Memo Musa, Chief Executive, NZNO

As many will know, the Government announced a review of the New Zealand Health and Disability System in September 2018. The purpose of the review was to identify opportunities to improve the performance, structure, and sustainability of our current Health and Disability System. Its goals are achieving equity of outcomes, and contributing to wellness for all – particularly Māori and Pasifika.

The first interim report by the Expert Review Panel (led by Heather Simpson, a special advisor in the Prime Minister’s Office) was released in early September 2019. In response NZNO met with Heather Simpson, Sarah Prentice and Margaret Southwick (a Panel member) in early October 2019 to present our work and suggestions around the report’s three key themes of Leadership, System Complexity and Equity. The presentation was prepared by Eldred Gilbert (Visibility of Nursing Project Lead), Hilary Graham-Smith (Associate Professional Services Manager) and myself, with input from Kaiwhakahaere Kerri Nuku and President Grant Brookes. The presentation was led by Hilary.

We agreed that the current Health and Disability System is not serving people living in Aotearoa New Zealand well. We discussed the utility of nursing as key to making a difference to the issues of equity and access for under-served individuals, families and communities. After all, nurses are well-versed and experienced in population health. They understand: wellness, health promotion and illness prevention; their framework for care is holistic; and they are experts in system and boundary navigation. Nurses also have a common agenda – to work in partnership in an integrated system that best serves the needs of people.

Unfortunately, the current system makes it impossible for nursing leadership to be freed up and maximised in policy and services design/delivery at a Tier 1/Primary Care level. Funding, contractual and employment arrangements constrict the way nurses practise, and impede them from working in the way they could to reduce system complexity.

It is important the Panel considers establishing a ‘peak body’ of nurses to help in co-design processes for nursing that allow for integration of services, and to develop a model of care whereby nurses can fully contribute to the health and social care needs of the population by utilising all of their skills – and this is what we have recommended. With abundant knowledge, skill and adaptability, nurses have the opportunity to offer alternative and innovative approaches to delivering health services that can make the real difference required.

Such a nursing renaissance falls well within the scope of the NZNO Strategic Plan 2015-2020. The first pillar of our Strategic Plan is to improve health outcomes by promoting excellence in patient care. The third is having a strong workforce by strengthening nursing and workforce planning, sustainability and leadership.

There remains much work to do in further developing our thinking and we will keep you updated on progress. We are pleased that members of the Review Panel are listening and that the Panel has the skills and knowledge to appreciate our suggestions.

I would like finish by thanking Eldred Gilbert and Hilary Graham-Smith for their ongoing work on this project, and Kerri and Grant for their input and support.