We need a health system that meets the needs of the nation

Tuesday, 17 May 2022

NZ Nurses Organisation’s Sarah Barker says staff shortages, amid Covid-19, could put patients at risk. (First published in December 2021)

Paul Goulter is chief executive of the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO)

OPINION: I’ve been listening to Grant Robertson foreshadow Thursday’s Budget. I like the terminology he’s using – I just hope we are talking about the same things.

As chief executive of the largest health union in Aotearoa New Zealand I’m pleased the Budget will be all about health, because Robertson is right, we do need a new health system that actually meets the needs of our nation. He’s also right that the foundations of that system will require sustained investment and that spending must result in value for money, targeted where it can make a difference.

Of course, I am thinking of the frontline, and nurses in particular. There have been signals that a focus of this Budget will be paying off the debts of the outgoing DHBs. That’s fine, but it would be a mistake to do that at the expense of the frontline workers. There is no better value for money and nothing that will make more of a difference in health than safely staffed and properly resourced hospitals and medical services.

The quest for safe staffing levels was among the drivers for nurses, midwives and health care assistants to strike in 2021. (File photo)

Nurses (including health care assistants, midwives and kaimahi hauora) are doing it tough because there is a nursing shortage crisis right across the health sector. Immigration windows have been shut for years, so there are no new nurses from overseas. Desperate and dire working conditions are causing many to leave the profession, and those left behind are labouring in workplace environments most would describe as unbearable. They are heartbroken every day because they do not have the time or resources to provide proper care.

* Serious under-staffing of nurses across the country's hospitals, Government review finds

NZNO’s Paul Goulter said the result of the ballot, which closed at noon on Wednesday, was decisive. (File photo)

* Why we should be glad nurses have settled with the DHBs

That’s why I expect to see a significant allocation of funds to address this crisis on Thursday. You can tinker with bureaucracy to make it more efficient. You can replace the fragmented DHBs with two shiny new health authorities. You can build more hospitals and buy more beds. But without trained nurses all that spending will come to nothing.

The first thing the Government must do is honour its promise to backdate the DHB nurses’ pay equity settlement to December 31, 2019. It must then extend the new pay equity base rates to every nurse, everywhere, so nurses can work where they feel called to, instead of just where the better money is.

Failure to honour that backpay commitment will cost the Government far more in terms of the last remaining shreds of goodwill nurses have than it will ever save them in dollars. Failing to roll those better rates out across the board will perpetuate health inequalities. Nurses working for Māori and iwi providers, for example, earn more than 30% less than their DHB colleagues and a new Māori Health Authority won’t solve much while that basic inequity remains.

Investing in health must start with addressing the 4000-plus nursing vacancies we estimate nationwide right now.

We need to see investment in nurse education, free training and intensive recruitment drives, but before young people will want to actually become nurses the Government’s approach must change. Members tell us decades of underfunding, not listening, not consulting and failing to keep promises about pay and safe staffing have led to experienced nurses not recommending nursing as a career option. You get better money and treatment picking fruit. How does that make any sense?

We need more Māori and Pasifika nurses and a health system that works culturally for our tāngata whenua. We agreed to that when we signed Te Tiriti, but it’s never been taken seriously. Perhaps it will now with the new Māori Health Authority, but one thing is certain, we all pay dearly when Māori lag so horribly behind in terms of health outcomes.

Together these things make up the focus of the NZNO’s campaign work this year, and we will be relentless in pursuing these goals. We know, too, that the public are behind us – and their support may be one of the last remaining reasons nurses are still turning up to work. Thank you.

Thursday’s Budget is indeed crunch time. Nurses are the foundation of the health system, and they require the sustained investment Grant Robertson is talking about. Will this Budget be good for nursing and therefore good for the health of all, or will it be one more poorly targeted initiative that fails to make a difference or deliver value for money?

We have the fixes, and we have the heart to help the Government with this crisis. Let’s talk and get this problem solved once and for all.