Submission to the Ministry of Health on Ageing New Zealand and Health and Disability Services: Demand projections and workforce implications, 2001-2021. March 2005.

Older people and independent living

The Foundation believes that the New Zealand Disability Strategy will encourage agencies to develop programmes that equip older people to lead independent lives. That is certainly a key objective for the Foundation in its own delivery of services, and it agrees that "a sustained, heavily information-based approach" is necessary to understand the social impact of lifestyle changes.

Disability and inequity

Socio-economic factors do limit the lifestyle choices available to disabled people. Inequities in access to education, long-term unemployment, and the additional costs of disability (direct costs, opportunity costs, societal costs) continue to have a significant impact on the lives of blind, deafblind and vision-impaired New Zealanders.

A range of agencies deliver aged care

Services for the aged are of course delivered by a range of agencies, including not for profit organisations which are not funded for the level of life skills and health-related preventative training they could undertake if they were better resourced. More research and the identification of unmet need are likely to require new rather than realigned funding.

Foundation services equip people for independent living

Orientation and mobility training is one example of a rehabilitation and habilitation discipline that equips blind and vision-impaired people with the skills to travel and enter any familiar or unfamiliar environment and navigate it safely, effectively, and independently. Overseas experience suggests that elements within the orientation and mobility training provided by the Foundation to its members could assist other people with low vision or reduced mobility to move about with a lower incidence of falls and injury.

The Foundation's Adaptive Daily Living instructors provide services such as educating people and businesses that a simple colour and texture contrast can help distinguish surfaces (i.e. a doorway from a wall or a step down from the floor level). Such interventions make a demonstrable difference in the day-to-day quality of life experienced by Foundation members, and could be funded to meet the needs of the general population as it ages and experiences age-related vision impairment.

Technology to support the ageing population

The Foundation believes that the New Zealand Digital Strategy has the capacity to encourage blue sky thinking. With the right technological infrastructure in place, it will be possible to develop services that support a range of people in a variety of situations, e.g. older people with or without disabilities who choose to remain in their own homes. Already many New Zealanders use a personal alarm system consisting of a wireless transmitter worn around the neck or wrist which can relay a signal to a remote location via the unit plugged into the telephone line. It is not difficult to see the value of extending the functionality of such monitoring technology to assist people who need some level of support to cope and avoid injury in their own homes.

The need for staff to understand sensory disability

Whoever provides support to people who are blind or vision impaired must be trained to be confident and competent communicators with people who cannot follow visually presented information or see their environment clearly. Deafblind people have unique communication needs, all too frequently overlooked in mainstream settings.

Over the course of their lives most people will experience temporary or lasting "disability". People who have a particular sensory disability are whole persons who have the right to live in a society that includes them and accepts their disability as what it is, not as the equivalent of a condition experienced by someone else. Two actions within the New Zealand Disability Strategy are especially pertinent:

7.8 - Develop a highly skilled workforce to support disabled people.

7.9 - Ensure that disability services do not perpetuate the myth that disabled people are ill, while recognising that disabled people do need access to health services without discrimination.

The Foundation is keen to use further consultations to discuss in detail how training can enable "a highly skilled workforce" to provide services in a way that does not unintentionally discriminate against people who are blind and vision-impaired, or against deafblind people. Workforce training must be informed by an understanding of blindness, deafblindness, and other sensory disabilities.

The importance of the voluntary sector and of volunteers

The Foundation will also use any further consultations to comment on volunteers (7.9, p.59). The Value Added by Voluntary Agencies project (http://www.nzfvwo.org.nz) indicates the economic value volunteers contribute to New Zealand society year by year. As an organisation that relies heavily on volunteers across a range of programmes that it could not otherwise operate, the Foundation is fully aware of the difference freely given time and expertise make to the independence of blind, deafblind, and vision-impaired people and their social engagement.

Asking whether policy should "regulate and formalise this sector" in respect of a section of the workforce about which "relatively little is known" seems precipitate. Most organisations of any size that are reliant on volunteers will already have in place appropriate recruitment strategies, training, codes of conduct, monitoring programmes, volunteer acknowledgement and reimbursement systems, and other safeguards to ensure safe practice.

Informal volunteering

Informal volunteering at the level of neighbour helping neighbour or family supporting family should not be undervalued. The recent Carers Summit (http://www.carers.co.nz/summit) drew attention to the role of unpaid carers. Some of the technological developments referred to above are likely to remove barriers that currently prevent some would-be volunteers from undertaking voluntary work.

Consult the voluntary and community sector

The Foundation recommends that in order to establish "workforce research priorities" the Ministry adds umbrella groups of voluntary and community agencies as well as individual representative agencies to its list of consultees.

Conclusion

The Foundation believes that understanding the workforce implications of the demand for health and disability services is a step towards the vision of a non-disabling society advanced in the New Zealand Disability Strategy.