New Zealand’s aged-care system is heading towards an affordability and capacity crunch unless major structural changes are made now, according to the man tasked with reviewing how Aotearoa cares for its ageing population.
David Cunliffe, Chair of the Aged Care Ministerial Advisory Group, joins Waatea following the release of a major report containing 40 recommendations aimed at creating a more sustainable and accessible aged-care system.
The review paints a picture of a system under increasing pressure as New Zealand’s population gets older and more people require support at home, residential care and healthcare services.
At present, aged care can involve a complicated mix of home and community support, residential facilities, GPs, hospitals, carers and government agencies.
The advisory group says that fragmentation can make the system difficult for older people and their whānau to navigate, while increasing pressure on already stretched health services.
The financial challenge is also growing.
Without significant reform, the cost of aged care is expected to nearly double over the next 20 years, while demand for residential beds and workers continues to rise.
The group’s recommendations propose shifting more emphasis towards helping people remain safely and independently in their own homes for longer.
But keeping people at home requires more than simply reducing reliance on rest homes.
It means strengthening home and community support, improving coordination between health and aged-care services and ensuring whānau and carers have the support needed to make home-based care sustainable.
The report also calls for additional residential-care capacity to meet growing demand, alongside a more integrated system that follows people through different stages of ageing rather than forcing them and their whānau to navigate disconnected services.
One of the more politically challenging questions is how the country pays for it.
The advisory group wants the Government to reconsider how aged-care costs are shared between taxpayers and people who have the financial means to contribute towards their own care.
The argument is that reform now could ultimately save the country substantial amounts of money.
The group estimates its package could avoid more than $830 million a year in unnecessary taxpayer costs by 2037/38, while improving health outcomes and reducing pressure elsewhere in the health system.
For Māori, the conversation also needs to address what ageing well looks like for kaumātua.
Supporting kaumātua to remain connected to whānau, whenua, whakapapa and community can require different models from a one-size-fits-all aged-care system.
That places culturally appropriate home support, Māori providers and whānau-centred approaches firmly within the wider discussion about reform.
There is also the workforce challenge.
More older people will require more nurses, caregivers, home-support workers and health professionals, meaning any expansion of services will depend on whether New Zealand can recruit, train, retain and properly support the people providing that care.
For Cunliffe and the advisory group, the message is that waiting will not make those challenges disappear.
The question now is whether the Government will turn the report’s 40 recommendations into action — and whether Aotearoa is prepared to invest today in the system tomorrow’s kaumātua will depend on.
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