Hon PETE HODGSON (Minister of Health) Link to this
I move, That the Social Security (Long-term Residential Care) Amendment Bill be now read a third time. The principal purpose of the bill is to clarify the Government’s longstanding policy intent that a person assessed as needing long-term residential care shall pay no more than the maximum contribution for contracted care services. This legislative clarification of Government policy is required because varying interpretations of the current legislation have resulted in some older people being unfairly charged more than the maximum contribution to receive a basic package of care.
The clarification of the maximum contribution policy in this bill means that all older people in a rest home or a continuing care hospital that has a contract with a district health board for Government funding will pay the same price in that region for the same basic package of services set out in the contract. The maximum contribution policy is not new, and it reflects the Government’s commitment to fair treatment for all older New Zealanders requiring longer-term residential care. Nothing in this bill prevents an older person from agreeing to pay for extra services over and above that basic package of contracted care services. That freedom of choice remains.
One of the changes to the Social Security Act 1964 included in this bill is a redefinition to ensure that overseas private pensions and annuities are treated the same as New Zealand private pensions and annuities when older people are being means assessed financially for eligibility for the residential care subsidy. This change addresses an inequity in the way that private overseas pensions have been treated in the income assessment for residential care.
Another change is the clarification of eligibility for disability allowance for people in community residential care services and age-related care. This change recognises the difference in contracting arrangements for services provided to the two groups, and ensures that predominantly younger people with disabilities in community residential care can receive the disability allowance on the same basis as others in the community.
The Social Security (Long-term Residential Care) Amendment Bill also has a number of minor technical amendments that address anomalies identified during implementation of the earlier 2004 changes in income and asset testing. Those technical amendments include: firstly, the insertion of a purpose and overview section in Part 4 of the Social Security Act to aid understanding of the long-term residential provisions; secondly, the increase of the income from assets exemptions for couples with one partner in care so that they are not disadvantaged compared with single people or couples with both partners in care; and, thirdly, the provision that people who are exempt from asset testing, such as people who are subject to compulsory treatment orders or who have been deinstitutionalised from long-stay psychopaedic or psychiatric hospitals, are able to retain a weekly personal allowance.
The bill resulting from the Committee stage also addresses issues around the backdating of eligibility for residential care subsidy, the payment of disability allowance, and two minor technical amendments. The extension of the backdating period for eligibility for a residential care subsidy from 28 days to 90 days is a fairer policy for what proved to be an impracticable period of time for people to apply for a residential care subsidy.
People with disabilities in community residential services such as IDEA Services homes who apply for the disability allowance within 12 months of the 2006 Budget will now be able to receive payment from that date—18 May 2006—or from the date they became entitled to receive it, whichever is later. This means that they will receive their full entitlements even if they take some time to apply.
Two other minor technical amendments arising from the Committee stage are, first, a change to the date that repeal of the regulation making the 1 July 2006 consumer price index adjustment to the incomes from assets exemption will take effect and, second, the date that the bill will take effect has been altered to the day after the date of Royal assent.
The changes made to the Social Security Act 1964 by the Social Security (Long-term Residential Care) Amendment Bill promote fairness for older people in New Zealand. These changes clarify Government policy so that it can be easily understood and fairly applied. I commend the bill to the House.
JUDITH COLLINS (National—Clevedon) Link to this
I rise on behalf of the National Party to oppose this bill. Parts of this bill are good, and I am not going to go over those tonight because the Minister has already mentioned some of them. But I will take issue with one of the points that the Minister raised. He stated that, effectively, this bill allows and requires the elderly to be charged the same rates for the same services across the spectrum of old-age care. That might sound like a very, very nice egalitarian sort of outcome to seek. But unfortunately it completely ignores the fact that the price of land and the price of property for rest homes providing old-age care depends very much on where they are situated, what the outlooks are, what size the rooms are, and just what the actual facilities are. What that means is that if it is taken to its nth degree, it can require the ghettoisation of our elderly—our very vulnerable elderly people. We in the National Party consider that to be a gross infringement on the rights of the elderly. They need to be able to decide that they do not want to have to shift out of the suburb that they have lived in all their lives. They should not have to shift away from an area where they know people and where they know the shopkeepers, and instead be required to shift to an area where they do not know people but where the rest home happens to be situated because that is where the land is cheapest.
Of course, if people go into care, or if they are assessed as such, then they often have to go into rest homes or the equivalent. We on this side of the House do not believe that it is fair to say to people that just because they are elderly and are getting State assistance for their care, that is all they can get. We do not believe that they should pay only for extra services rather than, for instance, the view they are enjoying, the area in which they are living, and the amenities in the general area. We think that is a gross infringement. It says to people that the Government knows best—but very seldom does the Government know best. In fact, adult New Zealanders are best able to make up their own minds.
We think it is a very good thing to increase the amount of assets people can keep before the State starts to take back some of that money, because we understand that there has been a certain amount of inflation—particularly so over the last 7 long years of the Labour Government. But, having said that, I say that we are deeply offended at the concept that adult New Zealanders cannot make a choice about whether they wish to increase the level at which they pay for facilities because they wish to be in the area of their choice. We think that is deeply offensive and we could not possibly support it.
In addition, I note that this bill at its third reading is significantly different from the bill we saw at the second reading, and there is a reason for that. It is that Labour members did not turn up—or, rather, did not stay—in sufficient numbers for the vote in the Social Services Committee so that its amendments could be put into this bill. In fact, the House has had to wait several months for the Labour Government’s amendments to become part of the bill at this very late stage, because Labour members just could not be bothered turning up on time in the select committee to vote for their own bill—even though the chairperson of the select committee happens to be a Government member. So we have to say that what we have in front of us is a bill that is a testament to the inability of the Labour Government to turn up and to stay for its own bill.
As my colleague Dr Hutchison says, they are going anyway—it is just not quite soon enough.
We have here a bill that is unamended by the very good amendment that my colleague Dr Paul Hutchison had put forward in the Committee stage of the bill, which would have allowed elderly people with up to $150,000 worth of assets to purchase an apartment within a rest home and still retain their subsidy. He wanted to put it forward, with the support of the National Party, because in our opinion it is very unfair that people in that situation should lose their subsidy if they use their money or assets to purchase an apartment within that sort of facility. We think that it is cruel, degrading, and completely unnecessary. At the end of the day the average New Zealand taxpayer does not mind if someone has an apartment, a house free-standing on its own, or a unit. What they do want to know is that people who need help will get help. They want to know that they are not being ripped off, and that their elderly mums, dads, and grandparents will be able to have a rest home, if they need it, in the area of their choice and close to their family and friends, rather than being told that, unfortunately, we cannot afford to have a rest home now in the area that they like because of the Government’s ideological bent—which, frankly, is very bent on this issue.
What has happened under 7 years of this Labour Government’s regime? What we have seen is a lot of small operators going out of business. A lot of mum and dad operators of rest homes set up for the care of the elderly have gone out of business, and what has happened? A lot of foreign-owned companies have come in and made a lot of money out of this area. That, of course, is because they have economies of scale, they can have agreements with their staff, and they can work things around. They are not hidebound, like small operators are, by mortgages, debt, and an inability to be as flexible with staff as some of the bigger providers are. We have met some of those people running small businesses over the last few years, and many of those people have said that all they have ever had out of this Government is an increase in regulations and a decrease in the understanding that they are providing a service that many people in this country actually value.
Most people who are elderly, and even those who are quite sick, are often living in their own homes or living with their families. One of the good things that happened in the 1990s was, in fact, the increase in numbers of people being able to age in their own homes. I think that that is a very, very civilised way in which to approach old age and, often, the illnesses that come with it, because life is not just about the fast lane, and about fun and those sorts of things; a lot of it is about dying and its process. Many of us who have actually had this happen in our own families understand that even though it might at times be inconvenient to have an elderly relative living with us, it is actually a blessing, because it shows us the value of life and how precious it is. It is a wonderful thing for our children and grandchildren to see that life is not just about the fun times but also about looking after those who have looked after us and who have put a lot of effort into us and into looking after our own children.
I think that one thing we can be very proud of is the fact that we now do not institutionalise people as of right or normality just because they are old, they are unwell, or their health is failing. We can be proud of the fact that after those changes in the 1990s, we now embrace our elderly and take them into our homes and into our hearts. We understand that we cannot just shove them aside to be visited occasionally at Christmas time; they are part of our lives. I think that that is a hugely humanising aspect of one of those changes—and I congratulate this Government on continuing with that progress. But I would ask the Government to please not ghettoise our old people who cannot stay in their own homes or with their relatives. I ask the Government to allow them to have the dignity of choosing where they stay, what they pay, and what they should expect instead of saying this silly nonsense about elderly people not having the right any more to choose what suburb they live in if they live in a rest home, because, frankly, rest homes cannot afford to have those basic facilities in an area where land is expensive. Rest homes are businesses, and they are not going to want to lose any more money just to be able to provide something that people want.
Anne TolleyOne of the comments from my colleague Anne Tolley was about where prisons are sited and so on, but I think that if we look at it, we realise that elderly people are not incapable of making their own decisions. Why does this Government not trust them to do what is right for themselves? Why will it refuse to allow elderly people to decide that a one-bedroom or two-bedroom unit is not the same, depending on which suburb it is in? It actually does make a difference.
GEORGINA BEYER (Labour) Link to this
I am proud to take a call in the third reading of the Social Security (Long-term Residential Care) Amendment Bill. That previous speech was rather amusing to some degree. It said a lot about caring for elderly people. I do recall, some time in the past under Mr Bolger, a bit of a reneging of a promise about a surcharge at some point. That really showed a lot of concern for elderly people at that time! I have to wonder to myself, with that speech from Judith Collins—from those sometime eloquent words coming from her—whether that was some purport of a vision coming from the National Party, because if it were, could we put that down to some form of leadership bid that might be occurring? Vision really is something. Those members ought to look at that lady as one of the contenders, because when she was talking about those poor, elderly people who should be able to make up their own minds, I believe that Don Brash might want to consider what he might like to do about making up his own mind on his leadership state at the moment.
But, no, the important matter before us in this third reading this evening is, of course, elderly people, whom Labour is committed to—not only elderly people but families, young and old.
Labour believes in fair treatment and dignity for our senior citizens, and this bill continues to make progress on both fronts by providing certainty for all.
In the bill, the maximum contribution for the provision of care is agreed on by funders and providers, and it is the same for all needs-assessed residents in a region, regardless of the type of care they need—rest home, dementia, continuing hospital, or specialist hospital. Strangely enough, I have just come from a meeting with Alzheimer’s New Zealand, and those who were present at this particular meeting highlighted to us the many needs to be met in their particular sphere of concern, and said that they were able to interface with the Government. The meeting I have just come from this evening is an indication of progress and of taking notice of our elderly people, which of course this bill is endeavouring to do.
Finally, I would just like to mention that the bill precludes people from receiving both the residential care subsidy and the disability allowance. That allowance will now be able to be used more widely, to go towards the same costs that those living in the community can use it for. With that, I commend this bill to the House and look forward to its conclusion.
Dr PAUL HUTCHISON (National—Port Waikato) Link to this
Thank you for the opportunity to speak on the Social Security (Long-term Residential Care) Amendment Bill. National is indeed opposing this bill, and the reason we are opposing it is that it represents a reminder, once again, that Labour has failed the elderly in the detail. That is very much the case in this particular bill. We heard Georgina Beyer, chairman of the Social Services Committee, say that Labour is committed to certainty for all. How wrong that was for the elderly couple who were married for 57 years, and Labour had through this bill the opportunity to ensure that they would be able to age together. I put up an excellent amendment to ensure that that would happen, and the Minister totally ignored it. So when we have the chairman of the select committee, who went painstakingly through this bill, say that Labour provides certainty for all, this bill is a living representation that this Labour Government, once again, fails the elderly when it comes to detail.
National does acknowledge that there are some useful aspects to this bill, and one of them was mentioned by the Minister when he talked about the 28-day rule being extended to 90 days so that elderly couples would have the chance to make arrangements, without penalty, when one went into long-term residential care. I think that was certainly an important aspect. But I go back to the two parts of this bill that are very concerning and are an indictment on this Labour Government if it claims it really cares for the elderly.
The first one, of course, is in relation to ageing together, which the Labour Government claims it is for, and that so flagrantly is opposed by its action in this bill. The second one relates to the freedom of New Zealand’s elderly to be able to choose whether they can live in the retirement home of their choice; but instead, the Labour Government chooses to cap the subsidy so that that choice is taken away from them.
We hear a gasp from the Labour Government, but that in principle just represents the grey, socialistic ethos of this Labour Government deciding that everybody in New Zealand should have the same, and should not have choice. It is the reflex reaction that it has had for many years and just cannot get over.
I want to go over the situation of this couple who were married for 57 years. As they did not have assets of their own, their daughter bought an apartment for them valued at $150,000 that was attached to a rest home so they would be able to live there. The wife, on clinical needs assessment and on financial assessment, was indeed eligible to receive a subsidy from the State. But when it came to the actuality of it, the district health board refused to pay that subsidy, and the only way that that couple could have gone on was for the wife to move through the wall, next door, and away from her husband of 57 years. That is the situation, and the Labour Government had the opportunity to correct it.
Let us just hear what the Minister said in his second reading speech: “There is one last matter …”, and it is interesting that the Labour Government put this matter last. But, anyway, he said: “I am aware that the National Party has indicated that it is introducing a Supplementary Order Paper. It asks that an additional amendment be made to the bill to ensure that couples residing together in a retirement village under an occupation right agreement—a ‘licence to occupy’; sometimes known as an LTO—can stay together when one has been assessed as needing care.” Then he goes on to say, and we dare not say that “h” word: “The Government also believes that couples should be able to stay together as long as it is possible and safe.” He says even further: “There seems to be agreement across the House about that. That is the aim of the Government’s older people strategy.”
Why on earth did not the Minister agree to support my amendment or the amendment of Sue Bradford from the Green Party—either of those amendments—and make that possible? But he chose to say: “No, we won’t do that.” He goes on to say: “National’s amendment, perhaps unwittingly, allows for that double-up payment to occur.” Well, maybe it did, but that could have been solved by the Minister making an appropriate amendment himself. He says: “The Government expects parties to work together to find a solution, and some providers and district health boards have already done just that.” Well I ask the Minister to name one district health board that has done that.
Then he goes on: “Residential care providers will need to address the way in which they write their residential village occupation rights agreements, and district health boards will need to address this issue in their age-related residential care contracts.” They are empty words. We know that time and time again this Labour Government has failed in detail for the elderly. It had an opportunity here, but on this occasion it decided outright that that elderly couple were not going to be able to age in a place together.
The reason we are cynical is that it was only a month or two ago that Dr Nick Smith brought up, in the New Zealand Superannuation and Retirement Income Amendment Bill, the situation of an elderly man aged 90 and his wife, also married for 50 years, where the wife had to go into care because of Alzheimer’s. The Labour Government made it not possible for him to have a living alone entitlement. That is how miserable it was. Nick Smith first of all wrote to the Minister, and the Minister refused him not once, but twice. He then went to the Human Rights Commissioner, who ruled that this was a flagrant abuse of that elderly man’s entitlements; and it took that to happen, before the Labour Government took notice. But then, what happened? Michael Cullen decided that the amendment Nick Smith put up would increase the Crown’s total operating expenses and total operating revenues by approximately $600,000, so he decided to refuse that elderly man.
Here we have two occasions in a few months showing why we should not trust this Labour Government when it comes to details in terms of caring for the elderly. The Government clearly has very wide and altruistic rhetoric that, when it comes down to detail, simply means nothing. Labour had the opportunity twice in this bill, by means of an amendment from National and an amendment from the Green Party, to have sorted out the problem for that elderly couple. Instead, it chose, very cruelly, not to.
With the district health board situation right now, there are dozens of elderly couples—some not in the position to have a daughter pay for them as was the case of this couple—who will literally be torn apart because of the lack of care by this Labour Government for elderly couples when it comes to details in legislation. Unfortunately, the National Party cannot support this bill, because, once again, it realises that the Labour Government simply does not care when it comes to the detail in looking after New Zealand’s elderly.
BARBARA STEWART (NZ First) Link to this
On behalf of New Zealand First I rise to support the third reading of the Social Security (Long-term Residential Care) Amendment Bill. [ Interruption] It is an excellent decision. The bill is largely of a technical nature and amends some of the anomalies identified in the changes to the income and asset-testing regime that had been implemented. This bill also clarifies that people who receive a residential care subsidy for disability-related care can receive a disability allowance on the same basis as those who live in the community. That group of people definitely needed to have their residential care subsidy clarified. We also note that people who receive a residential care subsidy for age-related care may not receive a disability allowance, because the residential care subsidy is intended to meet their assessed disability-related needs.
We approve of the changes that were implemented to the legislation during the Committee stage of the bill; they were good changes. We were particularly pleased that the 28-day rule was extended to 90 days, because we know that it takes a long time for a person to ensure that the necessary changes in his or her living circumstances are made.
New Zealand First members believe that the treatment of our seniors sends a clear signal of our status as a developed nation—hence our Supergold card. With an ageing population, we must have high-quality, affordable care available for all older New Zealanders when they require it. Of course, certainty is always needed about how much an individual needs to contribute towards his or her care. New Zealand First members are adamant that retired couples must be able to grow old together, with all of their due entitlements. After all is said and done, they have earned the right to do that, and they need to enjoy life together for as long as they possibly can.
We were very pleased to hear the message repeated by the Minister that retired couples under an occupation right agreement are able to stay together for as long as possible, with all of their entitlements. We are adamant that with the passing of this bill, any person eligible for a subsidy for care should receive the care component of the subsidy—including couples who reside under occupation right agreements. We raised that matter directly with the Minister of Health’s office, and we now await the agreed outcome, which is that district health boards will be encouraged to constructively engage with providers in order to find an agreed solution to that issue. Put simply, the care component of the subsidy must be disentangled from the accommodation component. There are currently examples of district health boards and providers negotiating fair solutions to that issue. We believe that can and should happen right across the country.
If someone with an occupation right agreement is assessed as needing rest home - level care to be provided at that person’s place, then the Government should pay for that care, and the owner of the facility should not be paid twice for the accommodation component. New Zealand First wants to ensure that if a senior citizen is eligible for a subsidy, then he or she receives it. Additionally, if individuals are receiving the same care package, they should pay the same price. We have a commitment from the Minister’s office that the Government expects the parties to work together to find a solution. Residential care providers will need to address the way that they write their retirement village occupation right agreements, and district health boards will also need to address the issue in their age-related residential care contracts. So we are confident of reaching a fair and an equitable solution on this matter and, of course, we will be monitoring the Government to ensure that it follows through on its undertakings. Couples who want to stay together must receive care together.
The bill also allows those exempt from a financial means assessment—asset testing—to retain a personal allowance, and it clarifies that any person who is needs-assessed as requiring indefinite long-term residential care in either a rest home or a hospital that has a contract with a district health board will pay no more than the maximum contribution for the services set out in the district health board provider contract for services, whether or not that person is subsidised. The bill clarifies that if the cost of the contracted care services provided to a resident assessed as requiring care exceeds the maximum contribution, the funder is liable to pay the difference. It is essential that if a taxpayer’s subsidy is paid, a certain level of service is provided, regardless of whether the person concerned is State-funded or self-funded. In this House we would all agree that for people to receive anything other than the same level of service or medical care would be totally outrageous, and of course we are very aware that residents are able to purchase any additional services on top of those that are subsidised. The element of choice is still there.
The bill makes it clear that even if people have assets of more than $150,000, they will pay no more than the maximum contribution for their care. In this House we are all only too aware that the cost of residential care very quickly erodes the savings that many people have worked for, and then very carefully put away, for their senior years. We have all had people visit our offices and discuss that issue at length.
We were pleased to read that the bill now treats New Zealand and overseas private pensions and annuities equitably. That means that in both cases, only 50 percent of a private pension or annuity is to be included as income in a means assessment. Previously, 100 percent of an overseas private pension was treated as income. The treatment of overseas private pensions as income for assessment was unfair, and it is good to see that that anomaly has been amended and that those people will not be unfairly penalised.
We in New Zealand First believe that in the future many elderly people will choose to opt for quality home-based support services, but we are very aware, too, that the provision of those services is challenging.
New Zealand First supports this bill. The matters raised in it do need to be resolved, and we look forward to a very speedy resolution of them.
SUE BRADFORD (Green) Link to this
The Green Party supports the third reading of the Social Security (Long-term Residential Care) Amendment Bill. Although we would have preferred to see the asset test for long-term residential care abolished completely—and, for that matter, the Social Security Act itself completely rewritten—we remain happy to support the tidy-up provisions contained in the bill. However, when the bill was before the Social Services Committee, one particular issue was drawn to our attention by submitters, which was that of people in need of long-term residential care who are unable to obtain a residential care subsidy because of the nature of the contracts between district health boards and care providers.
The standard district health board contract contains a clause that precludes care providers from entering into service arrangements such as “licence to occupy” agreements that result in the provider receiving payment, benefit, or value from the district health board or anyone else, including the resident, for the provision of such services to residents. The consequence of such a clause has been the anomalous situation whereby residents who meet the needs and means assessments for residential care subsidies have been denied them because of the nature of the agreement they have with their care provider. In some situations this has resulted in the bizarre scenario that Paul Hutchison talked about earlier of a couple having to effectively separate, with one partner in a “licence to occupy” unit and the other bundled off to a room somewhere else in the rest home facility so that the subsidy can be provided. That approach harks back to the dark ages when people with disabilities were separated from their families and led a lonely existence hidden away from society—days that I hope are long since past in this country.
I agree that it is not acceptable for providers to double-dip by obtaining funding from the district health board and other sources for the same service, but this is an issue that could have and should have been properly worked through with the providers and, preferably, through the legislation that went through the Committee stage yesterday.
From recent discussions with aged-care providers I learnt that they have been attempting to resolve this problem with the district health boards for some considerable time. Providers reported reluctance from district health boards to negotiate the issue in good faith. I therefore proposed a Supplementary Order Paper at the Committee stage that would have had the effect of setting a 6-month time frame for the district health boards and providers to negotiate the unbundling of “licence to occupy” agreements into their care and non-care components, which would stop the double-dipping aspect of it. My Supplementary Order Paper would have precluded the district health boards from contracting to providers in a manner that excluded residents with “licence to occupy” agreements from funding.
Unfortunately, business in the House proceeded more rapidly yesterday than a lot of us anticipated it would, and I was unable to be present for the Committee stage of the debate. However, I thank the Māori Party in particular for its support for the Green Party amendments. Although the Government did not find its way clear to vote for our Supplementary Order Paper, I also thank the Hon Peter Hodgson for his comments indicating that he and the Government are taking this issue seriously. I hope he will be able to persuade the district health boards to negotiate through the issue with better faith and greater enthusiasm than has been demonstrated to date.
In conclusion, I acknowledge all of those who took the time to make submissions on this bill. I know that the whole submission-making process sometimes feels like a thankless task, especially on bills like this where not a lot of public or media attention is paid to what is happening. But, as ever, submitters are making an invaluable contribution to the workings of democracy, and we MPs do listen to them, even if our amendments do not always get through.
TE URUROA FLAVELL (Māori Party—Waiariki) Link to this
Kia ora, Mr Deputy Speaker. Kia ora tātou katoa. This week as I returned to Parliament I brought with me a very special portrait. It is a portrait of a renowned weaver, the kuia Ranginui Parewahawaha Leonard. She is a woman of much significance, so much so that my first-born child is named after her. Ranginui Parewahawaha was my grandmother and, as it happens, one of her great-grandchildren is sitting in the gallery tonight. She was 112 years old when she passed away, some 22 years ago, yet my memories of her are very vivid, as were her piercing eyes. Her tiny frame was rather deceptive; her strength was formidable. Her nimble and meticulous skills, in particular with raranga—that is, weaving, for those who do not know—stayed with her right through to the end. She was one who at the age of 100 years would still carry her firewood in a sack on her back from my uncle’s place to hers—a trek of some 800 metres or so.
So she was a very strong woman and, as we come to this bill, the Social Security (Long-term Residential Care) Amendment Bill, I think of her. For her first century she lived pretty proudly in her own home, only conceding to be cared for by my mother and my auntie in the last few years of her life. It was a life that I would think must have been very hard, but a life that was fairly fulfilling. It was a life of independent means, of strength, and of good heart. So in this bill tonight we of the Māori Party bring the aspirations that the proposals to amend the income and asset testing regime for elderly people requiring indefinite long-term residential care will guarantee the same autonomy and good health that my kuia enjoyed in her time.
A critical component of well-being is, of course, financial stability. We welcome the proposals that the people assessed as requiring indefinite long-term residential care will pay no more than the maximum contribution for care, whether or not they are subsidised. People who have assets over the applicable assets threshold, and who receive contracted care services that cost more than the maximum contribution, will pay only the maximum contribution. That sense of a cut-off point from which no other charges will be incurred is an important one. The Māori Party supports these changes to the means-testing policies, because we believe that they bring with them the capacity to truly ensure manaakitanga is applied when considering the care of pakeke.
We were disappointed that the bill was reported back to the House with no amendments, and that no report or commentary on this bill was tabled by the Social Services Committee. It was not as if the submissions received by the committee were of little significance. Indeed, I am told that at the time of the second reading of this bill my colleague Tariana Turia referred extensively to the expert advice and counsel of the submitters, particularly the macroeconomist Susan St John. It was St John’s contention that the opportunity to consider the appropriate funding of long-term care had been lost with the fast passage of this bill. Her advice to the Social Services Committee made it clear that the legislation had arisen solely to meet the obligations of a political promise.
Last night I laid in the House the longest place name in Aotearoa. It was an 85-letter word.
TE URUROA FLAVELL Link to this
That is true. Tonight I have another word for the House. It is not quite as long. In fact, it is only 12 letters in all, but it is one that we must all wrap our lips around and commit to memory if we are truly to be representatives of the people. What is the word? It is “consultation”. Consultation is critical to the attainment of quality policy. A commitment to produce effective policy means that it would likely be useful to get the views of New Zealanders in developing options and assessing them. Without a proper consultative process, and a serious effort to define and address the actual problems New Zealand faces in the provision of long-term residential care, policy will be created in a vacuum. In addition, consultation offers new approaches for considering the dilemmas associated with such variables as income assessment, including the income-from-assets exemptions for couples, and residential care subsidies for disabled-related care. Effective consultation enables us to point out pitfalls or gaps in our thinking—and, of course, to raise issues we have not considered.
There is a particular reason why the Māori Party is identifying the lack of consultation in this bill, and that is, of course, as a result of the responsibilities the Crown has through Te Tiriti o Waitangi. At its heart the Treaty confirms the relationship with Māori. It promises commitments to a constructive and mutually respectful relationship. So we look to the proceedings in this House to learn what our kaumātua, kuia, and koroua have thought about the current asset-testing regime. We are interested in the perspectives of whānau, hapū, and iwi in regard to funding for the provision of services and care to older people.
The nation is entitled to transparency in discussions regarding payments for long-term care. I understand that the rōpū HealthCare Providers New Zealand came to the select committee stating that it did not support raising the threshold for asset testing. The Royal New Zealand Returned Services Association suggested that we should remove asset testing in total as soon as possible. I am told that the Salvation Army presented a submission stating that the residential care sector had to be better funded. It was the Salvation Army’s view that, given the demographics, it is likely the market will develop a form of care that sits outside the regulations. The logical flow-on effect of that would put older people potentially at risk of inadequate and costly care.
I have mentioned just a few of the submissions that were heard, in my attempt to ensure that the Hansard record is a more fulsome one than perhaps the one we would otherwise receive. But the broader issues of a fairer and sustainable sharing of long-term care must be examined in a public forum. We absolutely endorse the views of Susan St John that there is not enough transparency or discussion with regard to paying for long-term care. It was for that reason that we were interested in the royal commission of inquiry.
Earlier tonight I paid tribute and made reference to my grandmother Ranginui Parewahawaha Leonard, and said that our family was fortunate we were able to care for her. The future, however, is not so clear. As the demographics indicate, the proportion of our population requiring residential care, and the needs of our elderly people, will grow. We think that we must prepare; we must take every care, every effort, to consult, to care, and to plan reasonably for the future. It is with this in mind that the Māori Party supports this bill.
A party vote was called for on the question,
That the Social Security (Long-term Residential Care) Amendment Bill be now read a third time.
Ayes 68
Noes 49
Bill read a third time.