Turner Judy: Social Security (Long-term Residential Care)  Amendment Bill — First Reading 
Turner Judy: Social Security (Long-term Residential Care)  Amendment Bill — First Reading 
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JUDY TURNER (Deputy Leader—United Future) 
: 
 I stand on behalf of United Future to speak to the first reading of the Social Security (Long-term Residential Care) Amendment Bill. I begin by saying that we will support the bill going to select committee but like other members in this House we have one or two areas of concern. We will be very interested to hear what submitters say about those issues and the outcome of how the bill is progressed beyond that stage will be of interest to us and may even determine our ongoing support. 
I want to correct a couple of interesting things the National member Sandra Goudie mentioned in her speech. She created a bit of a misunderstanding—it sounded like there are hundreds of residential care facilities closing down all over New Zealand. I think there are a few people out there who think that is the truth. I looked at that issue a little while ago and found out that no a number of residential care facilities have been sold and have changed owners but most of them remain in operation. A few that were beyond maintenance or would have been too costly to bring up to spec have closed down—and that is probably a good thing. A number of providers—I spoke in particular to Presbyterian support services up north—explained that they had sold on some of their residential care facilities to providers so they could focus their attention on home-based care. Home-based care is becoming the cutting edge of age care in New Zealand and they wanted to be part of that. They therefore felt that there were a number of sensible and good providers that were able to take over the work they were doing so they sold their facilities in order to engage in home-based care. 
Part 1 of the current Act is to do with disability allowances and this particular amendment bill that we are talking about sets out to amend section 69C of the Act with provisions to preclude those who are already catered for in a residential care facility from receiving some disability allowances because the understanding is that they are now receiving it within the facility. The great thing I found when I read the fine detail of this is that if there is some care that their disability allowance covers when they are in community care that is not covered by the residential provider—it may be something like some physiotherapy that they are in need of to stay mobile that is not offered on site at their residential facility—they are still allowed to get that disability allowance to cover that lack of service where they are living. I think that is a really really good thing. 
The amendments proposed to Part 4 and schedule 27 of the Act are probably the areas that will be the most controversial. I expect that we will hear from people involved in aged care from Grey Power and from people who want to talk to this bill. It is an area that United Future has some questions over. 
Those who require long-term residential care indefinitely are those who are affected by this bill. Providers with contracts with district health boards will not be able to require a resident to pay any more. Let me say up front that I think it is important that people are not treated unfairly. I think the intention of this legislation is to make sure that there is no unfair treatment of people in residential care. However the concern we have is that on one hand we are encouraging New Zealanders to save towards their retirement and their needs in their senior years and on the other hand we are now saying that having gone to all the trouble of saving and providing for themselves they cannot use the money from their assets to provide a better standard of care for themselves. That is flawed. That is the kind of area that I would like to see properly discussed at the select committee so that we can have some flexible arrangements around that. 
Having said that I reiterate that our concern does not mean that we believe there should be two standards of care given to elderly residents in residential care. The standard of medical care needed by anybody in one of those situations should be consistent across the board. We need to make sure in talking about flexible arrangements that those flexibilities are not dependent on a person’s ability to pay. However it is possible that people who have gone to a lot of trouble to save towards their retirement and their needs may be able by adding some of their own money to the money offered to have a larger room to have their own TV or maybe to have a room with a view. There may be some additional comfort factors that they could choose to pay for and secure for themselves and I think that needs to be considered. If we ask people to save and make provision for those last years then we should not suddenly remove their ability to use those savings productively for what they want. We need to look at that and I will be really interested in it. However I say again that this must not be about the level of care that is given but about the comfort factors that people may want to afford. We really are keen to see that. 
United Future does support the clarification of assessment against income not assets and we support the intention to treat income assessment equitably regardless of whether it is secured in New Zealand or overseas. That is a great move. 
The explanatory note of this bill explains under the heading “Funder liability”: “If the cost of contracted care services provided to a resident assessed as requiring care exceeds the maximum contribution the funder is liable to pay the difference.” This raises some questions for me. Many of us have heard from providers that the assessor—the person who determines what level of care an elderly person will receive—is also the funder. A lot of providers say that they often receive somebody who has been assessed at one level of care and in reality find that the person needs a much more intensive level of care than he or she has been assessed at. Currently funders have to absorb that loss themselves. Does that mean then that despite what an assessor may decide a person’s level of care needs to be the provider can then invoice the district health board that funds that person for additional funding if the provider believes that the level of care required is more intense than has been designated to the person? If that is what it means then that is very interesting. Has anybody calculated what that could possibly cost us? I suspect that no one has. We need to be very clear about what that means. 
United Future totally supports the intention to correct any disadvantage that is currently experienced by couples in the matter of increasing the income from assets exemption when one partner is in care. That is a really good provision. 
I say in finishing that I have an interesting background to this issue. My paternal grandmother—and I was the only grandchild who ever enjoyed staying at her house having her conversation lollies that she kept in little jars and seeing her make dolls’ clothes for our toys because the other grandchildren were never old enough to be able to be left in her care—had a stroke that left her in residential care for the last 11 years of her life. She had serious mobility problems and a loss of speech. That meant that nearly every Sunday afternoon for 11 years of my life I went over the hill at the Raglan deviation—if anyone here travelled it in those days he or she will know that it was no small trip—and spent 3 hours with grandma. When someone has lost her power of speech and get confused by lots of people talking at her the way those 2 or 3 hours are managed is by taking turns. So I spent a large part of my childhood wandering around the hospital wing of a rather lovely residential care place and getting to know and befriending lots of people. I was really impressed with the level of care that was given. But I will say one thing here. My dad and his brother could never have afforded to pay the full cost of what that service provided over those 11 years. It would have taken my father out of the small farm that he owned and changed our life for good if we had had to pay the full amount. We have always been eternally grateful to Presbyterian Support Services which owned the home that my grandmother lived in for 11 years for the subsidies that allowed us to see her in very good quality care to visit her at will and also to befriend a lot of other people. 
We need to make sure that we remind ourselves that the measure of a nation surely is how we treat those who are most vulnerable in our society. This bill is all about that. United Future is happy to support its first reading.