Part 7 : Putting building blocks in place
United Nations Population Fund
7.1
In this Part, we summarise our findings for the building block (or instrumental) indicators for the three priority areas identified in the Madrid Plan, which are:
- older people and development;
- advancing health and well-being into old age; and
- ensuring enabling and supportive environments.
7.2
Instrumental indicators assess whether governments have introduced legislation, programmes, or policies in certain areas. Our detailed findings are available at www.oag.govt.nz/2013/ageing.
All but two of the building block indicators to promote older people's well-being and participation in the life of the country are in place. However, some national strategies lack frameworks to measure effectiveness and identifying long-term results can be difficult because of the way that data is reported.
Keeping older people involved
7.3
The Madrid indicators' building blocks to support older people's development were mostly in place.
7.4
The Madrid indicators have highlighted the importance of increasing the employment of older workers and delaying their complete retirement. In New Zealand, almost no-one can be forced to stop working because of age,13 there is a universal pension that is not affected when other income is earned and is not asset tested, and other legislative barriers to employing older people have been removed. To that extent, there are policy settings that do not hinder older people getting and keeping jobs.
7.5
The Madrid Plan considers that guidance is needed for public entities and others to consider:
- changes to the structure of a country's population;
- increases in the number of older people; and
- how their policies will affect older people.
7.6
In New Zealand, the New Zealand Positive Ageing Strategy (2001) (the Positive Ageing Strategy) provides the framework for preparing and understanding government policy with implications for older people.14 It addresses the last of the three aspects highlighted in paragraph 7.5.
7.7
In 2007, an indicator framework was set up to allow for monitoring and reporting the progress towards achieving the Positive Ageing Strategy. The method used to report on the indicator framework makes it difficult to identify long-term trends and whether the results achieved represent good progress.
7.8
Natural disasters often disproportionately affect older people, which is why humanitarian groups consider older people to be a vulnerable group in need of special protection. Local authorities, government departments, and crown entities have requirements and guidance to identify vulnerable people in the community and plan to meet their needs. This includes older people, especially those living in residential care or receiving publicly funded home-based support services.
7.9
Public entities are expected to consult with relevant parties. It is good practice to consult people of all ages when preparing policies and making decisions that affect them. Most public entities are required to consult when introducing new policies or making significant amendments to policies. Guidelines for doing this effectively continue to be refined. This applies as much to older people as it does to other age and interest groups.
Helping older people stay healthy and well
7.10
All but one of the building blocks to advance health and well-being into old age were in place.
7.11
There are national health and disability strategies that include older people's health needs, and a wide range of guidelines have been published to promote the health and welfare of older people. Subordinate documents identify current priorities, which include older people. However, the lack of indicator frameworks to assess how effective the Health of Older People Strategy and the Disability Action Plan are, and inconsistent practices for reporting on the New Zealand Health Strategy, make it more difficult to evaluate long-term results.
7.12
New legislation allows for minimum levels of care for health and disability services to be prescribed, ways to audit how services are delivered,15 and various ways to complain about the standard of care, treatment, and rehabilitation.
7.13
Primary health services are designed to be accessible to most people. Guidelines have been introduced to help ensure that services are seen as culturally appropriate. Policies are in place to make it cheaper for people with high healthcare needs to use primary health services. Statistics are kept about the proportion of people who have not accessed services because of cost. The Accident Compensation Corporation has identified that older clients may need extra help after being injured and some of its co-ordinators specialise in providing these services.
7.14
Public entities hold data about the number of geriatric facilities and beds. However, data about the specialist health workforce has yet to be collected in enough detail to report on the number and proportion of medical practitioners qualified in geriatrics or the health of older people despite difficulties recruiting and training specialist medical practitioners being recorded in 2004. Health Workforce New Zealand told us that it is working with the Medical Council of New Zealand to collect this data.16
Ensuring that enabling and supportive environments for older people are in place
7.15
The building blocks are in place to ensure enabling and supportive environments for older people.
7.16
Having accessible transport makes it easier for older people to take part in social and leisure activities, volunteering, and paid work. The SuperGold Card and other new policies increasingly make public transport physically accessible to older people and make it cheaper to use at off-peak times.17 All disabled people can use subsidised mobility taxi services. Public entities collect data and report on whether older people have access to a motor vehicle.
7.17
There are national legislation and programmes to protect older people from abuse and neglect, poor quality health and disability services, scams and crimes, and age-discrimination.
13: Judges must retire at age 70 but can be employed in other roles.
14: In this report, we discuss other strategies, programmes, and policies that consider the needs of older people.
15: We published a report on Effectiveness of arrangements to check the standard of services provided by rest homes in December 2009 and a follow-up report in September 2012. Both reports are available at www.oag.govt.nz.
16: Health Workforce New Zealand, set up in 2009, has overall responsibility for planning and developing the health workforce and is part of the Ministry of Health. See www.healthworkforce.govt.nz.
17: See the SuperGold Card website, www.supergold.govt.nz/.