‘How we got to where we are’ – Speech to NZNO Canterbury/Waitaha & West Coast/Tai Poutini Regional Convention

Notes of a presentation to NZNO Canterbury/Waitaha & West Coast/Tai Poutini Regional Convention on 28 May, as part of a leadership session alongside NZNO Kaiwhakahaere Kerri Nuku and Chief Executive Memo Musa.

Photo courtesy of Jacqui Bennetts.

E ngā mana, e ngā reo, e ngā rau rangatira mā, tēnā koutou. 

To the authorities, the voices and the many leaders, greetings. I acknowledge in particular the fellow members of the NZNO Leadership Team, Chief Executive Memo Musa and Kaiwhakahaere Kerri Nuku. Thanks to Regional Council Chair, Cheryl Hanham, and Te Rūnanga rep Ruth Te Rangi for the invitation to be here today. To the staff and all the nursing leaders in the whare (which is everyone here), greetings to you. 

Who am I? Ko wai ahau?

Ko Kapukataumahaka te maunga, ko Ōwheo te awa, ko Cornwall te waka.

Ko Don rāua ko Helen ōku mātua, ko Tangata Tiriti tōku iwi, ko Grant Brookes tōku ingoa.

Kua maumahara ahau ki tēnei whakataukī i tēnei rā: “He ora te whakapiri, he mate te whakatakariri”. 

Nō reira, tēnā koutou, tēnā koutou, tēnā koutou katoa. 

I hail from Dunedin. I grew up at the foot of Mt Cargill and by the Water of Leith. My ancestors arrived in Dunedin on board the ship Cornwall in 1849. The son of Don and Helen, my name is Grant Brookes.

As we gather today, I recalled the whakataukī: “He ora te whakapiri, he mate te whakatakariri”. “There is strength in unity, defeat in anger and division”. 

So greetings, one and all. 


It’s always good to be back here on the Mainland, on Te Waipounamu. I called this city home for a time, when I moved north from Dunedin and took my first job after leaving school. That was some time ago now, back in the mid-1980s, a while before I discovered my true passion in nursing.

But I cannot stand here today without acknowledging the tragedies which have befallen this beautiful place in the years since, and the resilience of its people. 51 lives, on 15 March. And you, “heartbroken but not broken”. 

This is the ninth and final NZNO Regional Convention for me this year. 

In the eight previous conventions, I’ve been asked to address a variety of topics – each under the general theme for this year: “Nurses A Voice to Lead – Health For All”. 

Today, I think the three of us have been given ten minutes each, with ten minutes at the end for questions. I’d like to use this short time to give some reflections on our past year, and what this means for NZNO going forward. 

From my perspective, one thing has overshadowed all else in the time since we last met. It’s not to downplay development across our incredibly broad sector, but if there’s one thing that dominated, for me it’s the bargaining in the DHB Sector, and its aftermath. 

When I last stood before you at this venue one year ago, our momentous #HealthNeedsNursing rallies had just wrapped up. 

Some of you will remember coming together that day in April in Hagley Park South, over the road from the hospital. Others, I’m sure, turned out on Mairehau Road, at Burwood Hospital, or at the corner of Lincoln and Annex Roads, outside Hillmorton. There were rallies too at Caroline Bay, by the Z station, and at the Ashburton Checkerboard.  

For my part, I remember leafleting morning commuters at Wellington Railway Station, and demonstrating with my fellow members outside Wellington Hospital in Newtown. 

Those rallies, it turned out, were just the beginning. 

The effects of nine years of underfunding, which we highlighted and rallied against during 2017, finally compelled us to take unprecedented industrial action. 

For just the second time, nurses in New Zealand’s public health system took nationwide industrial action, alongside midwives and health care assistants covered by the DHB MECA.

For me personally, the hours I spent picketing and marching with my fellow NZNO members on 12 July 2018 will stand as the proudest moments of my nursing career. 

The MECA bargaining sparked a campaign of extraordinary drive and determination, on the part of NZNO members and staff alike. Together, we achieved momentous things. 

At the beginning, as you’ll recall, most members were being offered three pay increases of 2%, over 33 months, and a lump sum of $350 (pro rata).

After the #HealthNeedsNursing rallies in April and the #HearOurVoices marches in May, the offer was almost twice as big. The lump sum was bumped up to $2,000. Pay rises ranged from 9.3% to 15.9% over 26 months. An extra $38 million was pledged by the Government to employ 500 more nurses and $10 million allocated for additional expert nursing staff to support implementation of CCDM. 

At the end of July, after two more votes to reject, health minister David Clark put his signature to a new Accord, strengthening commitments to make sure there are enough nurses and midwives in our public hospitals to guarantee safety for staff and patients. 

The journey was not easy. We didn’t win everything needed to rebuild our public health system. But every single one of these advances was powered by the unity and determination of thousands of NZNO members, who should be enormously proud of themselves. 

At the same time, however, there are some unresolved problems. As we faced difficult decisions in the MECA bargaining last year, differences emerged between members, and between members and their representatives. At times there were signs of strife, of the “anger and division” which our whakataukī warns about. 

From my vantage point, I’m sorry to say, it appears that these divisions haven’t all healed yet. 

As many of you will know, we are in the middle of an independent review of last year’s DHB MECA. This is being conducted by former CTU President Ross Wilson. He has sought the views from all sides of the debates. I expect that his final draft report, which is due in June, will bring together these different perspectives, showing the truth in each and our shared path ahead. 

At the same time, the DHB MECA campaign set the pattern for a renewal of NZNO as an organisation which is united, open and responsive to members. 

Members last year made the big decisions through democratic votes. We were able to vote online for the first time. This saw the greatest member participation in any decisions in NZNO’s history. 

Campaign and LPS planning took place through cooperation between NZNO staff and member leaders, from local workplace delegates to the nationally elected board. Actions were designed to maximise member participation.

It’s democracy and participation like this that has the power to forge unity, out of division. A democratic vote can resolve many individual differences into one collective union decision. As we continue the democratic process of overcoming differences, strength will grow; “he ora te whakapiri”. 

Looking ahead, I can see three major opportunities this year for members to participate in the democratic process and shape NZNO’s evolution. 

First up, 2019 is an election year for NZNO. In August, members will be able to vote for up to seven directors who will lead NZNO over the next three years. 

Secondly, under the new “one member, one vote” system, all members will have a say – for the first time – on remits. Remits are statements proposing changes to NZNO policy or to our Constitution, which outlines such things as the rights and responsibilities of members and who in NZNO has the power to do what. As we heard first thing this morning, voting on these proposed changes takes place in August, too. The results will be announced at the NZNO AGM in September. 

Thirdly, the NZNO Board is leading a review of our current five-year strategic plan, which expires next year. Consultation on a new NZNO Strategic Plan 2020-2025, which will set the organisation’s key priorities and actions for the next five years, happens in late 2019 and early 2020. Once members have given input, a final draft will be presented for delegates to vote on at next year’s NZNO AGM. 

It’s possible there will be other big democratic decisions this year, as well. The current issue of Kai Tiaki reports on a petition for a Special General Meeting of NZNO, to vote on a particular motion. If it’s signed by one percent of members, then an SGM will be held. 

While this is still uncertain, it is important for members to know that despite the bits and pieces you may have heard, from various sources, the current Leadership Team you see before you are willing and able to lead the organisation, in a spirit of partnership and cooperation. 

It’s also important to stress finally that healthy democracy is more than simply majority rule. 

Our professionalism reminds us to work respectfully with colleagues, who may be in the minority. It says so in our Code of Conduct from the Nursing Council. Our professionalism reminds a majority that others have a right to hold different opinions – and to remain collaborative towards them at all times. 

In conclusion, only once before in New Zealand – back in 1989 – have nurses taken nationwide industrial action. That mobilisation reshaped nursing and four years later, in 1993, led to the birth of NZNO. 

The winds of change blowing this last year will also be felt beyond the DHBs. 

The surge which has drawn unprecedented numbers members into action is bound to power the ongoing transformation of NZNO. 

Nō reira, tēnā koutou, tēnā koutou, tēnā tātou katoa. 

‘The mana of our people’ – Speech to NZNO Top of the South Regional Convention

Notes of a presentation to NZNO Top of the South Regional Convention on 16 May, as part of a leadership session alongside NZNO Kaiwhakahaere Kerri Nuku, Manager, Nursing & Professional Services Mairi Lucas and Industrial Services Manager Cee Payne.

Ko Ranginui kei runga, ko Papatūānuku kei raro, ko ngā tāngata kei waenganui – Tīhei mauri ora! 

Ranginui is above, Papatūānuku below, and we the people are in between. 

Ko te kupu tuatahi ka tuku ki te Kaihanga. Koia rā te timatanga me te whakamutunga o ngā mea katoa. Kei te mihi anō ki a Maungatapu, ki a Maitahi hoki. 

The first word is to the Creator, the beginning and end of all things. I also greet the great mountain Maungatapu and the River Maitahi (or Maitai), who define this place. 

E ngā mate, haere, haere, haere. Rātou te hunga mate ki a rātou. Tātou te hunga ora e huihui mai nei, tēnā tātou.

I greet those who have passed on, and the living gathered here. 

E te tiamana, ko Joan, tēnā koe. Ngā whakawhetai ki a koe mō tāu pōwhiri ki a ahau. E ngā rangatira, Kerri, Cee koutou ko Mairi, tēnā koutou. E ngā kaimahi, me ngā kaiārahi nēhi e huihui nei, tēnā koutou.

To the Regional Council Chair, Joan, thank you for your invitation. To the rangatira – Kerri, Cee and Mairi – to the staff and all the nursing leaders gathered here (which is all of you), greetings. 

Who am I? Ko wai ahau?

Ko Kapukataumahaka te maunga, ko Ōwheo te awa, ko Cornwall te waka. Ko Don rāua ko Helen ōku mātua, ko Tangata Tiriti tōku iwi, ko Grant Brookes tōku ingoa.

Kua maumahara ahau ki tēnei whakataukī i tēnei rā: “Kaua e takahia te mana o te tangata”. Nō reira, tēnā koutou, tēnā koutou, tēnā koutou katoa. 

I hail from Dunedin. I grew up at the foot of Mt Cargill and by the Water of Leith. My ancestors arrived in Dunedin on board the ship Cornwall in 1849. The son of Don and Helen, my name is Grant Brookes.

As we gather today, I recalled the whakataukī: “Kaua e takahia te mana o te tangata”. “Do not trample on the mana of the people” – or translated simply, “don’t humiliate anyone”. This is so fundamental to who we are as NZNO that it’s enshrined in the NZNO Constitution as a statement of our Philosophy. So greetings, one and all. 

It’s great to be here in Whakatū/Nelson today, with my feet back on the Mainland I come from, and on the day before Pink Shirt Day. As you can see, I’m dressed for the occasion. 

Celebrated annually around the globe, Pink Shirt Day began in Canada in 2007 when two students, David Shepherd and Travis Price, took a stand against homophobic bullying after a new year 10 student was harassed and threatened for wearing pink. 

My older child Tama is a year 10 student this year. He’s in the LGBTQI+ club at his high school, and he wears pink. I’m wearing this shirt partly for him. 

But many of us here, I know, have experienced bullying from people in positions of power. Perhaps some of us are facing that situation in our working lives right now. 

Bullying takes a terrible toll – not only on us as nurses, midwives and healthcare workers but also indirectly on those we care for, because we can’t give of ourselves fully when we’re anxious, stressed and worried. 

In recognition of this, one of the other NZNO Regional Conventions last month featured a session on bullying from NZNO Organiser Deb Chappell that was profoundly insightful and very practical. A few of you may have seen it at the 2018 NZNO AGM and Conference in Wellington. I first came across Deb’s presentation at the Greater Auckland Regional Convention last year. 

Some of Deb’s points have stuck in my mind. 

Bullies, she said, thrive on secrecy. They work by isolating us from our support networks. They make sure nobody else knows what’s going on. They say to us, we’ll only make it worse for ourselves if we tell. 

But as a fellow survivor of bullying, I am here with you. I’m here to tell you that I believe in the message of Pink Shirt Day 2019: “Kōrero Mai, Kōrero Atu, Mauri Tū, Mauri Ora”. If we speak up and stand together, we can stop the bullying. And as soon as we start to do that, the weight lifts and suddenly it can become all so unexpectedly easy. 

This is the eighth NZNO Regional Convention for me so far this year. 

In the seven previous conventions, I’ve been asked to address a variety of topics – each under the general theme for this year: “Nurses A Voice to Lead – Health For All”. 

Today, I’ve been asked to speak for ten to 15 minutes. I’d like to use the rest of that short time to give some personal reflections on our past year, and what this means for NZNO and for our people going forward. 

From my perspective, one thing has overshadowed all else in the twelve months since we last met. It’s not to downplay development across our incredibly broad sector, but if there’s one thing that dominated, for me it’s the bargaining in the DHB Sector, and its aftermath. 

When I stood before you at this Regional Convention, a year and one day ago, it was at a different venue – the Tahuna Function Centre, looking out to the beautiful Tasman Bay/Te Tai-o-Aorere. Our momentous #HealthNeedsNursing rallies, held in the month of April 2018, had just come to an end. 

Some of you will remember coming together here in Nelson, on Waimea Road. Others, I’m sure, took to the streets outside Wairau Hospital. 

For my part, I remember leafleting morning commuters at Wellington Railway Station, and demonstrating with my fellow members outside Wellington Hospital in Newtown. 

Those rallies, it turned out, were just the beginning. 

The effects of nine years of underfunding, which we highlighted and rallied against during 2017, finally compelled us to take unprecedented industrial action. For just the second time, nurses in New Zealand’s public health system took nationwide industrial action, alongside midwives and health care assistants covered by the DHB MECA.

For me personally, the hours I spent picketing and marching with my fellow NZNO members on 12 July 2018 will stand as the proudest moments of my nursing career. 

The MECA bargaining sparked a campaign of extraordinary drive and determination, on the part of NZNO members and staff alike. Together, we achieved momentous things. 

At the beginning, as you’ll recall, most members were being offered three pay increases of 2%, over 33 months, and a lump sum of $350 (pro rata).

When we rejected that offer, the lump sum was increased to $1,050. 

After the #HealthNeedsNursing rallies in April and the #HearOurVoices marches in May, the third offer was almost twice as big. The lump sum was bumped up to $2,000. Pay rises ranged from 9.3% to 15.9% over 26 months. An extra $38 million was pledged by the Government to employ 500 more nurses and $10 million allocated for additional expert nursing staff to support implementation of CCDM. 

At the end of July, after two more votes to reject, health minister David Clark put his signature to a new Accord, strengthening commitments to make sure there are enough nurses and midwives in our public hospitals to guarantee safety for staff and patients. 

The journey was not easy. We didn’t win everything needed to rebuild our public health system. But every single one of these advances was powered by the unity and determination of thousands of NZNO members, who should be enormously proud of themselves. 

Then as Summer arrived, there were signs that the long, cold winter for nursing and for the people we care for was coming to an end. 

It will take more struggle yet to clear away all the dark clouds over the DHBs – not to mention the deeper chill still lying across the rest of the sector. But the first of the extra nursing and midwifery staff were being appointed. By the end of Summer in March, just over half of the 500 were in place. Rates of new graduate employment through the ACE Nursing scheme hit record highs. 

At the same time, however, there are some unresolved problems. As we faced difficult decisions in the MECA bargaining last year, differences emerged between members, and between members and their representatives. At times there were signs of division, and the inherent mana of people was trampled upon. 

From my vantage point, I’m sorry to say, it appears that these divisions haven’t all healed yet. 

As many of you will know, we are in the middle of an independent review of last year’s DHB MECA. This is being conducted by former CTU President Ross Wilson. He has sought the views from all sides of the debates. I expect that his final draft report, which is due in June, will bring together these different perspectives, showing the truth in each and our shared path ahead. 

At the same time, the DHB MECA campaign set the pattern for a renewal of NZNO as an organisation which is united, open and responsive to members. 

Members last year made the big decisions through democratic votes. We were able to vote online for the first time. This saw the greatest member participation in any decisions in NZNO’s history. 

Campaign and LPS planning took place through cooperation between NZNO staff and member leaders, from local workplace delegates to the nationally elected board. Actions were designed to maximise member participation.

It’s democracy and participation like this that has the power to forge unity, out of division. A democratic vote can resolve many individual differences into one collective union decision. As we continue the democratic process of overcoming differences, strength will grow. The mana of each person and of the group as a whole will be enhanced. 

Looking ahead, there are three major opportunities this year for members to participate in the democratic process and shape NZNO’s evolution. 

First up, 2019 is an election year for NZNO. In August, members will be able to vote for up to seven directors who will lead NZNO over the next three years. 

Secondly, under the new “one member, one vote” system, all members will have a say – for the first time – on remits. Remits are statements proposing changes to NZNO policy or to our Constitution, which outlines such things as the rights and responsibilities of members and who in NZNO has the power to do what. Voting on these proposed changes takes place in August, too. The results will be announced at the NZNO AGM in September. 

Finally, the NZNO Board is leading a review of our current five-year strategic plan, which expires next year. Consultation on a new NZNO Strategic Plan 2020-2025, which will set the organisation’s key priorities and actions for the next five years, happens in late 2019 and early 2020. Once members have given input, a final draft will be presented for delegates to vote on at next year’s NZNO AGM. 

But healthy democracy is more than simply majority rule. 

Our professionalism reminds us to work respectfully with colleagues, who may be in the minority. It says so in our Code of Conduct, from the Nursing Council. Our professionalism reminds a majority that others have a right to hold different opinions – and to remain collaborative towards them. This is also, I believe, the meaning of our whakataukī. Respect the inherent mana of every person. 

In conclusion, only once before in New Zealand – back in 1989 – have nurses taken nationwide industrial action. That mobilisation reshaped nursing and four years later, in 1993, led to the birth of NZNO. 

The winds of change blowing this last year will also be felt beyond the DHBs. 

The surge which has drawn unprecedented numbers members into action is bound to power the ongoing transformation of NZNO. 

Nō reira, tēnā koutou, tēnā koutou, tēnā tātou katoa. 

Stop bullying! A blog for Pink Shirt Day 2019

Today I was in Nelson/Whakatū, for the NZNO Top of the South Regional Convention. It was great to be back, with my feet on the Mainland where I come from, on the day before Pink Shirt Day. As you can see, I was dressed for the occasion. 

Celebrated annually around the globe, Pink Shirt Day began in Canada in 2007 when two students, David Shepherd and Travis Price, took a stand against homophobic bullying after a new Year 10 student was harassed and threatened for wearing pink. Pink Shirt Day aims to create schools, workplaces and communities where all people feel safe, valued and respected.

My older child Tama is a Year 10 student this year. He’s in the LGBTQI+ club at his high school, and he wears pink. I’m wearing this shirt partly for him. He says it’s ok to tell you this. 

But many of us at the NZNO Convention and elsewhere in health, I know, have experienced bullying from people in positions of power. 

Perhaps some are facing that situation in our working lives right now. 

Bullying takes a terrible toll – not only on us as nurses, midwives and healthcare workers but also indirectly on those we care for, because we can’t give of ourselves fully when we’re anxious, stressed and worried. 

In recognition of this, one of the other NZNO Regional Conventions in Palmerston North last month featured a session on bullying, from NZNO Organiser Deb Chappell. It was profoundly insightful and very practical. A few of you may have seen Deb’s presentation at the 2018 NZNO AGM and Conference in Wellington. I first came across it at the Greater Auckland Regional Convention last year. 

Some of Deb’s points have stuck in my mind. 

Bullies, she said, thrive on secrecy. They work by isolating us from our support networks. They make sure nobody else knows what’s going on. They say to us, we’ll only make it worse for ourselves if we tell. 

But as a fellow survivor of bullying, I’m here to tell you that I believe in the message of Pink Shirt Day 2019: “Kōrero Mai, Kōrero Atu, Mauri Tū, Mauri Ora”. 

If we speak up and stand together, we can stop the bullying. And as soon as we do that, suddenly the weight starts to lift and it can become so unexpectedly easy. 

There’s advice on what to do about bullying from NZNO, and on the Pink Shirt Day website

If you believe you’re being bullied, as NZNO members you can reach out for help by calling the Member Support Centre on 0800 28 38 48. 

You are not alone. We’re in this together, and we will overcome. 

The President comments: ‘A member-driven organisation?’

“DO YOU believe NZNO is a membership-driven organisation, and how confident are you that the voice of the members is being heard?” 

This was one of the tough questions put to me by members at the NZNO Central Regional Convention in Palmerston North last month. 

It got me thinking. How would we know that NZNO is a membership-driven organisation? What does it look like when the voice of the members is being heard? 

Eventually, I decided that when the diverse voices of the membership are being heard, then the priorities of the organisation match members’ priorities. Our dreams and daily frustrations, our heartaches and our innovative solutions become the focus of action by the organisation. NZNO works for us in the same way we work for our patients, residents and tāngata whaiora. 

In Palmerston North, I offered only a short answer: “Yes, NZNO is a membership driven organisation to an extent – but it needs to become more so.” 

Having thought about it more since, I can now say how to make that happen, because there are four major opportunities this year for members to shape NZNO’s future direction. 

Firstly, any member can get involved in their NZNO regional council. Details are under “groups” on the NZNO website. 

Secondly, 2019 is an election year for NZNO. In August, members will be able to vote for up to seven directors who will lead NZNO over the next three years. You may even wish to put yourself forward as a candidate, when nominations open in June. 

One member, one vote 

Thirdly, under the new “one member, one vote” system, all members will have a say – for the first time – on remits. Remits are statements proposing changes to NZNO policy or to our constitution, which outlines such things as the rights and responsibilities of members and who in NZNO has the power to do what. 

Voting on these proposals takes place in August, too. The results will be announced at the NZNO annual general meeting (AGM) in September. 

Finally, the NZNO board is leading a review of our current five-year strategic plan, which expires next year. Consultation on a new NZNO strategic plan 2020-2025, which will set the organisation’s key priorities and actions for the next five years, happens in late 2019 and early 2020. Once members have given their input, a final draft will be presented for delegates to vote on at next year’s AGM. 

If all of this sounds a bit like more work, on top of long hours in paid employment or study – and maybe after caring for family as well – then you’re probably right. 

But there’s no easy way round it. Having a greater say means taking more responsibility. If you don’t feel you know enough to cast a vote, for instance, then spend a few minutes finding out. Read the information, talk with your colleagues and work out where you stand. 

If you want NZNO to be more membership-driven, then you have to get in the driver’s seat and steer. 

When you do, then together we can deliver on the pledge I made on my re-election as president last year, that NZNO will be open and responsive to the members. • 

First published in Kai Tiaki Nursing New Zealand, May 2019. Reposted with permission.

Questions & answers for members at NZNO Tai Tokerau Regional Convention

At the NZNO Tai Tokerau Regional Convention in Whangarei on 9 May, Kaiwhakahaere Kerri Nuku, Chief Executive Memo Musa and I were invited to be part of a Q&A panel. We were asked ten questions, sourced from NZNO members in the Region and provided to us earlier in the week. 

At NZNO Tai Tokerau Regional Convention: (l-r) NZNO President Grant Brookes, Organiser Odette Shaw, Regional Council Chair Sacha Young, Delegate Tammy Von Keisenberg.
Martin, a delegate at Whangarei Base Hospital, asks a question at the NZNO Tai Tokerau Regional Convention.

The questions reflected some common concerns which have been aired at all six NZNO Regional Conventions held so far, such as the independent review of the DHB MECA, and some local concerns specific to Te Tai Tokerau. After dividing up the questions between us, I prepared these notes to answer six of them.

1. Can the panel tell us a bit about themselves to assist with introductions? This could include their marital status, children, grandchildren, animals, the region they live in and any hobbies. 

Kia ora koutou, thank you for inviting me here today. When I was asked to be part of this panel by your Regional Council, I wrote back and commended them for building member responsiveness and leadership accountability into the convention programme in this way. 

When I speak at meetings, I usually introduce myself with a mihi. I see this as part of whakawhanaungatanga, the establishing of connections by way of whakapapa. Answering this question will be a little bit like that, making connections with you by sharing something else about myself. 

So to answer the question, I am “happily unmarried” to my partner of 22 years, Linda. Together we have two children, Tama (aged 14) and Rosa (aged 11). At our home we have one cat and one rabbit. Although I’m originally from Ōtepoti/Dunedin, I am now a naturalised Wellingtonian. 

2. Can you describe what your role is and how is it different from the others on this panel.

I would like to answer this question in some depth, referring to our core documents. 

The framework for my role as President is defined in Clause 17 of the NZNO Constitution, which says: 

“The President and Kaiwhakahaere shall be the joint heads of NZNO, whose functions shall be to:

  • 17.2.1 Be spokespeople for NZNO where appropriate;
  • 17.2.2 Act in accordance with the position descriptions laid down by the Board of Directors;
  • 17.2.3 Consult with… the other officers of NZNO in furthering the objectives of, Annual and Special General Meetings and the Board of Directors; and
  • 17.2.4 Attend and preside over all Annual and Special General Meetings and meetings of the Board of Directors.”

Those “other officers of NZNO” I need to consult with are the Kaiwhakahaere, Tumu Whakarae, Vice-President and the Chief Executive Officer. So currently that’s the two people here with me on this panel, plus Titihuia Pakeho and Cheryl Hanham. 

The position description which has been laid down by the Board is available on the NZNO website. It describes my role in more detail. For example, it says:

“As joint heads of NZNO the President and the Kaiwhakahaere shall;

  • Be the public face of the Board of Directors and NZNO membership
  • Be spokespeople for the NZNO Board of Directors and NZNO members on matters of policy and strategy, speaking with one voice.
  • Co-chair meetings of the Board of Directors, the Annual General Meeting and any Special General Meetings of NZNO
  • Serve the legitimate collective interests of all NZNO members
  • Have oversight of NZNO’s external relationships
  • Have oversight of NZNO’s membership groups and networks
  • Support the Board in effective governance.”

Over all, I think the three broad areas in my position description are oversight of the membership, managing relationships with external stakeholders and governance. 

My position description also talks about how my role relates to Kerri’s role, as Kaiwhakahaere. It says: “In essence this is a job share situation requiring negotiation between the President and Kaiwhakahaere as to the performance of their shared responsibilities.”

So while Kerri has some additional responsibilities relating to her role as leader of Te Rūnanga, as the joint heads of NZNO our roles are exactly the same. Although we may not look like it, we’re actually interchangeable. 

In terms of how my role differs from the Chief Executive, my position description says: “The role of the President is governance leadership. The President has no authority to direct or constrain the chief executive in the authorised and legitimate performance of her or his management duties. NZNO staff do not report to the President.”

So in summary, the President co-chairs the Board, which appoints the Chief Executive. The Chief Executive controls the staff. In the most general terms, the Board determines “what” needs to be done by NZNO; the Chief Executive and his management team decide “how” to do it. 

Finally, it’s important to stress the limitations on my role. My position description says: “The President… has no authority independent of the authority of the Board as a whole. The President must… seek approval or confirmation of action taken on behalf of the Board”. 

To make the point absolutely clear, it adds: “The President has no authority to unilaterally change any aspect of Board policy”. So in terms of power and authority within NZNO, my role sits underneath the Board of Directors. 

That’s the long answer, describing my role and how it compares. I hope it’s helpful.

3. What is NZNO’s position on climate change and how active are we and where is the accountability?

NZNO developed a position statement on climate change in 2016. This was a result of a policy remit which was passed at the NZNO AGM in 2015. The position statement outlines NZNO’s commitments. These include: 

“NZNO commits to collaboration with other health professions to lobby for government ratification of enforceable climate change treaties, and to meaningful action to reduce New Zealand’s contribution to global warming, including a substantial reduction in gross domestic emissions, an end to fossil-fuel subsides, and a moratorium on deep sea oil drilling and fracking.”

The big news on action to reduce New Zealand’s contribution to global warming, released yesterday, was the unveiling of the government’s Zero Carbon Bill (ZCB). 

In fulfilment of the commitment in our position statement, NZNO participated in the ZCB consultation last year, in collaboration with OraTaiao – the New Zealand Climate & Health Council. Among other things, we called for net zero emissions by 2040, across all greenhouse gases. Unfortunately, the bill contains neither of these goals – and neither are its targets enforceable. 

Launching the ZCB yesterday, Prime Minister Jacinda Ardern distinguished between “carbon” and “methane”. We all do some biochemistry as part of our undergraduate nursing education, so everyone here probably knows that methane, which accounts for about half of New Zealand’s emissions, is also a carbon-based molecule, just like carbon dioxide. And tonne for tonne, it has approximately 80 times the Global Warming Potential of CO2 over a 20-year timeframe. So the government’s failure to take meaningful action through the ZCB means that NZNO will need to keep working hard in the select committee stage of the bill. 

NZNO also participated in the earlier review of the Emissions Trading Scheme. Although suggesting improvements, we commented that we are “not assured that it is the most effective or equitable tool to either reduce emissions or address climate change”. 

Last year we supported the lobbying efforts of Greenpeace, writing a letter to Jacinda Ardern calling for an end to oil and gas exploration, and we have supported actions on the streets including the People’s Climate March and the recent School Strike For Climate. 

Also in our position statement: 

“Nurses assert our role and responsibility to contribute to the development of national action plans and policies, and to be part of disaster preparedness to mitigate the impact of climate change on health, and to support to calls for humanitarian assistance wherever health is adversely affected by climate change – especially from our Pacific neighbours.”

Here, we walk the talk. In the wake of Cyclone Winston in 2016, NZNO members joined the New Zealand Medical Assistance Team providing surgical services to affected islands. NZNO donated $5,000 and collected an additional $370 to support the Fiji Nurses Association. In 2018, we donated $5,000 to the Tongan Nurses Association assist with recovery after Cyclone Gita. 

“We call for well-designed and resourced public transport and safe walking and cycling routes [here, for example] – developments that, in addition to reducing carbon emissions, would also produce significant health gains. 

“We agree that healthy public policy on sustainable, energy efficient housing and urban planning which, in addition to reducing emissions, have the potential to reduce the burden of disease and save energy costs in our poorest families [as in our submission on the Healthy Homes Guarantee Bill].” 

“Nurses also advocate specifically for the introduction and enactment of public policies related to reversing the widening deprivation and income gap in Aotearoa New Zealand, which is inextricably linked to health inequalities. 

“NZNO acknowledges the knowledge, customs and practices of tāngata whenua and indigenous peoples relating to the protection of the environment.

“We commit to informing and enacting strategies to increase the environmental sustainability of health care, and to reduce waste.”

According to Associate Health Minister Julie Anne Genter, “New Zealand’s healthcare sector contributes between 3% and 8% of New Zealand’s total greenhouse gas emissions. Hospitals, for example, use about twice as much total energy per square foot as traditional office space”.

NZNO is active at the local level in initiatives to reduce this carbon footprint – for example at Counties Manukau DHB, which has reduced its emissions by 21 percent since 2012. 

“At an organisational level, we commit to undertake steps to reduce and mitigate our contribution to carbon emissions, including stopping investment in fossil fuels.”

In April 2018, the NZNO Board met with Niamh O’Flynn, Executive Director of 350.org, for advice on how we might do this. As a result, the Board is taking steps ourselves, such as moving to paperless Board meetings. We have commissioned an audit of NZNO’s carbon emissions, to identify areas for attention at the organisational level. 

This work is sitting with the Chief Executive. But it has already been decided that when our car fleet comes up for replacement next year, we’ll be looking at hybrid vehicles.

Finally, as you may know, NZNO holds money in reserve to protect against unforeseen events. These investments used to include shares in fossil fuel companies. In 2016, NZNO divested from direct investments in fossil fuels, again as a result of the policy remit passed by members at AGM. 

Climate change is a problem so big that you could say that no matter what an organisation is doing, it’s not enough. But I have outlined here some of the actions on our key commitments. 

4. Is the MECA report being made available to members?

I will give a very brief answer, quoting from an article in the February issue of Kai Tiaki, and then hand over to the Chief Executive. The article is headed, ‘DHB MECA review under way‘, and says: 

“The review’s terms of reference, which were signed off by the board, state the CE will provide the final report to the board “and any other person who, in the opinion of the CE, should receive the report”. 

NZNO president Grant Brookes said there was wide discretion around the review’s release. “I believe that transparency will help build trust and heal divisions. So I will be supportive of its release to members, once any information relating to individuals has been redacted, mindful however that the final decision rests with the CE”.”

5. Why doesn’t NZNO have a union shop where we sell promotional material and clothing at cost/subsidised to members?

This is a long story, and perhaps one without a very satisfactory ending. 

“Creating a rewards programme” was the top proposal in a paper to the Board from the Co-leaders in August 2016, to address issues of volunteer sustainability, member engagement and leadership development. The proposals came out of a meeting of Chairs of Regional Councils, Colleges and Sections and Te Rūnanga held in March 2016. The paper said, “Rewards may include attractive, culturally appropriate NZNO merchandise”. 

In response to this paper, the Board decided to engage a consultant to produce a report on how to improve volunteer sustainability. 

That report was eventually delivered to the Board in February 2018. The minutes of that Board meeting record: “The project scope referred to a rewards programme, remuneration of volunteers and providing budget lines for members working on specific projects. The President has concerns that none of these has been considered except for facility time and is also concerned that the report does not reflect the Terms of Reference that were provided. Therefore the next budget for 2019/20 would need to take into account the monetary requirements relating to the volunteer sustainability report.”

Production of NZNO merchandise has also been requested by the Membership Committee, over a long period. 

The NZNO budget for 2019/20 was approved by the Board in February. However, I am not aware of any definite plans at this stage to produce promotional material and clothing for sale at cost to members. 

6. What do you all do to relax and revive?

Thanks for asking! This is a question which was also asked recently by NZNO Nurse Managers NZNO, in an interview for their quarterly newsletter, Te Wheke. I told them that I recharge by getting out into the “great outdoors” with my family.

The theme of Mental Health Awareness Week 2018 really rings true for me – “Let nature in, strengthen your wellbeing – Mā te taiao kia whakapakari tōu oranga!”.

To maintain my sanity, every now and then I have to get away from wi-fi networks and mobile coverage – preferably under canvas, in the bush or up on the mountain. 

But that doesn’t happen as often as I would like. So sometimes I also need to blow away the cobwebs by getting my glad rags on and hitting the dancefloors down on Courtney Place. 

‘Reflections on a year of advances & strife’ – Speech to NZNO Midlands/BOP/Tairāwhiti Regional Convention

Notes of a presentation to NZNO Midlands/BOP/Tairāwhiti Regional Convention today, as part of a leadership session alongside NZNO Kaiwhakahaere Kerri Nuku and Chief Executive Memo Musa.

I thank Diane Dixon, Chair of the NZNO Midlands Regional Council, for inviting me to take part in the NZNO Midlands/BOP/Tairāwhiti Regional Convention.

Ko Ranginui kei runga, ko Papatūānuku kei raro, ko ngā tāngata kei waenganui – Tīhei mauri ora! 

Ko te kupu tuatahi ka tuku ki te Kaihanga. Koia rā te timatanga me te whakamutunga o ngā mea katoa. 

Kei te mihi anō ki ngā maunga, ngā awa me ngā wāhi tapu o tēnei rohe. 

E ngā mate, haere, haere, haere. Rātou te hunga mate ki a rātou. Tātou te hunga ora e huihui mai nei, tēnā tātou.

E te tiamana, ko Diane, me ngā mangai-ā-rohe o Te Rūnanga, ko Tracey kōrua ko Anamaria, tēnā koutou. Ngā whakawhetai ki a koutou mō tā koutou pōwhiri. E ngā kaimahi, me ngā kaiārahi nēhi e huihui nei, tēnā koutou.

Ko wai ahau?

Ko Kapukataumahaka te maunga, ko Ōwheo te awa, ko Cornwall te waka. Ko Don rāua ko Helen ōku mātua, ko Tangata Tiriti tōku iwi, ko Grant Brookes tōku ingoa.

Kua maumahara ahau ki tēnei whakataukī i tēnei ata: “He ora te whakapiri, he mate te whakatakariri”.

Nō reira, tēnā koutou, tēnā koutou, tēnā koutou katoa. 


Ranginui above, Papatūānuku below, and the people in between – behold! 

My first word, I sent to the Creator, the beginning and end of all things. I also acknowledge the mountains, rivers and sacred areas of this district. 

I greet those who have passed on, and the living gathered here. 

To the Regional Council Chair, Diane, and the Rūnanga reps, Tracey and Anamaria, thank you for your invitation. 

To the staff and all the nursing leaders gathered here (which is all of you), greetings. 

Who am I? 

I hail from Dunedin. I grew up at the foot of Mt Cargill and by the Water of Leith. My ancestors arrived in Dunedin on board the ship Cornwall in 1849. The son of Don and Helen, my name is Grant Brookes.

As we gather this morning, I recalled the whakataukī: “He ora te whakapiri, he mate te whakatakariri”. “There is strength in unity, defeat in anger and division”. 

So greetings, greetings, greetings to you all. 


It’s good to be here in Kirikiroa/Hamilton. This is the fourth Regional Convention for me so far this year. 

In the three previous conventions, I’ve been asked to address three different topics – each under the general theme for this year: “Nurses A Voice to Lead – Health For All”. 

Today, I’ve been asked to spend ten short minutes giving some personal reflections on our past year. In this annual review, my words will be words drawn from articles and speeches I’ve written before. 

From my perspective, one thing has overshadowed all else in the twelve months since we last met – and that’s the bargaining in the DHB Sector, and its aftermath. 

When I stood before you at this Regional Convention a year ago, it was at a different venue – the Eagle Ridge Conference Centre, overlooking the beautiful Tauranga Moana. Our momentous #HealthNeedsNursing rallies, held in the month of April 2018, had just come to an end. 

Some of you will remember coming together here in Hamilton, outside the Elizabeth Rothwell Building at Waikato DHB. Others, I’m sure, took to the streets last April outside Tauranga Hospital. 

There were rallies at Whakatāne Hospital, on the corner of Lake Rd & Kuirau Park in Rotorua, on the lake front in Taupō – even at Thames Hospital.  

Some of you were there on Ormond Rd, at the main entrance to Gisborne Hospital. 

For my part, I remember leafleting morning commuters at Wellington Railway Station, and demonstrating with my fellow members outside Wellington Hospital in Newtown. 

Those rallies, it turned out, were just the beginning. 

The effects of nine years of underfunding, which we highlighted and rallied against during 2017, finally compelled us to take unprecedented industrial action. 

For just the second time, nurses in New Zealand’s public health system took nationwide industrial action, alongside midwives and health care assistants covered by the DHB MECA.

For me personally, the hours I spent picketing and marching with my fellow NZNO members on 12 July 2018 will stand as the proudest moments of my nursing career. 

The MECA bargaining sparked a campaign of extraordinary drive and determination, on the part of NZNO members and staff alike. Together, we achieved momentous things. 

At the beginning, as you’ll recall, most members were being offered three pay increases of 2%, over 33 months, and a lump sum of $350 (pro rata).

When we rejected that offer, the lump sum was increased to $1,050. 

After the #HealthNeedsNursing rallies in April and the #HearOurVoices marches in May, the third offer was almost twice as big. The lump sum was bumped up to $2,000. Pay rises ranged from 9.3% to 15.9% over 26 months. 

An extra $38 million was pledged by the Government to employ 500 more nurses and $10 million allocated for additional expert nursing staff to support implementation of CCDM. 

At the end of July, after two more votes to reject, health minister David Clark put his signature to a new Accord, strengthening commitments to make sure there are enough nurses and midwives in our public hospitals to guarantee safety for staff and patients. 

The journey was not easy. We didn’t win everything needed to rebuild our public health system. But every single one of these advances was powered by the unity and determination of thousands of NZNO members, who should be enormously proud of themselves. 

Then as Summer arrived, there were signs that the long, cold winter for nursing and for the people we care for was coming to an end. 

It will take more struggle yet to clear away all the dark clouds over the DHBs – not to mention the deeper chill still lying across the rest of the sector. But the first of the extra nursing and midwifery staff were being appointed. By the end of Summer in March, just over half of the 500 were in place. Rates of new graduate employment through the ACE Nursing scheme hit record highs. 

At the same time, however, there are some unresolved problems. As we faced difficult decisions in the MECA bargaining last year, differences emerged between members, and between members and their representatives. At times there were signs of strife, of the “anger and division” which our whakataukī warns about. 

From my vantage point, I’m sorry to say, it appears that these divisions haven’t all healed yet. 

As many of you will know, we are in the middle of an independent review of last year’s DHB MECA. This is being conducted by former CTU President Ross Wilson. He has sought the views from all sides of the debates. I expect that his final draft report, which is due in June, will bring together these different perspectives, showing the truth in each and our shared path ahead. 

At the same time, the DHB MECA campaign set the pattern for a renewal of NZNO as an organisation which is united, open and responsive to members. 

Members last year made the big decisions through democratic votes. We were able to vote online for the first time. This saw the greatest member participation in any decisions in NZNO’s history. 

Campaign and LPS planning took place through cooperation between NZNO staff and member leaders, from local workplace delegates to the nationally elected board. Actions were designed to maximise member participation.

It’s democracy and participation like this that has the power to forge unity, out of division. A democratic vote can resolve many individual differences into one collective union decision. As we continue the democratic process of overcoming differences, strength will grow; “he ora te whakapiri”. 

Looking ahead, there are three major opportunities this year for members to participate in the democratic process and shape NZNO’s evolution. 

First up, 2019 is an election year for NZNO. In August, members will be able to vote for up to seven directors who will lead NZNO over the next three years. 

Secondly, under the new “one member, one vote” system, all members will have a say – for the first time – on remits. Remits are statements proposing changes to NZNO policy or to our Constitution, which outlines such things as the rights and responsibilities of members and who in NZNO has the power to do what. Voting on these proposed changes takes place in August, too. The results will be announced at the NZNO AGM in September. 

Finally, the NZNO Board is leading a review of our current five-year strategic plan, which expires next year. Consultation on a new NZNO Strategic Plan 2020-2025, which will set the organisation’s key priorities and actions for the next five years, happens in late 2019 and early 2020. Once members have given input, a final draft will be presented for delegates to vote on at next year’s NZNO AGM. 

But healthy democracy is more than simply majority rule. 

Our professionalism reminds us to work respectfully with colleagues, who may be in the minority. It reminds a majority that others have a right to hold different opinions – and to remain collaborative towards them. 

In conclusion, only once before in New Zealand – back in 1989 – have nurses taken nationwide industrial action. That mobilisation reshaped nursing and four years later, in 1993, led to the birth of NZNO. 

The winds of change blowing this last year will also be felt beyond the DHBs. 

The surge which has drawn unprecedented numbers members into action is bound to power the ongoing transformation of NZNO. 

Nō reira, tēnā koutou, tēnā koutou, tēnā tātou katoa. 

‘Health For All means Health For Nurses, too’ – Speech to NZNO Greater Wellington Regional Convention

These notes of a presentation to NZNO Greater Wellington Regional Convention on 30 April 2019 were amended on 4 June 2019, to clarify the current position of CCDM implementation at Hutt Valley DHB. I wish to apologise that I did not make this sufficiently clear at the Convention.

Photo courtesy of Shammi Kumar.

E ngā reo, e ngā mana, e ngā karangarangatanga maha o te rohe – tēnā koutou. 

Ka tū ahau ki te tautoko i te karakia timatanga. Ka mihi anō ki ngā maunga, ngā awa me ngā wāhi tapu o te mana whenua. 

E ngā mate, haere, haere, haere. Rātou te hunga mate ki a rātou. Tātou te hunga ora e huihui mai nei, tēnā tātou. 

E te tiamana, ko Rerehau, me te mangai-ā-rohe o Te Rūnanga o Aotearoa NZNO, ko Lizzy, tēnā kōrua. Kei te whakawhetai ahau ki a kōrua mō tā kōrua pōwhiri. 

E te rangatira kua hoki mai nō tāwhiti, tēnā koe Kerri. E ngā kaimahi, me ngā kaiārahi nēhi e huihui nei, tēnā koutou. 

Ko wai ahau? 

Ko Kapukataumahaka te maunga. Ko Ōwheo te awa. Ko Cornwall te waka. Nō Ōtepoti ahau, engari kei te noho ināianei ki Pōneke. Ko Don rāua ko Helen ōku mātua. Ko Tangata Tiriti tōku iwi. Ko Grant Brookes tōku ingoa.

Ka maumahara ahau ki tēnei whakataukī i tēnei wā: “Te Amorangi ki mua, te hapai o ki muri”. 

Nō reira, tēnā koutou, tēnā koutou, tēnā koutou katoa. 

——

To the authorities, the voices, all the many alliances and affiliations of this region, greetings.

I stand to support the greetings to the Creator, to whom belong all things. I also acknowledge the mountains, rivers and sacred areas of the indigenous people with authority over this place. 

I greet those who have passed on, and the living gathered here. 

To the Chair, Rerehau, and the Rūnanga rep, Lizzy, thank you for your invitation. 

To the chief returned from afar, greetings to you Kerri. For those who may be unaware, Kerri is just back from New York where she addressed the UN Permanent Forum on Indigenous Issues and is due to arrive at this Convention very soon. 

To the staff and all the nursing leaders gathered here (which is all of you), greetings. 

Who am I? 

Although I now live in Wellington, I hail originally from Dunedin. I grew up at the foot of Mt Cargill and by the Water of Leith. 

My ancestors arrived in Dunedin on board the ship Cornwall in 1849. The son of Don and Helen, my name is Grant Brookes.

For reasons I will soon explain, at this time I recall the saying: “The leader at the front and the workers behind the scenes”.  

So greetings, greetings, greetings to you all. 

So many old familiar faces. It’s wonderful to be back here with you again. 

——

The theme of today’s convention is the one set by the International Council of Nurses (ICN) for the upcoming International Nurses Day on the twelfth of May. “Nurses: A voice to lead – Health for all”. 

In keeping with this theme, the topic I’ve been asked to speak on is the following (it’s a long one!):

“Nurses, HCAs and Midwives face a number of issues on the shop floor on a daily basis, while working for the health of New Zealand… we ask that you speak with the aim of motivating and inspiring our members to harness/channel their momentum, energy and input into health for us as members. 

In doing so, please include information on anticipated changes off the back of the MECA, a summary of the current campaigns, how the various health sectors can communicate with and support each other with these campaigns, and any plans around the organiser structure to support this.”

It was this suggested topic that made me think of the whakataukī, “Te Amorangi ki mua, te hapai o ki muri”. Literally, “The leader at the front and the workers behind the scenes”, this saying expresses the general idea that everyone is of equal importance. 

Or as former Minister of Māori Affairs Te Ururoa Flavell has explained, the late Wiremu Tawhai “provides a far richer meaning [for this whakataukī] which is expressed in terms of sustainability and survival. He suggests the mana of the whole group is dependent on the support and guidance provided by ‘te hapai o’.”

It occurs to me that the same is true for health and wellbeing. The health of the whole group is dependent on the health of those who do the work of delivering healthcare. So when we talk about “health for all”, we must consider health for us. 

As ICN President Annette Kennedy put it last year: 

“All over the world, there are individuals and communities who are suffering from illness due to a lack of accessible and affordable health care. But we must also remember that the right to health applies to nurses as well! We know that improved quality and safety for patients depends on positive working environments for staff. That means the right to a safe working environment, adequate remuneration, and access to resources, and education. We must add to this the right to be heard and have a voice in decision making and policy development implementation!”

I have opted today to talk in detail about a handful of key developments, rather than offer a broad brush overview. If you miss any of the facts and figures in my talk and want to find them later, my speech notes will be available on my blog at nznogrant.org. 

So firstly, what can we anticipate off the back of the DHB MECA? 

‘Immediate relief’?

When the collective agreement was ratified in August last year, it came with $38 million in extra funding from the Ministry of Health for “immediate relief on staffing and workloads” and a promise of “500 extra nurses”. Without this movement on positive working environments in DHBs, this access to resources, then improved quality and safety for patients will be very hard to achieve. 

Eight months on, where are we at? 

According to the latest update issued by the Ministry of Health, as at 13 March, 222 FTE registered and enrolled nurses, 19 FTE midwives and 42 FTE Health Care Assistants have been employed as a result of the additional $38 million.

“A further 118.04 FTE are… in recruitment processes… Some DHBs have recruited all their allocated FTE, others have recruited most of it and some have asked to defer a portion of their funding to the 2019/20 financial year.”

So about half the extra nurses promised “immediately” have been employed, with job ads out for a further quarter. Although all DHBs got their share of the extra funding last year, some of them don’t want to (or can’t) spend it all on employing extra staff – or at least, not this year. 

In summary, off the back of the DHB MECA we can anticipate what I predicted in Kai Tiaki last December: “It will take more struggle to clear away all the dark clouds over our public health system – and the deeper chill still lying across the rest of the sector”. 

To get what we’ve been promised by employers, we’re going to have to hold their feet to the fire. This struggle will require a whole-of-organisation effort. But crucially, the struggle will now take place under conditions which are more favourable than before the DHB MECA settlement. 

This is a theme that will run through the remainder of my talk. 

Safe Staffing Accord 

Also off the back of the DHB MECA, of course, was the Safe Staffing Accord between the Ministry of Health, NZNO and the DHBs. The Accord contains three commitments. The first of these is the one where we may anticipate the biggest and fastest progress. It says the parties will “explore options for providing employment for all nursing and midwifery graduates…” 

The latest available report on the Advanced Choice of Employment Nursing intake, dated November 2018, shows that 85.7 percent of the 468 mid-year applicants received a place in the Nurse Entry to Practice (NETP) or Nurse Entry to Specialist Practice (NESP) programmes.

This compares with a new grad employment rate of 54.6 percent in 2016 and 64.8 percent in 2015. 

Preliminary data for the 2018 end-of-year intake show that as of January 2019, 71.3 percent of the 1,253 applicants had been placed. This number will rise when the final report is released in July. 

CCDM

The second commitment in the Safe Staffing Accord links directly to the Terms of Settlement for the DHB MECA – to “develop any accountability mechanisms the Parties believe are necessary (over and above those already agreed) to ensure DHBs implement the additional staffing needs identified by CCDM within the agreed timeframe” of 30 June 2021. 

Hand on heart, I cannot say I expect all DHBs to achieve this, if left to their own devices. I base this on some information which I’m not at liberty to share but also on past experience, which will be very well known to some of you here today. 

Hutt Valley DHB commenced implementation of CCDM back in 2013. In March 2014, Board meeting minutes record that “The Coronary Care Unit was selected as the Pilot Ward for Part 1 of the CCDM Programme… There was excellent buy-in to and engagement with this from all staff; nurses, doctors, allied health, clerical and health care assistant staff. The data is still being entered and then will be analysed.”

By January 2015, staffing methodology (which at that time was called the “Part 2 mix and match calculation”) had been completed for three inpatient areas, setting their base nursing FTE requirements, and was under way in a fourth ward as well. 

But then, after changes in the Executive Leadership Team during 2015, a full external review of CCDM was commissioned by the DHB (see this link). The FTE calculations, which had showed that extra nursing staff were needed, got shelved. 

“Recalling this history is not to make any comment about HVDHB now. HVDHB is in fact well on track to have CCDM fully implemented by June 2021, with support from across the DHB and Board and an excellent relationship with NZNO and the Safe Staffing Healthy Workplaces Unit. Rather, it is to remind us what to look out for elsewhere, and what we need to do to help make sure all DHBs follow through on their CCDM commitments.”

So I anticipate that winning increases in baseline staffing off the back of the MECA is another change that will require a whole-of-organisation effort – from nurses on the floor entering their Trendcare data, to delegates pressing for oversight through local data councils for their ward. Delegates must blow the whistle, for instance, on any manager who alters Trendcare data after it’s been actualised. And they must have paid release time to do this and other CCDM work. 

Organisers, Professional Nurse Advisors and senior delegates on the DHB’s CCDM council must demand adherence to the programme and to timelines. FTE calculations must be accurate and acted upon, even if it means cost increases. And people like me and Hilary Graham-Smith must ensure DHB accountability through the Safe Staffing Unit Governance Group, while Chief Executive Memo Musa does the same there and in the Health Sector Relationship Agreement Steering Group and the Safe Staffing Accord Operational Group. 

The pace and scale of implementation means I expect workloads to increase over the next two years. But again, we’ll be working under conditions more favourable than before. At last, there is a deadline for CCDM implementation. The Minister of Health himself has requested regular progress reports. 

Pay equity 

The final development off the back of the DHB MECA which I’ll discuss is pay equity. 

NZNO raised a pay equity claim as part of the MECA negotiations. DHBs acknowledged that nursing has been undervalued. A pay equity process with an implementation date of 31 December 2019 was agreed.

Soon, expressions of interest will be sought from NZNO delegates at the DHBs chosen to participate in the assessment process. 

After that, claimant (our) data will be gathered through interviews with job holders, including senior nurses, registered nurses, public health nurses, nurse practitioners, enrolled nurses karitane nurses, obstetric nurses and health care assistants including psychiatric assistants. This part of the process will take through to late September/October. The pay equity claim for NZNO’s midwifery members will be progressed in a concurrent but separate process. The interviews will be conducted using pay equity assessment tools that have been purposefully developed to be gender-neutral. 

Finally, an NZNO bargaining team will be democratically selected. The union team will use the assessment data and comparisons to negotiate and conclude a pay equity claim. Ratification will happen when an agreed outcome has been identified based on the evidence, between the DHBs and union negotiating team. I expect this work will occur between early November and late December.

At this stage I anticipate that the deadline will be met, but I am also aware that the timeframe for completing the work in time for implementation by 31 December is very tight. 

In Safe Hands 

Regarding current campaigns, and how the various health sectors can support each other, last month saw the launch of what will be NZNO’s flagship campaign for 2019. “In Safe Hands” is calling on the government to review and update the Aged Care Safe Staffing Standards, to set minimum staffing levels based on residents’ needs. 

Stage one of the campaign seeks to sign up NZNO members from all health sectors as activists and asks them to send an initial message to the Government. You can get involved at www.insafehands.co.nz

Without this campaign, I would expect that trends of reducing care hours and increasing workloads – identified in new research from Dr Julie Douglas and Associate Professor Katherine Ravenswood of AUT – are likely to continue across the aged care sector.

Based partly on initial reactions when we raised it with the Minister of Health, I anticipate that achieving the goal of this campaign is going to be hard. But together, with the whole organisation behind us, we can do it. 

PHC MECA

The Primary Health Care Sector is another where we will have to struggle to achieve the ambitious goals around positive working environments, adequate remuneration and health for us as members, within very tight timeframes. 

The Terms of Settlement for the PHC MECA, which was ratified last month, contained an agreement that employers and NZNO will undertake a joint exercise to scope the nature of Health Care Assistant, Nurse Practitioner and Designated RN Prescriber roles within PHC by 31 August 2019. That’s just four months away. 

It also said: “NZNO and NZMA have agreed to jointly lobby government as soon as is possible and no later than April 2019 to increase funding to the sector to enable the sector to be able to recruit and retain nurses and to meet expectations regarding nursing salaries following the DHB settlement”. 

In particular, increased funding will be essential to securing new steps 6 and 7 in the next PHC MECA negotiations, as in the DHB MECA, and any pay equity process that might be agreed in future. I probably needn’t remind you that today is the 30th of April 2019. 

Also within the PHC Sector are Māori and Iwi providers. Here I am optimistic enough to finally predict – after more than a decade of work led by Kerri and Te Rūnanga – movement this year on the issues of inequitable funding models and pay disparities. 

Violence in the workplace 

A second campaign will address one of the six Global Health Challenges highlighted in the ICN Guidance Pack for International Nurses Day: “the effects of violence on health care and all of us”. 

“Violence is an everyday occurrence around the world for health workers”, says ICN. “This includes violent physical, sexual and verbal assault from patients and potentially their families. The issue is so bad that across the world, nursing is considered more dangerous than being a police officer or a prison guard…

“Violence against nurses threatens the delivery of effective care and it violates their human rights. It damages their personal dignity and integrity. It is an assault on the health system itself.”

Health for us as members means freedom from violence at work. To this end, NZNO is producing a “Position statement: Violence and aggression towards nurses”. This will serve as the basis for a campaign. A project team has been established, with leaders drawn from across our organisation. 

Through the Council of Trade Unions, NZNO is also participating in the creation of a new legally enforceable convention on gender-based violence at work under the auspices of the International Labour Organisation.

Organiser structure 

Before I finish, I was also asked to speak about any plans around the organiser structure to support these efforts and campaigns. I take this to mean the structure of the organising work performed and supported by by NZNO staff. 

The annual, weekly and daily planning of this work is an operational matter, under the direction of NZNO management. But I can report on some discussions around resourcing and strategic planning at the Board level. 

First of all, earlier this month the Board of Directors approved business cases to increase the number of NZNO organisers by 2.0 FTE during the current financial year. What does this number mean? 

This represents a 6% increase in the existing organiser workforce of 35.95 FTE. The last increase in the number of organisers was in 2017, when an extra 1.5 FTE was approved. The increase before that was back in 2007. That year, total NZNO membership sat at 39,000. It is now 52,000. A planned review of organiser resource in 2011 was deferred in favour of setting up the Member Support Centre. 

So in the last 12 years, we have seen the establishment of MSC, while the number of members has grown by 33 percent and the number of organisers has been boosted by 10 percent. 

To address this mismatch, and current workload issues such as those arising from rapid nationwide implementation of CCDM (noted previously), the initial business case put to the Board in February this year sought an extra 5.0 FTE for the organiser workforce, plus 1.0 FTE for casual or “relief” organising. 

The Board decision to approve a lower number than six full-time equivalents was based on the need for a break even operating budget. But clearly, there are issues with sustainability and pressures are building. These pressures could be resolved in a number of ways. 

Firstly, business cases declined this year could be funded in the future. Alternatively, the pressures could also be addressed by reorganising the way we work. On a part of the NZNO website you may not have visited, it says:

“Wherever possible, we use the “organising” model which simplistically means, an approach to working with members that empowers them to act in their own interest, with NZNO’s elected leadership and staff on a team basis. This approach is distinctly different from that where a staff or elected member “fixes” things for members.”

“Wherever possible” depends on factors like the number of delegates in a workplace and their skills, confidence, engagement and their resourcing, including the amount of their paid release time, along with the nature of member issues. It also depends on how staff work to empower and educate members. 

Clearly, addressing growing pressures on our organiser structure is not a case of “either/or”. A combination of more staff and changing the way we work is possible. 

This concludes my talk. Thank you for listening. I will be available to answer any questions now and throughout the day. 

Nō reira, tēnā koutou, tēnā koutou, tēnā koutou katoa.