This is an excerpt from the text of a presentation delivered by Dr David Bratt, Principal Health Advisor to the Ministry of Social Development entitled Working New Zealand:
Work Focused Support
Overview
Dr David Bratt gave an overview of his new role as the Principal Health Advisor within Work and Income NZ (WINZ) as part of the Ministry for Social Development (MSD) and WINZ’s new focus of working across the wider determinants of health and with a broader range of providers. Other new appointments established to support the new way of working include a Principal Disability Advisor, 13 Regional Health Advisors, 13 Regional Disability Advisors, 55 Employment Co-ordinators and 13 Regional Health and Disability Co-ordinators.
WINZ recognises that in order to make a difference for their clients, in some cases more specific services are required and WINZ is keen to make use of those services that already exist. For example, 40 percent of those on the Invalids Benefit have stress and/or depression and would benefit from access to DHBs mental health services. Where there is no existing service, or where a particular person is not eligible for an existing service, then WINZ would consider funding this. Therefore, WINZ is keen to engage with DHBs and PHOs around this.
David noted that one factor which presents a challenge to greater collaboration between WINZ and the health sector is that the MSD regions do not coincide with DHB regions.
Other limitations to the change process identified by David were:
- the extent to which this is a cultural change for MSD;
- the variability to which the MSD regions have meaningful relationships with their respective DHBs;
- the funding available for these new services is only $10 million per year, therefore it is important that WINZ is able to leverage off the services that already exist and use its funding to perhaps make those services more viable;
- capability to engage in those discussions
Paper excerpts:
1) DRIVERS FOR REFORM
Improving Labour Market Participation
- One in eight working age households has no-one in work
- Most people want to work, and can, with appropriate assistance, move into employment
- Others – like sole parents caring for children – can plan for employment in the future
Refocusing the social support system on work
- Change policy, practice and legislation to better support people on benefits getting jobs
- Clients with caring responsibilities or ill-health/disability are an increasing proportion of working age beneficiaries
2) TRENDS IN BENEFIT NUMBERS
We need to do more to help people on benefits with caring responsibilities and strengthen our focus on those with ill-health or disability
Dr Bratt presented the above graph to show the trends in benefit numbers since 2000 and they reflect the rapid drop in unemployment, the transfer of some people on unemployment benefits to more useful sickness or invalid benefits and a decline in the use of the domestic benefit.
He then outlined the new structures to support an increased focus on supporting people to work and addressing health issues in an integrated fashion.
3) CASE MANAGEMENT
New roles to support this new way of working
- Principal Health Advisor – Dr David Bratt
- Principal Disability Advisor – Anne Hawker
- 13 Regional Health Advisors ( mostly nurses)
- 13 Regional Disability Advisors
- 55 new Employment Co-ordinators
- 13 Regional Health and Disability Co-ordinators
Thirteen Regional Health Advisors
- Provide Work and Income staff with specialist advice on:
- health issues
- their impact on a person’s ability to work
- the services available to help return to work
Thirteen Disability Advisors
- Provide Work and Income staff with specialist advice on issues relating to:
- disabled people
- their ability to work
- the support options and services available to assist them achieve their employment goals
Fifty Five Employment Co-ordinators
- Work closely with both employers and clients
- Build and maintain relationships with external agencies
- Link people to existing services and programmes
- Develop new services and programmes for people who need help to move towards employment
Thirteen Health and Disability Co-ordinators
- Build working relationships with health practitioners and disability service providers
- Provide information on Work and Income services available for their clients
4) SERVICES
Contracted Services
- Contracted mild to moderate mental health services and awaiting specialist assessment, treatment or surgery services will be progressively available in regions once contracts have been finalised.
- The aim of these services is to provide appropriate treatment for clients experiencing ill health and disabled people to give them the opportunity to start work, or to help them stay in work.
5) WHAT WILL CLIENTS EXPERIENCE?
Clients can expect:
- income support
- enhanced service
- own doctor can complete medical certificate
- use of other existing assessments
- further assessments only if existing information is not sufficient
- no need for people on Invalid’s Benefit to re-establish eligibility if illness or disability is clearly permanent
- planning for return to work or community participation
- help with returning to work
- employment and training programmes
- services to support people into work
Editors note
This work should be of immense interest to nurses because it represents a more integrated approach to combining matters of health and disability with aspects of social wellbeing which fits well with a nursing approach. In addition it seems likely that boundary spanning NP roles could make significant contribution to the goals of this project. |
