‘Hundreds’ of international nurses are leaving because they can't find jobs

Thursday, 8 August 2024

Te Whatu Ora - Health New Zealand says it has hired more than 2899 full time equivalent nurses, 205 senior medical officers, 103.5 resident medical officers and 390.8 allied health workers in the year to March.

There appears to be confusion between Health NZ and the Health Minister about whether the nurse workforce gap is in the hundreds or thousands but regardless nurses are struggling to find work in New Zealand.

Health NZ is progressively ceasing to reimburse international nurses the $10,000 it costs for the course which helps them work here.

A surge of internationally qualified nurses who moved to New Zealand have left or are leaving, despite the already understaffed health system estimating it needs nearly two thousand to fill critical roles.

Saju Cherian, a Palmerston North-based nurse who is on the board of the New Zealand Nurses Organisation, holds a list of more than 330 nurses - originally from India - who had moved to New Zealand to work in nursing.

“I understand that it is the best to grow our own [nurses] domestically. But it’s a big failure from the part of the government in workforce planning. This shortage is not something that happened overnight.”

Stuff spoke with dozens of them who - after completing a competency assessment programme (CAP) which costs about $10,000 - could not find work. Many had been looking since the start of the year. Te Whatu Ora - Health New Zealand is also progressively stopping reimbursing nurses their costs for the assessment, which nurses can recoup when they find a job.

A handful were moving to take up nursing roles in Australia. Others had been looking for work for six months or more, and were burning through their life savings.

Stuff is not naming them to protect their employment prospects, as many were still holding out hope they would find work in New Zealand. One 27-year-old, who has tried to make New Zealand her home for the past seven months, said she was offered a job at Southern DHB, as a pool nurse, but was told this was now on hold.

The woman, who is originally from Kerala in southwest India, said she choose New Zealand because of its record on human rights.

“They respect women there, and they respect nurses too.”

Stuff put detailed questions to Te Whatu Ora - Health New Zealand about why this was happening, if any changes had been made to nurse recruitment and whether the agency was aware of the issue but the organisation refused to comment.

How many nurses short are we?

A spokesperson for Health Minister Dr Shane Reti said Te Whatu Ora - Health New Zealand had shifted its focus on increasing the “homegrown” nursing workforce while Te Whatu Ora Health New Zealand chief executive Margie Apa last month suggested the agency had hired more nurses than it needed.

“Over the last six months, we found ourselves actually over-correcting much quicker than what we expected … Our vacancy rates for nurses is at about 6%. When I started this role, it was about 12% to 15%,” she said.

But there appears to be confusion about the actual vacancy rate for nurses. Reti told Stuff it was in the hundreds.

Health NZ’s Chief People Officer Andrew Slater said they were 1954 nurses short as of March, but more up to date information would be published in August. There were also 265 midwifery vacancies, and 670 vacancies for senior doctors.

Publicly available data suggests the figure could be about 2700. According to the New Zealand Nurses Organisation, it has about 40,000 members. It estimates a further 10% of the nursing workforce are not members. If 6% of the total roles - estimated at about 45,000 - are vacant as Apa described, this equals 2700.

When pushed about whether vacancies were in the thousands, not hundreds, Reti conceded that he did not want to give a detailed figure because Health New Zealand doesn’t know, “but I think that [6%] vacancy rate is a good figure to work towards.”

Lester Levy, the man tasked with finding $1.4 billion in savings and coming up with a “turnaround plan” for Te Whatu Ora - Health New Zealand after Reti sacked its board, put the number of nursing vacancies at “just under 1000”. However he said he was struggling to get a “definitive answer” from officials.

“There's a lot of conflicting narratives. I even get conflicting data,” he said.“ So we have going to have to sort this out.”

Paul Goulter, chief executive of the NZNO, said it was difficult for officials to know the number of nursing vacancies outside of hospitals. “You are dealing with a number of employers ranging from very big to very small, community providers and also the smaller aged residential care facilities. It is very difficult to get a definitive steer about that.”

But it was a different picture for nurse vacancies inside the hospital system. This was because they use a system called care capacity demand management (CCDM), which picks up what the need is.

However Goulter said nurses were “running into difficulties in getting decisions made based on that evidence”.

This was the case in Thames - where staff last week protested over staffing levels, and said the hospital was 20 full-time nurses short, he said, adding it was a widespread issue. Goulter said it was also the case in Masterton, where nurses reported they were short 40 roles - but the vacancies were not being advertised.

Data obtained by the union under the official information act found one in four shifts - a total of 158,966 - were understaffed in 2023.

Goulter said Health New Zealand hadn’t responded to the organisation’s official information requests this year, so he couldn’t say whether the situation had improved.

But he said short-staffing on wards was so chronic it was a health and safety issue for nurses - as well as patients - because many were unable to stop for short breaks, including to have a glass of water, because of the demand.

“They are really under the pump. In the emergency department it’s well documented now, but mental health is an area of major concern which the government has acknowledged … but then we have other wards we have found on that evidence that have been consistently understaffed including children’s health and women’s health. It is endemic across the system.”

Why can’t the international nurses find work?

The agency would not respond to questions about the 336 nurses struggling to find work when there are vacancies but Cherian said international nurses were facing barriers to employment at every point.

Some had been told they did not have the right visa for work - despite following the Immigration New Zealand advice for international nurses wanting to work here.

It sets out that international nurses can apply for a Occupational Registration Visitor Visa, which lets them come here and finish their CAP. Once they have completed this, registered with the Nursing Council, and - if they meet Immigration New Zealand visa requirements - they can work in New Zealand.

Cherian said nurses had been told one of Immigration New Zealand’s requirements was for nurses to have offers of employment before they could move off the occupational registration visa. At the same time, some had been told they needed to hold a visa to work - such as an accredited work visa - before they could be offered a role.

“It’s bit of Catch 22 situation because the employers are saying if you don’t have a work visa, you can’t apply for this position, whereas immigration is saying [if] you come with a job offer, we will give you work visa,” he said.

An Immigration New Zealand official said it was not a requirement for the nurses to have a job offer, while a Health New Zealand spokesperson said nurses on an Occupational Registration Visitor visa could be offered a job.

However they cannot commence work in that employment until they are eligible for– and have been granted– a relevant work visa, such as an Accredited Employer Work Visa.

Reimbursements for nurses cut

Labour’s health spokesperson, Ayesha Verrall, said they problems were a result of underfunding.

“The government has underfunded the health system and has reduced the number of nurses that have been hired and unfortunately that is taking a toll on the people who have come from overseas to help us.”

Te Whatu Ora - Health New Zealand is progressively closing its scheme which reimbursed internationally qualified nurses $10,000 towards their costs to work in New Zealand once they found a job.

It closed the scheme for nurses who found work in hospitals from May 31, and it will close for nurses working in community, primary and aged care on October 31.

On its website, it said it has done so “in response to changing workforce needs”.