Anne Daniels, President
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

I recently read that “stories aren’t written about women who follow the rules. Stories are written about women who break the rules and show us all what’s on the other side”.

In 1893, Kate Shepherd led the way for all New Zealand women (Māori and Pākehā) to vote. But for some women, where rules are adhered to religiously, the vote has taken a lot longer. It wasn’t until 2015 that women in Saudi Arabia, were supported to vote, but only in local elections.

Following the rules does not lead to change.

Gender equality in New Zealand is taking a lot longer. Women like Kristine Bartlett, a professional caregiver, successfully argued in the Employment Court that her low hourly pay rate was a result of gender discrimination under the Equal Pay Act. She advocated for pay equity and won her case in 2013. But caregivers are back battling against further disadvantage and discrimination in our New Zealand streets again today.

Some say, if it’s not broke, don’t fix it. But when something is broken, a decision needs to be made about whether it’s worth fixing or in our throw away society, whether to toss it.

Our health system is broken. Worse, it is not being fixed by those who can fix it, the Government and nurse employers. It needs to be fixed. We can’t let it be tossed aside and replaced by a (worst case scenario) private insurance-based health care. We all know that doesn’t work either.

Nurses make the health system function. We deliver majority of the health care. But it’s not functioning at all well now. We need many more nurses, midwives, and health care assistants. Since 2001, NZNO members have been crying out for safe staffing. In response, NZNO proposed to the government of the day that they fund a nurse patient ratio pilot. But this was rejected. We argued that we need enough nurses, with the right knowledge, skills, experience to provide safe care, where and when its needed. Nurse shortages were predicted and there was a real need for substantive planning, implementation and evaluation of options that did not include the status quo because it just wasn’t working.

Now, 23 years later, despite the introduction of Care Capacity Demand Management (CCDM) following a safe staffing and healthy workplaces inquiry in 2006, the predicted nurse staffing shortages and crisis are the lived experience of all our 62,000 plus members, every day. A 2022 review of CCDM exploring why the program has not achieved safe staffing and how we can do better, found we are just not growing enough New Zealand nurses in this country. Bottom line, there are not enough nurses to provide safe care.

Successive governments and nurse employers have failed our nurses, midwives, and health care assistants by not walking the talk. The Memorandum of Understanding 2018 to fully implement CCDM by 2021 has not been met. Talking with government officials about the need for action, never sees change. This is why we need a fit for purpose culturally safe nurse patient ratio legislation, underpinned by CCDM. Our trust in those who should be following the rules of the ethics of meeting agreed contractual obligations has dissipated. But why should we be surprised when the obligations under te Tiriti o Waitangi have never been fulfilled.

Maintaining the status quo is not an option as our health system is broken. It is up to us to stop doing what is expected and do the unexpected. Advocacy is about influence through rational discussion. When that doesn’t work, activism must take its place.

We cannot afford to lose one more nurse from our health system. We cannot afford to wait and hope that someone, somewhere will do right by us and those we care for. We cannot afford to keep asking. Now is the time for telling. Now is the time for unexpected, innovative action.
Nurses, who are natural leaders, will harness their anger and energise change through action.

This is our why. We will no longer tolerate ratio Injustice, racism, gender discrimination, rejection of our truth, our experience, and our evidence. He Tipua – Ratio Justice conference is just the beginning.