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Taking it to the streets…

Anne Daniels, President
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

As I write NZNO Te Whatu Ora members are taking our fight for safe staffing and fair, equitable pay to the streets, in rolling strikes around the nation. We are fighting the good fight for every NZNO member, everywhere, and all those we care for.

Our actions are not taken lightly. We know that we stand in the breech to halt the tide of misinformation and political doublespeak that is demeaning to our membership. Decisions are being made behind closed doors about us, without us.

We know that our patients, families and communities are being put in harm’s way with the constant cuts, redundancies and regionalisation rationalisations being made in a context where the almighty dollar rules.

But my hope, our hope is in the people who stand beside us, walk with us, in burgeoning numbers, as we take our fight to the streets of this land, countering the sound bites that state “there are no cuts”, “there is no CCDM pause”, “there is no more funding”, and last but not least “nurses pay equity has blown Te Whatu Ora’s budget” when it is patently too low to meet the needs of our people.

Despite the chaos reigning in the political landscape, NZNO members are shining a light of truth, integrity, and solidarity on the direction we are taking.  We are not tolerating any breeches to our contracts and inherent conditions of work. We are striking and visible to the public on the streets. We are taking our fight to the courts. We are sharing our stand for the health and well-being for all through our members’ experiences in the media. We have a growing presence in the hearts and minds of the people of Aotearoa, reflecting the power engendered in our activism and solidarity.

Christmas is a time of hope and the New Year a time for realisation of those hopes. We cannot and will not fail because many depend on us to succeed. We can do this, together.


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A year of chaos

Kerri Nuku, Kaiwhakahaere
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

As another year draws to a close I am reminded of the whakatauaki, Ka mua,ka muri – walking backwards into the future. It suggests that time is a continuum, with the past present and the future connected and where learning from the past can help inform future actions.

Having just completed the national Te Whatu Ora strike for safe staffing and fair pay, further questions being raised in the media about the health budget, I wonder what learnings we can take from 2024.

The year has been fraught with (among other issues) conflicting messages, their lack of proper communication and consultation and a legacy of destruction.

At the start of the year there was a general acceptance among nurses and Te Whatu Ora that there were approximately 4000 nurse vacancies across the sector – a fact acknowledged in the build up to the 2023 elections. By March the cracks began to surface with Budget issues announced blaming over recruitment of personnel, especially nurses as the significant contributor to budget blow out. Te Whatu Ora were instructed to collectively save $105 million by July using ‘cost containment’ methods including banning double shifts, pressure to take leave, non-replacement of sick staff and wiping unfilled roles.

All the while offering reassurance to the public that none of the cost saving methods will impact the level of care patients receive. Despite reassuring messages patients were impacted and the health professional alike all expressed serious concerns about burn out, fatigue and staffing pressures.

Then the announcement of a recruitment freeze for non-patient-facing hospital roles followed together with the hiring limited places available for the mid-year intake of new graduate nurses. We were told in the nine months from June 2023 to March 2024, 2886 nurses were recruited. There was no mention of retirements in an aging workforce, resignations and nurses migrating overseas, especially to Australia.

In June NZNO released accessed information under the Official Information Act (OIA), Te Whatu Ora data showed more than a quarter of nursing shifts were below target staffing numbers, and some wards operated below safe staffing levels nearly all of the time. NZNO did not receive responses from Te Whatu Ora, something wasn’t adding up ,how can we reassure the public of quality health care when Te Whatu Ora data identified nursing shifts were understaffed.

Then it seemed to make alittle more sense , the Commissioner is reported as saying “there are too many nurses for the budget ’’while the CEO of Te Whatu Ora acknowledges the new 3000 nurses are needed for patient safety. So what and who sets the budget -are we working for determining what quality of care looks like to meet the needs of the community and staff accordingly or are be setting a budget based on funding cuts and recruiting the nurses to fit the budget.

The burning platform is what about the other parts of the sector , the impact on rural communities where staffing and funding is impacting of the quality and accessibility of services to these communities, or how about nurses in Primary care and community how well are they supported to cope.

As we walk into 2025, I can only encourage the Minister to stop talking to the sector and talk to the nurses, health care workers and tauira we are all in healthcare to make a difference that I am sure of.

We can’t continue to walk confidently into the future without a comprehensive long term workforce plan designed by those with real knowledge of the issues.


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‘Hearts and Minds’

Anne Daniels, President
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

‘Hearts and minds’ is a concept occasionally expressed in the resolution of war, insurgency, and other conflicts in which one side seeks to prevail not by the use of superior force, but by making emotional or intellectual appeals to sway supporters of the other side. The use of the term ‘hearts and minds’ reference a method of bringing a so-called subjugated population on side.

The term was widely used by the British who were intent on sanitising the experience of fighting wars of decolonisation. The British systematically hid evidence of their counterinsurgency campaigns in a bid to mislead. The ACT party is using a similar strategy, using misinformation to galvanise sympathy and support for their Treaty Principles Bill, a strategy that has been torn to shreds by many including Kennedy Warne  in his New Zealand Geographic critical piece A Matter of Principles.

As I write, possibly the largest uprising of tāngata whenua and citizens of this land are voting with their feet as they join a nationwide hikoi towards parliament grounds. Why? The foundation of this nation is being disrupted in the halls of government with an overt attack on the constitutional status of te Triiti o Waitangi to remove its effect in law and limit Māori rights and Crown obligations. This will undermine social cohesion by strengthening discrimination and racism. It will increase  the divide of social determinants of health experienced by Māori, and those who have not rather than have. This will directly negatively affect the health and well-being of Māori and an increasingly impoverished population. As such, it is the business of our NZNO members, to stand up and advocate for those we care for. The time for political neutrality is well past.

Disruption, by this Coalition government, is evident everywhere you look. For example, the expectation that the health system will be there to take care of us, when and where we need it. We all know that that is no longer true. We have shifted from the pre 1990s, where the public and primary health care system were free for all New Zealanders, to an increasingly user pays system that is blocking access to timely health care for many, resulting in increasing acuity and emergency department presentations, long wait times, and for some avoidable harm and death as outlined in this story by The Hui.

The lack of resource to prioritise patient safety is becoming an alarming pattern, for all to see.  A ‘pause’ on Care Capacity Demand Management (CCDM) data collection, at Te Whatu Ora, is a case in point as it has a direct effect on knowing if there is a need for more nurses to be recruited to a specific unit, or if a particular shift is under target and there are not enough nurses on duty to provide safe care. How can Te Whatu Ora rationalise this ‘pause’in terms of patient safety? All fingers point to saving money rather than saving lives. If you don’t know how many more nurses you need to recruit, you don’t need to be accountable to recruit them, nor pay them once recruited. If you don’t know the required full time equivalent (FTE) nurses you need on any one shift (with the right knowledge, skills and experience), then you don’t have to fill the gaps, and you don’t have to pay the wages.

The pause on CCDM data collection has galvinised our NZNO members working in Te Whatu Ora to overwhelmingly vote to strike. There has been a mindshift within our membership. Gone is the polite waiting for the employer, who historically drag their feet in negotiations, to eventually come to the table with an offer. NZNO members are very angry. We are sick and tired of doing more with less. Being told that they must meet unrealistic expectations of a Government who has set health targets that cannot ever be met in an under resourced and grossly underfunded system has pushed us past our limits of tolerance. We suffer when our patients suffer. On 3 December, our members too, will vote with their feet.

We are not the only ones. About 35,000 people protested against the proposed changes to the Dunedin Hospital rebuild business case. Thousands more protested in the recent Council of Trade Unions (CTU) ‘Fight Back Together’ campaign to keep workers’ rights. And now an estimated 50,000 are walking to Parliament to fight for te Tiriti o Watangi. Instead of division through disruption, the opposite is true. The groundswell of change, ‘in the hearts and minds’ of the people are reflected in those who have never protested before but are now. Maranga Mai! We are rising up together. The power will always be with the people, the many, not the few. We will overcome.

Kia kaha!


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Health Justice – The mana of our mokopuna

Kerri Nuku, Kaiwhakahaere
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

This week, reports came out of tamariki in Ōpōtiki left alone after armed police raided their homes and arrested their parents. A kuia and her daughter-in-law strip searched for no clear reason. Other tamariki were left at school with nobody to collect them.

The police minister vehemently denies it, but Māori parents know all too well that these stories aren’t made up. Too many of us have too many similar stories to believe otherwise.

No mokopuna should ever have to go through the trauma of seeing their parents arrested to then be left to suffer alone. 

This Government’s ‘tough on crime’ approach is not only ineffective but is also producing a new generation of traumatised tamariki and rangatahi. 

Dame Whina Cooper said, “Take care of our children. Take care of what they hear. Take care of what they see. For how the children grow, so will the shape of Aotearoa.” 

That couldn’t be more relevant than now. 

How we treat tamariki and rangatahi, and especially how we treat the mokopuna of those we believe to have done social harm, is one of the most significant reflections of the moral sensibility of a society. 

And how do we see Māori, African American, Palestinian, Aboriginal and First Nations tamariki and rangatahi being treated? They are criminalised, put into abusive state care, and traumatised through over-policing and an injustice system. 

This all reflects pure dehumanisation. It shows a racist ruling class that believes that it is ok to trample on the mana of mokopuna. More than that, it shows a government whose definition of justice causes further intergenerational trauma through force and fear.

It is a dark week, where the Treaty Principles Bill has been introduced early in a cowardly attempt to avoid the mass hīkoi happening down the motu. 

In this darkness, there are so many lies spread about who should make decisions and what equality means. After all, the Treaty Principles Bill says, in essence, that the colonial government can do what it likes irrespective of what actually works for tangata whenua – like boot camps or Oranga Tamaraiki. 

That’s why it’s important to remember that contrary to whatever the Government will try to have you believe, Te Tiriti o Waitangi is all about justice. It’s about hapū and iwi doing what they know best to make the world safe and prosperous for their whānau and mokopuna. Part of that is dealing with social harm through our own tikanga.

As health workers we must think more broadly about health justice broadly, we see the physical, emotional, and mental toll of racism, colonialism and dispossession first hand. 

So, to re-focus us we need to return again to the words of Whina Cooper.

“Take care of our children… For how the children grow, so will the shape of Aotearoa.” 

What shape do we wish to see? Can’t we see that how we care for our children is how we care for our future? Don’t we wish for justness that upholds the mana of our mokopuna? 

I know what kind of Aotearoa I believe in. It is own time to be courageous and shape Aotearoa.


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(Un)Intended consequences

Anne Daniels, President
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

Unintended consequences are outcomes of a purposeful action that are not  planned or foreseen. The concept provides a useful tool for explaining complexities resulting from government policy and law. For the less serious matters, it can be laid alongside Murphy’s law as a way to view outcomes that perhaps should have been seen as self-evident. For more serious matters, it provides a perfect lens through which to view and analyse complex reactions and the impact of change. As a case in point, one could ask if there are any (un)intended consequences regarding the current Coalition Government’s position on the Dunedin hospital rebuild?

Unintended consequences can be seen as intended if they are driven by the need for an immediate solution, a need so urgent that the decision to ignore outcomes is deliberate such as the strong and repeated evidence that Dunedin must have a tertiary level care hospital to support not only the Otago region but the whole of the South Island. There are currently only two, the other being Christchurch Hospital.

There is also the concept of a “self-fulfilling prophecy” which describes a false definition of the situation evoking a new behaviour which makes the originally false conception come true such as misinformation through the use of specific language that negates and hides the truth. An example of this is the Government saying the Dunedin hospital rebuild will happen suggesting we will get the tertiary level care hospital that is needed for the whole South Island but offering a secondary level hospital instead.

Currently, Dunedin Hospital provides tertiary level care (see primary, secondary, tertiary, and quaternary care). It’s services support all primary and secondary health and regional hospital services within the Otago region which has increasing demand as it grows as a vibrant and growing tourist mecca. Dunedin Hospital also provides a myriad of high-level specialist care services to meet the patient need throughout the South Island. And, as identified in the original 2021 business case, one of the key drivers for change is  Otago’s high older population who are more likely to experience health challenges such as stroke (70% of strokes occur in patients 65 or older), heart attack (60% of MI occur in patients 65 or older), abdominal aortic aneurysm (triple A), or trauma (over 40% of people over the age 65 experience trauma and are more likely to die than younger people).

Why is this important?

If the Government gets its way and the level of tertiary care is reduced, what will this mean for patients? We all know TIME is brain/heart muscle and we have heard of the golden hour in trauma care. Acute care is usually time-sensitive and can result in death or long-term disability if the person does not quickly receive the care they need. Further, advanced trauma care can only be provided by Level III intensive care units and Emergency Departments, of which Dunedin Hospital is one of two in the South Island.

Reducing capability and capacity of the “new build” will also reduce the level of care and the ability of the Otago Medical School to provide the level of clinical placements it needs to continue to attract students. This in turn will impact the economic outcomes of the city and region. Fewer services mean fewer health care professionals and support staff, and poor if not tragic outcomes for the people who need tertiary care services. Lastly, the impact on demand for the Christchurch Hospital tertiary level care (if it is the last one standing) will be monumental.

On 23 October 2024, the Council of Trade Unions led a nationwide revolt against “the most anti-worker government in decades, who are attacking rights of workers and the right to publicly funded health care that meets the need of the people over their lifetimes”. Thousands of people stopped work, as was their right, and made it clear to the Coalition Government that when workers have their backs against the wall, they will fight back, and win. The Dunedin hospital rebuild is not a regional issue, it belongs to all of New Zealand. it will set a precedent for this Government, to continue to divide, rule, and dismantle. But together, we are fighting back, and we will win.

To be a part of the change you want to see, please sign and share the petition to build (Dunedin Hospital) it once, build it right..

You can sign the petition here


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There are benefits to sharing power with one million Māori

Kerri Nuku, Kaiwhakahaere
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

It’s not unusual in any political cycle that indigenous people are used as political fodder. Internationally, nationally and regionally, indigenous people are blamed for increasing violence, homelessness, poverty and draining state resources particularly in justice, welfare and health.

It becomes easy for ordinary people to believe this because the perpetrators of lawlessness and violence, relentlessly splashed all over the media, are disproportionately images of people of colour. At the heart of these political games are people, children and mokopuna who are already prejudged by parts of society because they look a certain way or are born into a particular class of people.

Shifting the burden of responsibility is easier to do because it is harder to admit that we have failed as a country and we have failed to support our indigenous people.

In Aotearoa, a year into the Coalition Government, attacks on workers, unemployed and Māori are clear to see. From the Treaty Principles Bill and the Māori Wards referenda to the scrapping of Fair Pay Agreements, benefit sanctions, and the war on health and safety legislation, this is a right-wing Government bent on stoking racism, eroding worker rights, and helping the rich get richer.

The assault on our rights is overwhelming, but it has also heightened the consciousness of those who want a more just world. Yet, though we say it all the time, we have to acknowledge that even though this coalition is absolutely terrifying and hateful, no Government of the past few decades has made truly transformative change that benefits the health of our people.

We can’t wait for more promises from politicians or experts to tell us what we already know. We know what it would take to be truly valued in the work we do, and we know what it would mean to live in a society that upholds equity, human rights and Te Tiriti o Waitangi.

We all know what Māori health inequities look like.

As nurses, we know Māori are unlikely to live as long as non-Māori. We also know that by the time many Māori reach the hospital, their illness is advanced and sadly, the clock already began ticking for them before we even triaged them.

There is one common question I’m often asked by non-Māori members and colleagues, who like me are sick of seeing so many tangata whenua die of things that could have been prevented or treated if caught earlier.

That question is: “what’s the best way to address Māori health inequities”?

In my view, the answer does not lie in the medical or the clinical.

The answer lies in sharing power (and responsibility) with Māori at all levels from the boardroom table to the frontline, backline and sidelines, inside and outside our union.

The Māori population is now at its highest – one million – and at the rate my whanau, hapu and iwi are going, it will only rise.

From the people of Ngai Tahu in the South Island to the people of Ngapuhi at the top of the North Island, Māori want the genuine partnership guaranteed to them in Te Tiriti o Waitangi. They want to be in control of their own destiny, they want mana motuhake.

Māori have proved they can fix themselves when power, and that includes resources and spaces, are shared with them and when they are not micromanaged.

In the 1980s, the Māori language had almost become extinct until Māori created the kōhanga reo movement. Forty years later, the language has been saved – tens of thousands of Māori are speaking it. And hundreds of thousands of non-Māori are benefiting too.

At NZNO, we are still on the journey of sharing power, resources and spaces with Māori. The position I hold is a clear example that we have started that journey. But it must not stop there.

We must let Māori fix themselves. Tangata Tiriti or non-Māori in Aotearoa can do that by sharing power, resources, spaces with Māori at every level of our mahi.

Sometimes that means tangata Tiriti stepping aside to let Māori talk rather than talk for them.

What’s good for Māori, can only be good for this nation because when the most disadvantaged in our society are empowered, everyone in that society benefits.


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Heads stuck in the sand

Anne Daniels, President
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

Putting ones’ head in the sand is a well-known idiom that suggests that you are ignoring or avoiding something challenging. It alludes to the idea that the ostrich put its head in the sand to ignore danger when, in actual fact, the ostrich was turning the eggs it had laid in a hole in the sand.

The current coalition government is doing both. It is ignoring the realities of the underfunded, under-resourced health system and looking after its own interests.

The Coalition Government is “not responding, or debating, just trying to rewrite history – trying to put a positive spin on a Budget that doesn’t add up …despite significant cuts to the health and other budgets,” Labour MP Kieran McAnulty recently told Parliament.

For those of us who work in the health system, we know unsafe nurse staffing has been exacerbated by this Government’s obsession with cutting costs.

There is a myriad of examples of this truth despite all statements to the contrary:

These truths and many others are being ignored by the current Government and those who are responsible for the health and wellbeing of carers and the cared for.
Minister of Health Dr Shane Reti was the opening speaker at last week’s NZNO Annual General Meeting.

In introducing Dr Reti, I asked him to have a direct conversation with the NZNO delegates – who represent you, our 62,000 members – about the underfunding and unsafe staffing realities they face every day. Instead, he told us we had to do more with less to meet his health targets within existing resourcing.  He then left before any conversation could be had.

Despite the ‘head in the sand’ approach by those who govern, our story must be one of hope, not despair and told to those who will listen and act, the people, our people.

The first day of bargaining for the Te Whatu Ora collective contract, covering 35,000 of our members, began on Wednesday. One of our most important claims to address the nurse and midwife workforce crisis, is nurse patient ratios that are culturally appropriate (2024 Claims – Maranga Mai (nzno.org.nz).

We know the problems, but we also know the solutions. Nurse and patient outcomes improve when nurse to patient ratio legislation (underpinned by a fit for purpose Care Capacity Demand Management system) is implemented. The evidence is strong and irrefutable:

Our Tōpūtanga Topuhi Kaitiaki o Aotearoa/NZNO Maranga Mai! strategy calls for “every member, everywhere to act”. 

If we want change, then we all need to use the power of the biggest health union in the country to make the change happen.

When the call for all NZNO members goes out to stand up and fight back, to stand on the picket line, to march in the protest, to stop doing overtime or extra shifts, to go on strike, to act – we must all be there.

We will win when we rise up together. Maranga Mai!


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Our leaders speak: Find your why

Kerri Nuku Kaiwhakahaere
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO

Despite the difficult workforce and working conditions at the height of COVID, nurses were part of the critical workforce providing care under such extraordinary circumstances. Internationally hailed as heroes – the nurses didn’t ask for bouquets or applauds, they are trained and skilled to work under these exceptional situations. They asked not to be forgotten once the crisis was over.

Unfortunately, that is exactly what has happened.

Over the past four years, I have seen nurses challenge the political narrative that the health system and nursing workforce isn’t in a crisis, that workplaces are safe and adequately staffed and that health system is built around quality of care with the patient central to that care. While the reality is that nurses are still fighting for compliance with collective agreements, holidays payments, understaffing, and a lack of investment in health funding while there is criticism that nursing is the reason for the health budget blow out.

It is hard to image patients at the center of care when the language being used to describe the health sector seems more like a production line, words like productivity, efficiencies and effectiveness, and maldistribution of the workforce.

Almost two weeks ago in the build up to the Indigenous Nurses Aotearoa Conference, in a media release, I spoke of the anger of Māori nurses fed up with the historical issues of underfunding, pay parity and working conditions. But additionally, the frustration amplified further as legislation is set to roll back the gains made by Māori since the passing of Te Tiriti o Waitangi Act almost 50 years ago.

The Coalition Government’s efforts to remove references to Te Tiriti from legislation and Crown entities, exemplified by the proposed Treaty Principles Bill, not only threatens to deny Māori as Indigenous people but to erase Te Tiriti/the Treaty in law.  From health, to education, to the environment, to social services, there will be no recognition given to Te Tiriti/the Treaty. While this is significant, it is yet another blow to the already numerous legislative changes attempting to dismantle mana Motuhake. From the dis establishment of Te Aka Whai Ora, rolling back the official use of te reo Maori, threats to Maori wards, repeal to smokefree legislation and diminishing the importance of whakapapa for children in state care through the remove of 7aa, just to name a few.

These nurses are not only committed to the fight to protect their tino rangatiratanga, but also to fight to protect the work they do as nurses, kai mahi and tauira.

Nursing is being squeezed everywhere and the role of the nurse will become less and less about the unique and intimate relationship between nurse and patient, but rather transactional episodes to meet production efficiencies.

Over the coming months, nurses must take to the streets and join together to fight back. 

Find your why and help create the future for nursing as nurses, health care worker, kaimahi and tauira!

Kia kaha!


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Our leaders speak: Stand up fight back, workers’ rights are under attack

Kerri Nuku Kaiwhakahaere
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO

International solidarity is critical! In recent weeks as representatives of NZNO, we were given the opportunity to interact with our visiting colleagues from the US. What we found was that even though they are a world away their problems are similar.

We discovered one of their main issues as well was solidarity of nurses. There is power in solidarity and nurses worldwide need to unify now more than ever. We need to fight back against the powerhouses in authority, and health as the link to get us where we need to be in order to fight for the social justice that society’s most vulnerable deserve. Therefore, it is critical that we share information and ideas.

We can use health as an access point to think about justice broadly. It’s where we see the physical, emotional and mental toll of racism, colonialism, and dispossession firsthand. What we need is collective union voice of nurses to fight back not just to protect the profession of nursing, but also the role that we have as unionists.

Whether we like it or not, health is intrinsically intertwined with politics. Take the US elections for example. Its impact has already reached our shores, or it is on its way. If Donald Trump gets elected as president again, the impact he will have across all three political platforms will be detrimental to workers’ rights. The US unions are terrified of as they know that as soon as Trump comes in, it will almost be the death of the unions. He will reverse the rights of workers and the right to unionise.

There is an uncanny parallel between Trump’s Republican Party and our coalition Government. They’re both all about privatisation and building capital and privatised wealth. In Aotearoa, we’re witnessing the power of the Government to make or shift government policies to the right.

What Aotearoa urgently needs is a government that understands the value of healthcare. It is our jobs to ensure they understand this. NZNO has been described as militant, but I think it’s what is required from us. We’re here to protect the rights of workers and we’ve got to remember that. The union is about holding strong and allowing members the freedom to do their work.

As a union, we need to make sure that we’re united. It’s about Kotahitanga because Kotahitanga to me, is not just about being united, but caring for those you need to unite. That’s what we need to do as a union. We’re going to face many battles, but we’ve got to be clear, and remember those who have struggled for us to get to where we are today. And we’ve got to make sure that we leave it in a better place for our mokopuna so we’ve got to keep holding the line and keep pushing forward.

And like we’re doing and it’s significant that we share information and ideas.

I want to conclude by saying this is our fightback and this is our opportunity to push back. This week, I listened to the Access health workers battle cry: “Stand up fight back, workers’ rights are under attack”. and I think we’ve got to really keep that in the forefront because we are seeing workers’ rights diminished and our power undermined. And we are finding it more and more difficult to work in the health sector unless we are united.


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Our leaders speak: Following the rules (Yeah? Nah!)

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.