No quick fix for aged care staffing

In common with many issues facing health service provision, the staffing shortages in aged care have been a long time in the making and there is no magic wand handy to whisk them away.

As Southern District Health Board chief executive Chris Fleming told the board this month, workforce shortages continue to plague aged residential care in our area, often resulting in staffing which does not meet requirements.

It was a credit to the remaining staff that, in most cases, they continued to provide services seamlessly, but the stress on staff was enormous.

Pay parity for registered nurses with their district health board counterparts, and ways for internationally qualified nurses and their families to enter New Zealand must be addressed urgently, he said.

New Zealand is not alone in having staffing shortages in this area, a situation exacerbated by the Covid-19 pandemic.

In the United Kingdom the pandemic has had a big impact, due both to staff illness and workers leaving for other sectors, forcing many homes to close their doors to new admissions.

Across the Ditch, aged care workers are understandably flexing their muscles during the general election campaign, highlighting examples of poor care and unsafe incidents.

Here, Aged Care Association president Simon Wallace estimates the workforce is short about 1000 registered nurses.

Demand for aged residential care is expected to increase by about 15,000 beds by the end of the decade.

But in the past six months, 500 hospital beds in aged care homes were closed in New Zealand due to the shortage of nurses, he said.

There has been recent television coverage of long-settled residents having to face the stress of abruptly having to move elsewhere.

There are concerns that the shortage of beds will mean an increasing number of people will only be able to find accommodation distant from their families or community.

The association points out the subsidy rates for hospital level beds are too low, with a difference of $750 a day in what is paid to aged care providers compared with a public hospital bed.

In some instances, the only option will be using public hospital beds which is far from ideal when those hospitals are also under staffing pressure.

The staffing shortages involving both nurses and carers also affect the provision of care for those living at home, known as ‘‘ageing in place’’.

Some are hoping the health reforms will shift more money into this area, keeping people out of residential or hospital care for longer.

However, that is not the only answer because residential or hospital care will still be needed and people entering such care are likely to have higher acuity.

Better pay and conditions would help, although it must be remembered there is a shortage of nurses in every setting.

There will be some relief when more internationally trained nurses enter the country, but more will be required than stopgap measures.

And another thing

We hope Dunedin’s 25-year-old Midwinter Carnival will be a success this year in its new setting at First Church.

The carnival is to run over two nights this year, on July 8 and 9, the same weekend as the All Blacks-Ireland rugby test in Dunedin.

There has been some grumbling about the decision to impose a $5 ticket cost for this year’s event when previously it has been a donation only occasion, but with the cost to stage this event expected to be $250,000 and fundraising not covering that cost, it is an understandable move.

The shift from the Octagon has also not been appreciated by some, but it seems mean-spirited to criticise this before experiencing it.

That a small not for profit organisation can run such a spectacular event at such a low cost is something to be celebrated.

That said, we are sure organisers would not say no to some extra funding from generous benefactors.

Comments

There is no quick fix but there will be no fix if nothing is done. We need to train more nurses and maybe even think of developing a specific nursing qualification for care of the elderly. Pay the students to train. Actively recruit from overseas (may need a different minister of immigration as the present one is a major obstacle). If nurses are not paid in a comparable way to those overseas we will continue to lose them. None of this is rocket science but we clearly don't have the current leadership to sort it.

Private rest homes are not staffed by nurses.

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