My ‘Report Card’: Nursing & Health in 2015

Nursing and health in 2015 made great strides forward in:

Great strides have been made this year in removing regulatory barriers that prevent nurses from making the best use of their knowledge and skills.

The movement of the Health Practitioners (Removal of Statutory References to Medical Practitioners) Bill through Parliament raises hopes that we’ll soon achieve this, enabling a more efficient and effective health system.

NZNO supports this Bill. We also hope our suggested improvements are taken on board by the Select Committee when it reports back to Parliament in February.

Passed but could do better next year:

The progress made in implementing Care Capacity Demand Management (CCDM) across the district health board (DHB) sector deserves a pass mark.

This year, Bay of Plenty achieved the distinction of being the first DHB “over the line”, meaning the core components of CCDM have been implemented for all their acute medical/surgical areas.

Hawke’s Bay and Taranaki DHBs joined the CCDM programme, and Auckland DHB began the enormous task of rolling it out across its many inpatient areas.

But from NZNO’s perspective, there are still five DHBs not currently active in the programme, with two more “pending”. Progress elsewhere remains painfully slow. There are even backwards steps at some DHBs.

Given the critical importance of safe staffing, both for NZNO members and for quality of care in our public hospitals, more definitely needs to be done in 2016.

Areas showing initial promise but failing to deliver in 2015:

For new graduate nurses, the year began with movement towards NZNO’s goal of 100 per cent graduate employment by 2018 at the latest. NZNO’s 2014 petition campaign, alongside a report from the National Nursing Organisations, had secured funding to cover Health Workforce New Zealand’s contribution towards another 200 NETP (nursing entry to practice) places.

Raising the cap from 1100 to 1300 places this year still wouldn’t provide full employment. And the actual number of places was always dependent on the ability of employers to offer jobs.

Sadly, cash-strapped DHBs and insufficient participation from other sectors has meant the promise of 1300 NETP places was not fulfilled.

In September, therefore, delegates to the NZNO AGM voted for a motion: “That NZNO continues to prioritise and support campaigns towards nurses and midwives entry to practice programmes, for registered nurses, registered midwives and enrolled nurses, with the campaign goal of 100 per cent employment of new graduates and improved health workforce planning in Aotearoa”.

Areas that failed abjectly:

Budget 2015 failed abjectly, once again, to provide sufficient funding for health.

According to Council of Trade Unions economist Bill Rosenberg, Vote Health was $245 million behind what is needed to cover announced new services, increasing costs, population growth and the effects of an ageing population.

The accumulated funding shortfall in government health expenditure for 2015/16 compared with 2009/10 is more than $1 billion.

This is what underlies the painfully slow adoption of CCDM, the failure of new grad employment opportunities to live up to their promise, and the growth of serious, related problems like care rationing.

This has to change next year.