Nurses want to contribute to new system, not just watch a game of musical chairs

If the reforms’ disruption sparks new collaborative opportunities, then nursing is ready, reports Fiona Cassie

The health reforms docu­ments don’t shed much light on specific health workforces in primary care.

The papers discuss general prac­tice’s or GP teams’ role and funding under the new locality network sys­tem. A fact sheet on primary and community services includes dis­trict nurses and public health nurs­es under that umbrella.

Health minister Andrew Little says the reforms mean doctors, nurses and other health workers can “concentrate on patients in­stead of battling bureaucracy”.

In his launch speech, Mr Little added that, among the five “system shifts” required to reform the health system it is stated that “health and care workers will be val­ued and well trained for the future health system”.

The new agency Health New Zealand is to be responsible for national workforce planning and development.

Nursing leaders hope the re­forms’ disruption will open up opportunities for significant change and for new voices to sit at the policy table.

The New Zealand Nurses Organisa­tion hopes the focus on a single nation­al health system may see resolution of the large pay-parity gaps experienced by many nurses working outside DHBs.

NZNO president and kaiwhakahaere Kerri Nuku aspires for nurses to be “rec­ognised and paid as a group of health professionals, not depending on where you work”.

College of Nurses Aotearoa executive director Jenny Carryer says there is not enough detail to see how the reforms’ new structures will pan out for primary health­care nursing.

She is hoping for sig­nificant change, includ­ing the release of nursing from “current employ­ment constraints”, more new graduates into pri­mary care settings, and investment to foster and grow Māori and Pacific nursing workforces.

Professor Carryer says these changes require a detailed workforce devel­opment strategy, and requires “following the advice nursing has provided for many years, which has fallen on deaf ears”.

This was echoed by Ms Nuku. She says nurses want more than public sympathy for pay disparities, including the iwi and Māori nurses whose cause she has long championed. “We want to be recognised and contribute actively across all tables.

“And what Māori nurses have also said is, we don’t just need to shift man­agers from one position under an old health system to the new health sys­tem, we also need to be looking at peo­ple who will bring innovation, will listen and are not afraid of change.”

She says nursing also hopes bringing in the consumer voice may help “decon­struct what is predominantly quite a medical space”, and foster innovation and better collaboration.

Former Ministry of Health chief nurse Margareth Broodkoorn told the recent National Rural Health Confer­ence that the health sector reforms should focus first on what people need, and then build services and workforce around that.

“We can’t be precious about setting up systems that respond to us keeping our jobs; we need to look at other ways of doing things, including using our un­regulated workforce,” says Ms Brood­koorn, who is also chief executive of Hauora Hokianga.