‘Influencing the health of our communities’ – Speech to NZNO Greater Auckland Regional Convention

E ngā mana, e ngā reo, e ngā karangarangatanga maha e huihui nei, tēnā koutou.

Ka tū ahau ki te tautoko i ngā mihi ki te Kaihanga, me te kaupapa ō te hui nei.

Ko wai ahau?

Ko Kapukataumahaka te maunga

Ko Ōwheo te awa

Ko Cornwall te waka

Nō Ōtepoti ahau

Ko Don rāua ko Helen ōku mātua

He tangata tiriti ahau

Ko Grant Brookes tōku ingoa.

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

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

I stand to support the acknowledgements to the Creator, and the purpose of this convention.

Who am I?

I hail from Dunedin. I grew up at the foot of Mt Cargill, beside the Water of Leith.

I am the son of Don and Helen, descended from those arriving on the ship, Cornwall. My name is Grant Brookes.

So good morning.

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This is my first time standing before you, here at the Greater Auckland Regional Convention. I am honoured to be in the presence of so many distinguished people who deserve acknowledgement – Jacob and Shannon, Regional Council chair and vice-chair; Memo and Kerri, our CEO and Kaiwhakahaere; I see Sonya, chair of the Cook Island Nurses Association, and Eseta, my fellow Board member and Pacific Nurses Section chair; Ben, National Delegates Committee rep for Counties Manukau, and Bronwyn, from Waitematā. And to the workplace and professional leaders of nursing in Auckland – sitting on every seat in this room – greetings.

My invitation to attend today contained a request for a ten minute update from the President – just enough time, really, for a few key points.

The theme of this Convention is, “Nurses a force for change: Influencing the health of our communities, impact and visibility”.

As I travel around Aotearoa, the NZNO members I meet tell me that the single biggest factor holding back their ability to influence the health of their community is short staffing.

It affects all sectors. But the place where we are best positioned to be a force for change right now is in the DHB sector. There, our MECA contains a mechanism to address short staffing – the Care Capacity Demand Management programme. As the pace gathers in the DHBs, then we can also build on our pay equity success in Aged Care and tackle short staffing there.

CCDM was created and sustained by all of us who took part in DHB MECA campaigns over the last 10 ten years.

Here in the City of Sails, one DHB (Auckland) has now made the commitment to begin implementing the programme, under the aegis of the Safe Staffing Healthy Workplaces Unit.

But CCDM will only succeed at ADHB to the extent that nurses, through NZNO, remain a force for change within the programme. Your impact and visibility will be vital, from ward and unit level up.

We are aware of the budget woes at all three of Auckland’s DHBs. We are aware of long delays in filling some nursing vacancies. We are aware that some areas not yet implementing CCDM are struggling to keep existing staffing numbers. We know that Auckland and Counties Manukau were short by millions when it came to affording the pay rise for existing nurses – much less employing the extra staff we desperately need.

At some DHBs, outside Auckland, we have been told explicitly that CCDM was halted due to budget constraints.

Last year, Treasury calculated that funding to the three Auckland DHBs failed to keep up with  “population cost pressures” to the tune of $74 million. That number rolls easily of the tongue, doesn’t it? $74 million. But it translates to thousands of nurses who could not be employed. A review of the population-based funding mechanism last December will see ADHB lose at least another $10 million next year, if all recommendations are implemented.

So this is the next area where nurses, collectively, must have impact and visibility if we are to influence the health of our communities. And the impact must go beyond DHBs, across all sectors.

Government spending on health has failed to keep up with increasing costs and population pressures nationally for each of the last six years. Health spending as a proportion of GDP has fallen since 2010. This is why we are all being pushed to be more “flexible”, and to “do more with less”.

When Kerri, Memo and I met with the Minister of Health in February, we signalled that Government spending on health is going to be a key campaign priority for NZNO, starting later this year and running into 2017 – which is an election year, and also the year we renegotiate the DHB MECA.

I believe we have already shown, at a local level, how nurses can succeed in making changes to government spending decisions.

Three weeks ago, it was announced that Canterbury DHB would receive a $20 million injection of funding for mental health services.

The way Health Minister Jonathan Coleman told it, he woke up the morning after the Valentine’s Day earthquake and realised that Christchurch would need more money for mental health. And a month later, hey presto! There it is.

But I think it has more to do with a community rising up, united in demanding that its needs are recognised. The calls came loudly over a long period from the DHB itself, from local politicians, community groups, the media – and from nurses in NZNO.

Nurses have helped to force change once, and we will again. We can start later this morning – we will have a chance to impress upon politicians from the Greens and NZ First our priorities as nurses.

In our efforts to influence the health of our communities, we must also address what the World Health Organisation calls the single biggest risk to health this century – climate change. Climate change is such an all-encompassing problem that it will leave no area of society and health untouched. The warming climate will bring loss of life through more extreme weather events, it will bring crop failures, economic instability and new diseases.

This is not a future scenario. It’s happening already. Did you hear the announcement last week? The Ministry of Health reported that a batch of the Aedes mosquito – the tropical species responsible for spreading the zika virus – had been found in a drain near Auckland Airport. So I am pleased to see climate change on the agenda today.

But for nurses to be a force for change, we must also strengthen our own organisation. We must make NZNO more responsive to members, by strengthening the diverse member voices within it.

Under our commitment to Te Tiriti o Waitangi, our first obligation is to our Treaty partner.

NZNO has been on a journey towards biculturalism ever since it was formed in 1993. We are enormously fortunate to have established a relationship between NZNO and Te Rūnanga o Aotearoa, along with a co-leadership model, with the president and kaiwhakahaere working alongside each other. The NZNO Board is introducing changes to make NZNO more responsive to Māori.

But, as we were reminded at last year’s AGM and conference by guest speaker Heather Came, we’re still not completely there yet. Heather is speaking to us again today.

Then there’s another group of members who also need attention. According to the Nursing Council’s latest report on the New Zealand nursing workforce, over a quarter of us qualified overseas. Internationally Qualified Nurses are the fastest-growing groups within NZNO.

We have started responding to you. In February, the Greater Auckland Regional Council organised a Migrant & Internationally Qualified Health Workers Conference. But there is still work to be done in strengthening your voice within our organisation.

This work is part of a larger project to remove barriers to participation in NZNO for all members.

NZNO is a democratic, member-run organisation. You, the members, collectively decide our direction, through your involvement in many NZNO groups. As co-leader of this organisation, I am taking on the responsibility of streamlining our membership structures.

I want to make it easier for you to get involved, to support the voluntary work which you put in to represent your fellow members – whether it’s in the workplace, college or section, Regional Council, Te Rūnanga or the National Student Unit – and to ensure that your voices are listened to.

Ultimately, nurses must join together with others to amplify our influence on the health of communities. I was enormously encouraged to see the support you have showed here in Auckland for our DHB colleagues and co-workers in the PSA. And their success in standing up for #QualityCareEveryday is an inspiration to us.

I am definitely looking forward to hearing, after morning tea, about the imperative to move from health advocacy to health activism. Because if ever there was a time for health activism, I believe, the time is now.

Thank you.