A paralysed Kawerau man who needs 24/7 support was so frustrated by an ACC policy change that he took a stand that cost him dearly, meaning hospital for him, and the pound for his cherished dog. Gill Higgins reports
‘I just want my own carers back’: Watch this story on TVNZ+.
It was 30 years ago that Dave* was paralysed after a cliff dive that went wrong. It was just two weeks after his 21st birthday. Since then, Dave has been totally reliant on his care team. He admits to bouts of depression but says two things have made a big difference: his dog Zeus and his team of carers that became friends. “They have been working for me for three years, in fact, some of them for 18 years.”
But these long-term carers are now gone. In December last year, ACC unexpectedly cut their funding, offering Dave home support with an alternative contracted agency called Healthvision.
ACC says it’s standard practice to review rates from time to time and that it gave Dave a choice. But it’s hard to see what choice he had, given his former care team said they couldn’t afford to keep working, due to their travel allowance having been cut.
That former team doesn’t want to be named saying they don’t want their other clients to worry. But one staff member, Yvonne Kirk, felt it was only right to stand up for Dave. “I just think ACC have treated their client wrongly.”
It was Kirk who first got in touch with Fair Go, saying the agency she worked for were fighting the changes imposed by ACC. The key issue was that travel payments had been stopped and other rates were “ridiculously low”.
The travel payments were needed because Dave lives in the small Bay of Plenty town of Kawerau, which has few carers appropriate to Dave’s specific needs. The agency managed to employ one such carer, but the other five in the team were based in Tauranga and had to travel 70km each way for shifts. The travel costs came to about $2000 a week.
After the review, these payments were stopped and ACC says the flat rate was cut back to the standard non-contracted rate. It had previously been higher in recognition of the difficulty finding local care.
The amount offered after the review was $4629 a week. Kirk says using that to cover everything, such as pay equity rates for staff, travel costs, Kiwisaver contributions and holiday pay would mean the business had to operate at a loss of $2000 to $3000 a week.
ACC says it doesn’t expect any agency to suffer losses but it wasn’t willing to add travel costs back into the mix.
“We weren’t asking for the world,” says Kirk. “We were asking for enough to pay our staff to have Dave’s care.”
Initially there was a stalemate. Dave wanted his old carers. So for a few weeks ACC continued under the pre-review rates to keep them on board. It gave Dave a chance to come to terms with the change and for Healthvision to find local carers.
It came to a head in February. ACC were no longer willing to pay his former carers the higher rate. But Dave wasn’t willing to accept a different team, a decision that meant he had to be hospitalised. He stood his ground in hospital for a few days and then relented and came home to care for his dog.
Later that month he gave TVNZ a call, sounding exhausted and dejected. “It’s just turning to shit right now and i don’t know what to do, it’s too much for me, I don’t want to go back to hospital, it’s like a jail.”
But within a couple of hours, the ambulance arrived and took him away.
Dave doesn’t think ACC appreciates the value of continuity and friendship that carers can bring. He stood his ground in hospital for a few days, trying to prove that point, but then relented and came home, worried about his dog.
Current plan costs more than original
Now Dave’s being cared for by Healthvision. ACC say those carers are being paid $8070 per week. It took a bit more digging, but we confirmed they were also being paid travel costs, averaging at $3500 a week. Healthvision hadn’t been able to find a full local team either. It was having to bring in carers from as far away as Auckland and Te Kuiti, so trips of 200 to 300km each way. These extra travel payments took their weekly pay up to $11,570. Remember, the former carers were offered $4629. Nothing more.
That rate of $4629 was partly so low because it included 56 hours at an “oversight” rate of $13.98 an hour, which Kirk describes as a kind of babysitting service, hours during which carers were not obligated to do anything for Dave other than be there. But that wasn’t entirely realistic. “What happens when he yells out for drink or we have to empty his catheter bag, or he needs help putting clothes on? There was a big argument with his case manager about that rate saying, you know, is he supposed to get up and walk to the fridge and get himself his own drink?”
We pushed ACC about this and it admitted it had made a mistake. It said the use of this rate was down to “human error”, and that it’s only intended as a contribution to a family member living in the same home.
Kirk doesn’t think that rate should exist at all. “It’s not even minimum wage.”
With this rate increased to the standard carer rate, it boosts the potential funding for this former agency to $4949. The carers made it clear they would be happy to accept that amount if travel could still be covered. I put this to ACC, but it didn’t budge.
ACC acknowledged this was “disappointing” for Dave. It also acknowledged that the pay to the former carers if travel was included would be similar to the $8070 basic pay for Healthvision. But it said it expects more from a contracted business like Healthvision, such as training provision and health and safety reports.
The problem is Dave feels he’s getting less. We received another call one night in March. Dave had been left alone. “I’ve been left here since four o’clock by myself. They have no-one to look after me.”
ACC confirmed he was left alone for about eight hours, but said he’d been given a choice after a support person called in sick. The choice was a local male carer, despite Dave having made it clear over the years that he felt uncomfortable receiving intimate care from a male.
Or Dave could go back to hospital, which would mean his dog going back to the pound.
Or he could wait for a replacement carer from Auckland. Which he did.
“I’m freezing here, I’ve got no lights on through my house.”
The carer arrived after midnight.
ACC said it made regular welfare checks during these hours, and it expects fewer problems when more local carers are employed. It’s been nearly two months now.
Kirk isn’t surprised. “They are still trying to put a team together. This is what really frustrates our company. We’ve always had a team for David. We could literally go out there right now. Sorted. He loves all of us.”
*Dave chose to keep his second name private for this story.
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