Liam Butler speaks to Hon Jo Goodhew Minister for Senior Citizens and the Associate Minister of Health

Hon Jo Goodhew

Now a Minister in the 2011-2014 National-led Government, Jo was elected as the Member of Parliament for Rangitata in 2008, having been elected to Parliament as the MP for Aoraki in 2005.

While in opposition, Jo was a member of the Health Select Committee and the National Party spokesperson for Aged Care and Rural Health. As a member of the National-led Government, Jo was the Chair of the Social Services Committee before being promoted to Junior Whip.

Jo is the Minister for the Community and Voluntary Sector, Senior Citizens, Women’s Affairs, Associate Minister of Health and Associate Minister for Primary Industries.

Jo was born and schooled within South Canterbury where she grew up on a local farm. She qualified as a registered nurse in 1982 and has practised in New Zealand and in London in both hospitals and in general practice. She gained a Bachelor of Nursing degree in 1995. Her professional involvement has extended to tutoring in Health Sciences at the Aoraki Polytechnic, acting as recruitment coordinator for Breastscreen South Ltd., and she was also the founder of the Aorangi Nursing Agency.

Jo was employed as a coordinator for the Timaru Safer Community Council immediately prior to campaigning for the Aoraki seat.

Her extensive voluntary community involvement has included membership in a large number of organisations, including the South Canterbury DHB - Community and Public Health Committee, the Craighead Diocesan School Board of Trustees, the Timaru Multiple Birth Club, and she has a history of involvement with Victim Support as a volunteer and team leader. She is also a former Chair of the Waimataitai School BOT, Branch President of Timaru Plunket, and Chair of the Aoraki Community Organisation Grants Scheme. She also has a history of involvement with Victim Support as a volunteer and team leader. In the 1980s Jo represented Young Farmers Clubs on exchange to Australia and was one of two New Zealand exchangees to the UK in 1984.

Jo is married to Mark, and they have three daughters. She likes to read, regularly exercise and occasionally finds time to ski.

Question One. Do you think that NASCs should provide the same level of care through out the country? For example should the criteria for and the service for home based support services be the same for a older person regardless of where they live?

Response:

Needs Assessment and Service Coordination (NASC) services ensure that older people with health needs receive a comprehensive clinical assessment that then enables a care plan to be developed and implemented to meet needs identified through assessment. NASCs do not usually deliver the care identified in a care plan. Those care services are normally delivered by providers that contract with District Health Boards to deliver services.

New Zealand is a diverse country so a focus on delivery of the same services regardless of location may not necessarily be the best way of achieving high quality services in all catchments.

The emphasis is therefore on ensuring that, regardless of location or specific type of need, an older person is able to be appropriately assessed and have their health care needs identified and met. This achieves equity in access to and provision of assessment and services, whilst retaining flexibility to meet local service needs, within national standards and expectations.

To ensure services cater for local needs within national standards and guidelines, DHBs determine the exact nature of services they will purchase to best meet the needs of older populations in their catchments. National consistency is monitored by the Ministry through expectations it sets for DHBs in purchasing services, including assessments.

A number of initiatives have been introduced to improve access to appropriate assessments and services. Comprehensive clinical assessment of health needs of older people is now being undertaken using the interRAI assessment framework. This has been implemented in home and community support services and is now being implemented in aged residential care, with its use for assessing residential care needs of older people becoming mandatory by June 2015.

In home and community support services (HCSS), consistency and quality are being enhanced through the requirement for these services to meet the Home and Community Support Sector Standard (NZS 8158:2012). Meeting this is a contractual requirement of HCSS providers and is the standard against which providers are audited. Conformance with this standard is being monitored by the Ministry.

Question Two. Do you think that enough emphasis is placed on supporting older-people to engage in weight bearing exercise given its ability to reduce pain and improve well being?

Hon Jo Goodhew's Response :

In January 2013 the Ministry of Health released Guidelines on Physical Activity for Older People (aged 65 years and over): (www.health.govt.nz/system/files/documents/publications/guidelines-on-physical-activity-for-older-people-jan2013-v2.pdf)

The physical activity guidelines have guideline statements that recommend older people aim to do aerobic activity on five days per week for at least 30 minutes, and add three sessions of flexibility and balance activities, and two sessions of muscle-strengthening activities per week. The physical activity guidelines are also accompanied by a fact sheet for the general public (www.health.govt.nz/system/files/documents/publications/physical-activity-for-older-people-factsheet-v2.pdf), which gives the guideline statements, why they are important for older people, and also some ideas of the types of activities that can help an older person achieve the guidelines.

The Health Quality and Safety Commission, in conjunction with ACC, are running a national campaign for reducing harm from falls. The "Strength and Balance: Stay on your Feet" topic (http://www.hqsc.govt.nz/our-programmes/reducing-harm-from-falls/10-topics/) is due to be introduced in December 2013. The topic will summarise the types and ‘dose’ of exercise that work to reduce the chance and harm of falling, and ways to encourage older people to keep exercising.

Individual DHBs are responsible for the health of their population. As an example, Canterbury DHB offers programmes within their region, such as the Otago Exercise Programme, Stay On Your Feet and Modified Tai Chi, that are aimed at improving strength and balance.

Question Three. Given the success of the green prescription, what can be done to normalize healthy eating and healthy exercise again for over 65s

Hon Jo Goodhew's Response:

In 2012/13 there were over 32,000 Green Prescriptions referrals for support and of these, 10 percent were for people aged 65 years and older. The success of the Green Prescription programme saw a doubling of its funding in Budget 2013 at a cost of $7.2 million over the next four years.

As well as Green Prescriptions, the Ministry offers guidance and advice to health professionals on both physical activity (see question 2) and nutrition for older people (www.health.govt.nz/system/files/documents/publications/food-and-nutrition-guidelines-healthy-older-people-background-paper-jan2013.pdf).

The Food and Nutrition Guidelines for Healthy Older People give recommendations on healthy eating. These guidelines are used by a range of health professionals to educate older people directly, and to also guide health promotion programmes developed for older people. The Ministry also produces health education resources, based on the guidelines, which have been specifically written and designed for older people.

DHBs are also important for helping to normalise healthy eating and physical activity for older people as they can provide nutrition and physical activity programmes that are tailored to their population. An example if the Senior Chef programme in Canterbury DHB - a free 8 week cooking course for people aged 65 and over who want to improve their cooking skills, confidence, or motivation around cooking for one or two people.

Other initiatives, such as the Super Gold Card, enable older people to access low or no cost public transport, reduced entry to swimming pools and other discounts. This can encourage and support older people to combine activity with transport (eg they can walk to the bus stop before catching the bus to an exercise facility), access exercise facilities, and participate in society more fully (eg, by visiting friends or joining an activity group).

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