Nursing reports

Māori nurses are tired of waiting for long-overdue action addressing the 25 percent pay gap between themselves and those working for district health boards.

Kerri Nuku, Kaiwhakahaere of Tōpūtanga Tapuhi Kaitiaki o Aotearoa/New Zealand Nurses Organisation, says Māori nurses have been pursuing justice for years but have yet to see any concrete change.

"We’ve been on this kaupapa at least since 2006. We’ve spoken to successive governments and presented evidence time and again to action groups and the Waitangi Tribunal about the systemic racism we endure.

"Yet, despite our efforts, all we’ve been receiving is sympathy. What we really need is action."

Ms Nuku says the Government is more than willing to send Māori nurses to fight on the frontline, but that work is not being recognized and they remain at the back of the line when it comes to being valued.

"We are the ones on the ground, on the frontlines, doing the work to dismantle the systemic barriers facing health for our people. Without us, health inequities would be far worse than they are.

"So when will our contribution be acknowledged? When is the Government going to put Māori nurses first?"

Ms Nuku says Māori nurses are again trying to raise their case at the Waitangi Tribunal Mana Wahine inquiry, but says nurses can’t and shouldn’t have to wait until the end of the inquiry for action to happen.

"We keep opening the same wounds and reliving the same trauma for Crown lawyers to argue against, or at best, for politicians to feel bad about.

"But the injustice we face is real and tangible. We are paid drastically less than our Pākehā counterparts, and kaupapa Māori services are chronically underfunded.

"The Government must uphold Te Tiriti o Waitangi, and address the structural racism in the healthcare system. An urgent and crucial step in this is equal pay for Māori Nurses."

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Media Inquiries: Hugo Robinson, NZNO Assistant Media and Communications Advisor, 021 194 3408 

Māori nurses are tired of waiting for long-overdue action addressing the 25 percent pay gap between themselves and those working for district health boards.

Kerri Nuku, Kaiwhakahaere of Tōpūtanga Tapuhi Kaitiaki o Aotearoa/New Zealand Nurses Organisation, says Māori nurses have been pursuing justice for years but have yet to see any concrete change.

"We’ve been on this kaupapa at least since 2006. We’ve spoken to successive governments and presented evidence time and again to action groups and the Waitangi Tribunal about the systemic racism we endure.

"Yet, despite our efforts, all we’ve been receiving is sympathy. What we really need is action."

Ms Nuku says the Government is more than willing to send Māori nurses to fight on the frontline, but that work is not being recognized and they remain at the back of the line when it comes to being valued.

"We are the ones on the ground, on the frontlines, doing the work to dismantle the systemic barriers facing health for our people. Without us, health inequities would be far worse than they are.

"So when will our contribution be acknowledged? When is the Government going to put Māori nurses first?"

Ms Nuku says Māori nurses are again trying to raise their case at the Waitangi Tribunal Mana Wahine inquiry, but says nurses can’t and shouldn’t have to wait until the end of the inquiry for action to happen.

"We keep opening the same wounds and reliving the same trauma for Crown lawyers to argue against, or at best, for politicians to feel bad about.

"But the injustice we face is real and tangible. We are paid drastically less than our Pākehā counterparts, and kaupapa Māori services are chronically underfunded.

"The Government must uphold Te Tiriti o Waitangi, and address the structural racism in the healthcare system. An urgent and crucial step in this is equal pay for Māori Nurses."

Media Inquiries: Hugo Robinson, NZNO Assistant Media and Communications Advisor, 021 194 3408 

New Zealand Nurses Organisation media release, 19 October 2020

The New Zealand Nurses Organisation (NZNO) congratulates the Labour Party on its historic election win and promises to work with the new Government so that progress in health can “keep moving” in Aotearoa New Zealand.

NZNO President Heather Symes said both NZNO and the Government have a lot on their agendas in the coming year.

“We both want the same thing – a first rate health system where people are cared for as best as possible, and in which every health worker is safe and fairly paid.

“The Government has a clear mandate to progress with its agenda and NZNO is keen to work together in good faith on issues such as how improvements in health funding will keep moving forward and how the Government will address the findings of this year’s Health and Disability Commissioner’s report.”

NZNO Kaiwhakahaere Kerri Nuku said NZNO has worked steadfastly with the Government on these issues and pledges to continue doing so.

“We also share a commitment to pay parity for nurses and all health workers across the sector, and an end to persistent discrepancies in pay levels between those who work in district health boards and those who work in Primary Care.

“People working for Māori and Iwi health providers often work for 30 percent less than those working in public hospitals, despite having the same qualifications, experience and commitment to their employers and patients. This sort of historic injustice has to end right now.”

Ms Nuku and Ms Symes said that on NZNO’s agenda at present are several high level multi-employer collective agreements (MECAs) and, together with other unions, a pay equity initiative through which nurses will be paid the same as those working in similar but male-dominated professions.

“COVID-19 has ushered us all into a brave new world and that means we have to be brave and face our issues squarely so we do what’s right and just without delay. That’s what keeping moving means,” they say.

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 27 August 2020

The New Zealand Nurses Organisation’s (NZNO’s) College of Emergency Nurses (CENNZ) says the de-valuing of the nursing role evident in recent moves by the Canterbury DHB (CDHB) are deeply worrying, and that all New Zealanders should be concerned.

College Chair Dr Sandy Richardson says the loss of key personnel from the DHB such as Director of Nursing Mary Gordon, and the DHB Board’s decision to prioritise deficit management will have significant health effects.

“We’re looking at an anticipated $13 million cut in nursing staff costs. The willingness to target nursing whenever money needs saving is long-standing and shows a lack of awareness that patient safety is reduced when the number of nurses and skill mix is lower than required to meet patient need.

“It’s a failure to comprehend what nurses actually do and how vital their role is.”  

Dr Richardson said CDHB is unique in that Canterbury, the West Coast, Kaikoura and Marlborough have experienced ongoing and cumulative crises and disasters over the past decades, which have had a significant impact on the health system, the health workforce and community. 

“The ongoing effects of these remain in terms of physical, emotional and psychological reminders for people in these areas, and the health system has suffered financial, structural and institutional wounds – and now we have COVID-19. 

“Throughout this, nurses have continued to work effectively and efficiently, and to maximise savings.  There is no fat left to cut.  A nursing shortage already looms due to its ageing workforce, but the Board plans to reduce the number of new graduates being employed.”

Dr Richardson said the loss of important clinical voices and institutional knowledge resulting from the mass resignations is reminiscent of the 1998 Stent report which made 112 recommendations related to Canterbury Health. The investigation came after multiple warnings from clinical staff and professional organisations.

“Then Health and Disability Commissioner Robyn Stent recognised the damage done by cost cutting and loss of clinical expertise. Her report validated the warning letter sent by concerned staff ‘Patients are dying’. 

“This was centred on Christchurch Hospital and should be a reminder of the worst that can occur; but this seems to have slipped from the Board’s collective memory.”

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 16 June 2020

The New Zealand Nurses Organisation (NZNO) says it agrees with the direction proposed in the health system review report released today, and says the changes it suggests have been much anticipated.

NZNO Kaiwhakahaere Kerri Nuku says NZNO members have long advocated for the population health approach which the report rightly emphasises.

“We especially welcome the proposed structural changes, particularly the Māori Health Authority. These changes echo the recommendations of the Wai 2575 Health Services and Outcomes Inquiry and will better reflect Te Tiriti. They will also ensure obligations under Te Tiriti are reflected across the whole health system.”

NZNO Chief Executive Memo Musa said nurses are the largest regulated body of health workers in Aotearoa New Zealand, so it was good to see the centrality of the health workforce reflected. However, he said attention must be given to making sure the proposed changes serve the population and workforce well.

“The emphasis on strategic employment relations at tripartite level (government, employer and union) will be fundamental to sustained and sustainable health system change.

“We also agree with the proposed new governance arrangements because they could provide the strong leadership the system needs. They will also be an opportunity for nurses to step up and become more involved in high level policy and funding.”

But Mr Musa said the devil is always in the detail.

“We look forward to the changes and will be watching very closely. We very much encourage nurses to be involved in implementation and change, because this is where we have the most value to add.”

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 21 May 2020

After prolonged negotiations primary health care nurses have voted down a final offer from employers of 2.5 and 2 percent pay increases over two years.

The New Zealand Nurses Organisation (NZNO) has been negotiating the Primary Health Care Multi-Employer Collective Agreement (PHC MECA) since November last year. The MECA covers more than 3400 nurses, receptionists and administrators across more than 500 practices and accident or medical centres.

Despite approaches to the Health Minister, the Ministry of Health and DHB officials by NZNO and organisations such as the New Zealand Medical Association, Green Cross Limited and General Practice NZ, the additional funding needed to achieve pay parity with DHB nurses has not been forthcoming.

NZNO Industrial Adviser Chris Wilson says that in March this year employers gave their final offer based on what they say they can currently afford, but it was clearly insufficient.

“We have advocated strongly for an offer that would put primary health care nurses on a salary par with their DHB counterparts, but this offer falls woefully short and accordingly our members have voted it down.

“An experienced nurse covered by the PHC MECA is currently paid 10.6 percent less than their DHB colleague with the same qualifications and experience. This disparity can and must be fixed, and it really comes down to funding and political will.”

Ms Wilson says that despite NZNO’s advocacy, and widespread recognition of their valuable work – especially on the frontline against COVID-19 – the Government continues to undervalue the work of PHC nurses and the sector by not funding the gap that will secure pay parity. She says it’s time this recognition and praise were matched by pay.

“There was a post-Budget pledge of more funding to early childhood centres in recognition that they were undervalued and of their importance in the recovery from COVID-19. That’s a great outcome for them and it shows the Government is capable of addressing pay inequities. There are clear parallels here to primary health care and we would like to see a similar solution found.

Earlier this year NZNO surveyed its members covered by the PHC MECA and 70 percent of respondents said they were considering leaving the sector because of higher pay elsewhere. Many nurse leaders said in the survey that they are struggling to recruit new nurses or keep the ones they already have.

“These nurses provide expert care and advice which often reduces hospital admissions. Fewer nurses will mean these services become less available and more expensive,” Ms Wilson says.

“Not only is the pay inequality an injustice, it ultimately costs the system more in the long-term. We cannot let this go on.”

NZNO will resume negotiations as soon as possible in an endeavour to reach a proposed collective agreement that values primary health care workers’ contribution to delivering a quality service at the frontline of health.

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 18 May 2020

The New Zealand Nurses Organisation (NZNO) says it is pleased to see significant investment into health and disabilities in the 2020 Budget, but wants more detail about how that money will be targeted, lest important opportunities be missed.

NZNO Industrial Services Manager Glenda Alexander says it is really positive that the Budget acknowledges the crucial changes our health and social systems require.

“We welcome funding that targets the social determinants of health, including massive increases to state housing and insulation; lunches for 200,000 schoolchildren; and trades training, because good housing, nutrition and employment are central to good health.

“We also welcome $3.9 billion for district health boards announced earlier last week, but what we’d really like to see is some detail about how that extra money will flow into the Primary Health Care sector and towards Māori and Iwi providers. This is where the bottlenecks are.”

Ms Alexander said another issue not specifically addressed was staffing.

“How does the Government believe this extra health care it is funding will be delivered when the current health workforce is so understaffed? Additionally the urgent need for a skilled workforce in aged care has been starkly profiled by the COVID-19 crisis.

“So there’s a real opportunity here to look at re-training and support to meet this growing need, especially when we consider unemployment is likely to be around 10 percent or more.

“And if we’re speaking of opportunities, there is Budget funding ring-fenced for Māori and Pasifika communities ($485 million and $195 million respectively) that could and should be used to address equity issues.

“Finally, it is really disappointing to see that there is no progress to pay equity and living wage campaigns, both of which are central to work nurses, midwives, health care assistants and kai mahi hauora do.”

She said that, while it’s great that we now understand that money has to be spent, we do need to be reassured that money and resources are being targeted correctly to ensure the real problems we face are addressed at their real heart.

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 20 March 2020

The New Zealand Nurses Organisation (NZNO) is calling for measures to improve support for nurses in the Government’s next round of pandemic initiatives after still more infections were reported today.

NZNO President Grant Brookes says the Government is doing a remarkable job but that, while more funding has already been promised for the health system, some resources could now be specifically for nurses who bear the brunt of working on the frontline across all sectors.

“Things we could do include paid special leave to look after an isolated dependant or a child unable to go to school; or free child care so nurses can carry on working.

“The competing demands on nurses are incredible and unprecedented right now. We are already hearing of their fatigue and anxiety about getting sick themselves, or that they will take infection home to their families and communities.

“But nurses also know they are expected to be there, because they always have been in the frontline for any medical emergency. They’re actually the glue that holds our COVID-19 response together, and will be working long hours under extremely stressful conditions.

“The potential for overwork and burnout is enormous, especially in cases where nurses are the sole breadwinners.”

It’s still to be confirmed that all of the total 39 cases reported to date have all come from overseas, but Mr Brookes said community spread was probably inevitable.

“If and when that occurs, health employers are expecting 25-30 percent of staff to be on sick leave from becoming symptomatic or from the need to care for dependants who are ill or off school. Anything we can do to acknowledge and relieve the pressure nurses are under would be welcome.

“We will get through this, because we know we can rely on our nurses. Let’s give them what they need to do their jobs and keep themselves safe and well.” 

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 26 November 2019

The New Zealand Nurses Organisation (NZNO) welcomes Learning from adverse events: Te ako I ngā pāpono kōaro, released by the Health & Safety Commission last week.

However, NZNO Professional Nursing Adviser Kate Weston says the yearly report is once again evidence of an under-resourced health system that is putting the wellbeing of New Zealanders at risk.

“More than 50 percent of the 916 reported adverse events relate to clinical care and indicate under-staffing. Failure to rescue, for example, which has risen by an alarming 28 percent, happens when staff are busy and stretched. The high number of pressure injuries reported are also evidence of not having enough time to deliver proper care.”

Ms Weston says factors mentioned in the report reflect what NZNO members say across the country about too few nursing staff to meet ever-increasing patient needs.

“The report confirms the incredible stress nurses, midwives and health care assistants are under every day. How many times do we need to be reminded that the health system is not sufficiently resourced for employers to meet their obligations around safe staffing? How many adverse events will it take?”

The report suggests the increase in recorded serious events could be the result of better reporting, while acknowledging this should not be assumed. Ms Weston says, however, that the notion of better reporting has been around for too long to continue as an acceptable explanation and that the increases are more likely to relate to workloads, insufficient staffing and poor skills mix – which the report also acknowledges.

“Many of those affected by adverse events are our most vulnerable, such as the elderly. Apart from the pain and suffering caused, many will no longer be able to live independently, which is a huge cost to them on a personal and financial level, and to the health system funded by tax payers.”

Ms Weston said the report was a valuable tool and indicator of the need for increased spending on health. But she questioned the lack of security and staff safety reports.

“We are well aware there has been a significant increase in violence and aggression towards staff, and we also know this is being underreported because internal systems and policies around staff safety also tend to fail when staffing resources are stretched.”

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 30 May 2019

The New Zealand Nurses Organisation (NZNO) commends the Government for a good start towards a Wellbeing Budget for people living in New Zealand. In particular it commends the significant increase in Vote Health, and meaningful allocations in key areas such as: mental health and addictions; child wellbeing; family violence; and Māori and Pasifika wellbeing.

NZNO Kaiwhakahaere Kerri Nuku said that more specifically, significant investments have been promised in areas such as school-based health, homelessness, early learning to improve wellbeing; infrastructure support; and kaupapa Māori services. She said there is still more to be done.

“Nurses and nursing services will be key to each and every one of these extended services, but we agree with the Government’s observation that currently the required workforce needed for them is not in place.”

NZNO President Grant Brookes said NZNO was therefore pleased to see the Government identifying specific workforce targets such as the primary mental health services workforce (which must include nurses) and pathways to employment for the Māori and Pasifika health workforce.

“We are particularly pleased that the importance of supporting students to enter into nursing and midwifery practice has been recognised.”

However, Kerri Nuku said the glaring disparity in earnings between the DHB nursing workforce and those working in Māori and Pasifika, Aged Care and Community services should have been more clearly identified as a target in the Budget.

“NZNO looks forward to continuing to work with Government to develop the required nursing workforce and helping to ensure that working conditions and remuneration levels continue to improve so nursing remains an attractive option for young people seeking a professional career in health. Investing in the wellbeing of the workforce remains a priority.”

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.