What are the big concerns affecting the health of your community? Will your District Health Board candidates policies and promises improve community health and well being? To find out, we need to ask hard questions on the big issues.
At the National Conference in Christchurch we got the ball rolling with a workshop with John Ayling chairman of the Access Homehealth board. Access’s priorities are the clients whom they serve and the homecare workforce. There will be other issues unique to your community that you could challenge the candidates on.
Here are some hard questions for you to ask the candidates at the meet the candidates meeting.
Shorter stays in hospital
Most District Health Boards have a policy for limiting a person’s stay in hospital by sending them home with a care plan. This is clearly a cost saving to the hospital but in particular in rural areas the funding of that care plan falls short of costs to provide the patient with safe care. One example is the travel costs for homecare workers not being met or at best at a reduced rate, contracts that expect the maximum service for minimum funding are putting providers at risk and also creating barriers for the best possible patient care by a highly trained and skilled workforce.
- What will you do influence policy decisions with regard to passing on Government travel policy funding to rural home care workers and what guarantees do you give that the DHB will ensure its budget builds in additional funding for travel for the rural homecare workforce with the offset being greater savings made by reducing patient time in hospital?
- Do you think it is the DHB's responsibility to implement (fund and resource) the Govt's policies around early release (eg Crest) and people ageing in their own homes?
The Government has funded DHBs throughout the country $38 million to resource new mothers in the immediate post natal period to stay longer in a maternity unit. Publicity suggests that a number of DHB's are asking new mothers to take early discharge without advising them of their rights to stay in longer to establish confident mother/baby relationships and skills.
What will you do to ensure that your DHB uses the allocated funding for the purpose it was intended and will your board actively inform new mothers of their right to stay longer if they wish?
The rise in mental health issues in farmers is causing alarm The suicide rate is over 15 per 100,000 where as in other communities the figure is much lower (around 10 per 100,000.) Adverse events create additional stress and while the community is resourceful it also needs the support of the local DHB. While the Rural Support Trusts and rural based NGOs provide sterling service during adverse events it is heavily dependent on volunteer support by people who are also affected by the same event.
- How will you encourage your DHB to invest more in mental health in particular in the farming population.
- Will you support the investment in a directly funded policy to respond mental health impacts during and post adverse events when mental reserves are stretched.
"Nurse Practitioners provide the ideal model for innovative and quality health care in rural communities" - stated by the Minister of Health in 2002 in a foreword to the Ministry of Health Report – Nurse Practitioners in New Zealand.
It was further noted in the report, "...that much responsibility now rests with the DHBs, who will implement the role. They are encouraged to create a working environment .... that will ensure a sustainable and well-utilised nurse practitioner workforce."
Does your forward planning for rural and community settings include ensuring sufficient nurse practitioners in place to maintain rural services and access?
Funding for Home Support That Is Funding Other Services
Successive Governments have provided additional funding to DHBs for home support services for older people, only to see this funding diverted by DHB’s into funding other services.
What will you do to guarantee that your DHB will commit the funding increases it receives from Government, including those for inflation adjustments, are specifically passed on to homecare service providers?
A frequently asked question is why health care assistants with equivalent qualifications to a homecare worker earn more if they are directly employed by a DHB.
Do you support home support workers having equal pay with health care assistants, with equivalent qualifications, that are employed directly by DHB’s?
We were pleased to see $20 million allocated over four years in the budget in May 2013. Concern has been expressed that this allocation to DHBs may not be directed to the homecare support as per the intent of the budget.
What guarantee can you give that the DHB will fully utilise the additional funding provided in the budget directly for home care support?
What strategies does your party have in place to address the fact that New Zealand young women have one of the highest suicide rate in the OECD (4th according to WHO)?
Please contact Noeline Holt at National Office, or your Regional Councillor if you would like any advice/support on issues of concern to you. This is your opportunity to ensure candidates know the issues.