NZNO's Blog


Why the Trans-Pacific Partnership Agreement is a health issue

ImageWe’re hearing more and more people, from all over the world, talking about the Trans-Pacific Partnership Agreement  (TPPA), and they are all saying the same thing: trade deals that are negotiated in secret, that do not give citizens any say over the content, that have the potential to have huge effect on the lives of ordinary people should stop right now. We at NZNO agree; we have a right to know what’s going on.

The TPPA is a free trade agreement that is being negotiated between the United States and ten other Asian and Pacific Rim countries. The negotiations are being held in secret, so what we do know comes from leaked documents.

The things we are finding out are extremely worrying. Big business seems to be in control.

And when big businesses have more rights than States and Governments, you know that it is the citizens of those countries who will bear the brunt.

The group set up to demand transparency and fairness in the TPPA, says,

“From what we know so far, if the negotiations are completed it will become much harder for the New Zealand government to look after our environment, promote health, protect workers and consumers, and promote the public interest.”

NZNO is particularly concerned about that public health will be a major loser under the TPPA and this is why

Pharmac is New Zealand’s purchasing agency for medicines. It buys all the drugs for the country, in bulk and generic versions where possible, to give tax payers the best value for money. It’s a very clever system and as a result we end up paying much less for medicines and medical equipment than other countries like Australia and the US.

The agreement will give big pharmaceutical companies the ability to patent their products for longer, meaning that cheap “off-patent” generic drugs will not be available for years, and possibly decades. They will also be able to make tiny tweaks to existing drugs and then patent them again.

The agreement will also put into place “transparency” provisions which will interfere with the successful commercial strategies that PHARMAC uses to get medicines at an affordable price.

New Zealanders need access to affordable medicines. We are a small country; Pharmac uses our bargaining power very effectively and must be protected from provisions in the TPPA which reduce its effectiveness.

Unfortunately, this isn’t the only provision in the TPPA that will affect the health of New Zealanders and their safety. There’s more on the It’s our future  website and NZNO will blog about this important issue again.


No nursing vacancies?

no vacanciesIn November 2013 Health Workforce New Zealand (HWNZ) briefed the Parliamentary Health Select Committee on nursing and medical workforce issues in New Zealand.

We’ve read the report of the Committee (you can find it here ) and have come to the conclusion that HWNZ must be telling the members of parliament what they think they want to hear. It makes no sense to us at all.

Here’s what the Health Select Committee report says about nursing:

“HWNZ told us that at present there are no nursing vacancies, and district health boards are employing newly qualified nurses on a casual basis rather than in graduate positions.However, the average age of nurses is 50, and many are expected to leave nursing when the economy moves out of recession. This will result in vacancies, and HWNZ is working to ensure an adequate, sustainable nursing workforce over the next decade. For example, a “nursing pipeline working group” is being established to align nursing student numbers with employment opportunities.”

HWNZ’s assertion that “there are no nursing vacancies” is patently untrue. NZNO members tell us that they are constantly working under stress, that nurses on leave are not replaced and that vacancies are taking months to fill or are not being filled at all. All these factors create constant churn in the workforce, with the nursing team working short-staffed and under pressure. There is no fat in the system and patient safety and quality care is being compromised as a result.

Why is HWNZ pulling the wool over the Parliamentarian’s eyes? We know, and they do too, that good policy and legislation can only happen when select committees receive free, frank and honest advice. The Health Select Committee has said they will “monitor the situation with interest” – if they knew the truth they would be taking urgent action.

NZNO is doing what we can; lobbying, researching, planning, listening to members and finding solutions to the crisis in the nursing workforce. What we need now is for HWNZ to get on board and do the job they are supposed to do – engage, listen, plan, act.

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Health services on the West Coast must meet the needs of its population

ImageThe West Coast is a big place. It stretches pretty much the whole length of the South Island and its population is dispersed in small towns, from Haast in the south to Karamea in the north. It’s unique and so are its health needs.

The West Coast District Health Board is currently looking at different ways of providing services to the population. Some of its plans are controversial; with admissions there is the potential for harm and death to occur if some services are discontinued on the Coast.

NZNO thinks that’s not good enough. Every region deserves a sustainable healthcare service that meets the needs of its population and utilises its health workforce well. 

The employer has offered a meeting with all parties to discuss the issues but this has yet to occur, and certainly does not take the place of the formal consultation process under the MECA. 

We are concerned that although senior doctors have been consulted, nurses have only been minimally involved in the DHB proposal thus far. The obvious upshot of this omission is that the DHB’s business case is very “doctor-centric” and misses the great opportunity to implement a nurse practitioner model of care, which would work brilliantly in this environment. 

It is nurses who make up the bulk of health practitioners on the Coast and nurses who will have to bear the brunt of any changes to services. 

There is a proposal to move to a generalist nurse model in the acute care setting and the resulting reduction in beds will mean job losses. And if the region goes to an Integrated Family Health Centre (IFHC) model, it will mean that nurses will no longer be covered under the strong and effective partnership of the DHB MECA. The changes must not result in employers taking the opportunity to reduce wages and conditions for our members. 

NZNO is also concerned about the IFHC model as proposed. It’s a very “medical” model of delivering care, and if implemented would make integration between public health and health promotion, and inter-sector collaboration difficult. 

A major concern for us is that patient sourced funding in primary care increases substantially under the proposed new model. This will mean that the cost of providing healthcare will shift from the DHB to the patient, essentially privatising primary care in the region. 

The DHB business case suggests its new models of care will reduce presentations at ED, but our experience is that when communities are unable to access or afford healthcare when and where they need it, they end up at ED, sicker and needing more expensive acute care. 

We know that change needs to happen. Our members want a sustainable health service as much as anyone, but we see glaring issues that have not been addressed: 

  1. the lack of inclusion of the NP model;
  2. the lack of inclusion of inter-sectoral collaboration and broadening of the model to integrate this and public health and health promotion effectively into IFHCs;
  3. no discussion of how issues for nursing will be managed
  4. no consideration of how the community will be affected

It’s nurses who hold the whole thing together.  We look forward to engaging in a formal, constructive and productive consultation with the DHB. 

And we look forward to a West Coast health service that provides high quality health care to all Coast communities, when and where they need it.