Vulnerable people are receiving less home help as the Hawke's Bay District Health Board (DHB) struggles to contain a budget blowout.
Personal care remains a priority but cleaning services have been cut by about one third, general manager of planning and performance Andrew Lesperance said.
"We aren't reducing support for personal care in any way, this is a priority area - the only change some people will have is a small reduction in household cleaning time," he said.
About 2500 people received help with personal care such as showering, dressing, safety checks and medication oversight from the DHB each year.
Additional help with housework, such as vacuuming and laundry, was given to 2000.
Mr Lesperance said that, with 200 additional clients referred to the service in the past three months, housework cuts were needed to maintain personal care levels. The cuts - 1.5-2 hours per week of housework to 1 hour per week or 2 hours a fortnight - were small, he said.
Bill Baxton disagrees.
He lives with his blind 87-year-old mother in Wairoa where he says they "have a pretty good combination".
He drives her around town despite his cerebral palsy condition, which gives him poor balance so he needs a walking frame.
His mother was assigned 1.5 hours cleaning help a week but now it is just one. He said the DHB cuts "make a lot of difference to myself and others" and is worried more cuts will be made.
"Where does it stop?" he said.
"Do you want to see me vacuum the floor on my hands and knees?
"I'll be buggered for a week."
He said the cuts were the work of "bean counters" and part of a wider push to reduce elderly care.
"The DHB wants to get rid of them and put them in homes when there isn't enough room for them in the rest homes of Hawke's Bay.
"It's elderly bashing - elder abuse - call it what you like."
He also objects to the arbitrary way the decision was made.
"They didn't do any consultation with the clients." The first quarter of the financial year was described as one of the worst for the Hawke's Bay District Health Board, with a budget overspend of $1.3 million according to a report last month.
The surplus was expected to be $2.3 million by the end of the first quarter but instead was $941,000.
The overspend, and a drop in expected revenue, threatened capital projects and planned upgrades and that "supplementary financial controls" were needed, the report said.Mr Lesperance said Hawke's Bay was out of step with other DHBs in the Central Region, supplying more housekeeping services than the regional average.
"The DHB has chosen to prioritise personal care first, while continuing with a limited amount of housekeeping services," he said.
Mr Baxter said their house would still be cleaned, but there was no provision for any other household tasks.