NZNO's Blog


It’s not a skill shortage, it’s a planning deficiency

600px-New_Zealand_on_the_globe_(New_Zealand_centered).svgThe Immigration Department’s “Skill-shortage list” is a list of occupations that are in short supply in New Zealand. The list means that would-be migrants with those particular skills are given preference over migrants whose skills are not on the list. It seems like a great idea and a good way to ensure that New Zealand’s skills needs are met.

Unfortunately, it is sometimes used for the benefit of employers, not the NZ workforce as a whole.

NZNO is constantly responding to consultation requests from Immigration NZ as DHBs and other health providers, especially within the aged care sector, push for nursing and health care assistant roles to be added to the skills shortage list.

Recently, Hawkes Bay DHB, Southern DHB and Capital and Coast DHB have all applied to have registered nurse and midwife positions added to the skills shortage list, and to renew their accredited employer status so they can fast track offshore recruitment of nurses and midwives.

We absolutely reject that the DHBs need to recruit nurses and midwives offshore while there are large numbers of nursing and midwifery graduates still seeking employment.

As a country we need to start addressing the root causes of recruitment and retention difficulties and plan for a sustainable, home grown workforce.

It is not fair that we continue to educate and train nurses and then deny them employment while continuing to recruit offshore. Only 61 percent of last year’s nursing graduates have found placements in nurse entry to practice positions and only half of the country’s DHBs are offering placements in the second advanced choice of employment (ACE) round.

Overseas recruitment processes are long and expensive and often include a six week competence assessment programme. Surely, that time and money would be better spent on supporting new graduates into practice, and facilitating internal appointments with training and education that supports expanded practice and rewarding career pathways for nurses and midwives.

NZNO recognises that demand for nurses is increasing, as New Zealand’s population and the nursing workforce ages, but recruiting from overseas to fill workforce gaps is not the answer.


Don’t sign our future away!

TPPA311Last weekend Trade Minister, Tim Groser accused NZNO and others of being less than truthful when we say New Zealanders are not being consulted about the Trans Pacific Partnership agreement (TPPA), which is currently being negotiated in secret.

He said, in a RadioNZ interview, “There’ve been more discussions with stakeholders on this agreement by a country mile than any trade agreement I’ve been associated with negotiating in New Zealand in the past 30 years, it’s just that these are people taking a very, very politicised view of the matter.”

He then went on to assure New Zealanders that they would hear the facts when the deal was put before Parliament.

Sadly, he neglected to say that when the deal does finally “get to Parliament’ it will be waaaay too late to do anything about it. In fact, Parliament itself is not even able to do anything about it.

Professor Jane Kelsey explains, “Parliament’s role in treaty making is largely symbolic. It has no power to decide whether or not the TPPA should be signed or ratified and no ability to change its terms TPPA or require it to be renegotiated. The select committee process is a farcical exercise because its members know they cannot change the treaty.”

And as for those purported consultations… a few private briefings of selected health representatives does not qualify as transparent, informed public debate.

Why is the content of the TPPA a secret to New Zealand stakeholders? We expect transparency and the protection of public health as a key pillar of our social democracy. ‘Commercial sensitivity’ does not justify blanket secrecy where publicly funded health is at stake; especially when, unlike New Zealand citizens, US trade lobbyists have access to the ‘secret’ text.

We do know some things about what is being negotiated – I blogged about it here and it’s not good news.

Most governments, and it seems that ours is likely to be one, will be deterred from public health regulation because they’re scared of being sued by big business, though a few have refused to be intimidated. Australia went ahead with its plain packaging of tobacco products and is staunchly defending its right to do so against three investor challenges, at a cost of many millions of dollars. Disappointingly, New Zealand reacted by delaying its plain packaging legislation, leaving Australia to defend this important public health decision alone.

This agreement was initiated before the global financial crisis in 2008 and both the economic climate and the public’s willingness to accept deregulated markets allowing unbridled corporate growth have changed a lot since then. People are aware that while there have been tremendous gains as a result of new health technologies and medicines, the benefits have not been shared equally. Inequility is increasing globally, regionally and within New Zealand. The TPPA has the potential to exacerbate that inequity if the growth and innovation it promises increases the costs of health care as has been suggested.

Come on Minister Groser – release the text, release publicly commissioned information and analysis, and give New Zealanders a say in what you’re signing us up to.


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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.