will not solve the problem.
It proposes a more integrated and people-centred system that would allow more older people to remain safely in their own homes for longer, backed by stronger home and community support.
That could have particular significance for kaumātua Māori, where ageing well can include maintaining connections with whānau, whenua, whakapapa and community.
The proposed reforms also tackle one of the most politically difficult questions in aged care — who pays.
The advisory group recommends changing how people contribute towards their care, with those who have greater financial resources potentially contributing more while retaining a taxpayer-funded safety net.
Contracting and regulation would also be overhauled in an effort to give providers greater certainty and make services easier for older people and their whānau to navigate.
The group argues there is an economic case for acting now rather than waiting for the system to deteriorate further.
Its modelling estimates the proposed reforms could deliver better health outcomes while avoiding more than $830 million a year in additional taxpayer costs by 2037/38.
That puts pressure on the Government to decide whether it is prepared to make substantial investments now to avoid considerably greater costs later.
For Martin and the residential care sector, funding will be a crucial part of what happens next.
Any expansion of beds requires providers to have confidence that facilities can remain financially viable and that there will be enough nurses, caregivers and support workers to staff them.
The workforce question is equally significant for Māori and Pacific communities, who make up an important part of the care and support workforce while also facing the challenge of ensuring culturally appropriate services are available for their own ageing populations.
The report does not represent Government policy yet. Ministers and officials will now consider its recommendations before decisions are made about implementation and funding.
But with the number of older New Zealanders continuing to grow, the window for avoiding more serious shortages is narrowing.
For the aged care sector, the argument is increasingly straightforward — investing in a system capable of looking after tomorrow’s kaumātua needs to begin today.
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