Health New Zealand has denied claims by the Aged Care Association, including that it is looking to toughen eligibility to get into a rest home - and says “throwing mud” is unhelpful.

“In the next 15 years the number of New Zealanders aged over 85 are going to double to almost 200,000 people. And we want to make sure that we’ve got a system in New Zealand that cares for those people in the right setting,” said Andy Inder, Health NZ-Te Whatu Ora’s director of ageing well.

“And we shouldn’t be competing or throwing mud at each other around the size and scale of the challenge. We should be collaborating to make sure we are solving it together.”

Inder was responding to strong criticism against Health NZ, made by the Aged Care Association, which represents most aged care home owners.

The association’s chief executive, Tracey Martin, appeared before Parliament’s health select committee yesterday, which is holding an inquiry into the aged care system, including care for the rapidly growing number of Kiwis with early onset neurological disorders such as dementia.

Martin, a former NZ First MP, asked the committee to consider asking the Health Minister to pause the aged care sector redesign being led by Health NZ.

It was being done on flawed assumptions, Martin said, including that dementia needs will increase only mildly, and psychogeriatric need will flatline for the next 15 years. Services are already strained, she said, and a lack of funding incentive meant no new psychogeriatric beds are being built.

“Te Whatu Ora themselves cannot find current placement for New Zealanders who need this level of care. Individuals are being inappropriately placed with our members... putting at risk other residents and staff.”

Martin claimed that Health NZ was looking to lower asset and income thresholds to access residential care, and raise the level of frailty to enter rest home care.

This was denied by Inder, who also disputed Martin’s claim that Health NZ wasn’t planning for a big increase in demand for dementia or psychogeriatric beds in aged care homes.

“In dementia beds alone, we are forecasting at least 40% growth in the next 10 years…we have committed to [the aged care association] and other aged care providers to co-design funding and service models when we get to that stage, which we expect in coming months.”

A reform of the aged care system is proving controversial. Photo / 123rf

Martin also said Health NZ had a working assumption that about 20% of the current residential care population could be cared for at home. Inder said that proportion “is on the high end”, but there were people who might be able to have their needs met through home care, and they should be given that option.

“It is not correct to state that we are designing a system to force people out of aged residential care – we want a system that supports older people, based on their needs and allows them to be cared for in the appropriate setting of their choice. We are not in a design phase as yet, that will come once we know an investment pathway has been secured.”

Inder said on a national and regional level there were currently dementia beds available.

“However, we don’t always have the right mix of beds locally. For example, in the Palmerston North area we have rest homes looking to change rest home beds to dementia beds in response to community need there.”

Inder said he would seek a discussion with Martin, and would also reach out to Catherine Hall, the chief executive of Alzheimers NZ, who also submitted to the select committee yesterday, saying those in the sector were nervous about service cuts, despite denials by Health NZ.

Asked about those fears, Inder referred to a public promise by the commissioner of Health New Zealand, Dr Lester Levy, that frontline clinical positions wouldn’t be cut, despite the government’s wish to find $1.4 billion in savings across the health system.

“I think the commissioner has been really clear that frontline services are not going to be cut. He has said that multiple times publicly,” Inder said.

“I want to reassure people that we have a realistic view of the challenges we have on the horizon, and are looking to respond to them.”

Labour seniors spokesperson Ingrid Leary has backed the Aged Care Association’s call for the reforms to be paused, saying the search for savings in health “is driving a chaotic and short-sighted redesign of aged care that could have significant impacts on how seniors access the care they need and deserve”.

Nicholas Jones is an investigative reporter at the Herald. He won the best individual investigation and best social issues reporter categories at the 2023 Voyager Media Awards.