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Caring Counts Report

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Caring Counts Report Contents Part 1 Foreword ....................................................................................................................... 1 Recommendations ........................................................................................................ 3 Timetable for implementation ........................................................................................ 5 Part 2 Why this Inquiry? ...........................................................................................................7 About the Human Rights Commission .......................................................................... 7 Terms of reference ........................................................................................................ 8 How we conducted the Inquiry ...................................................................................... 9 Terminology ................................................................................................................. 13 Issues looked at in the Inquiry .....................................................................................15 Part 3 Respect and value ......................................................................................................17 Workforce supply, recruitment and retention ..............................................................23 Conditions of work ......................................................................................................33 Wages and pay parity .................................................................................................45 Staff to resident ratios ................................................................................................. 61 .......................................................................................... 73 Managerial competence ............................................................................................. 89 Men as carers .............................................................................................................97 Migrant workforce .....................................................................................................103 Regulatory frameworks ..............................................................................................112 Part 4 Diary of a carer .........................................................................................................127 .................................................................................................... 135 Impact of Christchurch earthquake ........................................................................... 141 Part 5 Financial modelling ...................................................................................................145 Human rights framework ........................................................................................... 154 Literature review ........................................................................................................162 Appendices ...............................................................................................................191 Index ......................................................................................................................... 196 Caring counts Tautiaki tika website: http://www.neon.org.nz/agedcareinquiry/ Published in May 2012 by the New Zealand Human Rights Commission www.hrc.co.nz Wellington, New Zealand. ISBN: 978-0-478-35621-2 (Online), 978-0-478-35622-9 (Printed) Part 1 Foreword As many as 48,000 workers in New Zealand, the vast majority of them women, undertake indispensable but largely invisible employment every day. They care for older people either in their homes, in residential aged care facilities, or in hospitals. The Human Rights Commission has used its Inquiry powers to examine equal employment opportunities in the aged care sector and has gathered evidence from 886 participants over a 12 month period in 2011-2012. Everyone, bar two participants who were managers for a residential aged care provider, want higher pay and more status for those who work as carers.1 The Commission extends its immense appreciation to the hundreds of older New Zealanders and their families, carers, nurses, doctors, residential aged care providers, home health care providers, civil society groups, District Health Boards, government agency representatives and Members of Parliament who met with us. A very special thanks to Grey Power, the New Zealand Nurses Organisation, the Service and Food Workers Union and U3A who helped arrange meetings around the country. A draft of the report was sent back to all those who participated asking for feedback which was incorporated in the final version. The recommendations were developed by the Equal Employment Opportunities Commissioner and the Inquiry team after this feedback and endorsed by the New Zealand Human Rights Commission. I would like to acknowledge the superb commitment of the very small team of Human Rights Commission staff members who contributed well beyond expectations and who worked long hours to complete the task. In particular I would like to thank Sue O’ Shea, Moana Eruera and Emilia Don Silva. In my time as Equal Employment Opportunities Commissioner there has seldom been the degree of unanimity about a work-related issue than there is about the low pay of carers. The consensus revealed by the Inquiry means that New Zealand has an unprecedented opportunity to address the indecency of poorly paid “emotional labour” undertaken by often marginalised workers looking after vulnerable older people. A much repeated comment up and down the country when the Commission undertook its field work was that the value we place on older people in New Zealand society is linked to the value we place on those who care for them. 1Carers are often called health care assistants or community support workers, and they include those who work in residential aged care and home-based settings 1 The sense of crisis that surrounds aged care is partly a reflection of our collective knowledge that we are not being fair and that a large group of workers is being discriminated against. Inaction on pay inequality and inadequate compensation for travel are breaches of fundamental human rights. Given their significance, these breaches cannot be justified by affordability arguments. To address the equal employment opportunities issues there needs to be a defined leadership within government. This should encourage a better developed sense of responsibility and accountability by all of us and particularly those with greatest influence such as the responsible government ministers; the Minister of Health, the Minister of Women’s Affairs and the Minister for Senior Citizens; the Ministry of Health; District Health Boards, providers, unions, and their peak bodies. The voice of older people and their families also needs to be legitimised, properly acknowledged and listened to. The recommendations in Caring counts, Tautiaki tika are solutions-focussed. The Commission has modelled the potential costs of a three-step process to restore some measure of equality to carers’ wages over three years. The report makes other recommendations aimed at eliminating discrimination and progressing equal employment opportunities. The Human Rights Commission is committed to supporting the implementation of this Inquiry’s recommendations so that equal employment opportunities are properly realised in the aged care sector. It’s time for action. In the interest of justice we should not accept further delay in addressing a systemic inequality that is within our power to remedy. The report is dedicated to all older New Zealanders, and especially our mums and dads, and our grandmothers and grandfathers. I waihangatia te pūrongo nei mā te hunga kaumātua katoa o Aotearoa, tae ake ki ngā whāea, ngā mātua, ngā koroua me ngā kuia. Dr Judy McGregor Equal Employment Opportunities Commissioner Kaihautū Oritenga Mahi 2 Recommendations 1. Leadership The Prime Minister ensures that the minister with responsibility for older people has a top ten Cabinet ranking to deliver better services, and to provide leadership and co-ordination across ministerial portfolios. 2. Pay The Minister of Health directs District Health Boards (DHBs) to develop a mechanism to achieve pay parity between health care assistants working in DHBs and carers working in home support and residential facilities. DHBs and residential care and home support providers implement pay parity for carers across the government-funded health sector within three years. 3. Fair Travel The Ministry of Health and DHBs develop a sustainable and consistent fair travel policy which is annually reviewed and adjusted, and which covers the real and actual costs of travelling including vehicle costs and time spent travelling. 4. Qualifications Providers in the aged care sector and the ITO (Careerforce) commit to ensuring all new staff achieve a Level 2 Foundation Skills qualification within six months of starting and that all existing staff achieve this qualification in the next two years. Within five years, Level 3 should become the normal level of qualification for all staff with 18 months service or more. 5. Safety Standards The voluntary standard “Indicators for safe aged-care and dementia-care for consumers” should become compulsory to ensure the protection of both carers and older people. The “Home and Community Support Sector” standard must also be compulsory. 3 6. Consumer information
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