Speech to the New Zealand Nurses Organisation Conference 2021

Kia Ora tatau katoa.
 
Ka tuku mihi ki nga nēhi,
He pou Hauora o Aotearoa,
E ora ai tatou.
 
Whakatau mai 
I runga i te kaupapa o te ra
Te NZNO conference.
 
Tena koutou tena koutou
Tena tatou katoa
 
Good morning, and thank you inviting me to take part in your conference.
I always enjoy meeting up with unions and union members, even if it is through a computer screen.
I want to particularly acknowledge you, kaiwhakahaere Kerri Nuku, for the work you do.
Just this week, your outstanding leadership has been internationally recognised by the journal Nursing Ethics, which has awarded you its Human Rights and Nursing Award.
Congratulations are due also to Anne Daniels on your election as president of the Nurses’ Organisation. Unions are nothing without the strength and involvement of their members.
NURSING IN A PANDEMIC
What I really want to do today, though, is to say thank you to all nurses.
As once again, we all dig deep against COVID-19, you are there in the frontline, as you always are in every health crisis.
You’re carrying more than your share of the load – working in testing stations and vaccination stations, and caring for those who have the virus.
And all while continuing with your usual – often highly stressful and demanding – work, including treating the victims of the recent terror attack in Auckland.
The job of being a nurse was hard before COVID got here.
For years, people working in the health system have been trying to hold things together in under-resourced hospitals, while dealing with the increasing demands of a growing and ageing population.
Conditions like diabetes, obesity, strokes, heart disease, cancer and chronic obstructive pulmonary disease are on the rise.
Problems in our wider society, like poverty and poor housing, are making problems for our health system.
And advances in medical science are putting more pressure on the system, and on you.
Since the arrival of COVID-19, you’ve been under even more pressure.
It’s not surprising that so many nurses are saying how tiring and exhausting it is right now, yet the appearance of the new Delta variant requires you to be even more vigilant and alert, as you juggle the jobs of looking after us, yourselves and your families.
STAFFING
The health system and the people who work in it have been under pressure for a long, long time.
I hear your stories of working short-staffed shifts, of working extended hours and of managing more and more patients.
You are entitled to work in conditions that keep you and your patients safe.
To know there are enough nurses working alongside you, so you can do the job professionally and to a high standard.
Dealing with the nursing shortage is a high priority for the Government.
In 2018, we and you agreed a safe-staffing accord that included funding for an extra 3000 nurses.
The accord included a provision to introduce Care Capacity Demand Management. CCDM should have been fully in place by June this year, but in half our district health boards it has been only partially implemented.
We are finding out why and we will fix it.
As I said I would do, I have ordered a review of the way CCDM has been implemented.
That review is now under way, overseen by a panel chaired by your own former associate professional services manager, Hilary Graham-Smith.
The other members of the panel are Nelson Marlborough DHB associate director of nursing Dr Jill Clendon, Massey University School of Nursing senior lecturer Dr Rhona McKelvie and Capital and Coast DHB integrated operations centre clinical nurse manager Kapua Quinn.
All four members have a deep understanding of the issues and I am confident in their ability to uncover the problems and come up with solutions.
The panel will report its recommendations to me by December and I hope we will be able to work together to fix the situation and fulfil the  original ambition for CCDM.
As well as the review into the safe-staffing accord, I have asked the Ministry of Health to develop a recruitment campaign so we can start filling the vacant positions at hospitals around the country, and I look forward to working with you on this.
This work is under way, and will focus on getting more people to train as nurses, and on encouraging those working overseas to come home.
NEGOTIATIONS
But recruitment campaigns won’t work if we can’t offer jobs with good wages and decent working conditions – the bread-and-butter stuff of a union.
The latest renewal of the collective employment agreement covering district health board nurses has been a long and arduous process.
I understand that you are now considering an offer that has been reviewed and recommended by independent expert facilitators.
It has taken a lot of hard work by the parties to get to this point, and I know that you will take the time you need to review and consider the recommendations.
I note that the independent facilitators recognised and accepted your arguments on a range of workforce issues.
They made recommendations on recruitment and on ways to improve DHB practices and to hold DHBs accountable.
The independent facilitators also recognised the significant impact the unions’ pay-equity claim for DHB nurses will have on rates of pay.
I am pleased to see progress being made in that claim, which covers 40,000 nurses directly and will affect all of you indirectly.
It’s taken longer than any of us would have liked to get here, but the legwork – the measuring, evaluating and comparing – is done and negotiations are now under way.
There’s still work to be done, and I know your union will represent you well in negotiating this hugely significant claim.
I want to say very clearly that the Government is committed to paying nurses fairly through pay-equity.
To recognising the skills and responsibilities of your jobs and the fact that you have never been paid what you are worth – largely because traditionally, nursing was a female profession.
As both the Minister of Health and as a former trade unionist, I am pleased we are – finally – doing something about it.
Frankly, it’s embarrassing that it’s taken this long. The Equal Pay Act was passed nearly 50 years ago. There is no place in 21st century Aotearoa New Zealand for 1950s attitudes to work predominantly carried out by women.
As I said last month, Cabinet has allocated funding for your pay-equity settlement and I believe it will make a real difference to you, your profession and to everybody in Aotearoa New Zealand.
And while this particular claim will apply directly only to nurses working for district health boards, it has implications for those working in other places too, including primary and community care and residential care for the aged.
We have to deal with these groups of nurses as well.
INVESTMENT
The failure to properly recognise and reward nurses is part of a wider crisis in the health system.
For years, it was starved of money. At a time of record population growth, the system wasn’t funded to keep up with demand and has fallen way behind.
In 2015 and 2016, no money whatsoever was spent on building new hospital wards and facilities – not a cent.
This year, we’re spending a record $22 billion on health alone.
We’re building new hospitals, funding new drugs, backing new treatments and hiring more people as we roll out our plan to fix the health system.
So far we’ve committed $6 billion alone to new buildings and information systems, with more to come.
But money alone is not enough. The system simply does not work for large numbers of New Zealanders.
Māori and Pacific communities still have worse health results than other communities do.
People living in rural areas struggle to get services.
And then there’s what’s known as the postcode lottery – the fact that your access to many treatments depends on where you live.
The health reforms we announced earlier this year are designed to fix these problems.
Health New Zealand, which will replace the 20 district health boards, and the Māori Health Authority will give us a chance to make a real difference on many workforce issues – to get some consistency of standards across all hospitals.
The reforms also give us the ability to work together more effectively on current workforce issues and, just as importantly, on long-term issues, such as thinking about nursing in the future and how we attract and develop the next generation.
The system can’t be fixed overnight and of course these are big challenges.
But we’re fronting up to them because we believe New Zealanders deserve a health system that works well for everyone.
Like lifting children out of poverty and tackling the housing crisis, rebuilding the public health system is critical to laying the foundations for a better future for all New Zealanders.
Again, thank you for the part you’re playing in rebuilding the health system and in keeping us all safe.
Nō reira, tēnā koutou, tēnā koutou, tēnā tātou katoa