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Sector Profiles 2013 Manawatū Region Health Care and Social Assistance The health care and social assistance sector is the largest sector for employment in the Manawatū region. With 7,440 employees recorded in February 2012, and total earnings (salaries and wages and self-employment income) of $337 million in the year ended March 2011, the sector accounted for 13.8% of employment in the region and 12.6% of earnings. At a national level the sector contributed 10.8% of total employment and 9.8% of earnings. Providing you with a better understanding of the different components of the Manawatū region economy and the contribution each sector makes to the demographic and economic growth of the region.
Contents images courtesy of U-Kinetics and Massey University
Contents
Contents 1
Executive Summary 3
Danish Red Cross
Introduction 6
Key Definitions and
Statistical Classifications 9
Key Sectors 11
Health Education 22
Green Prescription (or GRx) 15
About U-Kinetics 17 Sector Profile Manawatu Region Health
Characteristics
of the Health Care
and Social Assistance
Sector Labour Force 25
Population Trends 33
Aged Residential
Care Service Review 37
Estimating the
Economic Contribution
of the Health Care and
Social Assistance Sector
to the Manawatū Region 38
1
Images courtesy of UCOL and Sport Manawatū
Sector Profile Manawatu Region Health
2
Executive Summary
The health care and social assistance sector is the largest sector for employment in
the Manawatū region. With 7,440 employees recorded in February 2012, and total
earnings (salaries and wages and self-employment income) of $337 million in the
year ended March 2011, the sector accounted for 13.8% of employment in the region
and 12.6% of earnings. At a national level the sector contributed 10.8% of total
employment and 9.8% of earnings.
Employment in the sector has increased strongly in recent years, increasing by
35% (1,910 jobs) between 2000 and 2012, similar to national growth in the sector
(also 35%). The 35% increase in employment in the health sector in the region
was significantly higher than the employment growth of 16% recorded across the
Manawatū region. Average numerical growth in the sector for the period from 2000
to 2012 was 159 jobs per annum, more than a quarter of total employment growth
in the region.
The 12.6% contribution by the sector to total employee earnings in the region is
lower than its share of the number of total employees in the region. This is mostly
a reflection of the higher proportion of people employed in part-time and casual
positions in the sector. At the time of the 2006
Census 30% of the health sector workforce
worked part-time compared with an average Employment in the
of 23% for the total workforce in the region. sector has increased
Earnings in the sector have more than strongly in recent years,
doubled between 2000 and 2011 (the latest increasing by 35% (1,910
earnings data available), increasing by $194 jobs) between 2000 and
million over this period - an increase of 136%. 2012, similar to national
This accounted for 17% of total income
growth in the region over this period. Total growth in the sector (also
earnings across all sectors in the region 35%). The 35% increase in
increased by 75% between 2000 and 2011. employment in the health
The health care and social assistance sector
sector in the region was
encompasses a broad range of diverse significantly higher than
activities. Some of the key sectors, their the employment growth
employment numbers in 2012, and their of 16% recorded across
growth from 2000 are shown in the table the Manawatū region.
on page 19. Employment in the sector has
become more concentrated in the Manawatū
region from surrounding local authorities of the Manawatū-Wanganui region.
Most of the employment growth in the region over this period is concentrated in
Palmerston North. As a result of this growth, Palmerston North City accounted for
56% of total health care and social assistance sector employment in February 2012. Sector Profile Manawatu Region Health
Over the period from February 2000 to February 2012 total health care and social
assistance sector employment in the Manawatū-Wanganui region increased by 1,750
jobs, while Manawatū region employment in the sector increased by 1,940 jobs. This
means employment in other parts of the region declined by 190 jobs.
Major employment subgroups within the health care and social assistance sector are:
Hospitals
Nearly 2,300 people were employed in the three hospitals based in Palmerston North
(MidCentral District Health Board and the two Crest Hospitals, formerly Aorangi and
Southern Cross) as at February 2012, an increase of 454 jobs (25% increase) from
February 2000. The importance of the city as a major regional centre for hospital
based services is reflected in the region’s 3.4% share of national hospital employment.
The base regional hospital in Palmerston North has a dedicated Intensive Care Unit,
Coronary Care Unit and Neonatal Unit, amongst other services, and provides one of
the largest provincial trauma centres in New Zealand. Regional speciality services
are provided at the hospital to residents of the Taranaki, Wanganui, Hawkes Bay,
Tairawhiti and Wairarapa DHBs.
3
Residential Care Services
In 2012 1,710 people were employed in residential care services in the region. The
largest component of the employment in the residential care sector is aged care
residential services, where employment increased by 53% between 2000 and 2012
- well ahead of national employment growth of 21% in this sector. Statistics New
Zealand Census data shows the region experienced strong population growth in the
85 years and over age group, which increased by 45% between 1996 and 2006 while
the total population in the region increased by only 3%.
Other residential care services employed 610 people in 2012, an increase of 77% from
2000. The category includes the Arohanui Hospice, Idea Services accommodation,
MASH Trust, women’s refuge, respite residential care, and other residential care
facilities, such as Ozanam House (which provides accommodation for cancer
patients and their families). It has been suggested that Palmerston North has a high
number of people with a disability because of the wide range of services offered, the
affordability of housing and the ease of getting around the city. This is reflected in
Ministry of Social Development data, showing that the region has a 3.2% share of the
people receiving the invalids benefit as at December 2012, higher than its 2.5% share
of the total population. The higher than expected number of people with a disability
not only increases economic activity in the region through the additional number
of people employed to provide support, but
also adds to the level of spending in the city
by the people with a disability who have
chosen to move here. Other residential care
services employed
Other Allied Health Services 610 people in 2012, an
The “other allied health services” category increase of 77% from
covers a broad range of health providers 2000. The category
which are not covered elsewhere in the health
care and social assistance classification.
includes the Arohanui
These include midwives, podiatrists, clinical Hospice, Idea Services
psychologists, dieticians and nursing services. accommodation, MASH
In 2012 1,632 people were employed in Trust, women’s refuge,
the sector, with a significant proportion
respite residential care,
employed providing home and community
services. and other residential
care facilities, such as
Child Care Services Ozanam House.
The child care services classification includes
after-school care services, childminding
services and day care services which are not accredited preschool education
providers. Employment increased by 62% between 2000 and 2012, with 425 people
employed in February 2012.
Sector Profile Manawatu Region Health
Measuring Economic Benefits of the Health Care and Social
Assistance Sector
Health has long been recognised in development economics policy as one of the
fundamental determinants of economic growth and poverty reduction. The positive
impact that health has on growth and poverty reduction occurs through a number
of mechanisms, such as a reduction of production losses due to less illness among
workers, increased productivity as a result of better nutrition, lower absenteeism
rates and improved learning among school children.
Improved health also allows for the alternative use of financial resources that might
normally have been destined for the treatment of ill health.1 While the priorities
for health improvement in high income countries change from those in developing
countries, there is recognition that public investment in health services still produces
significant social and economic benefits.
1 Mexican Commission on Macroeconomics and Health (2004) Investing In Health For Economic Development:
4 Executive Summary
More direct economic benefits of the sector are seen in the Manawatū region as
a result of the $337 million generated in salaries and wages and self-employment
income for the people employed in the sector. The economic multipliers for the
sector, which measure how much additional economic activity is created in the
regional economy as a result of expansion of the health sector, show high indirect
benefits from higher health spending in the region but relatively low direct impacts.
Increased health spending does not lead to a significant increase in purchases for
local producers of health supplies (such as medical equipment and pharmaceutical
products) but a high proportion of the increase in health spending is on salaries and
wages, which are mostly spent in the local economy.
Infometrics GDP estimates suggest the sector contributed $434 million directly
to regional GDP in the year ended December 2011, 9.7% of annual GDP in the
Manawatū region. The indirect economic contribution of the sector is estimated to
have contributed to a further $288 million increase in regional GDP, giving a total
estimated GDP contribution of $722 million.
Other economic benefits from the expansion of the health sector are seen through
increased demand for visitor accommodation (patients, their family and friends,
conferences and training associated with the health sector), the attraction of people
to the region due to the availability of specialist services and expertise, and the
attraction of skilled staff and their families.
Sector Profile Manawatu Region Health
5
Introduction
The World Health Organisation defines health as “a state of complete physical, mental
and social well-being and not merely the absence of disease or infirmity”1.
Health and disability services in New Zealand are delivered by a complex network
of organisations and people. Each has their role in working with others across the
system to achieve better health for New Zealanders.
Around three quarters of Government funding for the health sector is administered
by district health boards (DHBs). DHBs plan, manage, provide and purchase health
services for the population of their district to ensure services are arranged effectively
and efficiently for all of New Zealand. This includes funding for primary care, hospital
services, public health services, aged care services, and services provided by other
non-government health providers, including Māori and Pacific providers. Accident
services are funded by the Accident Compensation Corporation (ACC).
Important roles in providing health services and ensuring efficiency and quality are
undertaken by public health units, primary health organisations, non-government
organisations, Crown entities, health professionals, and professional and regulatory
bodies for all health professionals – including all medical and surgical specialist
areas, nurses and allied health groups.
There is a range of educational and research
institutions involved in the provision of services Health is fundamental
and training of the workforce. There are also
many consumer bodies and non-government
to one of the main
organisations that provide services and inputs for economic
advocacy for the interests of different groups, development: human
and more formal advocacy and inquiry boards, capital. Along with
committees and entities. financial, intellectual,
Health and Economic Development social, and political
Health has long been recognised in the
capital, development
development economics field as one of the schemes rely on skilled,
fundamental determinants of economic healthy individuals
growth and poverty reduction. The positive as workers and
impact that health has on economic growth as consumers.
and poverty reduction occurs through a
number of mechanisms, such as a reduction
of production losses due to less illness among
workers, increased productivity as a result
of better nutrition, lower absenteeism rates and improved learning among school
children. It also allows for the alternative use of financial resources that might
Sector Profile Manawatu Region Health
normally be destined for the treatment of ill health. While the priorities for health
improvement in high income countries change from those in developing countries,
there is recognition that public investment in health services still produces significant
social and economic benefits.
A good example of this recognition is a 2011 health and economic development paper
prepared for the New York Regional Economic Development Council2. The paper
includes the following brief overview of how health and economic development
interact.
1 Preamble to the Constitution of the World Health Organization as adopted by the International Health
Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official
Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.
6 2 The New York Academy of Medicine. ( 2011). Health and Economic Development.
How do health and economic development interact?
Health is fundamental to one of the main inputs for economic development: human
capital. Along with financial, intellectual, social, and political capital, development
schemes rely on skilled, healthy individuals as workers and as consumers. When you
have a healthy population, economic benefits follow:
Half of the overall economic growth in the US during the last century is associated
with improvements in population health.3
A 10% reduction in heart disease mortality is estimated to be worth more than $3
trillion, and a 1% reduction in cancer mortality is estimated to be worth more than
$400 billion to current and future generations.4
A 10 - year increase in life span is associated with an increase of 4.5 percentage points
in savings rates because healthier individuals with increased longevity are more
concerned with future financial needs.5
Conversely, poor health and illness generate an economic burden to individuals,
companies, and regions. An unhealthy population generates costs in preventable
health care expenditures, higher premiums from insurance companies and healthcare
costs to business, and greater public expenditures on Medicaid and Medicare.
These expenditures come at the expense of other investments. The public sector
forgoes critical investments in education, transportation, housing and other
infrastructure, social services, and the arts. Businesses experience opportunity
costs and may have to sacrifice expansion and capital investment. Businesses want
to locate in regions with healthier populations because their costs are lower and
productivity is higher.
Furthermore, unemployment and low-income are among the leading determinants
of poor health. Unemployment is consistently linked with higher rates of illness,
injury, and premature mortality.
How can economic development produce health?
Health and economic development are often linked in people’s minds to the health
care industry: hospitals and health care systems care for the sick and create health
sector jobs. The health care sector is a major employer in New York. However,
economic development can also improve health and, over the long term, generate
health care system savings in other ways.
Economic development strategies create the overarching “socioeconomic, cultural,
and environmental conditions” (illustrated in Figure 2)6 that influence population
health. Creating a business climate and supporting public investments that
contribute to good-paying jobs can create an economically thriving community
that strengthens education, social networks, and community resources, in turn
Sector Profile Manawatu Region Health
contributing to good health outcomes.
3 Nordhaus WD. (2002). The Health of Nations: The Contribution of Improved Health to Living Standards.
Cambridge, MA: National Bureau of Economic Research.
4 Murphy K, Topel R. (2003). Diminishing returns? The costs and benefits of improving health. Perspect Biol
Med. 2003;46 (suppl 3):S108–S128.
5 Bloom DE, Canning D, Graham B. (2003) Longevity and life-cycle savings. Scand J Econ. 2003;105:319–338.
6 Dahlgren, G., Whitehead, M., & World Health Organization WHO. (2006). European strategies for tackling
social inequities in health: Levelling up part 2. Copenhagen: WHO Regional Office for Europe. 7
Figure 2: Dahlgren & Whitehead’s Determinants of Health
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Economic development plans also present an opportunity to make direct investments
that can help prevent unnecessary illness and premature death from chronic diseases
like heart disease, cancer, pulmonary disease, diabetes, and obesity — all of which
have the same risk factors of diet, exercise, tobacco, and alcohol use. Investments
that support disease prevention can also yield economic returns.
Sector Profile Manawatu Region Health
8Key Definitions and Statistical
Classifications
Data on the Manawatū region Health Care and Social Assistance sector is based on
the Australian and New Zealand Standard Industrial Classification (ANZSIC) 2006.
Major groups within the Health Care and Social Assistance sector are:
Hospitals – general and psychiatric.
Medical Services – includes GPs and specialist medical services.
Pathology and Diagnostic Imaging Services
Allied Health Services – includes dental, optometry, physiotherapy, chiropractic,
osteopathic and midwifery services.
Other Health Care Services – includes ambulance service and blood bank.
Residential Care Services – includes retirement villages, hospice, Women’s Refuge
and other community care facilities.
Child Care Services – accredited preschool education is included in the education
sector.
Other Social Assistance Services – includes a wide range of social support services,
such as marriage guidance and youth welfare services.
It is important to note that all employment in an organisation is classified to
the predominant activity of the organisation. MidCentral District Health Board
employment is recorded solely to the Hospitals classification even though staff
employed by MidCentral are involved in a wide range of activities.
Other Terms Commonly Used
Public Health Services
Regional public health services are delivered by 12 district health board-owned
public health units, and a range of non-government organisations, each delivering
about half of these services.
Public health units focus on environmental health, communicable disease control,
tobacco control and health promotion programmes. Many of these services include
a regulatory component performed by statutory officers appointed under various
statutes, though principally under the Health Act 1956.
The MidCentral District Health Board Public Health District covers Manawatū,
Sector Profile Manawatu Region Health
Wanganui, Ruapehu (southern part)
Primary Health Care Services
Primary health care relates to the professional health care received in the community,
usually from a general practitioner (GP) or practice nurse. Primary health care covers
a broad range of health and preventative services, including health education,
counselling, disease prevention and screening.
Manawatū region
The Manawatū region covers the area of Palmerston North City Council and Manawatū
District Council. In June 2012 the region had an estimated population of 113,000
people, a workforce of 53,730 and a land area of 2,960 km2.
MidCentral DHB
The MidCentral DHB region covers the area of Palmerston North City Council,
Manawatū, Horowhenua and Tararua District Councils, and part of Kapiti Coast
District Council. The region had a population of 158,841 in 2006.
9Images courtesy of Massey University
Sector Profile Manawatu Region Health
Danish Red Cross
10Key Sectors
Hospitals
Nearly 2,300 people were employed in the three hospitals based in Palmerston North
(MidCentral District Health Board and the two Crest Hospitals (formerly Aorangi and
Southern Cross)) as at February 2011, an increase of 454 jobs (25% increase) from
February 2000. The importance of the city as a major regional centre for hospital
based services is reflected in the region’s 3.4% share of national hospital employment.
Palmerston North is the only provincial city in New Zealand with more than one full-
scale private hospital, which is likely to result in more work coming into the city from
a wide catchment area.
The base regional hospital in Palmerston North has a dedicated Intensive Care
Unit, Coronary Care Unit and Neonatal Unit, amongst other services, and provides
one of the largest provincial trauma centres in New Zealand. Regional speciality
services are provided at the hospital to residents of the Taranaki, Waanganui, Hawkes
Bay, Tairawhiti and Wairarapa DHBs. Some aspects of cancer services across the
continuum (prevention and early detection to palliative care) is provided by all
DHBs. Major cancer treatment centres for the lower North Island are based in Capital
& Coast (Wellington) and MidCentral (Palmerston North) DHBs. Clinicians from
these services undertake regular scheduled outpatient clinics in the other DHBs
(including Tairawhiti and Taranaki). All patients
who require radiotherapy travel to Wellington
or Palmerston North for that component of
treatment.
The base regional
In August 2012, Southern Cross Hospital
and Aorangi Hospital in Palmerston North
hospital in Palmerston
amalgamated their hospital operations and a North has a dedicated
partnership was formed known as Southern Intensive Care Unit,
Cross Aorangi Hospital Partnership. At the Coronary Care Unit and
beginning of April 2013, the partnership
Neonatal Unit, amongst
assumed a new collective identity and became
Crest Hospital. other services, and
provides one of the
Crest Hospital, by combining the experience, largest provincial trauma
services and heritage of the former Aorangi
Hospital and Southern Cross Palmerston North
centres in New Zealand.
Hospital, is able to provide the very best surgical
and medical care to Palmerston North and the
surrounding regions. Crest Hospital continues
to operate at both the former Aorangi Hospital
and Southern Cross Palmerston North sites, now named Crest Hospital on Grey and
Crest Hospital on Carroll respectively. Aorangi Hospital in Palmerston North was Sector Profile Manawatu Region Health
privately owned by a group of medical specialists who also practiced at the hospital.
Crest Hospital on Carroll currently has two operating theatres, 26 in-patient beds,
and provides specialist consulting and elective surgical services to both day patients
and in-patients. Crest Hospital on Grey has four operating theatres, 32 in-patient
beds and also provides a range of specialist consulting and elective surgical services
to both day patients and in-patients.
The hospital sector accounts for 31% of the health care and social assistance sector
employment in the region, with the three hospitals all located in close proximity in
the City. Trends in primary health care and increasing expenditure on primary health
provision is not well reflected in the job count statistics produced by Statistics New
Zealand because all District Health Board employment in Palmerston North is classified
to its predominant activity (hospital). Therefore, an increase in DHB spending on
primary health care will be recorded as an increase in hospital employment, unless
there is an increase in the funding which goes to other non-hospital health providers.
11Images courtesy of MidCentral District Health Board
MIDCENTRAL DISTRICT HEALTH BOARD ANNUAL REPORT SUMMARY 2012/13
IN OUR DISTRICT,
EVERY DAY, ON AVERAGE
228 items of equipment
6 babies 27 people have
25 adolescents issued by Enable New Zealand
are born an operation at MCH
have a dental check
1 27 113
person is admitted to
1811 6 people have an operation at MCH people visited WEKA website
people consult their General Practice team
Intensive Care Unit children have a B4
school check
2 14 78 16 8 1249
people are
people are
discharged
people seen by community mental
health & alcohol & drug services people received aged residential care services
admitted to young people drop into from MCH
Coronary Care Unit hospital care
2238
the YOSS health clinic
3 18 1 07 217 people attend a MCH outpatient appointment people receive home-based support services
babies have a people are seen
2241
people have a
228
hearing MRI scan by the chronic
screening test care team
Sector Profile Manawatu Region Health
6 25 1 1 1 items of equipment issued by Enable New Zealand laboratory tests are done in the community
babies are born
245 7769
adolescents have
a dental check
people attend ED
people are seen by a district nurse medicines are dispensed in the community
DELIVERED BY:
41 General practices
40 + Non-government organisations
35 Rest homes
32 Community pharmacies
22 Dental practices
8 Optometrists
6 Iwi/Maori providers
3 Integrated Family Health Centres
2 Community Radiology Services
1 Primary Health Organisation
1 Public hospital
1 Laboratory
12Hospital care facilities provided in retirement villages are included in the employment
data for aged care residential services. Some minor surgical procedures, such as
vasectomies and skin cancer removal are performed in clinics, consulting and/or
procedural rooms and are therefore included in the medical services classification.
This is because they can be performed in smaller facilities, without the need of a
general anaesthetic. Not included in the hospital sector data are some oral and
maxillofacial surgical procedures, and some minor plastic surgery procedures
performed in clinics on a strictly day-stay basis, including procedures under general
anaesthetic.
However primary health care services and other non-hospital services provided by
MidCentral DHB are likely to have been included in the hospital sector employment.
Data for the number of hospitals in New Zealand shows a 27% between 2000 and
2012, reflecting the trend towards consolidation of health services in major regional
hospitals and changes in the provision of mental health and intellectual disability
services.
Medical Services
The classification for medical specialists covers practices mainly engaged in the
independent practice of specialised medicine, apart from pathology and diagnostic
imaging services. These units consist of specialist medical practitioners who
generally operate private or group practices in medical clinics or centres.
Medical services employment increased by 9% between 2000 and 2012, with 351
people employed in the sector in February 2012. This understates the total level of
employment in this sector, since GPs will often be classified as employers or self-
employed, rather than employees of the practice. In 2012 there were 84 general
practice medical services operating in the region. Between 2000 and 2012 the
number of general practice medical services increased by 5 practices, an increase
of 6%. The growth in the number of employees in general practice medical services
was 8%, similar to the 8% growth in the region’s population. There has been some
consolidation of medical practices into larger facilities, which operate with more
than one GP and shared facilities in the practice.
There were a further 86 people employed in specialist medical services in the region
in 2012, an increase of 10% since 2000. As noted earlier, this may not fully reflect
total employment in the sector due to the number of medical specialist classified
as employers or self-employed. In 2012 there were 64 specialist medical services
operating in the region, an increase of 16 (33% increase) from 2000.
Pathology and Diagnostic Imaging Services
This activity area covers the provision of pathology laboratory or diagnostic imaging
services, such as analytical services including body fluid analysis, ultrasound or x-ray
services. Employment in this sector has increased by 10% between 2000 and 2012, Sector Profile Manawatu Region Health
with 213 people employed in February 2012. The data shows a doubling in the
number of units offering pathology and diagnostic imaging services between 2000
and 2012.
Allied Health Services
The Allied Health Services classification is a broad category covering dental services,
optometry and optical dispensing, physiotherapy, chiropractic and osteopathic
services and other health care services not elsewhere classified. Some of the key
activities included are:
• Audiology service
• Clinical psychology service
• Dental hygiene service
• Dietician service
• Hearing aid dispensing
• Herbalist service
• Homoeopathic service
13Images courtesy of Green Prescription
Sector Profile Manawatu Region Health
14Green Prescription (or GRx)
Green Prescription (or GRx) is a Ministry of Health (MoH) and MidCentral District
Health Board (MCDHB) funded programme aimed at getting more people physically
active. Sport Manawatū run the programme providing support, advice and
motivation to participants.
What is Green Prescription?
A Green Prescription is a script with a difference. It can be obtained from your doctor,
nurse or community health worker and instead of medicine, it prescribes physical
activity and lifestyle change.
Who is Green Prescription for?
For adults over the age of 18 years who participate in no or very low amounts of
physical activity (less than three times per week).
What can Green Prescription do for you?
• Inform you of the types of physical activity available
• Provide a support network
• Give you the opportunity to participate in physical activity
• Work with you to set your own personal physical activity goals and to monitor
these goals
How long does it take?
A term will go for 10 weeks. If it takes a little longer participants can re-sign for a
further term.
What costs are involved?
If you attend our weekly class the cost to you is only $2.00 each class.
What physical activity do you do?
We hold weekly activity classes for participants to attend. Class times and activities
vary depending on the area but usually include aqua aerobics, walking, resistance
exercises and Sit and Be Fit. For more information on classes and timetables, visit our Sector Profile Manawatu Region Health
GRx class page.
Green Prescription Programme (GRx)
Delivered by Sport Manawatu for the
Manawatū, Horowhenua and Tararua Regions
Sports House, Phone: +64 6 357 5349 (Sport Manawatu Offices)
50 Queen Street, or 0800 ACTIVE (22 84 83)
PO Box 797, Fax: +64 6 358 11778
Palmerston North email: website@sportmanawatu.org.nz
website: sportmanawatu.org.nz/grx
1516
Sector Profile Manawatu Region Health
Images courtesy of U-kineticsAbout U-Kinetics
U-Kinetics is a unique and innovative centre
based around providing supervised and
specific exercise programmes for clients Exercise is recognised
with medical conditions, injuries, or multiple as being an important
health issues. part of health and
Exercise is recognised as being an important rehabilitation, and
part of health and rehabilitation, and U-Kinetics is the first
U-Kinetics is the first specialised centre of its specialised centre of its
kind in New Zealand which links education kind in New Zealand
and health (both public and private
organisations) to improve services and
which links education and
client outcomes. We are currently running health (both public and
specialised exercise programmes for cardiac private organisations)
clients, respiratory clients and diabetics to improve services and
(referred from MidCentral DHB) and clients client outcomes.
with musculo-skeletal injuries (in conjunction
with TBI Health).
Your exercise testing and exercise sessions
will be supervised by UCOL Clinical Exercise Physiologists. A Clinical Exercise
Physiologist is an individual who specialises in the delivery of exercise, lifestyle
Sector Profile Manawatu Region Health
education and behaviour modification programmes for the prevention, management
and rehabilitation of chronic conditions, diseases and injuries for people from
every walk of life. This centre also provides clinical learning experience for UCOL
Postgraduate Diploma in Clinical Exercise Physiology students.
U-Kinetics
62 Grey Street Phone: +64 6 952 7100
Postal Address Fax: +64 6 952 7103
Palmerston North email: admin@u-kinetics.co.nz
website: ukinetics.co.nz
17• Hydropathic service
• Midwifery service
• Naturopathic service
• Nursing service
• Occupational therapy service
• Podiatry service
• Speech pathology service
• Therapeutic massage service
The provision of nursing services is a major component of employment in the
sector, accounting for a significant share of the 1,415 jobs in the “Other Allied Health
Services” classification in February 2012. There have been challenges with monitoring
employment in this sector, with the number of jobs in this classification declining by
457 jobs between February 2007 and February 2008. Statistics New Zealand noted
the prevalence of part-time and casual work in organisations providing nursing
services contributed to significant challenges in recording changes in employment.
There were 1,632 jobs in Allied Health Services in February 2012, an increase of 10%
from 2000 (153 additional jobs). One contributor to the growth in employment is
likely to be the growth in home and community support services. This includes home
care services for the elderly and others requiring home support, such as following
surgery or for people with a disability.
Other Health Services
The Other Health Services classification covers ambulance services (including
air ambulance services), blood banks and other health assessment and care
services. Restructuring by St Johns appears to be one factor in the strong growth
in ambulance services employment, with their regional office based in Palmerston
North. Restructuring may also be a factor in the strong growth of employment in
other health care services.
There were 236 employees in the Other Health Services sector in 2012, a significant
increase from the 34 employees recorded in 2000.
Residential Care Services
The Manawatu region residential care services sector has experienced the largest
increase in employment in the health sector, with 645 more jobs in February 2012
compared with February 2000, an increase of 61%.
The largest subcategory within the sector is the aged care residential services sector,
with 1,100 employees counted in 2012. This is an increase of 380 jobs since 2000 -
53% increase. The increase accounts for over two thirds of the employment growth
in this sector in the Manawatū-Wanganui region. Declines in the number of aged
Sector Profile Manawatu Region Health
care residential services and employees were recorded in Rangitikei and Tararua
Districts, reflecting consolidation of employment in Palmerston North and to a lesser
extent in Feilding.
Total New Zealand employment in the sector increased by 21% between 2000 and
2012. Thus the growth rate in the Manawatū region was significantly higher than the
national growth rate.
The strong growth of employment in the sector is also reflected in the strong growth
in building consents for the construction of retirement village apartments and villas
during the last ten years. Services offered by retirement villages include:
Independent living Townhouse, apartment or villa options
Assisted Living Serviced apartments
Resthome
Care Hospital
Dementia care (secure environment)
18Care options include day care, short-term respite care and long-term care for
residents of the village or rest home.
Even stronger employment growth was recorded in the other residential care services
classification, with employment increasing by 77% between 2000 and 2012, with 265
additional jobs in the region. One contributor to this growth is the closure of the
Kimberley Centre near Levin in 2006 and the transfer of former residents into cluster
housing in Levin and Palmerston North and single house community group homes.
However, the growth in employment is likely to be much broader than this. In 2012
there were 610 people employed in the sector, accounting for 4.1% of total New
Zealand employment in other residential care services at that time. One contributor
to this high share may have been the closure of Lake Alice Psychiatric Hospital, which
was finally closed in October 1999. Employment in the sector is highly concentrated
in Palmerston North, with 580 jobs based in the city and just 30 in Manawatū District.
It is likely that services are delivered across the wider region, but the employers are
primarily based in Palmerston North.
Arohanui Hospice
One example of an organisation in the ‘other residential care services’ sector is the
Arohanui Hospice, which is located adjacent to Palmerston North Hospital. The
Hospice provides specialist palliative care for Manawatū, Tararua, Horowhenua and
Rangitikei residents with a life-limiting illness, and support for their families. At any
one time there are approximately 180 patients receiving specialist palliative care
services in this area, and up to 650 patients and their families a year.
Ozanam House
Ozanam House cancer patient accommodation is provided for patients receiving
radiotherapy treatment at Palmerston North Hospital and their carers. Many are
often treated as out-patients but daily treatment means a place to stay near the
hospital is a major benefit for residents from outside the City. Many cancer patients
travel from throughout the lower half of the North Island: from Gisborne to Taranaki.
Ozanam House can best be compared to a residential club without staff. Housework,
cooking and recreation are often shared by mutual consent as guests come and go.
Economic impact estimates prepared by Palmerston North City Council in February
2011 were based on 15,700 patient nights on an annual basis and around 12,600
nights for accompanying people. This was estimated to result in an increase in GDP
in the city of $1.5 million each year.
IDEA Services
Intellectual Disability Empowerment in Action (IDEA) Services is part of IHC and
employs around 6000 staff in New Zealand. In 2010/11 IDEA Services supported 6,470
people in New Zealand to live, learn, work and enjoy life as part of the community. Sector Profile Manawatu Region Health
Services are mainly funded by government contracts through the Ministry of Health
and the Ministry of Social Development. IDEA Services has a range of accommodation
options for people; including group homes, supported living and contract board.
Does Palmerston North have a higher than average proportion of people with
disabilities who need access to care and support services?
It has been suggested that Palmerston North has a higher than average proportion
of people with disabilities, one of the factors in the higher than average economic
contribution of the health care and social assistance sector to the City economy.
There are a range of factors suggested for why Palmerston North is an attractive
place for someone to live who has a disability. These include:
• Housing is more affordable than most metropolitan or provincial cities,
• The flat terrain of the city and compact layout means it is an easy city to get
around in,
• The base regional hospital in Palmerston North offers a comprehensive range
of hospital-based and high quality primary health services,
19• A broad range of support services are available in the City, with strengths in
the provision of rehabilitation support and services. Enable New Zealand,
for example, started in Palmerston North and it has one of the best Needs
Assessment and Service Coordination Services in New Zealand,
• The City’s central position means it is easy for friends and family to visit,
• There is a wide range of educational opportunities available.
There is no comprehensive data on the number of people in Palmerston North who
need access to care and support services. One partial indicator may be the number
of people registered for the Ministry of Social Development’s Invalids Benefit. In
December 2012 there were 2,689 people in the region receiving the Invalids Benefit
- 3.2% of national Invalid Benefits. This was higher than the region’s 2.5% share of
New Zealand’s population. The proportion of benefits in the region for intellectual
disability was 3.5% of the national total, while benefits for psychological or psychiatric
conditions were 3.3%.
The Invalids Benefits data provides only a partial indicator since it only covers
people aged 18 – 64 years of age and it does not include people receiving support
through other means, particularly through ACC or from their family. It is interesting
to note that Auckland City accounts for 33% of the national population and 31% of
all Ministry of Social Development benefits but just 17% of the number of people
receiving the Invalids Benefit. This is likely to reflect the high cost of housing in the
Auckland region. This trend is also reflected in data for employment in the other
allied health services classification, with the Manawatū region accounting for 5.3%
of national employment, while Auckland City accounts for 25% of jobs in the sector.
Child Care Services
Organisations providing accredited preschool education are included in the education
sector classification of economic activity, but other organisations primarily providing
day care of infants or children are classified in the health care and social assistance
sector. Organisations classified under the heading of child care services include
before and/or after school care services, child minding services and other children’s
nursery or child care facilities that are not education providers. In 2012 425 people
were employed in the child care sector while a further 570 people were employed in
preschool education. Employment in child care has increased strongly since 2000,
with 163 more jobs in 2012, an increase of 62%. The annual number of births in
the region increased by 10% - from 1,451 in the year to March 2000 to 1,594 in the
year to March 2012. The much stronger growth in employment in child care (58%
increase) and preschool education (98% increase) reflects increased participation
rates and longer average hours of attendance. For example, average weekly hours in
licensed early childhood services increased by 66% in Manawatū District and by 43%
in Palmerston North between 2000 and 2011. Ministry of Education data on hours of
attendance is only available for licensed early childhood services, so we do not have
data on average hours in child care services.
Sector Profile Manawatu Region Health
Other Social Assistance Services
The other social assistance services classification includes organisations mainly
engaged in providing a wide variety of social support services directly to their clients.
These services do not generally offer accommodation, except on a short stay basis.
Activities listed in this classification include:
• Adult day care centre operation
• Aged care assistance service
• Disabilities assistance service
• Drug and alcohol counselling
• Marriage guidance service
• Welfare counselling service
• Youth welfare service
20Statistics New Zealand annual employment data shows there were 60 different
organisations in the region offering services in this sector, employing 605 staff.
Employment has increased strongly since 2000, with 232 more staff than in 2000, an
increase of 62%.
Manawatū Region Health Care and Social Assistance Sector Employment
Employee
2000 - 2012 change
Numbers
February
Number %
2012
Hospitals (Except Psychiatric Hospitals) 2,273 454 25%
Psychiatric Hospitals 0 0 0%
Hospitals 2,273 454 25%
General Practice Medical Services 265 20 8%
Specialist Medical Services 86 8 10%
Medical Services 351 28 9%
Pathology and Diagnostic Imaging Services 213 20 10%
Dental Services 112 45 67%
Optometry and Optical Dispensing 51 23 82%
Physiotherapy Services 36 13 57%
Chiropractic and Osteopathic Services 18 -3 -14%
Other Allied Health Services 1,415 75 6%
Allied Health Services 1,632 153 10%
Ambulance Services 86 77 856%
Other Health Care Services n.e.c. 150 125 500%
Other Health Services 236 202 594%
Aged Care Residential Services 1,100 380 53%
Other Residential Care Services 610 265 77%
Residential Care Services 1,710 645 61%
Child Care Services 425 163 62%
Other Social Assistance Services 605 232 62%
Total Health and Social Assistance Services 7,440 1,910 35%
Source: Statistics New Zealand
Sector Profile Manawatu Region Health
Health Care and Social Assistance Sector Earnings
(Salaries, wages and self-employment income)
Earnings 2000 - 2011 change
Year ended March 2011
($ million) $ million %
Manawatū district 19.5 9.0 85.0%
Palmerston North 317.6 185.0 139.5%
Manawatū region 337.1 193.9 135.5%
New Zealand 10,218.3 5,695.8 125.9%
Source: Statistics New Zealand
21Health Education
The strong base in Palmerston North for health education at Massey University and
UCOL (Manawatu Polytechnic) reflects the importance of the health care sector to
the Manawatu region and is also a factor in the strength of health services offered in
the region.
Massey University College of Health
Massey University has taken a fresh approach to the complex issue of health, wellness
and wellbeing by establishing a new College of Health in 2013. The College of Health
has three broad goals: health promotion (the promotion of health and wellbeing),
disease prevention (prevention of disease and injury at primary, secondary and
tertiary levels) and health protection (protection from environmental risks to health).
To achieve those goals, it has brought together specialists in public health, food
science and technology, nutrition and physiology, sport and exercise, rehabilitation,
nursing, Māori and Pasifika health, social work, occupational health and safety, social
work and social policy, and medical laboratory science.
Working together, these disciplines will create a stronger health focus for Massey
University students and researchers, one where there is greater understanding of the
complex interactions between physiology
and the social and economic factors that
underpin health and wellbeing.
The strong base in
UCOL Health Sciences Programme Palmerston North for
The Nurse Education Team at UCOL is one of health education at
the institute’s largest teams. The Bachelor of Massey University
Nursing programme leads to entry into the and UCOL (Manawatu
Nursing Council of New Zealand State Finals
examination, and UCOL students have an
Polytechnic) reflects
excellent record in passing this examination the importance of the
on their first attempt. The nursing simulation health care sector to
lab at UCOL is the only educational institute the Manawatu region
to have the new hi-tech audiovisual system and is also a factor in
SimView installed. The system provides
valuable reality-based hands on learning
the strength of health
and opportunities for assessment, including services offered in
full integration of patient voice, vital signs, the region.
hi-definition video recording and debrief,
and network access to activities within the
two sim labs.
UCOL’s Bachelor of Applied Science (Medical Imaging Technology) is community-
Sector Profile Manawatu Region Health
based and industry focused. There is a practical hands-on approach, combining
laboratory and classroom teaching with clinical learning.
UCOL’s Nursing and Medical Imaging degrees run alongside degrees in Exercise and
Sport Science and foundation level Health Science courses.
Last year UCOL opened a unique exercise and wellness centre U-Kinetics in
partnership with the health sector where staff and post graduate students enrolled
in the Postgraduate Diploma in Clinical Exercise Physiology run specialised exercise
programmes for cardiac clients, respiratory clients and diabetics (referred from
MidCentral DHB) and clients with musculo-skeletal injuries with TBI Health.
Health Programmes Offered in Palmerston North
Food, Science and Technology - Food technology is all about using science to add
value to commodity foods, such as dairy products, meat, fruit, vegetables and grains.
Health Disability and Rehabilitation - Offers a broad knowledge of the purpose,
practice and philosophy of rehabilitation. A major in rehabilitation provides specific
knowledge of the needs of people with physical, sensory, aged health related,
22 psychiatric, intellectual and social disabilities.Health and Life Sciences - Research in health and life science focuses on detection,
examination and determination of the risk environmental factors such as water
quality; noise control and hazardous substances play on human health also.
Human Nutrition - Study of biological, social and environmental aspects of nutrition
equips graduates for careers in public health areas, private practice, industry, research
and international organisations.
Human Physiology - The physiology major within the Bachelor of Science degree
shows how the cells, tissues and organs of living organisms function and interact to
ensure the survival and wellbeing as a whole, with early papers giving students an
overall understanding of body function.
Medical Imaging – Career opportunities include general radiography, mobile and
theatre radiography, computed tomography, digital angiography, mammography
(breast screening), forensic radiography, Magnetic Resonance Imaging, ultrasound
nuclear medicine, veterinary radiography, clinical teaching research, marketing and
sales application specialist.
Medical Laboratory Science - Enables graduates to provide the test results essential
for use by clinical medical staff in the detection, monitoring or prevention of disease.
It gives a thorough grounding in biological sciences.
Nursing - Nursing programmes are taught to prepare students to become registered
nurses
Occupational Health and Safety - Designed to provide advanced education in
the fields of safety management, occupational health, environmental control, loss
control and occupational hygiene.
Public Health - Brings together the combined efforts of many public health and Mäori
health research centres. It leads work in areas such as sleep carried out at the Sleep/
Wake Research Centre, research on numerous subjects related to environmental
and occupational health. The SHORE and Whäriki Research Centre is a collaborating
centre with the World Health Organisation,
Social Work and Social Policy - A thorough knowledge of human development, and
detailed study of social institutions and policies.
Sport and Exercise - Specialises in sports management and coaching, physical
education, sociology of sport and high performance sport.
Sector Profile Manawatu Region Health
23Images courtesy of MASH Trust; Sport Manawatū; UCOL and Broadway Radiology
Sector Profile Manawatu Region Health
24Characteristics of the Health Care and
Social Assistance Sector Labour Force
National and regional data for the health sector shows strong growth in the number
of people employed in the sector, as well as growth in median earnings. The
data presented in this section is based on a mix of Manawatū region, Manawatū-
Wanganui region and New Zealand wide statistics. The majority of indicators are
published at the level of the Manawatū-Wanganui region. In 2011 the Manawatū
region accounted for 61% of health sector jobs in the Manawatū-Wanganui region
and 61% of earnings in the region.
The data contained in this chapter of the profile is drawn from annual data from the
Linked Employer-Employee Data (LEED) series published by Statistics New Zealand
and the 2006 Census. The LEED data is created by linking a longitudinal employer
series from the Statistics NZ Business Frame to a longitudinal series of Employer
Monthly Schedule payroll data from Inland Revenue. Employment trends for the
health care and social assistance sector are:
Age Profile
The health care and social assistance sector in the Manawatū-Wanganui region is
dominated by older workers, with 54% of the workforce in the sector aged 45 years
and over compared with 41% for all industries. Just 9% of the health care and social
assistance sector workforce is aged under 25 years compared, with 20% for all
industries.
Manawatū-Wanganui Region Employment by Age
(2011)
16%
14%
Percentage share of total workforce
12%
10%
8%
6%
4%
2%
0%
15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Year (to March) Sector Profile Manawatu Region Health
All sectors Health Care and Social Assistance
SOURCE: STATISTICS NZ LEED
The sector has recorded very strong growth in the number of people aged 45 years
and over during the period from 2000 to 2011, with the strongest growth rates for
employees aged 60 years and over. The number of employees aged between 30 and
39 years declined over this period. These trends reflect broader demographic trends
in the region, with a decline in the size of the workforce in the 25 years to 39 years
age band between 2000 and 2011, and strong growth in the workforce aged 45 years
and over.
25Manawatū-Wanganui Region Health Care and Social Assistance
Sector Employment Change by Age Group
1200 (2010- 2011 change) 600
1000 500
Employment change (number)
800 400
600 300
400 200
200 100
0 0
-200 -100
15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Age(years)
Employment Employment
change (number) Growth Rate (%) SOURCE: STATISTICS NZ LEED
Manawatū-Wanganui Regional Employment Growth by Age Group
(2000-2011 employment change)
600%
550%
500%
450%
Employment change (number)
400%
350%
300%
250%
200%
150%
100%
50%
0%
-50%
15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Age (years)
Health All Industries SOURCE: STATISTICS NZ LEED
Part-time Status
Sector Profile Manawatu Region Health
At the time of the 2006 Census 30% of the Manawatū region health sector workforce
worked part-time, compared with an average of 23% for the total workforce in the
region (33% of the New Zealand health sector workforce was employed part-time).
There was a significant difference between Manawatū District, where 45% of the
health sector workforce worked part-time, and Palmerston North, where 28% were
part-time. The difference between the two areas may be explained by the high share
of Manawatū District employment in aged care residential services. The share of full-
time employment in the health sector has been increasing, with 65% employed full-
time in 1996, compared to 70% in 2006.
Gender
The health care and social assistance sector in the Manawatū-Wanganui region is
predominantly female, with males accounting for just 17% of the workforce. Males
hold an 18% share in the national health sector workforce. This small share for males
in the workforce contrasts with the 53% share for males in the total workforce in the
Manawatū-Wanganui region.
Males, however account for a much greater share of the work force in self-employment
in the sector, accounting for 38% of the health care and social assistance self-
26 employed workforce compared to just 15% of the health workforce receiving salaries
and wages.Strong growth in the health sector workforce between 2000 and 2011 is likely to be
one factor in the decline in the male share of the total Manawatū-Wanganui region
workforce, from 54.6% in 2000 to 53.2% in 2011. Growth in the male workforce in
the health sector in the region has been similar to the growth rate for females, with
the male workforces increasing by 32% between 2000 and 2011 while the female
workforce increased by 38%. This is similar to the gap for the growth rates for all
industries in the Manawatū-Wanganui region, with the male workforce increasing by
10% between 2000 and 2011 while the female workforce increased by 16.2%.
Female workers in the health sector accounted for one third of female workforce
growth in the Manawatū-Wanganui region while male workforce growth in the
health sector accounted for only 9% of male workforce growth in the region.
Median earnings for males in the health sector workforce are significantly higher
than those for females. The earnings information does not include details on average
hours worked, qualifications or the sub-sector of employment within the health care
and social assistance sector. The rate of increase for female earnings between 2000
and 2011 was higher than for males (increases of 58% and 39% respectively) but the
higher starting point for median incomes for males in 2000 meant the dollar value
increase was still higher for males than for females (median incomes for females
increased by $12,400 between 2000 and 2011, while median incomes for males
increased by $14,310).
Health Care and Social Assistance Sector Employment by Gender
Median
Number of % increase % increase
Main Income Annual
People (2000 - 2011) (2000 - 2011)
Earnings
New Zealand Male
Wages and Salaries 32,625 64% $47,910 39%
Self-Employment 6,090 17% $82,100 16%
Total 38,718 54% $51,130 34%
Manawatū-Wanganui Region
Wages and Salaries 1,779 40.9% $47,900 39%
Self-Employment 243 -11.0% $97,500 18%
Total 2,022 31.6% $50,990 39%
New Zealand Female
Wages and Salaries 158,628 42% $36,020 61%
Self-Employment 9,384 67% $44,360 28%
Total 168,012 43% $36,290 59%
Manawatū-Wanganui Region
Sector Profile Manawatu Region Health
Wages and Salaries 9,810 37.8% $33,730 59%
Self-Employment 399 51.1% $42,870 23%
Total 10,209 38.3% $33,890 58%
New Zealand Total
Wages and Salaries 191,256 45% $37,590 57%
Self-Employment 15,474 43% $55,000 18%
Total 206,730 45% $38,260 54%
Manawatū-Wanganui Region
Wages and Salaries 11,589 38% $34,970 53%
Self-Employment 642 19% $56,150 9%
Total 12,231 37% $35,360 51%
(Note: the information source used to derive median earnings does not contain any information relating to
the number of hours worked for those earnings)
Source: Statistics NZ LEED
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