Decent Work in health and community services

Health is important for all New Zealanders, especially our most vulnerable, but our health system hasn’t had the investment needed to deliver proper health and wellbeing for all of us, and the COVID-19 pandemic has served to highlight what needs to change. Ensuring a properly funded health system that requires workers to be trained to the best of their abilities is essential, if we are to encourage and support individuals to reach their full potential and to deliver a health system which meets all our needs. Our society currently treats its wisest members as disposable. We have contracted out elder care to slash spending and we have profit-making providers running our health services. One of the results of the pandemic is learning about the real vulnerability that’s faced by people delivering the care. Personal protective equipment (PPE) must be readily available to those on the frontlines of care: that means all healthcare, service workers, and care and support workers. Achieving Decent Work in health and community services furthers our mission as a union across our society in Aotearoa to eliminate poverty, create good jobs, and close the racial and gender wealth divides.

Home support has the least funding of any part of our health system, yet the needs of our elderly and vulnerable increase every year. Work is piecemeal and insecure, without decent hours, and the workforce still contributes to the cost of doing their jobs. Investing in home support is about ensuring good health for people remaining in their own homes and communities, avoiding poorer health outcomes which can lead to hospitalisation and residential care.

Disability support is chronically underfunded. Setting up unsustainable models of individualised funding and staffing won’t fix that, nor will it enable people with disabilities to live good lives. We need a highly skilled and well-trained workforce, funded to deliver good outcomes, with safe staffing levels, violence-free workplaces, and models for the future which speak to the real investment people with disabilities need to live their best lives. Full participation in society is worth investing in and cannot be done on the cheap.

DHBs are underfunded and understaffed and some workforces are not valued as the essential workers they are. To change this, cleaners, security guards, hospital food service workers, orderlies, maintenance workers, and others must be directly employed, not contracted out to for-profit providers, which sends money from our health system to offshore bank accounts. Workers must have long-term input into their work and be integrated into the hospital workforce. Workers need respect and recognition for their work, with decent standards, like all other workers across the health system.

Aged care is in disarray, and globally, aged care facilities have been shown to be death traps. COVID-19 has only highlighted how problematic a profit-driven model, with understaffing and dangerous working conditions, really is for our older New Zealanders. Aged care workers (including service workers) need a voice, recognition, and safe workplaces, with private profits removed from their workplaces. To deliver respectful, high-quality, and safe care, these services must be valued at more than the cost of a hotel room overnight.

Community services – all our community services, including mental health services, need recognition as the core part of our health system they really are. This means long-term sustainable funding and a commitment to the wellbeing of those these services support.

Solutions for health and community services

Prioritise community health and wellbeing

We need a health system which prioritises the wellbeing of our communities, not the profit of providers. We need care jobs to be seen as the green jobs they are, and we need governments to invest in care. This would increase the number of jobs and make sure care jobs are decent and well paid, so we deliver good community outcomes as a part of our transition to a green economy.

End inequalities in health

This means ending the rationing of care that our communities, especially those on the poverty line, need and increased funding for preventative healthcare like home support, primary care and dental care.

Keep and create decent jobs

We need safe jobs, with increased staffing in home and residential care to address rationing of care. We need jobs which are permanent, stable, and well paid, with a career pathway and pay which reflect how essential this work really is.

Union members need to be up front and involved

We need workers involved in all decisions about their work, including setting safe staffing rules and regulation of their industries.

Fix the systems that no longer serve us

• We need to fix the homecare model so communities receive good support and workers have real jobs they can count on.
• We need to fix disability support services so they can be focused on outcomes for those with disability, but with a sustainable workforce model which delivers full participation in society for the long-term.
• We need aged care which is founded on good care, not profit.
• We need the profit model out of our DHBs.
  
  

Our message to the Government:

Funding levels for care and support services need to be appropriate, fair, transparent and sustainable to deliver services that are person-centred and support quality service provisions and that also ensure any funding increases are passed on to care and support workers. In aged care, the lack of safe staffing requirements needs urgent attention.  The 2005 standards are out-of-date and no longer reflect the needs of residents. A full review of the 2005 staffing standards, leading to the setting mandatory minimum staffing numbers, is required.

New Zealanders cannot continue to fund a health system that sees the money go into the hands of private providers who are driven by the needs of their shareholders, rather than the needs of the people. In care and support, for example, history has shown that private providers prefer to pay their shareholders any increases in funding they receive, rather than passing it on to their workers. E tū encourages the Government to move away from supporting for-profit providers and to create a model that supports public ownership or not-for-profit organisations., We want people to be at the centre of any decisions around expenditure rather than shareholders, and a model where workers are on the boards of all health providers in receipt of government funding.

E tū believes the only way to address some issues is to halt the contracting out of any further District Health Board services until a proper social procurement policy is in place, to ensure any contracting out has the general wellbeing of people at its core. Ministry of Health tender criteria must include a requirement that all directly employed and contracted workers have a minimum rate of pay that is no less than the standards set within the DHB agreements, and certainly no less than the current Living Wage rate.

Take action!

If you work in the sector, but you’re not a union member, click here to join today.

If you’re already a union member, join one of the Facebook pages to get organised and active in our campaigns for decent jobs. Click on one of these links: aged care, IDEA Services, home support, DHBs (hospitals).

If you’re an active member, become a leader by putting your hand up for election by your workmates as a union delegate or health and safety rep.

Sign up to take action highlighting your issues and to meet with local MPs and candidates leading in to the election. Talk to your delegate or organiser to find out how to get involved.

Organise your local community leaders, advocates for the elderly, families, and others to join with us to make change!