Extra cash for Disability Ministry but cost pressures loom
An increase in funding for Whaikaha has been welcomed by the ministry, but with ever-rising demand for disability services it is unlikely to be enough
By: Emma Hatton
Newsroom: 31/05/2024
Disability Issues Minister Louise Upston has confirmed the Ministry of Disabled People Whaikaha will get an extra $1.1 billion until 2028. That’s on top of its baseline funding of just over $2.2b. Photo: Lynn Grieveson
The amount allocated to Whaikaha Ministry of Disabled People is 24 percent more than what it received last year, including $80 million before the Budget to see the department through an overspend.
The ministry will get an extra $1.1 billion until 2028. That’s on top of its nominal baseline funding of just over $2.2b.
Whaikaha (and Disability Support Services within Health before that) has regularly come up short on its appropriation.
In the 2023 year it was $41.2m, in 2022 it was $31m and in 2020 it was short $103.7m.
Minister for Disability Issues Louise Upston said the extra funding allocated in this year’s Budget would go toward support services, including support for people living in their own home, respite, residential care and the high and complex framework strategy.
It is primarily to deal with the increase in people eligible for support and inflation.
NZ Disability Support Network chief executive Peter Reynolds described it as a “sticking plaster”.
“It allows the sector to stand still but not move forward. We’re grateful for the funding confirmed in today’s Budget but this is the bare minimum required and won’t extend support to more people in need or increase the quality of care.”
Whaikaha has confirmed the extra cash does not mean the guideline changes to flexible funding will be changed back, which limited what carers and disabled people could purchase with their needs-assessed budget.
An independent review is currently investigating how services might be delivered, and for what, in an effort to prevent regular overspends and cost pressures.
And while increases in volume and inflationary pressures are significant, the ministry faces a raft of cost pressures that remain unfunded.
Widening the eligibility for who can access disability support services has been on the radar for some time.
In early 2023, a briefing paper prepared for then-minister Priyanca Radhakrishnan mooted widening eligibility to those with fetal alcohol spectrum disorder.
“Regular requests are also received asking for [disability support] eligibility for those with other neurodevelopmental conditions, particularly for access to carer support and respite services,” officials noted. This includes requests for ME/Chronic Fatigue Syndrome, Tourette’s, ADHD and Long Covid to be eligible.
It was agreed that Whaikaha would scope a policy work programme to review widening eligibility. It’s unclear where this work has got to under the changed Government.
Widening the scope of eligibility would add pressure to the current funding, something officials are aware of. This happened when autism became an eligible diagnosis.
“This happened in 2014 and at the time additional funding was not sought to add this group. Numbers of people with autism who receive [disability support] has grown considerably, contributing to ongoing funding and service delivery pressures,” the briefing paper said.
A question mark over widened eligibly compounds a question mark over a family carers claim going through the courts which could also see the ministry responsible for approximately 2500 new employees.
Two family carers claiming they are employees of the ministry for the work they do were overturned by the Court of Appeal last month. They will be filing for leave to have the case re-heard by the Supreme Court.
Another upcoming cost sits in the work Whaikaha is doing to shore up the High and Complex Framework – how intellectually disabled people who have committed a crime are treated.
The current system is in crisis with ‘risk register’ documents released to Newsroom showing bed space has been in emergency mode for years.
A report to Whaikaha from the Forensic Coordination Service shows a number of risks including an inability to provide bed space and complete assessments in the legislated timeframe are happening. Photo: Supplied/Whaikaka
The most recent intel available, which is for the three months to September 2023, describes how the secure service for youth had been closed for most of the quarter. Care coordinators relied on the Youth Court adjourning hearings, so as not to receive referrals.
“However on three occasions, the Youth Court has declined requests for adjournment and proceed to make a care order. Care coordinators are left with no option but to designate these people to the [secure service] knowing full well that rehabilitation needs will be compromised due to the staffing shortages,” the briefing said.
It details how the secure service assessment bed has been unavailable in the Canterbury region for 18 months, referrals were being turned down by the Dunedin service due to staff shortages and there was no psychologist available for the region because their sole employee had resigned.
In Waikato the secure service was operating above its available capacity and the services in Auckland were at capacity.
Whaikaha Specialist Services group manager Rachel Daysh, who has worked in the sector for years, said a combination of staffing shortages and infrastructure challenges which began some years ago has led to the current problems.
“This actually goes back to a combination of issues relating to the closure of institutions in New Zealand, where institutions were the training ground and the learning ground for a lot of health professionals and support staff who were working in the industry.
“There’s a lot of training and support particularly around mental health professionals, but not formal training around people in the disability enterprise and so the system became quite dependent on people who were part of what I would call an ageing workforce, but they also became quite dependent on overseas supply.”
The staffing shortages were compounded during the Covid-19 pandemic, although Daysh said in the past six months workforce issues had eased slightly, but the situation was by no means out of the woods.
In 2021, Ombudsman Peter Boshier released his report into the High and Complex Framework.
He found the Ministry of Health had failed in its duties.
“Problems had built up over the years, especially capacity problems. The Ministry of Health didn’t do what was needed to address these problems, and stop them getting bigger,” Boshier said when he released the report.
“This meant people needing framework services were not always able to be placed in suitable accommodation. In some cases, court proceedings were being deferred, and some people were spending longer in prison while waiting for a hospital placement.”
When Whaikaha was established, the delivery responsibility of the framework fell to them, however the statutory obligations remained with Ministry of Health.
Daysh said structurally the system was designed well but things fell short operationally.
“One is a workforce capacity problem and the other is an ageing of fitness of infrastructure problem.”
Both problems are addressed in Whaikaha’s recently released strategy to get the framework working properly.
“The implementation plan will have different responses to the different sorts of issues. So some regions are simply at physical capacity and the system requires more beds to be built.
“And they’re already being implemented now with Treasury to prepare programme business cases to build that infrastructure.”
Exactly how much it will all cost is another question mark.