Liam Butler interviews Rural Women New Zealand’s Margaret Pittaway.

07 April 2015

Liam Butler

Question:

How do you think legislation will lead to frustration for the Home care industry?

Margaret Pittaway Rural Women New Zealand Health and Social Development Spokesperson:

In 1994, the health and social policy ministers of OECD countries reached an agreement on the overall objective of policies for the care of frail older people:

Elderly people, including those in need of care and support should, wherever possible, be enabled to continue living in their own homes, and where this is not possible, they should be enabled to live in a sheltered and supportive environment which is as close to their community as possible, in both the social and geographical sense. (OECD 1994:3)

The unintended consequences of the new Health and Safety reforms due this year are the limitations with its interpretation and application that will put pressure on families to remove aged family members into institutional care, which conflicts with the 1994 agreement.

Rural Women New Zealand has had a long association with the home support industry and it would have to be one of the most imperfect and the most difficult work environments to create safe working conditions. While this will be the situation for all households we are particularly aware of the environmental challenges of a rural household for a home support worker.

Currently, when home based support is being arranged, a health and safety check of the client's home is undertaken with the client's consent and an individual support plan is prepared. Hazards are identified and either eliminated or minimised. A copy of the plan remains with the patient for reference by any relieving workers, with a copy placed on the database highlighting any issues for the care co-ordinators to enable them to stress any issues to relieving support workers. The plan is reviewed 6 monthly or yearly. Support workers advise their co-ordinators of any changes to their client's condition, or to any additional hazard to allow for changes in the care plan.

While inspections and plans are essential there are limits on the employer's ability to control the place of work if the home in which the care is to be provided is in a state of disrepair, is unhygienic or lacking in maintenance and is therefore hazardous for the worker - for example faulty equipment or appliances, unsafe electrical appliances or surfaces. When evaluating the hazards, support workers and employers need to take into account the clients beliefs and their right to make personal choices about the way in which they manage their home. The client may have the will but not the ability to create a safe and hygienic environment for the home support worker.

The value of work undertaken by care workers in rural communities is immeasurable, allowing the sick and the elderly to remain in their own homes and close to loved family members as long as security and dignity are ensured. The cost off set (socially and economically) of putting an elderly person into a rest home or hospital care over living in the home is well documented and the 1994 agreement remains relevant.

Ultimately though, the home support workers have the right to work in a safe environment, and if the hazards are too great the employer may have to withdraw services until conditions have improved for the worker. If the client is living in a rural area there may not be anyone nearby to help them.

The Health and Safety reforms situation will create conflict over who has the greater rights under which law - The Health and Safety reforms, the Employment Contracts Act or the Health and Disability Consumers Rights?

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