Nursing reports

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.

Suggestions that nurses replace doctors at GP clinics to address chronic staff shortages are uninformed, the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.

Prime Minister Christopher Luxon has suggested nurses and nurse practitioners can “do more of the work of what a GP does”.

NZNO’s College of Primary Health Care Nurses chair Tracey Morgan says the Prime Minister’s comments shows a complete lack of understanding about how frontline primary and community care best operate.

“Evidence continually shows a team-based approach creates the best health outcomes in primary care. That means integrating health care workers based on their professional skills and experience; from practice nurse, to nurse practitioner, to allied health professional (such as physio or occupational therapists), to the GPs.

“The nursing workforce can’t be stabilised and the much needed team approach developed with a high turnover of primary health care staff.

“This churn is created because nurses in GP and community clinics are paid on average between 14% to 20.8% (between $5.14 and $7.88) less per hour than their Te Whatu Ora counterparts.

“This is despite them having the same skills and qualifications,” Tracey Morgan says.

“Instead of making uninformed suggestions, the Prime Minister must pay nurses in GP and community clinics the same as their hospital counterparts.

“Only then will the Government be able to fix the chronic staff shortages in primary care which are resulting in people not being able to get to see their GPs, ending up in hospital even sicker and putting more pressure on already stretched hospitals.”

Culturally safe ratios within nursing must be urgently introduced in Aotearoa to turn around Māori health inequities and improve whānau health and wellbeing, a new report released today by the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) has found.

The report Kaupapa Māori Culturally Safe Staffing Ratios: Māori nursing leaders’ perspectives was released at Waitangi by NZNO Kaiwhakahaere Kerri Nuku.

The report tells a compelling and previously untold story through a Māori lens about the impact culturally unsafe practice has on our people, she says.

"It highlights that nurses needed to be both clinically and culturally safe in their practice; and they need enough time to be both.

"It shows the need for mandatory, fully-funded and legislated culturally safe staffing ratios."

Māori nurses need to lead the development and implementation of culturally safe staffing ratios, Kerri Nuku says. Kaumātua and kuia need to be involved, to ensure tikanga is upheld and whānau, hapū and iwi need to define what is culturally safe practice.

"Māori nursing and the wider Māori health workforce needs to continue to grow across the entire health system. Decision-making about staffing levels needs to be based on consideration of both clinical and cultural factors."

Kerri Nuku says there is considerable international interest in the experiences of Māori nurses whose "soft skills" or whanaungatanga and building trust - are critical to keeping Māori whānau engaged in the health system.

"Māori nurses in the report explain how they do all the regular things required of them, but often get called on to do more. Their cultural work is often invisible.

"They don’t work with individuals, they work with whānau. They check whether they have kai, whether they are vaccinated. This takes time and can’t be a matter of ‘you’re up next’," she says.

The Coalition Government’s scaled-back new Dunedin hospital build is putting cost-cutting ahead of health and wellbeing, the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.

NZNO President and emergency nurse Anne Daniels says today’s announcement fails to future-proof the health needs of the Southern community.

"This is short-sighted. The Southern community has a growing and aging population. We also have a failing primary care health sector which means more people will unnecessarily need hospital level care."

NZNO is disappointed but not surprised with today’s announcement, she says.

"We had hoped the Coalition Government would keep its promise to fund the new build as outlined in the 2017 business case which was worked on by 500 clinicians.

"But this Government is still intent on putting dollars before the people. That is a choice.

"They are making decisions about the health and wellbeing of the Southern community rather than doing what they were elected to do," Anne Daniels says.

The new hospital will open with 16 beds fewer than the existing hospital and even after it is scaled up over time, will have six beds less than originally promised, she said.

"Fewer beds also means fewer jobs for nurses as Te Whatu Ora will resource this hospital based on bed numbers." 

Media enquiries: Danya Levy, NZNO Communications Manager: 027 431 2617

Primary care nurses must be paid the same as hospital nurses to fix the chronic staff shortages causing New Zealanders to be turned away from GP clinics, the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.

A Victoria University of Wellington study has found 36% of New Zealand’s general practices didn’t take new enrolments in 2024, with workforce shortages cited as the major reason people were being turned away.

NZNO’s New Zealand College of Primary Health Care Nurses chair Tracey Morgan says the Coalition Government’s focus on the health sector is misdirected.

"While the Government is focused on the five health targets, they are ignoring the most pressing issue - chronic staff shortages in primary care.

"When people can’t get into their GP, they can end up at hospital even sicker. This puts more pressure on our already stretched hospitals and the Government’s own targets will be harder to meet," Tracey Morgan says.

Primary care nurses are leaving GP clinics to work in hospitals because they get paid 18% more despite having the same skills and qualifications, she says.

"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.

"Until this is done, it is everyday New Zealanders who are trying to see a doctor when they are sick who will pay the price.

"New Health Minister Simeon Brown has said he is ‘an advocate for everyday Kiwis who simply want timely, quality healthcare when they need it’. Here is his solution," Tracey Morgan says.

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) is calling on the Government to properly fund and resource the health sector to create an equitable health system that meets the needs of all New Zealanders.

Prime Minister Christopher Luxon today announced that Simeon Brown will replace Dr Shane Reti as Minister of Health.

NZNO chief executive Paul Goulter says it doesn’t matter to patients who the minister of health is.

“What matters to New Zealanders’ is that the Government accepts its responsibility to ensure we have an equitable health system that works for all New Zealanders.

“It’s now widely accepted that New Zealand has a health system that is under-resourced and under-funded. Patients are waiting too long for the health care they need, or not getting it at all.

“The only response the Government seems to have is further cutbacks.

“NZNO calls on the Government, now with Minister Brown at the helm of the health sector, to:

• Overhaul the primary and community care health system by paying primary care nurses the same as their hospital counterparts to address chronic staffing shortages which are exacerbating waiting times for GPs and driving sicker patients to emergency departments.
• Reverse the ideological decision to remove policies to reduce health inequalities for Māori.
• Fund Te Whatu Ora to provide safe and culturally appropriate staffing levels in hospitals rather than forcing a recruitment freeze to meet Government-imposed cutbacks and artificial budgets.
• Address low wages and falling standards in aged residential care.”

Paul Goulter says the Government claims it is investing more than ever in health.

“The Government’s funding has failed to keep up with our aging and growing population. People are sicker because they aren’t getting equitable and affordable access to primary and community health, and that impacts on an already under-resourced hospital system.

“The Government must also acknowledge its responsibility to Māori to improve health outcomes and access to health services,” Paul Goulter says.

New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) is concerned that some mental health nurses are so worried about their safety, they are asking Te Whatu Ora to look into the use of stab-proof vests and personal alarms.

It follows the stabbing of a nurse during an after-hours callout to the Rotorua suburb of Ngongotahā by Te Whatu Ora Lakes’ acute mental health response team on 28 December.

NZNO and the Public Service Association (PSA) - which both have members who are mental health workers - are calling for a full investigation into the incident by Te Whatu Ora and WorkSafe, and for the matter to be referred to the Health Quality Safety Commission.

NZNO mental health nurse and delegate Mitchell Mclaughlan said the stabbing was a random event.

"However, violent incidents have become more frequent in recent years. We are seeing escalating aggressive behaviours in the community. More members of our society are presenting as highly distressed due to their social and financial situations, increased drug use along with a swell in anti-social behaviours."

Rotorua mental health staff have requested a review of the incident with Te Whatu Ora management, Mitchell Mclaughlan says. "We want to discuss whether extra security measures such as personal alarms or stab-proof vests should be worn from now on by nurses and kaiāwhina working in mental health."

NZNO Mental Health Nurses Section chair Helen Garrick called on Te Whatu Ora to report the incident to the Health Quality Safety Commission and follow all "learning from harm processes" necessary to determine ways to enhance safety for all concerned including staff, whānau and service users.

"All aspects of this incident must be reviewed. Stab-proof vests and alarms may not have resulted in a different outcome and we don’t want knee-jerk solutions. We also shouldn’t accept that nurses have to deal with such a level of violence they need stab-proof vests.

"However, I understand mental health nurses are fearful and looking for solutions. They need to be safe when they’re attending call outs. With the Police proposing withdrawal from emergency mental health call outs, nurses are being left increasingly vulnerable," Helen Garrick says.

PSA Health National Sector lead Sue McCullough says the nurse, who is a PSA member, underwent surgery, and has been discharged from hospital. She is now recovering at home.

Sue McCullough says the PSA is supporting the nurse, and their members, following the very traumatic event.

"Health workers’ safety is paramount as they deliver essential health care to all New Zealanders. Devastating incidents like this highlight the consequences of the Government’s relentless health budget cuts. These funding cuts, along with short staffing, will continue to endanger the entire health care system and all New Zealanders’ health and wellbeing.

"Consultation on health cuts continues. We ask those who care about the health of New Zealanders and who care about our health care workers to speak up. Incidents like this have lifelong impacts and need to be prevented," Sue McCullough says.

For more on this story please see the NZNO nursing magazine Kaitiaki.

The New Zealand Nurses Organisation Tōputanga Tapuhi Kaitiaki o Aotearoa (NZNO) joins te ao Māori to mourn the loss of Dame Tariana Turia - a former Associate Minister of Health and Whānau Ora Minister.

NZNO Kaiwhakahaere Kerri Nuku says like nurses throughout Aotearoa, Dame Turia was passionate about achieving better health outcomes for Māori.

"Dame Turia was the most influential Māori politician so far this century to shift thinking on government health policy.

"She introduced the concept of whānau ora into the health system, and while that hasn’t been fully implemented yet, the seed has been planted.

"Dame Turia introduced policies aimed to achieve a smokefree Aotearoa. And she advocated for better support to improve the Māori nurse workforce and achieve pay parity for nurses everywhere, especially with especially Māori and iwi health providers."

Kerri Nuku said the sacrifices Dame Turia made to advance Māori health, and Māori rights, would not be forgotten by the Māori nursing community.

"She bled for our people! Her achievements didn’t just happen, she had to fight for them.

"We can only imagine the outcast treatment she would have got by exiting one political party to build another political party."

Kerri Nuku said much of what Dame Turia stood for was now under attack by the current Coalition Government but many Māori working in health are "drawing strength from her work".

"Our aroha goes to the whānau pani of Dame Turia - thank you to her children and mokopuna for giving us the taonga they did."

Te Whatu Ora’s Health Workforce Plan released today shows our health system is focused is on capping costs not meeting patients’ needs, New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.

NZNO Kaiwhakahaere Kerri Nuku says the plan normalises ongoing understaffing across all settings in the health system.

"It is entirely drawn from operating within a constrained funding environment and repeatedly cites workforce planning around ‘living within our means’ and ‘ensuring more sustainable workforce translates to a more financially sustainable system’."

One of the priorities is getting ‘workforce basics right’ by improving national workforce planning including by reviewing current and future supply models.

"NZNO calls on Te Whatu Ora to utilise safe staffing ratio tools for this work to ensure patient needs are met with sufficient nurse-to-patient numbers. This will also require the current pause in the FTE calculations for the Critical Care Demand Management programme - which Te Whatu Ora nurses are currently striking over - to be lifted," Kerri Nuku says.

Another priority in the plan is to "training more health workers locally" so they "reflect the diversity of our own communities".

"Unfortunately, this rings hollow given Te Whatu Ora’s failure to support new graduate nurses into employment and a lack of support for training more Māori and Pacific nurses to achieve population parity.

"Māori nurses are 7.5% of the nursing workforce but Māori are 20% of the population. Te Whatu Ora needs to properly invest in Māori-focused programmes, continue to fund effective initiatives to increase recruitment and retention of the Māori workforce and grow mātauranga Māori specialists," Kerri Nuku says.

The Coalition Government should mark Human Rights Day by agreeing to end all gender and ethnicity pay discrimination in the health sector, says the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO).

NZNO Kaiwhakahaere Kerri Nuku says today is Human Rights Day and it’s is a good time for the Government to do the right thing.

"Evidence before the Wai 2575 from our Māori workforce highlighted structural discriminatory practices in the health sector.

"Our members who work for Māori and Iwi health care providers face a double whammy - both gender and ethnicity discrimination.

"It’s time for the Government to be the change.

"For too long nurses, midwives, health care assistants and kaimahi hauora have been the victims of gender-based wage discrimination. It is almost 2025 and undervaluing women-dominated workforces should be relegated to the history books.

"They deserve to be paid the same as their colleagues in other parts of the health sector and at least the same as men in occupations the require the same or similar skills, knowledge, effort and responsibilities

"It’s time for the Government to show its respect and gratitude for the work done by the female dominated nursing workforce - including kaimahi hauora," Kerri Nuku says.

NZNO has pay equity claims being investigated for our nurses, caregivers and support members in aged care, laboratory members and nurses who work for Plunket, hospices, primary practices and urgent care centres, and district nursing services outside of Te Whatu Ora.