2. SUE KEDGLEY (Green) to the Minister of Health: Does he agree that older New Zealanders who live in rest homes are among the most vulnerable in our society, and is he satisfied that all rest homes provide safe levels of care for residents, as they are required to do under the Health and Disability Services (Safety) Act 2001?

Hon TONY RYALL (Minister of Health) : Yes; and generally yes. I also agree with the Auditor-General, who last year issued a damning report that the previous Government did not respond quickly enough to address the weaknesses and risks in the arrangements, which it had known about since 2004. The new Government is tackling these years of neglect in a number of ways.

Sue Kedgley: How can he ensure that rest homes provide safe levels of care for residents, when there is no minimum training or qualification needed to be a caregiver, and when many people literally walk in off the street with no prior training or experience and begin to care for our vulnerable elderly?

Hon TONY RYALL: A number of training programmes are in place for those who go and work in aged care. The Government was also concerned about the lack of investment in nursing quality and supervision in rest homes, and that is why we put in an extra $18 million last year as part of meeting that need.

Sue Kedgley: How can he ensure that rest homes provide safe levels of care for residents, when according to the Nurses Organisation survey, large numbers of unregulated caregivers are doing jobs that would normally be considered to be the domain of registered nurses—jobs such as administering medicines without supervision, and even administering drugs like morphine?

Hon TONY RYALL: There are very clear rules about who should be administering drugs anywhere in the New Zealand public health service. If the member has any information about breaches of those rules, it should be made available to the authorities. This Government is beefing up the audit and compliance regime associated with rest homes in order to ensure that the problems identified by the Auditor-General are addressed.

Jo Goodhew: What were the conclusions of the Auditor-General’s damning report on the monitoring of rest homes?

Hon TONY RYALL: Last year the Auditor-General’s report identified longstanding shortcomings in rest home monitoring. The Auditor-General’s report found that under the previous Government, the Ministry of Health had struggled for years to ensure the quality and safety of the nation’s rest home services. The Auditor-General was highly critical of the lack of action between 2002 and 2008, and the Auditor-General was particularly critical of the agencies that audit rest homes, and this Government shares that concern. The same report recognised the action that the new Government has under way.

H V Ross Robertson: Considering that this Government is clearly turning a blind eye to elder abuse in rest homes, does it intend—

Hon Gerry Brownlee: I raise a point of order, Mr Speaker. I would not normally raise a point of order on a new member, but this is a very, very experienced member. He has been in the House for some 35 years. I would have thought it is quite inappropriate for him to start a question in that manner. It is question time, not statement time. I also want to know whether he has a hat to go with his scarf.

Mr SPEAKER: The member’s point of order is perfectly valid. I do not normally intervene. The more comment like that that a member makes when asking a question, the more licence that a Minister has to be political in his or her answer. That is the way that I normally balance it. But the member’s point of order is absolutely correct. The member should ask a question rather than make—

Hon Trevor Mallard: I raise a point of order, Mr Speaker. Before you absolutely endorse the point of order, you might want to check the maths of the Leader of the House. Clearly, he cannot add without taking his shoes off.

Mr SPEAKER: I am not sure what that has to do with order.

H V Ross Robertson: Indeed, he should have his maths checked. Does the Government intend to continue to turn a blind eye to elder abuse in rest homes, and does it intend to do anything about the other issues for the elderly that Grey Power raised yesterday—namely, cutting home help, cutting hearing aid subsidies, cutting elder abuse education programmes, cutting elder driving courses, allowing ever-increasing electricity bills, and transferring the financial burden of the emissions trading scheme from the polluter to the taxpayer?

Hon TONY RYALL: I would ask where that member was for 9 years when the Auditor-General was slamming the party opposite for its behaviour when in Government towards rest homes in New Zealand. This Government has done more than any other in the last 18 months to address those issues. We are now auditing the auditors, we require the auditing agencies to have international accreditation, we are providing additional funding, and we have introduced spot auditing. We now have transparent reporting online of rest home quality standards as per the audit, which is colour-coded for easy reference. Blue is very good, and red is very bad.

Sue Kedgley: How can he ensure that residents living in rest homes now are provided with safe levels of care, when nurses who work in the aged-care sector report that they are responsible routinely for the care of as many as 64 residents and are so overworked that they simply do not have time to care for residents properly or safely?

Hon TONY RYALL: What I am well aware of is that the Government put in an additional $18 million last year to improve the nursing quality and supervision in rest homes. We have increased the subsidies a further $16 million this year. We are putting a considerable effort into improving the auditing and compliance regime. As I travel to rest homes around New Zealand, nurses are giving me a very clear message that the neglect of the previous regime is being addressed by this Government.

H V Ross Robertson: I raise a point of order, Mr Speaker. Given the Government’s barracking during the asking of my question, I seek leave of the House to table the media release put out by Grey Power yesterday, which the Government did not believe.

Mr SPEAKER: The House is not about to do that.

Sue Kedgley: Is it not the case that as long as there are no minimum staffing levels in the sector or formal qualifications or training required to be a caregiver, he simply cannot ensure that rest homes provide safe levels of care for residents; and does he concede it was a mistake for the Government to veto a select committee inquiry into aged care?

Hon TONY RYALL: No, it was not a mistake for Government members of the select committee to not have an inquiry into aged care, because frankly it saved that member, who supported the previous Government for 9 years, from a lot of embarrassment.

Sue Kedgley: I seek leave to table four documents. The first document is an email dated 19 May of this year, in which a caregiver on $13.26 an hour explained that she gives out medicines for 46 patients, including signing for and giving morphine.

Mr SPEAKER: Leave is sought to table that document. Is there any objection? There is no objection.

• Document, by leave, laid on the Table of the House.

Sue Kedgley: I seek leave to table another email from a caregiver received on 10 June, explaining that on many occasions staff have found that residents had been lying on the floor for 2 or 3 hours after a fall, before being picked up.

Mr SPEAKER: Leave is sought to table that document—

Hon Dr Nick Smith: Is there a name on it?

Mr SPEAKER: Let me just clarify this for the House. Is the name of the person who sent the email on the document?

Sue Kedgley: No, I have removed the name of the person.

Mr SPEAKER: So we have got no idea who is making this allegation. Members are aware of that. I will put the leave. Leave is sought to table the document with no name on it as to whom it came from. Is there any objection? There is objection.

Sue Kedgley: I seek leave to table a Nurses Organisation aged-care survey done in 2009, which points out that medication is frequently administered by caregivers without the supervision of nurses.

Mr SPEAKER: Leave is sought to table that document. Is there any objection? There is no objection.

• Document, by leave, laid on the Table of the House.

Sue Kedgley: I seek leave to table my final document, from 17 May. It is from a nurse who said she has left the sector because she could not stand working in an environment where she was unable to ensure that patients received the care that they are entitled to.

Mr SPEAKER: Is the name of the person who sent that letter attached to it?

Sue Kedgley: I have removed that name.

Mr SPEAKER: Leave is sought to table that document, to which no name is attached. Is there any objection? There is objection.