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Limited showers, no meal prep: 'Ruthless' plans to cut disabled care revealed

Author
Kirsty Johnston, NZ Herald,
Publish Date
Sun, 21 Apr 2019, 9:20am
Advocates say the plans are happening by stealth. 9Photo / 123RF)
Advocates say the plans are happening by stealth. 9Photo / 123RF)

Limited showers, no meal prep: 'Ruthless' plans to cut disabled care revealed

Author
Kirsty Johnston, NZ Herald,
Publish Date
Sun, 21 Apr 2019, 9:20am

Health bosses planned to limit showers and meals for the disabled, create long wait lists for specialist care, and refuse help for autistic children as part of a desperate cost-saving bid.

Documents obtained by the Herald on Sunday reveal the "ruthless" cuts disability funding agencies offered to make after a $100m sector overspend this year - suggestions so appalling a national rollout was eventually stopped.

However, advocates, providers and their disabled clients say the cuts - designed to save $10m by June, and $20 million each year after - are now simply happening by stealth instead.

The only revelation for them was seeing the cost-cutting tactics they've long suspected were being employed by agencies written down for the first time.

"It's absolute ruthlessness. They're reducing people's allocations to the point where anything resembling a good life is simply not possible," said Garth Bennie, chief executive of sector group Disability Support Network.

"And now there's no official plan but spelled out there in endless detail is how they go about cutting funding, whether it's nationally or one person at a time - which we know is happening."

The documents show that in January, the Ministry of Health realised it was approaching a $90 million budget blowout.

It met with the heads of its regional needs assessment agencies (NASCs) on February 1 and asked them to come up with cost saving plans within two weeks.

It also drafted an announcement about the cuts for clients, explaining it had increased funding to the $1.268 billion disability support sector each year for five years, but could no do so longer.

Pay equity settlements, more expensive equipment, more people seeking support and more people with complex needs were all placing pressure on the system, it said.

"The current demand driven funding model is now unsustainable," the draft read. "The Ministry is reviewing its options and is identifying a set of actions that will help it realign its disability support services spending to fit within the allocated budget."

By the end of February, each NASC had come up with its plans to help save money.

These included cutting people's access to current services - like in-home help and meal prep, recreational activities, limiting shower times and personal care - and capping new clients' packages.

Cost saving was easiest with new clients, one NASC wrote. "This is because there is no pre-existing client expectation or dependence and our experience ... is that this is the optimal time to engage natural supports."

Others suggested restricting access to residential services by using wait lists, refusing to fund behavioural support for autistic children under 5, and tightening the threshold for service entry - for example, removing foetal alcohol syndrome from the accepted conditions list.

Another popular option was reviewing "expensive" clients plans more frequently. One NASC said anyone funded at over $165k would be reviewed every three months - even though their funding had been approved for a year.

Advocates shown the plans by the Herald on Sunday were furious. Some were despondent. One disabled person cried as the documents were read out.

The Disabled Persons Assembly said it was appalled that support might be cut or reduced in any way - particularly after it was given reassurance there would be no reductions.

"Taking away from barely enough leaves not enough – this isn't just about some line in a budget," said President Gerri Pomeroy. "It's about disabled people being able to live their lives at the most basic level."

CCS Disability Action chief executive David Matthews said the system had never been demand driven - no one was funded for their real needs.

"To imply that seems to imply this is disabled people's fault for having a disability," he said. "They're being made the scapegoats."

He said despite denials of a national rollout, he was seeing clients' packages cut each week as a result of downward pressure.

"It's a crisis," Matthews said. "We are punishing people for having a disability. Anyone suggesting these cuts needs to go to see what it's like to help someone with high and complex needs have a shower."

The Herald on Sunday understands the plans were pulled after ministers intervened.

However, the Ministry of Health refused to answer questions about when the rollout was stopped, or why. In a letter it said after further analysis of the "likely impact" of the cuts, the decision was made not to go ahead.

It said further information about funding would be available in the May Budget, but pressures mean that sometimes the amount it spent had to remained fixed, regardless of demand.

Associate Health Minister Julie Anne Genter also did not respond about why the cuts were stopped, or if she personally stepped in.

She said at no time had there been any intention to spend less on disability support services, and she and the ministers of health and disability had made it clear that services must be maintained.

 

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