Disability advocates say disabled people are still being abused and neglected in both residential and respite care five years on from a select committee inquiry.
They say better auditing, training and funding is needed, along with a high level discussion about disabled care.
A parliamentary select committee inquiry was held in 2008 after repeated reports of physical abuse and neglect of disabled people, as well as financial mismanagement in some care facilities.
It made sweeping recommendations to improve disabled care following reports of abuse and neglect.
The Government agreed to a range of measures, including improved auditing and better training.
The coordinator of the Complex Care Group Trust, which helps the parents and caregivers of disabled people with severe impairment, says abuse is so systemic that many families fear using respite care.
Jan Moss - who has a daughter with a cognitive disability - told Radio New Zealand's Nine to Noon programme disabled residents are often physically harmed and neglected but the victims usually cannot speak for themselves and complaints are seldom followed up.
An Auckland lawyer who represents disabled people says spot audits and protection for whistle-blowers need to be introduced.
Huhana Hickey says without cameras or other witnesses, abuse allegations are often disregarded because disabled victims are considered unreliable.
"I've seen cases where, even sexual abuse or allegations of sexual abuse in respite care, even though the evidence, the physical evidence, is there - the parents have taken it to the police; the police aren't interested because the person cannot articulate and therefore they say she was willing."
But the Service and Foodworkers Union, which represents care workers, is reluctant to support security cameras.
The union says a better solution is improved training and higher pay for staff.
The Ministry of Health says it does already carry out some unannounced audits on providers that it suspects aren't up to standard.
The ministry says some providers have also introduced CCTV cameras but cameras aren't always appropriate because they can intrude on the privacy of clients.