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NZNO Chief Executive Memo Musa: AGM Speech 2019

17 September 2019

Tēnā koutou, Tēnā koutou, Tēnā koutou katoa.
It is my pleasure to welcome you all here to NZNO’s 26th AGM and to the Conference tomorrow.

I would like to acknowledge the outgoing Board, the incoming Board, Te Poari and the Membership Committee. I would like to thank our exhibitors and sponsors for both the AGM today and Conference tomorrow, and especially our sponsors Summerset and Pharmac.

The theme of tomorrow’s Conference is “Leaving No One Behind – Health For All” and I want to talk about the past financial year in light of that theme which captures the very reason we exist as an organisation.

We are here to support nurses, midwives, student nurses and health care workers as they work daily to ensure “no one is left behind”.

Nurses are there for us from the day we are born to the day we die, and on many occasions in between. They provide expert but compassionate care, often under trying circumstances. They are trained, knowledgeable and skilled, and they positively affect the health and wellbeing of us all.

The theme of our AGM and Conference is an appropriate one as it relates to the first pillar of our Strategic Plan which is improved health outcomes.  We want a sustainable, strong and skilled nursing workforce (the second and third pillars) so all people living in New Zealand can be healthier, and no one is left behind.

On top of what we achieve for members by supporting them in their nursing professional practice and negotiating collective agreements, there is the collaboration we engage in with the Ministry of Health, employers and other partners to improve working conditions and achieve pay equity.

As well as the industrial and professional support we give members daily, there is the research and advocacy work we do to improve policy around nursing both here and internationally in collaboration with other organisations.

A lot of what we do is highlighted in the Annual Report for the year 2018/19 and in my CE report within it. In what has been a challenging year, it is timely to focus on the positive. Alongside our members, we are doing many good things for the health and wellbeing of New Zealanders so no one is left behind.

I would be remiss not to mention our membership growth and finances. At the end of March this year our membership numbers reached 52,093 – an increase of 2.7 percent from the previous year; and we are currently at 51,339 members.

We ended the year with a net financial surplus of $153,288.  The gains from the investment portfolio increased that to $996,164.

I would like to conclude by reminding us, as I have done before, that united we stand, divided we fall. We are one profession with many roles and voices, we are a collective and together we can continue to have a massive influence. Together we make an effective team.

I would like to place on record my sincere appreciation the work our staff have done on your behalf.  I also thank you as delegates for the many volunteer hours you have put into NZNO’s work.

No reira, Tēnā koutou, Tēnā koutou, Tēnā koutou katoa.

Memo Musa, NZNO Chief Executive


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A nursing renaissance – NZNO’s input into the Health and Disability System Review

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.


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Celebrating the International Day of the Midwife

On Thursday 3rd May midwives from Aotearoa took to the streets in a National Day of Action. Why? Like nurses, midwives are fed up with the chronic under-funding of the maternity system. Despite having launched a Pay Equity claim with the high court in 2015 midwives have largely been ignored. In the spirit of good faith the claim was taken out of court and into mediation where a new funding model (co-designed by the College of Midwives and the MoH) was agreed on. But it is waiting to be given the green light because it will involve a significant increase in funding.

Thursday saw the culmination of a two-month long campaign to raise awareness of the issues for midwives, particularly the Lead Maternity Carers (LMCs). Charlie Ferris, an LMC from Southland started the “Dear David” campaign after being told by her accountant that her business was just not sustainable. A breakdown of costs revealed that despite working up to 80hrs a week, Charlie was earning just $7.45/hr. And she isn’t alone. One analysis of LMC work has put the average hourly rate for an urban midwife at $12.80 and $7.23 for rural practice – that’s less that half the minimum wage!

After marching through the streets of Wellington we arrived at Parliament grounds where a petition with over 13,000 signatures was presented to the Minister of Health, David Clark. We heard from a line-up of speakers including Associate Minister of Health and Minister for Women, Julie-Ann Genter. A bound book of Facebook posts was also presented, and we were assured that our impassioned pleas had “been heard”.

In New Zealand there are two arms of the midwifery workforce, the LMCs and the DHB employed ‘core’ midwives. We have a symbiotic relationship and when one arm is under stress the other arm is called upon to carry the extra load. LMCs are on-call 24/7, have no sick pay or annual leave and their travel is not billable. Effectively it’s like being a contractor but without any ability to adjust your fees. Core midwives are paid under the DHB MECA and are represented by either NZNO or MERAS. It is my opinion that the lack of industrial voice for LMCs has resulted in the situation we have now where pay and conditions have become untenable. LMCs are leaving the profession in droves and our world-class maternity system is in crisis.

There is important mahi to be done in the DHB space as well. Midwives are specialists in maternity care and undertake a four-year degree programme. Despite functioning as autonomous practitioners who have the legal authority to prescribe, diagnose and discharge we are not remunerated as such and so feel very under-valued! I am hopeful that the pay equity process which forms a key component of our NZNO MECA claim will address these disparities.

As for funding the new co-design model, well that depends on how much gets dished out in what feels like the very long-awaited budget.

This International Midwives Day will go down in history as the year we midwives stood together, LMC and core, united and impassioned in our love for our work and our belief in delivering a quality service for the people of Aotearoa.

In solidarity
Sarah Gilbertson (Midwife, NZNO delegate)


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NZNO celebrates World Smokefree Day by lodging our smokefree services petition

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Today, the 31st of May is World Smokefree Day. Every year the Health Promotion Agency puts out great resources for people want to quit smoking and stay off tobacco for good. They have infographics to download and motivational facts like the one below. Not many people know that smoking makes you deaf!

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Researchers have identified though that without further big changes, New Zealand will not reach our smokefree 2025 goal, particularly for Māori and Pacific communities. That’s why NZNO was distressed when we heard last year that funding for some iwi and community smoking cessation providers was being cut, as well as for advocacy services like the Smokefree Coalition. NZNO Kaiwhakahaere Kerri Nuku said ““It doesn’t make any sense that on the one hand the Government supports the goal of Smokefree Aotearoa 2025, but on the other is pulling funding out of Smokefree advocacy services including the Smokefree Coalition, ASH and Smokefree Nurses. Every day we see the effects of smoking on our patients’ physical and mental health, and the social, economic and cultural wellbeing of their whanau. It’s heartbreaking.”

Nurses working to stop smoking in the community say they need advocacy and specialist services to refer patients to and reinforce their stop smoking message. Porirua Community Union’s Litia Gibson talked about the need for these services to NZNO last year in this video. “Any cut will affect all our services. Because it’s not just the services we provide, it’s the patients and the populations that we are caring for who are already in vulnerable positions.”

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NZNO decided to run a petition with Together, the digital campaigning arm of the Council of Trade Unions, to ask for more funding for these services. Today, we delivered 1823 signed names of nurses, caregivers, midwives, kaimahi hauora and their supporters to Marama Fox MP, in recognition of the longstanding work that she and her predecessors in parliament have done on ending smoking in New Zealand.

Litia and Marama had a little chat afterwards where Litia broke down the issues around referral services and increasing workload for nurses. “Without specialist services, we don’t have the time. You need to pack so much into an appointment, because with health funding where it is, community need is so great.”

Marama agreed on the need appropriate smokefree services and the future benefit this can bring to our country. “Being smokefree puts real money back in the hands of whānau. It protects our future generations, and ensures they don’t have to make the same decision to quit because they never start. It’s all about whānau.”

Marama had brought along a beautiful kete to put our petition in and present it to parliament. Litia in return swapped her red flower to put in the MP’s hair for the afternoon- ‘There, now your outfit is complete!’


We are proud that a little bit of NZNO is being delivered to parliament on World Smokefree day to support our Smokefree 2025 goal. Kia kaha koutou, thank you for supporting this mahi. Your names are now part of history.

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Older people deserve a little more of our time

Lyn Shirley is a Registered Nurse who works in aged care. She is also a Shout Out member leader and delegate for NZNO. Lyn’s involvement in Shout Out for Health led her to speak to M.P.s about how health under-funding is affecting the aged care sector. A public meeting in Nelson held by two political parties was the perfect opportunity for her share her nursing experience.

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“I feel very strongly that the issues nurses and other staff face in aged care need to be better understood by politicians and the public. Both staff and residents are impacted by under-funding and short-staffing, as is the whole of the health sector. With an aging population, more families will have to experience these problems soon if we don’t better plan and fund services now.

Elderly people who have just entered an aged care setting are vulnerable. They are more often high needs or even in end of life care. Nurses and other staff need to spend time with them to reassure them about the journey they are going through, moving out of their own homes and away from their communities and the people they know. Sometimes they can be confused about what is happening with their health. This is why it’s really important there are enough staff who can explain to them clearly and calmly what we are doing for them. For this to happen in aged care we need more government funding. All MPs need to be aware of our situation. After all, they may well be in an aged care home one day too!

Way back in 2011 I was involved in the Caring Counts report on the aged care sector, and I didn’t know what had happened to the recommendations of that report. I suspected not a lot, given my experiences working in the sector.

When there was a public meeting in Nelson on aged care earlier this year, I was keen to go. Labour Deputy Leader at the time, Annette King and Green Party Co-leader Metiria Turei were speaking and answering questions from people at the meeting, as well as Rachel Boyack, the new Labour candidate for Nelson. The public comments at the meeting matched my own experiences as a nurse working in aged care – it really validates our clinical expertise on the need for safe staffing for our elderly. There were a couple of student nurses there too who spoke with passion and confidence about the issues facing our sector.

After the meeting I managed to speak directly to an MP about some of these continuing issues; the inadequate staffing levels, the increasing workload due to the residents being more unwell, and problems with the way people entering care are assessed.

I spoke about needing more time to carry out the social and clinical assessments and interventions that we have trained for, and that it was so important in our jobs not to be rushed. This is how to treat the patients with the dignity they deserve. I also described how as nurses we need to not be so overburdened with work that we barely have time to think. The paperwork required of registered nurse has become more demanding. On some days I could be on the computer for hours, taking valuable time away from caring for the residents. I became a nurse to deliver care, not just reports!

We need more nurses to work in aged care. I know a lot of nurses in aged care experience moral distress and burnout when they can’t act in their patient’s best interests because they are short on staff, equipment, and time. We are experts in our own jobs. Part of being the best advocates for our patients is making sure their issues, and ours, get through to decision makers.

I felt really good being able to share just a little of my experiences and hearing others do the same at this meeting. I encourage our other members to make an appointment with their MP too. It’s a simple way you can get your voice heard, and your local NZNO staff will support you.”

To take action on health funding, contact your local NZNO office to be put in touch with a member leader like Lyn, or plan your own MP visit with the help of your local staff. You can also sign the open letter on health funding by leaving a comment at the bottom of this blog post.


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Where to next on pay equity/equal pay?

This blog is by Cee Payne, Industrial Services Manager for NZNO. Cee represented NZNO as part of the cross union bargaining team in the hard – won settlement offer for caregivers. Here she outlines some issues with the new proposed law, and what NZNO members can do to make it better.

IMG_5116Excitement at the pay offer settlement announcement for caregivers. Cee is pictured centre in the red skirt in front of Memo Musa, NZNO CE, Grant Brookes NZNO President at left, and NZNO caregiver members.

Pay equity/equal pay has been on a roller coaster ride in the last few weeks in New Zealand. First, we had the historic announcement of the Government’s $2 billion offer of settlement for Kristine Bartlett’s pay equity case for caregivers. The mood from caregivers across the motu was one of total relief and celebration. These women have been waiting so long on the minimum wage or close to it for better recognition of their value. It felt like the confetti had barely settled the very next day when the Government announced they were introducing a new draft Employment (Pay Equity/Equal Pay) law. This law includes a new ‘principle’ –the ‘proximity principle’ – that could have stopped Kristine’s case from ever happening

The mood of celebration turned into a gasp of disbelief from many of our members, who understandably worry about what this means for them. Unions were just as upset at both the message and the timing. The really annoying thing is that apart from this problem and a few other issues we can improve on, the new law sets out a better and easier process for making future pay equity/equal pay claims. It means other groups of women don’t have to go through many expensive rounds of court battles to achieve pay equity/equal pay.

I was one of the negotiators on the pay equity settlement for care and support workers and on the cross union, government and business equal pay principles working group. We had nearly two full – on years of research, meetings, and consultation to get the result we did for care and support workers. And although it was a long process, I believe the principles we used can work, if they are not restricted by this new ‘proximity principle’. In fact, New Zealand will probably have the best pay equity/equal pay law in the world if we can sort this out.

Kristine and the negotiation team signing the terms of settlement of the pay equity offer for caregivers in the Beehive, Monday the 2nd of May 2017. Cee is signing on behalf of NZNO.

Pay equity is being paid fairly for different jobs that are similar, and equal pay is being paid the same as men for the same work. What the Government is proposing for pay equity is that for women in historically female dominated jobs you have to first find a relevant male-dominated job to compare yours to in your own workplace. Then if there is no relevant job available, you can look in your own industry before you can look outside your sector at other jobs done mostly by men with the same or similar skills, training and responsibilities. So for Kristine Bartlett for example, her employer wanted to argue she should be compared to a gardener working at a rest home. But wages are low across the whole aged care sector because it is female dominated, so her union E tū thought she should be compared to a Corrections Officer-a better fit for her skills, responsibility, effort and conditions of work. These male dominated jobs are called ‘comparators’.

Finding the best comparator or even multiple comparators can be a long process but it’s an important one to get right. There will be no perfect male-dominated equivalent, so you might need to take one job for the qualifications, another for the effort, and a third for similar conditions of work to make your case. NZNO believes it’s really important we find the best job, not the physically closest, especially since so much of the health sector is female dominated. Otherwise, equal pay cases could be artificially restricted by the same discrimination we are trying to re-balance.

The good news is it’s not too late. The Government is taking submissions on the new law until the 11th of May before it has to start going through parliament. The more people that write to them, the better chance of removing this new principle to get the fairest comparators. It is imperative the Government passes the best pay equity/equal pay law in Aotearoa/New Zealand.

We don’t know yet which other parts of the membership could be eligible for cases in the future, or if police, engineers, or any other job would be the best ‘comparator’. NZNO is committed to 100% of our members who are performing work historically undertaken by women achieving pay equity/ equal pay. There are existing pay inequalities between different groups of our membership, and we need to carefully go through each group once we have the new law. Any case of course would involve significant consultation with and campaigning from members, just like we did with caregivers.

But right now the most important thing for all future cases is getting a fair and sustainable law that works. For that we need your support. If you feel passionate about women being paid for their worth and ending gender discrimination forever, write to the Government right now and tell them why you don’t support the ‘proximity principle’ before they write it into the law. Send us a copy of what you said too by emailing nurses@nzno.org.nz. It could be the best invested 5 minutes of your life.

 


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An open letter to New Zealand voters.

blog banner open letterPictured- NZNO members and Registered Nurses Phoenix and Michael.

 

This year, we are asking for your help.

This isn’t something people working in healthcare would normally do – it’s usually the other way around. We help you in your time of need – in your hospitals, your Plunket office, your home, your marae and in your community. We love our skilled work, and turning your worst day into a better day. When you are sick, injured or in need of support, you can turn to us for healing, comfort and safety. We help no matter who you are, where you come from, how much you earn or where you live. Knowing we can help is what drives us to work in health.

 
Right now it’s getting harder to do the work that we trained for. We want the best for everyone who comes into our care, but health underfunding means that sometimes we’re not able to give you the best. We are often short staffed, rushed, and need a little more time to give you care. We are sad sometimes because of what we couldn’t do for your tamariki, your grandparents or your neighbour. Many of you are feeling frustrated by delays in getting the healthcare you deserve and expect. We are frustrated too.

 
Together, we can fix this. If health was funded sustainably now and into the future we could improve that service for every New Zealander. We can have a health system where every patient knows that when they need care, they will see the right health professional, with the right skill, in the right place, at the right time. This is the proud tradition of our country.

 
It is election year. Who you vote for is your personal choice, but we are asking you to use your vote to help us give you and your loved ones the best care. Make sure you are enrolled to vote now, and that the people you know are enrolled . Check out which political parties are committed to increasing health funding. Pay close attention to what they say about resourcing us to give you quality care.

 
We are asking you to make health funding your first priority this election. Talk to your friends and family about voting for health. Without an increase to health funding we are all in serious trouble. With your vote, we can improve and save lives.

Yours sincerely,

NZNO Kaiwhakahaere Kerri Nuku, NZNO President Grant Brookes, the undersigned nurses, caregivers, midwives, healthcare assistants, kaiāwhina, and the people they care for.

You can add your name, where you’re from and message of support as a comment on the blog. Your nursing team would really appreciate it.

Authorised by Memo Musa, New Zealand Nurses Organisation,
Crowe Horwath House, 57 Willis Street, Wellington
PO Box 2128 Wellington