Speech to the Ministers on the Pay Parity Campaign

Thursday 15th Dec 2005

Good afternoon, I am Rosemary Minto.  I have been Chair of the College of Practice Nurses, NZNO for the past 3 years.  I have worked in the primary health care sector for the past 9 years, as a practice nurse.  I am this year completing a Masters degree in Health Practice with a prescribing pathway, which I have funded largely from my practice nurses wages, using annual leave and leave - without pay - days to attend study days and completing assignments on weekends and after 8-hour days.  I have not had paid study leave nor are there appropriate merit levels to recognise financially my increasing level of expertise.

This experience would have been very different for me and many other primary health nurses who are battling the same conditions if we had had the same pay and conditions that our DHB colleagues have, and which we are asking for with the Pay Parity campaign we bring to you here today.

Until the launch of the Primary Health Care Strategy, primary health nurses were the invisible workforce. Along with plunket, family planning, iwi provider and other primary health nurses, practice nurses were striving to deliver the philosophies of the Primary Health Care Strategy before it was even a twinkle in the Honourable Annette King’s eye! 

Primary Health nurses are the people who talk to the distressed mum on the end of the phone to try and decide if she needs to bring her unwell baby in to be assessed, we are often the first health professional people see. We advise on how to maintain healthy lifestyles to stay well, how to manage wounds, injury and illness. We plaster fractures, counsel teenagers, ensure people understand test results and provide a cervical smear taking service. We implement many of the Services to Improve Access projects driven by Primary Health Organisations. We provide an essential link between the hospitals, the GPs and our patients.  Without practice nurses there would not have been a Meningococcal B immunisation programme or indeed any childhood immunization programme in general practice.

Primary health nurses see people in their homes and in their workplaces, managing the day-to-day care and having the responsibility of the health of New Zealanders. And yet our pay and conditions have slipped far behind those for other community roles such as teaching and policing.

Because of the current privately owned business and employment structure of general practice, and with the current funding streams and mechanisms of payment from the Government into the primary sector and general practice, practice nurses often do not see any of the increased income that comes into the general practice through their efforts. One of the outcomes of this Pay Parity campaign needs to be a commitment to analysing the anomalies of this current model of primary health nursing employment and how it adversely affects the service delivery of PH nursing services and THEN a commitment  to making change happen…

Practice nursing has traditionally been seen as the job a hospital nurse goes to when she wants a rest and regular hours. With the increased access to information through the Internet and the resulting knowledge and questioning from patients about health and illness, the complexities of health as the population ages and legislation and bureaucracy that has exploded in the primary sector over the past ten years, I challenge the notion that any hospital nurse can come into the general practice environment and be able to work immediately at the required level of generalist expertise and speed.

Yet following the DHB fair pay settlement, a practice nurse working full time will receive $160 less a week than a registered nurse in the local DHB by July next year. It is no wonder that I have had numerous reports of practice nurses leaving general practice to work at the hospital – they may leave the regular hours to return to shift work but they don’t have to work as many days and they have the extra opportunities of professional development that we in primary health care do not.
 
You see, it’s not just about the money! Many primary health nurses are doing postgraduate papers now. With the passing of the health professional competency assurance Act nurses must complete continuing education. But in the primary sector we have no assurance that we can get paid study leave or indeed that we are able to get the time off to attend courses.  Our employers are able to make it very difficult for nurses to complete continuing education, despite the requirement by law that we do so. Most employers see the wisdom of allowing, and I use that word with much teeth gritting, nurses to complete education, but it is ad hoc with little financial reward offered for increasing expertise
 
It is fair to say that temperatures are rising amongst the hardworking and dedicated, but underpaid, nursing workforce in primary health. However we do not want to see our patients having to pay for our pay increase with increased co-payments. We also do not want to see the capitation payments to doctors increase to pay for practice nurses gaining pay parity.

We wish to see the government commit to the ongoing implementation of the Primary Health Care Strategy and its rhetoric that primary health care nurses are crucial to the success of this by agreeing to providing additional funding as a separate funding stream as they have for DHB employed nurses and midwives.

We have heard this week of the confirmation that there is a GP shortage. I was interested to hear the Minister of Health acknowledge earlier this week on National Radio that PNs are assuming some of the jobs that GPs have traditionally done. However if the pay discrepancy is not addressed, the increasing PH nursing shortage will further add stress to the country’s PHC sector and reduce the likelihood of the success of the PHC Strategy.

The Prime Minister has acknowledged the need for pay parity in primary health at the recent union government forum in Christchurch. Negotiations begin next week (20 December) for the biggest multi-employer collective in the country. Over 18,000 New Zealanders are asking that you support our claim for Pay Parity.

I challenge the Government to put their money where their mouth is and show true commitment to their PHC Strategy by supporting pay parity for PH nurses- including Plunket and Family Planning, with additional funding and by leading the change management required to implement alternative employment models for PH nurses. Because a successful outcome of our negotiations will be good for nursing, good for communities and good for the health of New Zealand.