Williams Poto: Home and Community Support (Payment for Travel Between Clients) Settlement Bill — Second ReadingText is incorporated into the Bound VolumeWilliams Poto: Home and Community Support (Payment for Travel Between Clients) Settlement Bill — Second Reading[Sitting date: 11 February 2016. Volume:711;Page:8960. Text is incorporated into the Bound Volume.]POTO WILLIAMS (Labour—Christchurch East): Kia orana. Firstly can I extend my greetings to this House. This is the first opportunity I have had to speak in the new year—Phil Twyford: Kia ora.POTO WILLIAMS: —kia orana—so I want to wish everyone a successful and robust year in the House. Greetings to the new member Maureen Pugh. Welcome to the House.I want firstly to talk about the role of a home-care support worker and some of the changes that have happened that have facilitated the need for this bill and to signal what may happen in the future in terms of home support. A home-care support worker does a variety of jobs within the home. It is not just about preparing meals or supporting someone to keep their home clean. It is often very intimate and very personal care that is afforded to the recipient of the home care. There is definitely a relationship of trust that needs to be developed between the person who delivers the care and the person who receives the care. As Jacqui Dean has just said often the recipient of the care will do what they can to ensure they are available when their carer is available because they have built that relationship and that trust and it is not an easy thing to then go and give that trust to another carer.What has happened over recent times in the home-care arena is that through new technologies and new ways of assessing the needs of recipients of home care we have actually got to a point where carers are delivering shorter and shorter and shorter periods of care. It may have been say 10 years ago or 6 or 7 years ago when I was in the business of managing a home-care service myself that you might have had 2 to 3 hours a week of care that included perhaps housework meal preparation and showering or some personal care. We have now proceeded through a process where our assessment of the needs for people has meant that they are actually provided with less care in terms of the amount of time that somebody goes into a care home. So what that means for a home carer is that they may have more clients. In an 8-hour day or a 10-hour day they would be travelling to say five or six clients whereas in the old days when the assessment was for longer periods of care they may have had two or three clients. So the need for addressing the issue of travel has become more apparent.Yes we did start thinking about this several years ago and the agreement was put in place all those years ago but I think that over the course of the next few years it will again shift and we will need to be thinking again about ensuring that we are up to date with not only the levels of care but ensuring that home-care workers are compensated for what they need to do and the number of clients that they are servicing within a day. So not only do we need to pay for that travel we are actually paying for more travel and paying for home-care workers to actually address the needs of more people in one day.Jacqui Dean did make the point about the rural community and there is often distance to be travelled. But often home-care workers are specialised in a particular type of care and it is not just rural workers who have a higher level of need in terms of the distance that they travel. It may be that because you deliver a specialist type of care your client base may be far-flung across a city environment even. Others have referred to those who submitted to the select committee and I just want to make comment about three of the submissions.Obviously the National Council of Women of New Zealand had a concern about the value that we place on women’s work. It is true that we continue to undervalue the role of women. Pay parity is a very very topical topic at the moment and the National Council of Women is very keen to ensure that we keep this uppermost in our consideration. The National Council of Women also talks about the clients living in rural areas which means that travel can be a significant issue. It was my view that before this settlement and also the discussion around how we pay residential care workers for overnights that we have in fact been allowing our home-care workers and our residential workers to really subsidise the care for our most vulnerable people.The submission from Access home health care included a really interesting snapshot of the demographic of the workforce. About 91 percent of the workforce are women and there are wide varieties of ethnicities within that workforce. I note it is quite interesting that when some home-care workers are from a different ethnicity to the person whom they are caring for it can be quite interesting at times when meal preparation is required because you can often have a wide variety of different ethnic foods depending on who is actually delivering your home care. The age profile is really interesting too. It tends to be older women over the age of 45 who are part of this workforce—from the age of 45 to 64. I think that does speak to a point that Carmel Sepuloni raised about people in this workforce actually wanting to do this work. It is work of a particularly caring nature and it does tend to be dominated by women who like to be part of the caring profession.Access also made comment on the changing nature of the homecare environment. It is interesting. If we were operating a home-care service in somewhere like Hong Kong or China travel would not actually be an issue because they live in multi-level apartments and the travel required would only be in the elevator to go up to the next floor to your next client.With the Home and Community Health Association Inc. it talked about the frame of the health sector investment and I thought it was a really interesting paragraph about the broad context of health sector investment. I want to quote from its submission: “If our workforce can transition towards a place where the workers are paid fairly for the work they do and are better trained; if provider organisations can be more financially sustainable and therefore more innovative and productive then New Zealand will have a health sub-sector that can defray the more rapidly rising cost of other health services”. It is a really really important issue: that keeping people well at home costs this country far less than to have those people cared for in an institution. This really should be where we think more about the investment dollar actually having a cost benefit to this country. I could not speak more highly of the cost effectiveness of having support at home as opposed to having support in a residential setting.Just to conclude this bill really comes to us as the already negotiated settlement agreement and we know Part A of that agreement sets about to ensure that people will be paid at least the minimum wage for the time that they are required to travel. Part B of the settlement which this bill does not cover but that I think the Health Committee will enjoy getting some evidence on at some point really looks at the regularisation of the workforce and also the review of the sector which I think would be quite valuable in terms of going forward and determining where the health-care sector can be in the future. Thank you.