The Office of the Ombudsman has been allocated $29 million over the next four years to fulfil the additional United Nations monitoring obligations identified by the Minister of Justice on 6 June 2018.
This involves inspecting the treatment and conditions of people held securely in approximately 230 privately-run aged care facilities, 60 court facilities, and those in any additional locations outside a prison who may be detained in the custody of the Department of Corrections, like prison vans, for example.
A spokesperson from the Office of the Ombudsman says this represents a 250 per cent increase in the number of facilities the Chief Ombudsman has to inspect, so the extra funding is to develop and implement the three additional inspections programmes. The other “places of detention” the Ombudsman are prisons, immigration detention facilities and child care and protection and youth justice residences.
It’s all part of New Zealand’s international obligations under the Optional Protocol to the Convention against Torture (OPCAT) which will see the Chief Ombudsman examining and monitoring the treatment of people who are, or may be, ‘deprived of their liberty’ in ‘places of detention’ and making any recommendations considered appropriate to improve that treatment.
“The funding will be increasing progressively over the next three years, to enable the Chief Ombudsman to gradually build the capacity required to deliver the inspections programmes over that time period,” says the Office spokesperson.
“The most significant investment over the next three years will be in recruiting and training the extra inspectors we need. With the first funding instalment received on 1 July 2019, we are now starting our first recruitment drive.”
A matter of duplication
But the New Zealand Aged Care Association isn’t convinced. Chief executive Simon Wallace thinks millions of dollars invested in monitoring places that are already monitored is a poor use of taxpayers’ money.
“We are audited by HealthCert, as we should be, and that process works really well. I really question whether $29 million over the next four years is a good spend for the Government when it could be spent on other areas like care or bringing up our nurses to pay equity with hospital nurses. It just seems to me to be not a good return on investment,” says Wallace.
The NZACA is advocating for the Ombudsman to work with HealthCert.
But the Ombudsman’s office counters that the Chief Ombudsman is an Officer of Parliament, not part of government and as such his inspections programme is fully independent of government, the health and disability sector, and private interests.
The Ombudsman’s office says their work does not duplicate that of HealthCert.
“The Chief Ombudsman’s inspections have a very different purpose from current audits and reviews, and so must be independent, completely new assessments.
“Current health sector audits and reviews check to see if a facility’s systems and standards comply with requirements set by New Zealand authorities… [whereas] the Chief Ombudsman is tasked with assessing the conditions and treatment of detained people to determine if there are any risks, poor practices, or systemic problems in the facility that could result in a human rights violation.”
Inspection process detrimental to residents
However, aged care providers are concerned that the inspection process could be violating in itself.
According to the Ombudsman’s website, the Chief Ombudsman will carry out “both announced and unannounced in-depth inspections as well as shorter ad-hoc visits of these facilities on a regular basis with a view to identifying conditions that could give rise to cruel, inhuman or degrading treatment or punishment”.
“I am concerned about the impact on residents, about a team of people that doesn’t necessarily have a care or health focus going into what are sometimes very small dementia units and the disruption and upset that this may cause to residents,” says Wallace.
The Ombudsman’s office says they are yet to confirm what format the inspections will take.
“We’re still working on exactly what will be involved in an inspection, including the number of inspectors who will visit a facility. We are still in our information gathering phase.”
Engaging with sector
At last year’s NZACA conference Chief Ombudsman Peter Boshier talked about how he wanted to engage with the providers on the process.
“Well that has not happened over the past 12 months,” says Wallace, “And I’m not happy about it. There’s been no co-design to date, and no intent for there to be any co-design process.”
The Office of the Ombudsman says the Chief Ombudsman will not be co-designing his inspections programme. However, he will be seeking the views of the aged care sector on his inspection criteria.
“The United Nations require the Chief Ombudsman to establish a totally independent inspection function so it is for the Chief Ombudsman to decide how to implement this function. The sector will be advised when there is an opportunity to provide feedback, as the proposed inspection criteria is developed,” states a spokesperson for the Ombudsman.
Impact on the sector
The aged care sector is understandably twitchy about not being involved. Following the inspections, the Ombudsman will make non-binding recommendations to providers. These could be anything from staffing requirements to changing the built environment.
Wallace is concerned about providers’ ability to implement recommended changes.
“Our providers won’t necessarily have the income to make the changes, which might include physical changes to the environment,” he says.
“You have to really question this sanction. And with the lack of information that’s been provided, it has been very difficult.”