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Fighting the future; the Ministry of Health’s planned budget cut

When the Government’s Budget comes out, I ignore the press releases and jump straight to the Budget documents. I like to see the actual numbers because it gives a better picture of what is actually happening. The trouble with press releases is that Governments love announcing new funding. They do not tend to announce when funding ends or is reprioritised. As a result, you can have lots of new funding announced, but the actual budget for an area is going down.

This is precisely what happened with the Ministry of Health’s Disability Support Services. There was a number of announcements about new funding. So you might be surprised to hear the Ministry is planning to reduce the Disability Support Services budget by $7 million.

There in black and white; a small planned cut

It is there in black and white on pages 81 to 84 of the Budget documents for the Ministry of Health. In the language of the Budget “This appropriation (National Disability Support Services) decreases by $7.061 million to $1,344.646 million….”

The Ministry of Health’s planned cut is small. $7 million is only 0.5% of the total budget for Disability Support Services. Yet if the demand for support grows as strongly as last year, it will require serious rationing and possible cuts to people’s support to achieve this. This planned cut comes after revelations earlier this year about attempts to cut costs.

The Ministries of Education and Health blew their budgets last year

What happened last financial year is that the Ministries of Education and Health both blew their budget for disability-related support. The budget for the Ministry of Education’s Learning Support went up by 7.8%. The budget for the Ministry of Health’s Disability Support Service went up by 8.4%.

The difference is the Ministry of Education have accepted the increase and are planning to increase spending by a further 5% this coming year. They are not fighting the increased demand for support from students. By comparison, the Ministry of Health is trying to hold growing demand down.

Demand is growing

The trend is crystal clear; demand is steadily growing for disability and learning support. Why wouldn’t demand be growing? The population is growing and disabled people and their whānau are rightfully demanding better and more support. There are also serious inequities with existing support, especially around less support being available for community and family-based support options.

It is also no secret that the government has relied on unpaid work and low paid work from, predominately female, family members, informal carers, and support workers to keep disability support costs low. The paid component of that is rightfully changing with the Pay Equity Settlement. The unpaid component is taking longer to solve with the Carer Support reforms delayed and Funded Family Care remaining a difficult option to qualify for.

The Pay Equity Settlement, while welcome, is not a permanent fix. To maintain the quality of disability support, wages will need to keep up with the wider labour market. The Government has acknowledged the importance of indexing benefits to wage growth. This is just as needed to ensure disability support does not worsen over time.

Previous attempted cuts have failed

Given all this, it is understandable that the growth in estimated actual spending has never been negative for either Ministry for at least a decade. The Ministry of Education planned a cut in 2014/15 and the Ministry of Health planned a small one in 2016/17. Both failed and estimated actual spending still increased. I am concerned that the Ministry of Health is more serious this time about cutting spending, especially in light of the planned cuts earlier this year.

A cut or even just holding spending down is likely to negatively affect people’s wellbeing

If the Ministry of Health does put pressure on Needs Assessment and Service Coordination (NASCs) agencies to ration or reduce support, it is likely to negatively affect the wellbeing of folks who use Disability Support Services. On that note, it is difficult to see any evidence that the Government applied a wellbeing approach to funding for Disability Support Services. Instead, Disability Support Services appear to still be seen as primarily a cost to be managed. This needs to change.

Take a look for yourself

If you would like to see the trends for yourself, see below. The graphs are the same information as the tables.

Ministry of Education’s Learning Support Planned increases in spending Estimated actual increases in spending
2011/12 3.4% 3.8%
2012/13 3.8% 4.4%
2013/14 0.3% 1.2%
2014/15 -1.3% 1.5%
2015/16 2.4% 2.8%
2016/17 3.1% 4.9%
2017/18 0.9% 4.1%
2018/19 5.6% 7.8%
2019/20 5.0%
Ministry of Health’s Disability Support Services Planned increases in spending Estimated actual increases in spending
2011/12 5.2% 5.2%
2012/13 2.3% 0.8%
2013/14 6.1% 4.8%
2014/15 2.6% 1.8%
2015/16 4.2% 4.9%
2016/17 -0.1% 1.4%
2017/18 2.1% 4.4%
2018/19 2.4% 8.4%
2019/20 -0.5%

By Sam Murray, National Policy Coordinator, CCS Disability Action.