Nursing reports

Police withdrawal from mental health call outs should be stopped until Te Whatu Ora makes critical resources available, the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.

Phase Two of the changes come into effect on Monday (14 April) but police have delayed the starting date in all but five districts, saying other areas are not ready. The new phased roll out is the second time police have rescheduled the changes.

NZNO Mental Health College chair Helen Garrick says the health sector is not ready for the police withdrawal either.

“This is a matter of safety for everyone, including the people who need mental health support, their whānau and the mental health workforce.”

The first phase of the changes officially came into effect last November, but Helen Garrick says NZNO mental health nurses report the police withdrawal actually started long before that.

NZNO agrees with the Mental Health Foundation there is no adequate plan to support the transition away from police attending mental health call outs, she says.

“The police withdrawal should be stopped until the following resources and agreements are in place:

1. Resourcing for new crisis hubs to be staffed by a qualified mental health workforce 24/7.
2. Purpose built safe spaces attached to hospitals or community centres, staffed 24/7 and suitable for people experiencing mental distress, and their whānau, to wait for mental health assessment. Emergency Department waiting rooms are completely unsuitable.

3. Resourcing for nationwide co-response teams – consisting of a minimum of a mental health nurse and police officer – to transport people under the Mental Health Act.
4. Increased staff for mental health crisis teams and a commitment to workforce development and filling current vacancies, without the creation of an associate psychologist qualification.
5. Leaving decisions about mental health risk and the need for police assistance in the hands of mental health staff, not police communications.”
    

"The people have spoken, and it is a big fat no to that bill," says New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) Kaiwhakahaere Kerri Nuku.

Parliament's Justice Committee has released its report into the Principles of the Treaty of Waitangi Bill and has recommended it does not proceed.

"The call to scrap the bill is common sense and to show the nation it is listening, this Coalition Government should do away with it right now," Nuku says.

In January, Nuku with chief executive Paul Goulter, delivered a submission on the bill to the select committee.

"As advocates for more than 60,000 nurses, midwives and healthcare workers, we argued that if those principles were removed or tampered with, it would cost more lives starting with Māori lives."

The bill was the most submitted on proposed law in the history of this country, opposed by 90% of the 300,000 submitters.

Nuku also said the coalition should see the opposition to this bill as a warning for other similar legislation it had in the pipeline.

"They also need to save the nation, Parliament and themselves another headache, or walk to nowhere, and scrap another planned bill [Regulatory Standards Bill] which not only undermines the Treaty but puts our already struggling health workforce at risk."

Later this month, Nuku and other representatives from NZNO will head to the United Nations in New York to request that a special rapporteur travel to Aotearoa to investigate the series of attacks by the Government on Māori health.

"Even if these anti-Treaty bills are scrapped, there are still other attacks happening on Māori health, so we still intend to ask the UN to do what they can to help us. If the UN can’t stop these attacks, then at least they can let the world know what’s happening to Māori," Nuku says.

Health New Zealand Te Whatu Ora’s constant restructuring is not only putting the lives of patients at risk but is traumatising staff, New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO).

Chief executive Paul Goulter says NZNO members are disillusioned as critical events and serious issues continue to occur daily at Te Whatu Ora services.

"Our members don’t have any confidence that the leadership team at HNZ are across these risks. They’re failing in their duty to keep the public safe."

Recent findings of a Te Whatu Ora investigation into a mistaken identity incident, revealed the dangers arising from the constant restructuring in the name of ‘budget’.

One of the findings stated: "At the time of this event, the current escalation pathway did not reflect Health NZ’s structure which had changed due to restructuring. In particular, the current escalation pathway included the disestablished role of National Director Hospital and Specialist Services and did not include the recently established role of National Chief Mental Health and Addiction."

"This is dangerous to all. Restructuring needs to be halted immediately to allow proper risk evaluations and any consequent changes to be addressed. Patient safety cannot be compromised."

On Tuesday, New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) BUPA members will be making a stand on behalf of their communities over fears planned restructuring will harm the safety of residents.

The rally is part of a response to proposed nationwide changes by BUPA and other major aged care providers which will cut nurses’ and caregivers’ hours and increase workloads - putting the health and safety of elderly and frail residents at risk.

NZNO delegate and aged care worker Epenesa Mutimuti says staff at aged residential care facilities across the country are in shock that at a time when New Zealand is in dire need of health care workers, and they’re under tremendous pressure, aged care providers are proposing cuts to care time.

"The Government’s failure to adequately fund aged residential care is leading to providers to make impossible decisions that hurt both residents and workers, including Bupa.

"Cutting back nursing and caregiver hours at aged care facilities puts the health and safety of vulnerable residents at risk.

Epenesa Mutimuti says many workers are being forced to reduce their hours, which will leave them unable to afford essential living costs. Others are being made redundant after many years of loyal service.

"In the 20-plus years I’ve been working in aged care, these are the worst conditions I’ve come across. We have no time to see to residents anymore."

Residents, their families and staff were not consulted when proposed changes to staffing were made by the employer, she says.

"Staff feel their feedback, and that of residents and their families on the impact of quality care and health and safety has not been fairly considered."

The main rally takes place from 3.30pm at the corner of Park Road and Carlton Gore Road in Newmarket, Auckland.

The Government’s reviewing of health workforce legislation represents another attempt to attack health professions and the health workforce, New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.

NZNO Kaiwhakahaere Kerri Nuku says there is no basis to Health Minister Simeon Brown’s claims the current health workforce regulations were overly bureaucratic and slowed down access to care "making it harder for patients to get the services they need".

"There's basically no evidence presented to suggest that there needs to be a change anywhere. It's merely a set of ideological assertions. Where is the evidence of the problem that is being sought to be addressed?"

Kerri Nuku says the Minister has got this wrong on many fronts including the inclusion of an understanding of tikanga Māori, the workforce crisis, and the level of competency required by health professionals.

"Of course, the inclusion of an understanding of tikanga Māori is central to any profession in Aotearoa NZ and especially in health where the current underserving of Māori is a scandal.

"We've actually got 50% of our nurses from overseas. We need to find work for the Internationally Qualified Nurses already in NZ and ensure they’re culturally competent instead of bringing in more.

"New Zealand’s 1000 hours of clinical versus 800 hours in Aussie? How can it be a bad thing that we expect more of our nurses training?"

The review’s suggestions are regressive and needed a rethink as it seems like a return to the now discredited changes of the 1980/90s where ideology trumped evidence, she says.

New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) primary health care members have agreed to an 8% wage increase over 12 months but pay parity with their hospital counterparts is still needed to retain nurses in the sector.

NZNO’s College of Primary Health Care Nurses chair Tracey Morgan says there was overwhelming support for the Multi Employment Collective Agreement offer for an immediate increase of 5% followed by a further 3% in July.

“This is good news for primary and community care nurses. However, their base hourly rate remains on average about 10% below Te Whatu Ora nurses despite having the same skills and qualifications.

“Until primary and community care nurses are paid the same, they will continue to leave GPs and iwi and community clinics for better paid hospital jobs here and overseas.”

A recent Victoria University of Wellington study found 36% of New Zealand’s general practices didn’t take new enrolments last year, with workforce shortages cited as the major reason people were being turned away.

“If people can’t get the health care they need in their communities, they end up at hospital even sicker. This puts more pressure on our already stretched hospitals,” Tracey Morgan says.

“NZNO urges the Government to fulfil its pre-election commitment to pay primary care nurses the same as their hospital counterparts and introduce a sustainable funding model for the primary care sector.”

It’s no surprise there’s confusion in the health sector after the Government today released yet another plan to fix the dire state of Aotearoa New Zealand’s public health system, the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.

Health Minister Simeon Brown today outlined his plan to “fix the system” and his five key priorities.

NZNO Kaiwhakahaere Kerri Nuku says the Minister’s acknowledgement of the issues facing the health system is good for patients and health care workers.

“However, it isn’t clear how this latest plan fits with the plethora of other current health plans, strategies and legislative frameworks including the Government Policy Statement, the Pae Ora Act and the six accompanying Pae Ora Strategies, the health targets and the Health Workforce Plan.

“And this is not to mention Te Whatu Ora Commissioner Dr Lester Levy’s long awaited ‘reset’. It’s no wonder everyone in the health system is confused.”

There was also no mention in the Minister’s plan or priorities of improving the health outcomes of Māori or that of our vulnerable communities, Kerri Nuku says.

“Lifting the health outcomes of Māori, Pacific people and disabled people ultimately benefits all of Aotearoa New Zealand by creating a more equitable health system and improving access to quality health care for all.

“The Minister was also strangely silent on the role of Iwi Māori Partnership Boards (IMPBs) despite his Government having committed to them previously and his rush to have a locally delivered health system by July. IMPBs are enshrined in the Pae Ora Act and Simeon Brown needs to explain the role he sees them playing in his plan,” Kerri Nuku says.

This International Women’s Day, New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) calls on the Government to honour its pre-election promise to pay all nurses equally by providing pay equity across the funded sector including primary and community health.

NZNO President Anne Daniels says there are many hurdles to cross before women in Aotearoa are paid fairly and equally.

"The current Government has not been kind to women’s issues from the get-go. The disestablishment of the Pay Equity Taskforce last year is a great example of this.

"Before the Pay Equity Taskforce was disestablished, there was regular reporting on the positive impacts of pay equity settlements."

Ms Daniels says NZNO has at least 10 pay equity claims being progressed across branches of the health sector including Aged Care, Primary Health Care, Hospices, Plunket, Community Health and Laboratories covering many nurse and support worker roles. Some of these claims have been going on for years. The intention to raise a pay equity claim for Māori and Iwi is also planned for the future.

"This Government’s hands-off/hands-on approach means pay equity claims remain between employers and employees and their unions. But in the case of agreements being reached employers are not to make any offers to settle without the Government sanctioning the costs."

The right for girls and women in Aotearoa New Zealand to live whatever lives they choose free from gender discrimination is enshrined in our country’s law, and this includes workplace salaries, Ms Daniels says.

"Achieving pay equity, particularly in health, will ensure more people are recruited to nursing to meet the needs of the population and that culturally appropriate care is delivered that addresses the health inequities."

Government changes to bowel screening eligibility will leave more Māori and Pacific people at risk of dying at a younger age from bowel cancer, New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.

Health Minister Simeon Brown today announced the Government is repurposing funding set aside from now scraped plans to lower bowel screen eligibility to all Māori and Pacific people over 50, to lower eligibility for all New Zealanders from 60 to 58.

NZNO Kaiwhakahaere Kerri Nuku says the move will exacerbate health inequities for Māori and Pacific people.

"The reason eligibility for Māori and Pacific people was lowered was because they have a higher proportion of bowel cancer before they reach 60 - with a shockingly rate of 21% rate compared to 10% for non-Māori and non-Pacific peoples.

"The Cancer Society has called out the Government’s use of data to back up its decision as ‘very selective’. NZNO would go a step further and call it outright dangerous to the lives of Māori and Pacific people," Kerri Nuku says.

The Coalition Government claims to put need before race but there is a clear evidential need to screen Māori and Pacific people at an earlier age, she says.

"Bowel Cancer New Zealand has said removing the younger screening eligibility would result in 100,000 Māori and Pacific people aged 50 not getting earlier screening. These people are at greater risk of having later stage bowel cancer when they are screened eight years later.

"This decision smacks of political ideology over commonsense health policy and must be reversed," Kerri Nuku says.

Paying incentives to GP clinics to hire nurses won’t fix the systemic funding issues causing chronic staff shortages in primary and community health care, the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.

Health Minister Simeon Brown has announced incentive payments for primary care providers such as GP clinics of $15,000 for every graduate nurse hired in cities and $20,000 for every graduate nurse hired in rural areas.

NZNO College of Primary Health Care Nurses chair Tracey Morgan says the funding gives health care providers outside hospitals a temporary reprieve from the financially crippling co-payment system.

“Paying incentives to hire nurses to aged care providers, and now primary and community providers, won’t address the underlying cause of chronic staff shortages. Once the incentives run out, these clinics will still struggle to keep the doors open and see new patients.

“They won’t stem the flow of nurses leaving GP and community clinics to work overseas or for Te Whatu Ora in our hospitals, where they are paid on average between 14% to 20.8% (between $5.14 and $7.88) per hour more.”

Tracey Morgan says there is consensus that until primary nurses are paid parity with their hospital counterparts nothing will improve.

“There is also nothing in today’s announcement to boost much needed Māori nurse numbers.

“It is time for the Government to pay primary care nurses the same as their hospital counterparts and introduce a sustainable funding model for the primary care sector,” Tracey Morgan says.