Scott Lynda: Social Security (Long-term Residential Care) Amendment Bill — In Committee 
Scott Lynda: Social Security (Long-term Residential Care) Amendment Bill — In Committee 
[Volume:622;Page:17286] 
Dr LYNDA SCOTT (National—Kaikoura) 
: 
 The debate on Part 2 is much wider ranging because there is a lot more detail in this particular part. One question that really concerns me when we are talking about being able to pay a maximum contribution of $636 is whether that applies just to rest homes and hospitals. In the past it was for hospitals. In 1994 when it was brought in it was for hospital level care and the Government gave a top-up on top of that. Rest home care at that time was about $450 per week so it was much less. Now it is $636. Most rest homes are asking that; that is the minimum one pays for rest home care. Then there is a hospital care top-up on top of that. So even if people are paying $636 for contracted services the Government will face quite a price to pay the top-up for people even in rest home level care and hospital care. Home cannot deliver quality care at that price. They will exit.  
 I become concerned about the merging of rest home and hospital level care. In the past hospital level care was for those people who needed the care of a registered nurse. They needed to have a registered nurse on duty 24 hours a day to provide a much higher level of care. Rest homes are required to have a nurse for so many hours per day but the nurse does not have to be there at all times. Hospital level care means care for people who are very disabled. We often have people who are dying of cancer who have tracheotomies who have advanced Alzheimer’s and need a lot of care or people who have catheters. They need registered nursing care. 
To get a registered nurse these days with the very low unemployment rate that we have is very difficult and these homes can no longer afford to employ nursing staff. Therefore most of them are looking to the Philippines and other overseas countries to be able to bring in nurses to staff these facilities. They have found it so hard with the payments they receive to be able to have qualified nursing staff. It has been very very difficult. [ 
Interruption 
] I do not know the actual level of ability of nurses who are brought in from overseas but presumably they would have to meet New Zealand standards to be able to work here. However it does mean that it is very difficult for rest homes to be able to do that. In fact the increased asset money will go to the relatives of the people going into care. That is where the money will go. From July 2005 people can keep $150000 worth of assets when they go into care but it is not the elderly person who will benefit. It just means that the person’s relatives will benefit. 
Although National would support the increasing of the asset level it has come at the cost of all other aged-care services. We have seen all over New Zealand people having difficulty with access to equipment difficulty with assessment to get into rest homes and hospital care and difficulty with being able to pay for home-care workers so that people can remain within their own home. The whole sector is under pressure because of this bill that we are debating tonight. 
I would like the Minister to take a call and explain to us why the Government set the asset level where it did at the expense of all other aged-care services in this country. Because that is what is happening. This Government came into office having irresponsibly gone from one end of this country to the other saying it would remove income and asset testing but it was not able to deliver on that promise. I want to hear from the Minister why she thinks the asset level the Government has set is the right level when all other levels of aged-care services in this country are under pressure. They are under so much pressure that the not-for-profit organisations in the sector have had to exit. Presbyterian Support Services has exited and The Salvation Army today announced it is exiting and that is the reason. Those providers who came to the Social Services Committee were very concerned about the $636 which was going to be the maximum contribution someone could pay. Their concerns were that they could not deliver the services at that level. What is happening is that public patients who may be in a public hospital who then go into a hospital in the community are being subsidised by private patients.