Housework help for the elderly will be cut, saving about $4 million a year, the Otago and Southland district health boards confirmed yesterday.
The boards say they will no longer pay for housework help for those requiring only that service, except in exceptional circumstances.
Starting next week, those receiving one and a-half hours' help or less will be told they no longer qualify.
In the next two to three months, 1500 people in Otago and 500 Southlanders will receive letters telling them the service is to be discontinued.
Those getting more will be reassessed, probably by telephone, with a view to terminating their help.
Regional planning and funding general manager David Chrisp yesterday defended assessing elderly people by phone call.
Research showed it was a reasonable way of assessing people, he said.
GPs would be involved in the reassessment process, with the board likely to meet them face-to-face to discuss their patients.
Seeing GPs was a more efficient use of staff time than going to individual houses to assess the elderly, he said.
However, face-to-face assessments with some elderly would still be carried out if considered necessary.
Mr Chrisp did not accept that even one or two hours' housework might be all that stood between an elderly person staying at home and entering a rest-home.
Factors that "tipped" a person into a rest-home were always more complex than a couple of hours' housework, usually involving personal care.
Housework help had been targeted as a relatively low-risk service to make much-needed savings.
The boards could no longer afford to provide a house-cleaning service, he said.
The boards would not take a "one-size fits all" approach, and were willing to make exceptions in special circumstances.
Staff were told the new criteria last week.
No-one was "thrilled" to cut services, he said.
He indicated further cuts to services for those receiving both personal care and domestic assistance were on the agenda.
Because Southland started reducing housework help six months ago, the amount some elderly received had already been reduced to one hour.
That would be cut completely.
Those who had already been reassessed would be put at the end of the list.
Mr Chrisp acknowledged it might be distressing for elderly to be reassessed twice in a short time, which was why letters would not go to about 300 Southlanders until later this year.
The letters immediately cutting services would be staggered over the next couple of months to allow the housework providers time to adjust.
It would be possible for those affected to appeal, but Mr Chrisp was not sure what form it would take.
Presbyterian Support Otago chief executive Gillian Bremner feared the changes would force some people, who might have been managing at home, into a rest-home.
It was surprising what tipped the balance, she said.
Cutting home care might end up costing rather than saving the DHBs money.
Telephone assessments were inadequate for many elderly, especially those with hearing difficulties or dementia.
Elderly tended to be stoic, and put on a brave face even if they needed help.
As a provider of housework services, Ms Bremner said she could be seen as having a vested interest in the status quo.
However, she did support changes to the sector, which needed a new "vision" rather than just budget cuts.
The sector needed a new strategy that was less "entitlement" based and more proactive.
