Thank you for your letter of 3 July 2004.
I have noted the range of issues listed in the letter and attached resume, and thank you for bringing these to my attention.
My response will focus on the specific matters you have raised.
The intention behind PHOs is to provide better access to primary health care with cheaper doctor's
visits and prescriptions.
The introduction of new prescription charges for people 65 years and
older is a phased process with people in some PHO areas receiving the benefit of the $3 maximum charge
from 1 April 2004, while in other areas the benefits came in on 1 July 2004.
Many older people in the latter group might not yet be aware of the reduction.
Becoming a member of a PHO is voluntary and not all primary health care practices have chosen to join
a PHO.
While there are now 73 PHOs throughout New Zealand, I acknowledge that there are
still some people who do not have a PHO in their local area.
Assistance with meeting the cost of GP
visits and pharmaceuticals continues to be available to eligible people through the Community Services
Card, the High User Health Card and the Pharmaceutical Subsidy Card.
Work and Income is able to discuss an individual's eligibility for the Community Services Card and
High User Health Card and a person's pharmacist is able to provide advice about a person's
(or family's) eligibility for the Pharmaceutical Subsidy Card.
In addition, some people aged 65 and over may continue to pay the same fees as before, because they were already receiving reduced payments through the Community Services Card or High Users Health Card, or because they are enrolled in an Access PHO which received the higher level of funding prior to 1 July 2004 and were therefore already able to offer lower fees for all patients.
If a person has concerns about the fees charged by a particular PHO or practice, they should in the
first instance discuss this matter with their doctor or PHO. If this initial step proves unsatisfactory,
they should then contact the relevant district health board.
District health boards are responsible for monitoring PHOs, including their fee structures.
While it is appreciated that not all older people belong to a PHO, 3.5 million New Zealanders do belong to a PHO, with two million of them able to receive cheaper doctor's visits and prescription items.
I think it is important to bear in mind that New Zealand Superannuation is provided to every person in New Zealand aged 65 years and over, subject to residency criteria.
This entitlement is irrespective of the other income the person may earn, their level of assets, or their
overall wealth.
Additionally, every superannuitant gets the same level of New Zealand Superannuation,
irrespective of the amount of tax paid over their working lives.
The New Zealand state superannuation system is generally accepted as one of the most generous state funded pension systems in the world, and as recent research on the living standards of older New Zealanders shows, it supports an adequate standard of living for the large majority of older people.
As you are aware, people who need additional support can access a range of additional assistance to meet
specific additional costs.
The Disability Allowance, for example, is widely used by older people to meet
health and disability costs. Therefore, in looking at costs and available income, it is necessary to take into
account the total support measures available.
The government is committed to phasing out the asset test on residential care. An increase in the assets exemption from $15,000 to $150,000, together with the $10,000 a year incremental annual increase, is a major step in that direction.
While I appreciate older people moving into care are concerned about retaining their home, it would be
inappropriate to base criteria for asset test removal on property based assets.
Such a move would
seriously disadvantage people with savings and other forms of assets, including, for example, people who
have sold their house and moved in with a family member.
To favour a family home could also lead to patterns of care and support being determined by the need to protect a certain type of asset.
As you will be aware, one of the significant arguments in favour of removing the asset test is to eliminate asset retention as a prohibitive factor in accessing residential care for people who need it.
It is appreciated that Grey Power sought a harder line in some aspects such as the sale of vacated units.
One of the difficulties in framing legislation of this nature is to address appropriately the situation of residents
in, all types of villages, including in small villages which could have their financial risks increased by imposed
measures which that larger villages have the ability to absorb.
The provisions of the Act were designed to balance resident and operator interests without compromising the consumer focus of the Act.
We are aware of growing concern about the rising cost of housing, and the risks involved for households
which bear increasingly high levels of debt.
Housing New Zealand is currently consulting on a
discussion document entitled `Building The Future: Towards A New Zealand Housing Strategy'.
It is anticipated that the final New Zealand Housing Strategy will be due for release by the end of 2004. Research on older people's housing needs has also been released recently.
It will double the number of major hip and knee replacements funded by the public health system.
Public hospitals will be funded to increase surgery accordingly.
Thank you for your letter.
I hope that my response clarifies the issues you have raised.
Yours sincerely
Helen Clark
Prime Minister
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