Health Select Committee Presentation

6 November 2024

Andrew Malcolm, President of the Funeral Directors Association, and CEO Gillian Boyes, presented to the Health Select Committee. This meeting offered a vital platform to address claims made by Death without Debt and to share insights on areas we believe require thoughtful consideration for better deathcare outcomes in Aotearoa New Zealand:

Andrew

Tēnā koutou katoa and thank you for the opportunity to present to you today. I’m Andrew Malcolm, current President of the Funeral Directors Association, a practising funeral director for over 40 years, and owner of Kapiti Coast Funeral home.

Gillian

And I’m Gillian Boyes, Chief Executive of the Funeral Directors Association

We wanted to start by providing some brief background to our organisation. Andrew will then share some comments about areas we believe this committee should be thinking about to ensure better outcomes for deathcare in Aotearoa New Zealand.

Funeral Directors Association of New Zealand

We are a membership organisation representing around three quarters of funeral homes across New Zealand.

Prospective members must meet our criteria including having qualified staff and meeting our professional standards, a living document which includes factors of service, price transparency, respect, dignity of the deceased and of acting fairly, honestly and lawfully. [See copy of standards provided]

Our members range from small family firms to large funeral homes with multiple locations such as Lamb and Hayward in Canterbury or Legacy Funerals in Tauranga.

Over half our members are New Zealand owned with the remainder owned by Australian firms Invocare and Propel but all operating under local brands with local staff. In terms of total funeral homes across New Zealand, Australian-owned firms represent around 28% of funeral homes.

Select committee members will be aware there is no public provision of funeral service in our country, so together our members and other non-member firms provide 24/7 service across the country to whānau at their most difficult time.

They do this with compassion and the utmost respect for families while also juggling the challenge of running their businesses in the same cost of living environment we are all facing.

They provide a caring, respectful, and professional approach, not just for families in bereavement, but also for the bodies or tūpāpaku in their care. Yet these professionals are  sometimes vilified or, branded predatory because they must charge for their services in order to be able to afford to provide them.

Our members provide support through the grief journey offering a wide range of services at all price points.

This is a professional industry that is operating well for all cultures in our country, including opportunities for those who want to do some or all of the services around death themselves. It is not a broken, but we think there are opportunities for Government to improve its legislation and policies to support it by completing the review of the 1964 Burials and Cremations Act which began back in 2010.

Andrew

I want to now take you through some of the challenges we face.

Costs of operating

We are aware there is much discussion about the cost of funerals. As Gillian has explained we are private businesses having to cover all usual operating expenses of a business in Aotearoa New Zealand including costs such as;

• Purchase/ mortgages over or rental of property – ranging from offices and garaging to chapels, mortuaries, catering lounges, viewing suites, deceased storage and graphic design suites.
  
  
• Insurance - for not just plant, vehicles and equipment but also professional liability (total last year for my business was $60K).
  
  
• Compliance - including Council consents, annual registrations; health and safety costs include chemical handling certificates and regular professional training to hold a practice certificate.
  
  
• Cremation facilities have an initial outlay in the vicinity of $1.5 - $1.8 million. There has been more private investment in recent years as the council stock in New Zealand is old, proven by the recent RMA reviews. Councils seem to be cash-strapped and reluctant to provide new facilities, such as seen recently in Porirua where they closed for six months while upgrading causing issues for the public, or in Tauranga where after a similar closure the council reopened with a 50% price increase to the public.
  
  
• Finally staffing costs with 25-30% of overheads going to wages for staff who not only work long hours but also on call and shiftwork to provide 24/7 cover. Staff costs also include protective equipment for embalmers and specialised equipment and plant to assist staff such as specialised vehicles (hearses) and transfer equipment such as specialised stretchers to ensure compliance for health and safety for preparation and ongoing care of the tūpāpaku.

We think there are three things Government could do to help with the cost of funerals.

1. Price transparency for all
   We have been supporters of the recommendations in the Burials and Cremations Act review for greater price transparency. This price transparency is a requirement in our membership standards for our members.
   
   We’d like to see this price transparency requirement in law for all funeral directors.
   
   
2. Increase asset testing limit for pre-paid funerals
   
   Low stress financial decisions are encouraged through our Association with free consultations for those pre-planning and pre-paying a funeral.
   
   Many families are seen multiple times at no charge with many choosing to also pre-pay to remove future stress for their whānau. The most common deposit is $10K which is the amount allowed as an exemption for asset testing when assessing eligibility for a subsidy for long-term residential care.
   
   We believe increasing the outdated asset testing limit in the Residential Care and Disability Support Services Act would incentivise families to put more realistic amounts aside to better help their family after a death. We suggest an increase from $10K to $15K with annual CPI increases going forward.
   
   
3. Increase the Work and Income Funeral Grant
   
   We have campaigned for many years to increase the WINZ Grant to a more realistic amount. While we realise this isn’t within the remit of this committee, we feel there would be strong mental health benefits of an increase. We know funerals and other types of meaningful farewells help people better manage their grief. Covid was an example of the stress whānau faced not being able to have funerals and tangihanga.
   
   Enabling those with limited means to have a funeral that includes an actual gathering, not just a no-service cremation would contribute to better mental health outcomes particularly amongst Māori, Pacific families and the elderly who are the primary users of this grant. The current amount of $2,559.20 doesn’t even cover the cost of a burial plot at most council owned cemeteries.
   
   We strongly support an increase to the WINZ Funeral Grant.

Paperwork and processes

Previous presenters have raised concerns about paperwork and processes.

The Medical Referee system is a process that protects the public by requiring signoff by a qualified, independent referee, looking at both the family applications and the medical document.

Medical Referees are appointed by cremation authorities subject to approval by the Director-General of Health. We don’t have any secret lists we ‘own’ and like the general public, we are not allowed to have direct contact with medical referees as this risks influencing their independence.

Under Burials and Cremations Act proposals Medical Referees will be centralised and not available in weekends. We think this will cause more bottlenecks, particularly for families who for cultural reasons, might want the tūpāpaku back with them as quickly as possible. So our concern is not to remove the system but to ensure it keeps operating 24/7.

There have also been suggestions increased numbers of medical professionals could sign documentation and to do this for no charge. We don’t think this is realistic, as GPs have private practices and have the right to charge for their time based on their own operating models.

We also already see regular instances of errors being made in forms, and medical professionals contacting us for help in understanding how to complete these documents. Opening these to more professionals would exacerbate this problem.

We would urge officials to ensure that in updating Cremation Regulations, thought is given to improving the simplicity of forms and ensuring processes accommodate modern ways of working like secure video conferencing to verify death. It worked well in Covid and could reduce stressful wait times for families.

We don’t believe centralising the Medical Referee system is a good idea. If it is, it must be a 24/7 service. Errors could be reduced and potentially more people could help with paperwork by re-designing forms.

Changing funeral needs

A final point for Committee members to consider is changing needs and wishes around funerals.

As funeral directors we work with our families to personalise the experience depending what the whānau can afford and we tailor a tribute fitting to the life lived.

But currently the law stifles innovation in body disposal methods. Cremation and burial are the two primary methods. Modern death tech innovations such as water cremation or human composting, allowed in other places around the world, are denied in law in New Zealand.

We’ve spoken with officials who have applications on their desks for these methods but who can’t allow them because the Burial & Cremations Act doesn’t enable this.

We think that regulations need to enable consideration of these and other future alternative disposal methods to future proof death care in Aotearoa New Zealand.

Summary

In summary we’d like the committee to consider the following key points:

1. Funeral homes in Aotearoa New Zealand provide a high level of professional care and service in our communities. Consumers have wide choice at a wide range of price points including support for those who want to do as much as they can themselves.
   
   
2. The Burial & Cremations Act review needs to be completed. Our Association has provided helpful and constructive feedback over the many years of the review and the direction is largely there. We’ve highlighted today some specific points we think need addressing but our key message is we need to get on with modernising our outdated rules.
   
   
3. Talk with your colleagues in other Select Committees about sensible changes that could contribute to other improvements in New Zealander’s death experience:

• A higher asset testing exemption.
• A more realistic WINZ Funeral Grant that recognises the need for families to grieve in a culturally appropriate way.

Ngā mihi, and thank you for listening.