Speech to Alzheimers New Zealand's 2021 Conference
E nga mana
E nga reo
E nga iwi
Tēna kotou katoa
Ka huri ki nga mana whenua o te rohe nei. Tēna koutou.
He mihi hoki ki a tatou kua tau mai nei I raro I te kaupapa o te rā.
No reira tēna koutou katoa
It’s fantastic to have the opportunity to give the opening address for Alzheimers New Zealand’s 2021 conference - Living with dementia: Taking action for a better future.
I would like to acknowledge Alzheimers New Zealand, particularly Clare Hynd and Catherine Hall, for putting together this event.
And I’d like particularly to acknowledge those of you living with dementia, as well as your whānau and carers. Supporting you to live well with dementia is the key reason why we are all here over the next two days. I hope you find the conference inspiring.
The line-up of speakers will, without question, challenge and invoke thoughtful discussion. I also hope it will enable connections across the dementia and health sectors. As has been proven in recent times in New Zealand, we cannot appropriately respond to any health challenge or opportunity in isolation. We must all play our part.
As Associate Minister of Health, dementia is one of my priorities in my delegation for health of older people. And as many of you may know, the Labour Party made a manifesto commitment to support the implementation of the Dementia Mate Wareware Action Plan 2020 to 2025 - the development of which was led by Alzheimers New Zealand, Dementia New Zealand and the New Zealand Dementia Foundation.
So it is a great pleasure to support this conference and its kaupapa. The themes of the conference add value to the kōrero about dementia, and are important if we want to make real improvements to dementia services in the future.
I’d specifically Iike to talk about the theme of acknowledging our diversity.
Our COVID-19 Response
New Zealand’s COVID-19 response has recognised and supported the diverse needs of our population.
Through our vaccination roll out and alert levels, we have prioritised the health and wellbeing of older people - including people with dementia, and immune-compromised people. We have done this because we believe the lives of older people matter.
The success of this is now showing in the numbers of older people who are vaccinated. Our kuia, kaumātua and older people are leading the way. 94 percent of New Zealanders aged over 65 year olds are fully vaccinated. This is something to be celebrated, because it means we are protecting people’s lives.
Why are these impressive vaccination rates important for people with dementia? While we know dementia is not exclusively an older people’s condition, the likelihood of developing dementia increases with age.
And we know COVID-19 poses a significant risk to people with dementia. There’s the physical and mental impact of lockdown on them, their carers and whānau - who often take on additional responsibility because fewer formal supports are available when alert level restrictions are in place.
If someone with dementia catches COVID-19, it poses a significantly greater risk to their health and their life. This is a very good reason to continue encouraging younger people to be vaccinated, so we can better protect everyone and reduce the chances of spreading the virus to those who are more vulnerable.
I want to acknowledge the truly impressive support provided by local alzheimers and dementia organisations over the course of the pandemic, particularly when our country - or parts of it - are in alert levels three and four.
I know the COVID-19 lockdowns will have added pressure, through increased demand for information and support.
Your local organisations showed, and continue to show, a huge amount of flexibility and innovation, so people are not left without your valued assistance.
Equity and Diversity amongst people with dementia
Achieving equity is at the core of this Government’s mahi. We are looking to build a national health and disability system that ensures equitable access to healthcare - regardless of who you are, or where you live.
To do this, we need to recognise the diverse make up of our population. The health and disability system must respond to the particular needs of Māori, Pacific peoples, disabled people, and people living rurally - particularly in remote parts of New Zealand.
This means services and supports should reflect the diverse needs of the dementia population and be accessible, appropriate and respectful.
This includes the way they’re provided. The workforce not only needs to be well trained, it also needs to be representative of the communities it cares for.
It needs to understand the cultural and spiritual needs of the person with dementia, and to provide support that matches their values and preferences.
Currently, one of our biggest challenges is inequitable access to services because of what’s known as the postcode lottery. This could be for a number of reasons, including variable funding for local dementia or alzheimers organisations across the motu.
This obviously impacts on the level and type of support that can be provided to people with dementia and their whānau. I’m passionate in my belief it shouldn’t matter where you live, you should get the support you need.
We know other inequities also need to be addressed within the dementia population. Current services and support are either not available, or not adequately meeting the needs of people with younger onset dementia.
As we know, Māori, Pacific, Asian and people with an intellectual disability - particularly people with Down syndrome - are more likely to develop dementia at a younger age.
And sadly carers and whānau of people with dementia are also often not receiving the support they need.
There is a range of services provided for people with dementia and their whānau, to help them live independently in the community.
In 2020/21 DHBs spent $562 million on home support and $61 million on support for carers and whānau - including respite care and day programmes. The type of respite available varies between DHBs, but it commonly includes facility-based respite, a Carer Support Subsidy, dementia day programmes, and increasingly … but not widely used … in-home respite.
Clinical services and support are provided to diagnose dementia within primary care and secondary care
And DHBs provide some funding to local dementia and alzheimer’s organisations for community supports. By and large this funding is focused on education for people with dementia, their family and whānau.
Our commitment is to support improvements in dementia care and support, in line with the priorities identified in the Dementia/Mate Wareware Action Plan.
Work has been underway to identify how these priorities can be implemented in the short and long term. The sector has since revised the original Action Plan, to include a greater focus on equity and improving supports for Māori with mate wareware/dementia.
I’ve asked Ministry of Health officials and the health sector to focus on improvements to respite care, early diagnosis, and the provision of services which are more appropriate for Māori.
I’ll also be discussing with my colleagues how best to support the implementation of the Dementia/Mate Wareware Action Plan, and expect progress to be made throughout this year and 2022.
The health and disability reforms and leadership improvements across the sector
The reforms of the health and disability system also provide us with an opportunity to address some of the issues faced. Dementia sector leaders, including Alzheimers New Zealand and the Ministry of Health, are currently providing input and advice to the Transition Unit - which is overseeing the development of the interim Health Plan for Health New Zealand.
In order to ensure dementia sector leaders have an ongoing line of communication after the interim Health Plan has been developed, I have asked the Ministry of Health to establish a National Dementia Leadership and Advisory Group by the end of March.
This group will help support the future funders - Health New Zealand and the Māori Health Authority - in developing appropriate services and supports for people with dementia, and their family and whānau.
Another way the health and disability reforms will enable us to make gains, is through the establishment of the Public Health Agency. I am very supportive of a greater focus on prevention of dementia, and the Public Health Agency has a role in enabling that to happen. Importantly, when looking at modifiable risk factors, it should allow for a more joined-up approach with other long-term conditions.
In my role as the Minister for Seniors, I recently delivered on our manifesto commitment to establish an Aged Care Commissioner. We are in the final stages of appointing a Commissioner, who will provide greater oversight of New Zealand’s aged care sector.
My expectation is that they will help ensure older people - including people with dementia - experience consistent, quality care. They will provide leadership and advocacy for change across the sector, and also a clear pathway for people with dementia to raise concerns about the support they receive.
I’m committed to supporting and encouraging improvements to services for the dementia community.
I’m excited by the opportunities created by the health and disability reforms, and look forward to working with Alzheimers New Zealand and other dementia organisations to help shape and drive change.
I know if we continue to collaborate we can make a real difference to ensuring people with dementia, their carers and whānau can live good lives.
I wish you all the very best for a productive and informative two days ahead.
Ngā mihi nui.