Goudie Sandra: Social Security (Long-term Residential Care)  Amendment Bill — First Reading 
Goudie Sandra: Social Security (Long-term Residential Care)  Amendment Bill — First Reading 
[Volume:631;Page:3088] 
SANDRA GOUDIE (National—Coromandel) 
: 
 I begin by congratulating my excellent colleague the Hon Tony Ryall on such a superb speech. I think he very clearly outlined one of the shortcomings of the Social Security (Long-term Residential Care) Amendment Bill. After all this is meant to be about ensuring the residential care of our mums and dads when they can no longer care for themselves. He raised a very pertinent point about the continued viability of residential care services particularly when by 2020 20 percent of the population will be aged over 65 years. It is an incredible concern for us all. 
In response to Georgina Beyer I note that when the bill was introduced Age Concern urged the Government to be open and honest about what this bill means in terms of what older people can be expected to pay in rest homes and hospitals. Kerry Dalton the chief executive officer of Age Concern says that it potentially gives with one hand and takes away with the other. Of course that non-profit organisation is particularly concerned about the care safety and well-being of our older people and does a lot of work around elder abuse. But I will refer to more of that later. 
Kerry Dalton goes on to say that the changes in asset testing will see more older people qualifying for public funding but what that funding covers may be reduced under this legislation and what was meant to be good news for older people has a hidden sting. The bill brings in a new definition of what public funding covers called “specified care services”. Under the bill the older person is liable to pay for anything outside of specified care services. The $636 limit on what people have to pay also relates only to specified care services. The Hon Tony Ryall raised this point and wanted an explanation from the Minister so he will be looking forward to that explanation—if not from the Minister or the Government benches then in the select committee. 
More comments were made that it was thought that the changes contained in the bill have the potential to put older people at significant risk particularly those on low incomes. They may be in danger of not having essential health and disability needs met because they are unable to pay for them and there is also the risk of financial exploitation. Their understanding is that such things as transport to and from the specialist as well as ambulance costs in certain regions and the cost of customised equipment will be charged for and these are not luxuries. People need these things and should have them regardless of their ability to pay. 
Age Concern is concerned that older people will fall through the cracks between what the provider is funded to deliver and what the person needs. It is a concern. Those people who are paying privately for services are the ones who help to subsidise the Government-subsidised residents and that should not be forgotten. The benefit of that should not be underestimated. In the last 3 or 4 years 30 to 40 providers have gone out of the provision of residential care services. That should send a very strong message to this Government about needing to be very very careful about the policies that are put in place for our older people. 
The price district health boards pay for residential care is determined by the territorial local authority region in which the residential care facility is sited and the level of care provided. Prices paid to providers vary from $556.47 a week GST inclusive for rest home care in the Clutha district to $986.30 per week GST exclusive for hospital level care in the Auckland City area. So any amount any resident pays towards the cost of his or her care is limited to the maximum contribution which is gazetted by the Ministry of Health. The $636 cap is unrealistic and does not reflect the current cost of the provision of aged care. As regional variations currently exist it is the view that the current cap is largely fictional and should be removed in order to provide greater clarity on pricing for residents. The Hon Tony Ryall is absolutely correct when he says that it cripples innovation and stifles investment. People should have the freedom to pay what they want to pay for. If that helps others by creating a subsidy for people who cannot afford the same level of services then surely that is not a bad thing. Surely it would be a good thing to have more services for all those people in residential care even though only some of them may be paying for those services. 
One has to ask whether the Minister really has the health and well-being of our vulnerable people at heart. Age Concern raises that issue and Age Concern as members are aware is very much into the protection of our older people particularly our vulnerable older people. It has put out a very good report on elder care abuse. In that report information is provided on 1288 cases of elder abuse and/or neglect self-neglect or institutional abuse. I think that psychological abuse accounts for 59 percent of that. 
One of the other issues that Age Concern raised was enduring powers of attorney whereby older people because they are vulnerable can be persuaded into undertaking enduring powers of attorney. Now if they can be persuaded into giving other people their enduring powers of attorney then they can also be persuaded into allowing their photographs to be taken and then used for purposes that they are scarcely aware of. This is about elder abuse. If Age Concern is concerned about what can happen to the elderly as a result of some of the provisions of this bill then I think we should be listening to that. 
It is interesting to note that elder abuse has been in the news recently. It is disappointing that this Government—and indeed the Minister for Senior Citizens—has not come out and defended the vulnerable people whose photographs were displayed in the Nurses Organisation magazine in one instance without the permission it would appear of the family. It is quite clear that older people are vulnerable. We need to have their interests at heart. If we do not have their interests at heart how can we be putting policy in place through legislation that will really take care of them and protect them and their future care? I would like to see the Minister come out and support Age Concern and defend our vulnerable older people against elder abuse. Quite clearly those photographs in that magazine are elder abuse and anybody who has seen them will be absolutely appalled. 
If one does not have the concerns of our aged citizens—our vulnerable older people in residential care and home care—at heart how can one possibly put policies in place that will protect their interests? That policy is the exact one that Tony Ryall was referring to in regard to subsidised and non-subsidised paying residents. It is the paying residents who help to subsidise the supports necessary to ensure that our older people are effectively looked after in residential care. That cannot be understated in any way. If we do not allow the innovation and investment in residential care facilities we will not have those beds available in years to come when they will be absolutely critical to supporting our rising older population. I exhort Government members to really give some consideration to the very wise words of the Hon Tony Ryall. Hopefully their minds will be open to what it means for people to have the right to pay for what they want and for the Government not to start interfering with contracts that are essentially between private paying individuals and the service provider. 
In this instance the Government is attempting to interfere in that contract and is intending to interfere in that process. Price fixing should not be a part of this bill and I would exhort the Government to rethink its direction in this regard and spend some considerable time at the select committee. I am sure there will be submissions to the bill on that particular issue exhorting the Government to do that.