Practices In Relation To Disability And Ageing

Published Date: 02 Nov 2017

Name: Shayal Shivani Lata

July In Take 2012

COMPARING INTERNATIONAL DEVELOPMENTS TO NEW ZEALAND’S POLICIES AND PRACTICES IN RELATION TO DISABILITY AND AGEING.

INTERNATIONAL POLICIES ON DISABILITY FROM TWO COUNTRIES, SIMILARITIES AND DIFFERENCES BETWEEN THESE POLICIES AND THE POLICIES THAT OPERATE IN NEW ZEALAND.

DISABILITY

AUSTRALIA

The National Disability Agreement between the Australian Government and State and Territory Governments will improve and increase services for people with disability, their families and carers. The agreement reflects a strong commitment from both levels of government to provide more opportunities for people with disability to participate in and enjoy Australia's economic and social life. The new agreement is designed specifically to assist people with disability to live as independently as possible, by helping them to establish stable and sustainable living arrangements, increasing their choices, and improving their health and wellbeing. At the same time, the agreement focuses on supporting families and carers in their caring roles.

The Australian government created the National Disability Agreement to cater for those people with disability and their family members and relatives. The Agreement focuses on having a strong commitment to help those disabled people to enjoy Australia’s economic and social lifestyle. The formed agreement strongly emphasizes to assist people with disability to live independently as much as possible by improving their health and safety at the same time, help their families in catering to the needs of their family members with disability.

UNITED KINGDOM

The main purpose of the Equality Act 2010 (EA) is to streamline and strengthen anti-discrimination legislation in Great Britain. It provides the legal framework that protects people, including disabled people, from discrimination. It replaces a range of anti-discrimination legislation, including the Disability Discrimination Act 1995 (DDA) and subsequent amendments. The EA does not replace the UK-related parts of the DDA for civil servants working in Northern Ireland.

The EA ensures that the legal framework of equality law is more consistent for all people with protected characteristics, for example, race and gender (Section 4 of the EA and the Equality and Human Rights website both offer a detailed explanation of ‘protected characteristics’). By simplifying and consolidating previous equality legislation, the Act is intended to be easier to operate and understand than previous equality legislation. The EA generally carries forward the protection provided for disabled people by the DDA. However, there are key differences. The DDA provided protection for disabled people from direct discrimination only in employment and related areas.

The EA protects disabled people against direct discrimination in areas beyond the employment field (such as the supply of goods, facilities and services). The EA introduced improved protection from discrimination that occurs because of something connected with a person’s disability. The EA introduced the principle of indirect discrimination for disability. Indirect discrimination occurs when something applies in the same way to everybody but has an effect which particularly disadvantages, for example, disabled people. Indirect discrimination may be justified if it can be shown to be a proportionate means of achieving a legitimate aim. The EA applies one trigger point at which there is a duty to make reasonable adjustments for disabled people. This trigger point is where a disabled person would be at a substantial disadvantage compared to non-disabled people if the adjustment was not made.

The EA extends protection from harassment that is related to disability. Previously, explicit protection only applied in relation to work. The EA applies this protection to areas beyond work. The EA provides protection from direct disability discrimination and harassment where this is based on a person’s association with a disabled person, or on a false perception that the person is disabled. The EA contains a provision which limits the type of enquiries that a recruiting employer can make about disability and health when recruiting new staff. This provision will help prevent disabled candidates from being unfairly screened out at an early stage of the recruitment process.

NEW ZEALAND

The NZ Disability Strategy presents a plan for changing this. Disability is not something individuals have. What individuals have are impairments. They may be physical, sensory, neurological, psychiatric, intellectual or other impairments Disability is the process which happens when one group of people create barriers by designing a world only for their way of living, taking no account of the impairments other people have. Our society is built in a way that assumes that we can all move quickly from one side of the road to the other; that we can all see signs, read directions, hear announcements, reach buttons, have the strength to open heavy doors and have stable moods and perceptions.

Although New Zealand has standards for accessibility, schools, workplaces, supermarkets, banks, movie theatres, marae, churches and houses are, in the main, designed and built by non-disabled people for non-disabled users. This is our history of disability in New Zealand. Disability relates to the interaction between the person with the impairment and the environment. It has a lot to do with discrimination, and has a lot in common with other attitudes and behaviors such as racism and sexism that are not acceptable in our society.

People and groups of people should not be judged by one particular aspect of their lives - whether it's their race, gender, age or impairment. Individual beliefs and assumptions, as well as the practices of institutions, mean that many disabled people are not able to access things that many non-disabled people take for granted. The desire to break down the barriers that cause disability is also closely linked to ideas about the human rights of people with impairments. Without human rights we cannot live as full human beings.

Human rights include political, civil, social, cultural and economic rights. Human rights are described by international instruments - such as the Universal Declaration on Human Rights and core treaties such as the International Covenant on Civil and Political Rights,

Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) and the Convention on the Rights of the Child (UNCROC). In New Zealand we have legislation such as the Bill of Rights Act, the Human Rights Act and the Privacy Act.

The New Zealand legislation government forms a strategy called the New Zealand Disability Strategy wherein it caters to people with disability in New Zealand to enjoy and have the rights the same as of a normal person. In this strategy, New Zealanders with disability have the right to have a good life. The vision of this strategy is to help disabled people have a harmonious partnership with the government, communities, and support agencies. The society must recognize that the disabled people are also part of the society wherein they must acknowledge that these disabled people have some qualities and abilities that could contribute to the well being and growth of the community. The diversity of disabled people, including their cultural backgrounds is acknowledged that they can in anyway achieve their own aspirations and goals in life. The disabled people should be treated equally regardless of their gender, age, color, ethnicity, cultural background and their type of impairment or how the impairment was acquired. The community has the responsibility to ensure that these disabled people are granted the support they need to live in their own community and thus institutionalism is prevented.

SIMILARITIES

All countries emphasis on human rights and equality in their interactions with others in society. New Zealand will be inclusive when people with impairments can say they live in: ‘A society that highly values our lives and continually enhances our full participation.’ Ensuring disabled people have a meaningful partnership with Government, communities and support agencies, based on respect and equality. Disabled people will be integrated into community life on their own terms, their abilities will be valued, their diversity and interdependence will be recognised, and their human rights will be protected.

DIFFERENCES

In United Kingdom, the country’s legislation formed the Equality Act 2010 and the Disability Discrimination Act 1995. The Equality Act provides protection to disabled people beyond work where as before it only provided protection only within the workforce.

The Australian Government and State and Territory Governments will improve and increase services for people with disability.

The New Zealand Disability Strategy presents a long-term plan for changing New Zealand from a disabling to an inclusive society. It has been developed in consultation with disabled people and the wider disability sector, and reflects many individual’s experiences of disability.

INTERNATIONAL POLICIES ON AGEING FROM TWO COUNTRIES

AUSTRALIA

Ageing policy has been evolving over the last few years from being primarily a matter of interest to a few program delivery departments, to the realization that the profound demographic changes over the next four decades will have significant social and economic implications potentially affecting all areas and levels of government. Long term strategies to address issues related to population ageing need to be viewed and developed in this broader context, and will require ongoing collaboration between governments, their agencies and a variety of other industry and community-based stakeholders, as well as a process of ongoing communication and engagement with the wider community.

In collaboration with other departments, the Department has been progressing the development of a strategic approach to ageing issues for several years through the development and release of the National Strategy for an Ageing Australia and other work being undertaken by the Office for an Ageing Australia.

The government of Australia regards aging as one of the great interest when it comes to providing programs to its citizens. Due to the demographic changes related to aging in Australia, the government realized that during the four decades of development, aging tend to affect the economic and social status of the country. The government needs to have a constant review of context regarding the policy for aging people to address the issue about the collaboration between the government and the agencies as well as the institutions and their stockholders, various industries where the people of old age work and the community.

UNITED KINGDOM

THE CENTRE FOR POLICY ON AGEING (CPA) carried out a series of five literature based reviews in 2007 and 2009, commissioned by the Department of Health, to look for evidence of age discrimination in health and social care services in the United Kingdom. The reviews looked at the costs and benefits of age discrimination legislation and at evidence of discrimination in primary and community health care, secondary health care, mental health care and social care. The CPA reviews support the Department of Health’s activities to root out age discrimination in the context of the European Commission Draft Directive (July 2008)

– COM (2008) 426 and the introduction in the UK Parliament of the Equality Bill (April 2009) and related secondary legislation that will set out details of the new age discrimination ban in the provision of goods and services.

The body of work produced by CPA informed the national review on age discrimination,

which brought together evidence from a range of sources to examine the extent to which

health and social care services are differentiated by age, where people may receive less

favorable treatment because of age, and where this may be unlawful and therefore

constitute discrimination under the Equality Bill, culminating in a report to the Secretary of

State for Health in October 2009.

Key principles underpinning the work around age equality in health and social care include:

unjustifiable age discrimination and unfair treatment based on age have no place in a fair society, which values all its members.

personalization means that meeting individuals’ needs for health and social care

should be based on their individual condition and circumstances, not assumptions

about their age.

services should be differentiated by age only where this is beneficial and therefore

objectively justifiable.

Services should demonstrate value and beneficial outcomes for all people in the use of public funds.

NEW ZEALAND

The New Zealand Positive Ageing Strategy reinforces Government's commitment to promote the value and participation of older people in communities. Older people are important members of society and have the right to be afforded dignity in their senior years. They have skills, knowledge and experience to contribute to society, and the expected growth in the proportion of older people during the coming decades will provide New Zealand with a valuable resource. Further, continued participation in older age has benefits for the individual concerned, the community, and the country as a whole.

The aim of the Positive Ageing Strategy is to improve opportunities for older people to participate in the community in the ways that they choose. This will be achieved through identifying barriers to participation and working with all sectors to develop actions to address these, while balancing the needs of older people with the needs of younger and future generations. The New Zealand Positive Ageing Strategy provides a framework within which all policy with implications for older people can be commonly understood and developed. The framework incorporates broad principles that will guide the development of policies and services from a wide range of government agencies. It also identifies key areas that contribute to positive ageing. A review of existing policies and services has been undertaken to ensure consistency with the Positive Ageing Principles. In addition, extensive public consultation has identified priority areas for action, leading to the development of a government Action Plan for positive ageing.

SIMILARITIES

Comparing to Australia’s policy, the policy of United Kingdom is similar regarding the equality and fair treatment to its aging citizens. In contrast with the policies of Australia and United Kingdom, New Zealand’s policy affirms of the importance of having equal treatment of services to aging people and thus provide services that would cater to their needs and enable them to have a healthy and satisfying lifestyle.

The government of the United Kingdom proposed a policy catering for aging people. The Centre for Policy of Aging exercises the rights and welfare of United Kingdom’s people where they carry out the principles that the legislative body amended. Some of these principles include that in a community, meeting the need of an individual especially regarding health and safety should be based on their individual condition and not based on their age. Another principle would be that the services provided by the government should be fair and equal to its citizens regardless of an individual age.

The government of New Zealand proposed a strategy to exercise its principles that would cater to the needs of its aging citizens and residents. The New Zealand Positive Aging Strategy enforces the government’s commitment to promote the value and participation of aging people in the works and welfare of the society.

DIFFERENCES - The difference is that the United Kingdom has set up a specific agency to cater for the needs of the aging compared to Australia and New Zealand.

The New Zealand Positive Ageing Policies aim to encourage and assist older people to remain in their own home in order to enhance their sense of independence and self-reliance.

INTERNETIONAL SERVICE DELIVERY POLICIES ON DISABILITY

AUSTRALIA

In Australia’s disability service systems, initial efforts were identified and created to cater for the needs of its disabled people.

Services include but is not limited to:

Better measurement need – where there will be a survey regarding the collection of data for disabled persons, aged people and carers alike to estimate the needs and quality of demands and for a basis for further development of services.

Population Benchmarking service will be the basis of decision making processes.

Making Older Carers a Priority and Quality Improvement Systems based on Disability Standards – these two services speaks for itself where the disabled people of Australia will have the rights and assured quality lifestyle as well as a basis for continuous improvement of services rendered.

The Parties have agreed to concentrate initial national efforts in several identified priority areas to underpin the policy directions and achieve reforms in the disability service system. They are:

Better Measurement of Need – Under this priority: a national model to estimate demand will be developed by mid 2010; there will be improvements in the data collected through the Survey of Disability, Ageing and Carers (SDAC), which will provide a stronger basis for demand estimates and improvements in the quality of data reported under the National Minimum Data Set, and jurisdiction-level unmet demand data.

Population Benchmarking for Disability Services - A National Population Benchmarking Framework will be developed and initial population benchmarking of disability services, based on information available, will be achieved by mid 2010 and improve the evidence base to assist in policy, service and planning decisions.

Making Older Carers a Priority – The National Disability Priorities Framework will assist Governments to target services to more vulnerable population groups based on relative need (including older carers and Indigenous people with disability).

Quality Improvement Systems based on Disability Standards – A National Disability Quality Framework with a National Quality Assurance system for disability services will be developed to introduce a national approach to quality assurance and the continuous improvement of disability services by mid 2010.

Service Planning and Strategies to Simplify Access – The National Framework for Service Planning and Access will be developed, focussing on providing a person centred approach to service delivery and to simplify access to specialist disability services.

Early Intervention and Prevention, Lifelong Planning and Increasing Independence and Social Participation Strategies – An Early Intervention and Prevention Framework will be developed to increase Governments’ ability to be effective with early intervention and prevention strategies and to ensure that clients receive the most appropriate and timely support by mid 2011.

Increased Workforce Capacity – A national workforce strategy will be developed to address qualifications, training and cross sector career mapping issues and establishing the disability sector as an ‘industry of choice’ by the end of 2010.

Increased Access for Indigenous Australians – A National Indigenous Access Framework will ensure that the needs of Indigenous Australians with disability are addressed through appropriate service delivery arrangements.

Access to Aids and Equipment – More consistent access to aids and equipment by end of 2012.

Improved Access to Disability Care – Systems that improve access to disability care and ensure people are referred to the most appropriate disability services and supports, including consideration of single access points and national consistent assessment processes in line with nationally agreed principles by end 2011.

UNITED KINGDOM

The Office for Disability Issues attempted to provide these kind of services:

User-led Organisations: encouraging strong and sustainable Disabled People's User Led Organisations

Right to Control Trailblazers: giving disabled people more choice and control over the support they need

Jobs for people with learning disabilities: supporting cross-government projects to improve employment prospects for people with learning disabilities

Digital inclusion: ensuring disabled people can fully participate in the digital society

Independent Living Strategy: ensuring disabled people have choice and control in their daily lives

Choice and control: encouraging front-line practitioners to give disabled people choice and control

2012 legacy: making a lasting difference for over 10 million disabled people in the UK

United Kingdom offers their services to disabled people to having "projects" that are led by the ODI (Office for Disability Issues). One of the project is called User-led Organizations where in there will be an investment of 3 million pounds for four years that will aim to promote the growth and improve the sustainability of Disabled People. Another project is called Right to Control where it gives the disabled people to go on with their lives independently but will still continue to receive the same support for their needs. The third project is called Jobs for people with learning disabilities where this caters for disabled people with learning problems that will ensure that they will be given full support in education to get a better life and a well-deserved job. The fourth project is called Digital Inclusion where the disabled people are ensured to have access mainly on the internet for information and any technologies alike. The fifth project is called Independent Living Strategy where in the project focuses on the disabled people having control and freedom to control their own lives yet, they will still have a continued support when it comes to housing, education, employment, leisure and transport. Another key project is called Choice and Control where in the carers or practitioners are encouraged to give support and special attention to the disabled people.

NEW ZEALAND

The New Zealand Disability Strategy Government's objectives. Fifteen Objectives have been developed for the NZ Disability Strategy:

Encourage and educate for a non-disabling society.

Ensure rights for disabled people.

Provide the best education for disabled people.

Provide opportunities in employment and economic development for disabled people.

Foster leadership by disabled people.

Foster an aware and responsive public service.

Create long-term support systems centred on the individual.

Support quality living in the community for disabled people.

Support lifestyle choices, recreation and culture for disabled people.

Collect and use relevant information about disabled people and disability issues.

Promote participation of disabled Māori.

Promote participation of disabled Pacific peoples.

Enable disabled children and youth to lead full and active lives.

Promote participation of disabled women in order to improve their quality of life.

Value families, whānau and people providing ongoing support.

Basically, New Zealand’s services when it comes to delivering them to disabled people are based on the framework of "The New Zealand Disability Strategy" where in there are fifteen formulated objectives to ensure the quality services that are rendered to its disabled citizens and residents. One of its objective is ensuring the rights of disabled people where in it speaks for itself that disabled people must uphold and promote their rights too. Education is a part of the strategy where in as stated in objective 3, education should be given equally from children to adults regardless of their disability or how they have acquired their disability. Another objective of this strategy is that there should be equal opportunity for employment and economic development for the disabled because these people too are part of the human rights principle and therefore should have also adequate income and able to work in the job market.

SIMILARITIES

Much of the similarities of services rendered by the United Kingdom government compared to the Australian government are giving special attention to the needs of the disabled people and providing adequate support for them to enjoy their lives.

One similarity of New Zealand’s service as compared to Australia and United Kingdom as stated in the seventh objective of the New Zealand Disability Strategy: "Create Long-Term Support Systems Centered on the Individual" where in the services delivered to the disabled people should have quality and that the disabled people should have easy access to these types of support services. Furthermore, as stated in objective eight that the disabled people should enjoy life by having their own homes and live in a community.

DIFFERENCES

There are certain projects in place for United Kingdom to cater for older people compared to the New Zealand Policy. Australia gives priority to it’s older carers in improving it’s disability standards.

New Zealand delivery policies on disability proposes an integrated approach to health and disability support services, which is responsive to varied and changing needs which support older people remaining in their own home and reduces the need for institutional care.

INTERNATIONAL SERVICE DELIVERY POLICIES ON AGEING

AUSTRALIA

In April 2000, the Minister for Aged Care, the Hon Bronwyn Bishop, published a comprehensive discussion paper, The National Strategy for an Ageing Australia, which dealt with the current and future directions for the health and aged care system in that country.

The paper identifies that "healthier lifestyles, better coordinated services, higher retirement

incomes, more appropriate housing and transport and other improvements to social infrastructure have the capacity to keep older people healthier, independent and in their homes for longer. This is in the best interests of both older people and the community".

A range of strategies have been introduced to encourage healthier lifestyles and improve

population health, including Active Australia and the Food and Nutrition Policy and a framework for the prevention of chronic disease.

In 2004, the Commonwealth Department of Health and Ageing commissioned a comprehensive review of the aged care workforce. The review (Richardson and Martin 2004) concludes that there are few signs that the labour market is in crisis, or even under serious stress, but that there are some indications of stress in the aged care labour market.

Out of the various discussions and policy processes described above, several major policy themes emerge. These are of importance to a range of Commonwealth Government departments to varying degrees. This Department has an interest in each of these policy themes because of the fundamental importance of health and well being to economic and social participation. Australia’s retirement income policy is built on the three ‘pillars’ of means tested pension payments, compulsory employer superannuation and voluntary savings. The financial security derived from the three ‘pillars’ may also be affected by the cost and access to publicly subsidised health and aged care services funded by the Department of Health and Ageing. Eligibility for a Pensioner Concession Card or Commonwealth Seniors Health Card is particularly valued by older Australians for the access it gives to pharmaceuticals and primary health care services at concessional rates.

In addition to financial security in retirement, policies and programs administered by the Department of Health and Ageing also assist the capacity of mature age Australians to contribute economically and socially. Continued economic growth will be important for Australia to maintain health and aged care standards as its population ages, and maintenance of health and prevention of disease will be important to maintain the levels of workforce participation necessary to support economic growth over the coming decades. As the health and aged care system is funded in the main from public resources, fairness in the way those funds are collected and applied across generations is also an issue.

Achieving healthy ageing of the population requires action by governments, businesses, care professionals, communities and individuals. It is also affected by changes in social and economic conditions, and requires action across a person’s lifespan, as early life factors and the accumulation of health risks throughout an individual’s life, combine to affect the risk of experiencing ill health in later life.

Australia has services that could cater to the needs of the elderly people specifically when it comes to financial and security provisions, the government gives pension to its citizens for financial security as funded by the Department of Health and Ageing. Together with this, the Australian government gives access to having aged people special treatment to pharmaceuticals and primary health care services. Work on the other hand; in addition to financial security for the elders, the DHA (Department of Health and Ageing) also assists them in the contribution of the economic and stability of Australia. The continuous economic growth of Australia is important for the well being of aged people as per maintenance of healthy lifestyle and prevention of illness.

UNITED KINGDOM

The UK government has been aware of the ageing of the population for many years. The increasing importance of older people for the economy and government services has lead to several initiatives designed to improve awareness and thus services for older people. For example, the UK government has a ministerial group on ageing, has published the findings of a Royal Commission on Long Term Care and has a central group working on "Active Ageing" which has produced several reports. But foremost in the look into the future, the identification of policy options for the public, private, voluntary sector and individuals is the Government’s Foresight Programme.

The Government is aware of the potential problems of this trend continuing. It has commissioned a report and accepted the recommendations made (Cabinet Office, 2000) These fall under the four headings:

changing the culture to raise expectations of older people and stop making judgments based on their age range than their true value and potential.

enabling and encouraging over-50s to stay in work.

helping and encouraging displaced workers to re-enter work.

helping older people to make use of their skills and experience for the benefit of the wider community.

Older people are the heaviest users of health and care services, with utilization increasing with age. The ageing of the population has always therefore to be taken into account in government resource allocation, because most health services in the UK are publicly funded. Real increases of 6.3 per cent annually have recently been announced with an acknowledgement that older people will be among the principle beneficiaries. The large number of health and care initiatives relevant to the older population focus on improving the quality and coherence of services in the next few years.

NEW ZEALAND

A review of existing policies and services has been undertaken to ensure consistency with the Positive Ageing Principles. In addition, extensive public consultation has identified priority areas for action, leading to the development of a government Action Plan for positive ageing in New Zealand.

The following Positive Ageing Principles will guide the development of policies and services across the government sector into the future. Effective positive ageing policies will:

Empower older people to make choices that enable them to live a satisfying life and lead a healthy lifestyle.

Provide opportunities for older people to participate in and contribute to family, wha-nau and community.

Reflect positive attitudes to older people.

Recognise the diversity of older people and ageing as a normal part of the lifecycle.

Affirm the values and strengthen the capabilities of older Māori and their whānau.

Recognise the diversity and strengthen the capabilities of older Pacific people.

Appreciate the diversity of cultural identity of older people living in New Zealand.

Recognise the different issues facing men and women.

Ensure older people, in both rural and urban areas, live with confidence in a secure environment and receive the services they need to do so.

Enable older people to take responsibility for their personal growth and development through changing circumstances.

The Positive Ageing Strategy identifies ten priority goals, with recommended actions to achieve these goals. Specific work items will be undertaken by government departments to work towards the goals. However, their achievement also depends on the contributions of other sectors of society.

Good health and quality of life are particularly strongly linked in older age groups. Older people are significant users of health and support services, both in terms of frequency of use and the costs of supplying services. For both these reasons, assisting older people to maintain good health is important.

The wide range of health and support services for Older People that can assess as following:

-Primary health care services, encompassing General Practice related services delivered through Primary Health Organizations (PHOs) and Pharmacy services.

-Public (acute care) hospital services including specialist Assessment, Treatment and Rehabilitation (AT&R) services.

-Needs Assessment & Service Coordination (NASC) service.

-Aged residential care, including rest home and long stay hospitals.

SIMILARITIES

When it comes to funding, the government of the United Kingdom like the government of Australia has pension for the older population to give rise for financial stability and for elders to enjoy the retired state and quality lifestyle.

Following the New Zealand Positive Ageing Strategy, the services will be guided by its principles that are rendered to the older population of New Zealand. Positive outcomes would include that the older people will have a choice to grant them to live a satisfying and enjoyable healthy lifestyle. Thus, the elders could provide an opportunity to participate and contribute to the well being of their family and the community. Another principle of the strategy is to recognize the diverse culture of New Zealand and recognize that ageing is a normal part of the lifecycle. The strategy includes the assurance that aging people, both that live in urban and rural areas are assured to live in safe and secure environment and receive services that will support them in their daily need. This would enable the older people to develop their personal growth as can also be seen in the services rendered by the country of Australia and United Kingdom.

DIFFERENCES

For many years it has been a tradition for United Kingdom to cater for older people for the sake of economic and social awareness. Thus, the government gave rise to services and created policies that will support the elder people. The government created a Foresight panel which will cater to the issues in five of the identified priority areas: labour, leisure and learning finance, healthcare, design for living, Information and Communications Technology.

In labour market, the aged people of United Kingdom has the imperative equality whereas the United Kingdom decided to increase the retirement age for women that was before 60 now 65. When it comes to health care services, the aged people are the heaviest users. The government then tends to allocate more resources and funds to cater for the older people. A large number of health and care initiatives relevant to the older population focus more on improving the quality and coherence of services to the next years. This is to prevent premature death and avoidable diseases.

In Australia, the nurses, especially registered nurses, are substantially older than the typical female worker. Nurses are less content in their jobs in aged care than personal carers and allied health workers. A relatively high level of vacancies for registered nurses suggests some recruitment difficulties. There is a relatively high turnover of direct care staff, especially personal carers. However, the short training period for personal care workers means that the supply of workers for these jobs is quite responsive to changes in pay and conditions. Recruitment and retention of staff in aged care facilities would rise substantially if the overall Australian labour market became tighter.

The New Zealand Positive Ageing Strategy with implications for older people which can be understood and developed the framework incorporate broad principles that will guide the development of policies and services from a wide range of government agencies which also identifies key areas that contribute to positive ageing.