Home care challenges across the ditch

Australia and New Zealand can and should look to each other for aged care solutions, says Tracey Martin, former deputy leader of the New Zealand First party and chief executive of peak body Aged Care Association New Zealand Tracey Martin.

Speaking on day two of Ageing Australia National Conference 2025 in a session titled How the Australian experience can save New Zealand Aged Care – and how it can’t, Ms Martin said the New Zealand system is starting to “crack and fall apart.” But she added a royal commission of inquiry will not be able to deliver action at a fast enough pace.

“The pressure is starting to crush everybody, it’s constantly narrowing down, and at the moment it is our aged care sector and in-home care sector that are holding hands, maintaining what is the New Zealand health system,” Ms Martin said.

Similar to Australia, a key problem facing the New Zealand sector is that politicians and leaders have fallen for the myth that all older people are rich, own their own homes and can afford care, Ms Martin said.

But, in the next 15 years 660,000 over 65s will be renting.

“We are now talking about a large number of older homeless women. We’re talking in the context of [couch] surfing for women over the age of 65,” she said.

“But what it means is that the government cannot assume that it can’t meet its financial obligations around the provision of clinical care for its citizens,” Ms Martin added.

Funding reform needed

Ms Martin said New Zealand uses a lump-sum funding model but “nobody knows what it pays for.” Instead, she advocated for independent pricing, evidence-based pricing and case-mix care packages.

“We’ve had ageing in place for over 20 years now. So rest-home level care really doesn’t exist anymore but hospital level care, palliative, dementia, psychogeriatric, respite and recovery and return, those are all the places that we want individuals to have much more nuanced assessments,” she said.

She also called for a split funding model – clinical care under the government’s responsibility but with accommodation that older people will have to pay for. But she added that if an older person is in a rental property the Ministry of Social Development will provide an accommodation supplement.

New Zealand has also recently announced a bulk-funded singular contract to an alliance of four providers across the South Island, removing choice for consumers. This will be introduced into the North Island soon too, which Ms Martin said she believes is a move in the wrong direction.

Helping each other navigate change and challenges

A lot of New Zealand’s challenges are relevant to the Australian context and Australia’s experience in navigating through the reform has been “incredibly valuable,” Ms Martin said.

“You are what we are using to convince politicians that there is an alternative, there is a way to deliver this better, there is change that is required, and we can point to the parts that you have successfully implemented and where you have successfully changed up the game. So I just really need to thank you for what you have done.”

“You’re taking most of our workforce so we kind of need to have a bit of a one market at the moment anyway,” she joked. “But ultimately we’re on the same journey.”

But Australia can also learn from New Zealand, Ms Martin added, particularly in the provision of care to First Nations communities.

There should be no conversations without Aboriginal and Torres Strait Islander people, she said. “They should always be at the table. They are part of everything you do. They are humans, and so therefore their care needs are the same.

“It’s the environment in which they are delivered and how they are delivered and how they are recognised and acknowledged, which is the bit that actually people need to practice.”

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