We need a health system that meets the needs of the nation


Paul Goulter is Chief Executive of the New Zealand Nurses Organization Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO)

OPINION: I listened to Grant Robertson announce Thursday’s budget. I like the terminology he uses – I just hope we’re talking about the same things.

As chief executive of the largest health union in Aotearoa New Zealand, I am delighted that the budget is all spent on health, because Robertson is right, we need a new health system that actually responds to the needs of our nation. He is also right that the foundations of this system will require sustained investment and that spending must be value for money, targeted where it can make a difference.

Of course, I am thinking of front-line staff, and nurses in particular. There have been signals that this budget will focus on repaying outgoing DHB debts. That’s good, but it would be a mistake to do it at the expense of front-line workers. There is no better value for money and nothing that will make a bigger difference in health than hospitals and medical services with safe personnel and adequate resources.

Seeking safe staffing levels was among the reasons nurses, midwives and care aides went on strike in 2021. (File photo)

Valentina Bellomo / Stuff

Seeking safe staffing levels was among the reasons nurses, midwives and care aides went on strike in 2021. (File photo)

Nurses (including orderlies, midwives and kaimahi hauora) are struggling as there is a nursing shortage crisis across the health sector. Immigration windows have been closed for years, so there are no new nurses from overseas. Desperate and dire working conditions drive many people out of the profession, and those who remain work in working environments that most would describe as unbearable. They are heartbroken every day because they don’t have the time or the resources to provide proper care.

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This is why I expect to see a large allocation of funds to deal with this crisis on Thursday. You can tinker with the bureaucracy to make it more efficient. You can replace Fragmented DHBs with two shiny new Health Authorities. You can build more hospitals and buy more beds. But without qualified nurses, all these expenses will be for naught.

The first thing the government must do is honor its promise to backdate the DHB Nurses Pay Equity Settlement to December 31, 2019. It must then extend the new base pay equity rates to all nurses, everywhere, so that nurses can work where they feel called. to, instead of just where the best money is.

Failure to meet this reimbursement commitment will cost the government far more in terms of the last remaining shreds of goodwill nurses than it will ever save them in dollars. Failure to deploy these best rates across the board will perpetuate health inequities. Nurses working for Maori and iwi providers, for example, earn more than 30% less than their DHB colleagues and a new Maori health authority will not solve much while this fundamental inequality remains.

Paul Goulter, chief executive of the NZ Nurses Organisation:


Paul Goulter, chief executive of the NZ Nurses Organisation: “…one thing is certain, we all pay dearly when Maori are so horribly behind in terms of health outcomes.”

Investing in health must start by addressing the more than 4,000 nursing vacancies that we currently estimate nationwide.

We need to see investment in nurse education, free training and intensive recruitment campaigns, but before young people really want to become nurses, the government’s approach needs to change. Members tell us that decades of underfunding, failure to listen, failure to consult, and failure to deliver on promises about pay and staff safety have led experienced nurses not to recommend nursing as an option careers. You get better money and a better salary for picking fruit. How does that make sense?

We need more Maori and Pasifika nurses and a culturally functioning health system for our tāngata whenua. We accepted that when we signed Te Tiriti, but it was never taken seriously. Maybe it will now with the new Maori Health Authority, but one thing is certain, we all pay dearly when Maori fall so horribly behind in health.

Together, these things form the focus of NZNO’s campaign work this year, and we will be relentless in pursuing these goals. We also know the public is behind us – and their support may be one of the last reasons nurses keep showing up for work. Thank you.

Thursday’s budget is indeed a crucial moment. Nurses are the foundation of the health care system and they need the sustained investment that Grant Robertson talks about. Will this budget be good for nursing and therefore good for everyone’s health, or will it be another poorly targeted initiative that makes no difference or gets no value for money ?

We have the fixes, and we are committed to helping the government deal with this crisis. Let’s talk about it and solve this problem once and for all.


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