Making it happen: Investment in health for productive workplaces – Speech to NZNO Midlands/Bay of Plenty/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 ngā tiamana, Marianne kōrua ko Nicki, me ngā mangai-ā-rohe o Te Rūnanga o Aotearoa NZNO, ko Hinemotu kōrua ko Anamaria, tēnā koutou. Ngā whakawhetai ki a koutou mō tā koutou pōwhiri.

E ngā mēma o te poari – Tituhuia, Cheryl – tēnā kōrua āku hoa. 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.

Ka maumahara ahau ki tēnei whakatauāki o Te Puea Herangi: “Mehemea ka moemoeā ahau, ko au anake. Mehemea ka moemoeā e tātou, ka taea e tātou”. Nā konei, tēnei te kaupapa o te rā nei: ka huihui tātou kia whakapakaritia ake te mahi tahi. Ka kōkiri ngā nēhi, ka whitiwhitia te tautiaki.

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

There is 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 Chairs, Marianne and Nicki, and the Rūnanga reps, Hinemotu and Anamaria, thank you for your invitation.

To my fellow board members – Titihuia and Cheryl – greetings, friends. 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.

I recall this saying of Te Puea Herangi: “If I am to dream, I dream alone. If we all dream together, then we will achieve”. In sharing this whakatauāki, I acknowledge the mana of the Kingitanga. It also gives rise to the purpose of today: we are all gathered for the building of productive workplaces. When nurses are at the forefront, care is transformed.

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 month. In the preceding conventions, I have addressed the theme of the day. If you’ll allow, I will depart from my advertised topic in today’s programme and talk about this again: “Nurses at the forefront, transforming care – Building Productive Workplaces”.

At the Southern Regional Convention and Canterbury/West Coast Regional Convention, I also shared a whakataukī of Kai Tahu, the iwi with mana whenua in those areas.

“He mahi kai takata, he mahi kai hōaka”. “It is work that devours people, as greenstone wears down sandstone”.

Is this true? I think many here would acknowledge that it has some validity.

This month’s issue of Kai Tiaki contains the testimonies of many nurses, midwives and other healthworkers on this subject. It makes for sobering reading.

I’d like to share one, from Waikato DHB mental health nurse Gina Soanes. Gina is also the Chair of the NZNO Mental Health Nurses Section. She says:

“Nurses are still trying to do the best they can for their clients, but in a climate where resources are becoming increasingly stretched, this is difficult. 

“Clients are being admitted to hospital and discharged back into the community in greater numbers these days. The challenge is finding the right people in the community to provide the support they need. Many community-based services, eg counselling services, are being cut. This creates a chain reaction to other services like mental health. 

“The ongoing push of using unregulated staff in the community, particularly by non-government organisations, is putting even greater pressure on DHB nurses. We are responsible for supervising these unregulated staff. It’s another stress we have to cope with. 

“Older, experienced staff are not applying to work in the community in the way they once did. And for nurses at the coalface, being able to develop their leadership roles is becoming harder.”

The testimonies in Kai Tiaki are in line with research findings contained in the NZNO Employment Survey 2017, published in February.

It was NZNO’s fifth biennial employment survey of our nurse membership, and it revealed a steady decline of overall morale with specific concern about safe staffing levels, workload and pay. In addition there is an increasing loss of confidence in health sector leadership.

While the survey reveals that nurses show resilience and commitment to their profession in the face of continuing restructuring and resource constraints, there is a tipping point where nurses will just walk away from the profession.

Workload, increasing patient acuity, stress and lack of job satisfaction are contributing to staff turnover and to lower morale. Over a third surveyed experienced significant restructuring in the past two years. Some restructures were leading to loss of clinical nursing leadership in the health workforce.

A perception of poor pay relative to other professions such as for teachers and the police, is a growing source of dissatisfaction for many.

All these issues are a symptom of an underfunded health system that is under pressure.

While in Dunedin and Christchurch for those Regional Conventions, I visited our members in Dunedin Hospital, Hillmorton, Princess Margaret Hospital and Burwood Hospital. There, I heard them express these concerns in person.

“He mahi kai takata, he mahi kai hōaka”. “It is work that devours people, as greenstone wears down sandstone”.

And yet our vision for nursing is something different. We aspire, as NZNO together, to be “Freed to care, proud to nurse” – in productive workplaces.

How do we get there, from here?

Building productive workplaces requires a multi-faceted approach. This is reflected in today’s programme.

At the start of the day you were given a cultural perspective on workplace transformation, from Te Rūnanga.

You have heard also about the skills and knowledge needed in a productive workplace, from Sonya Saunders, Associate Director, Student Success, at Waikato University. Organisational Development Specialist Dr Maureen Marra explained the importance of workplace relationships in times of stress and pressure.

We will learn more about navigating workplace relationships shortly, from NZNO Professional Nurse Advisor Annette Bradley-Ingle. I think that many of us will want to know more about “Dealing with bullying and harassment in the workplace”, the focus when NZNO Educator Bethea Weir and organiser Paul Mathews join her at the front. And finally we will learn from each other, in the closing presentation on “How we are transforming the workplace”.

I will use the short time left to me now to highlight one more facet of the multi-faceted approach that’s needed.

Lifting productivity requires investment. This truth has been repeated for decades by politicians, business leaders and by unions.

And yet, it has not been heeded, at least in our workplaces. Annual increases in government health funding have failed to keep up with population growth and other cost pressures. Council of Trade Unions economist Bill Rosenberg has calculated that the cumulative shortfall means that health is now underfunded by $1.85 billion, compared with 2009 funding levels.

NZNO Kaiwhakahaere Kerri Nuku, Chief Executive Memo Musa and I meet twice a year with the Minister of Health. We have presented him with evidence of the need for greater investment. On its own, this has not been enough.

Recognition of the impact of underinvestment on workplace productivity – on our own stress and burnout, and on the people we care for – led the Board of Directors to decide last year that health funding would be a major campaign focus for NZNO in 2016/17.

On 23 March, the YesWeCare roadshow arrived in Hamilton, after visiting Gisborne and Wairoa, Whakatāne and Taupō, Rotorua, Tauranga and Thames. YesWeCare is a coalition of health unions and consumer groups.

Outside Waikato Hospital, the team assembled 200 life-sized cut-outs, representing the missing health workers who are needed to ensure safe staffing, safe care, 24 hours a day, 7 days a week. Some of you were there. A senior nurse, named only as Jan, spoke to the Waikato Times about why she was supporting the action. NZNO supports YesWeCare because it’s in tune with our own campaign for a fully-funded health system, Shout Out For Health.

In the build-up to DHB MECA bargaining and the general election in September, we are taking our Shout Out message to all decision-makers and all political parties.

Last month, the two main opposition parties announced “Budget Responsibility Rules” which would tightly restrict government spending in any future Labour/Green government. These rules are not good enough. We support CTU president Richard Wagstaff’s call for “higher levels of government activity and investment than these rules permit.”

“There is”, said Richard, “an urgent need”.

At the same time, we’re calling on the current government to restore the $1.85 billion missing from health in next month’s Budget.

But before then, Finance Minister Steven Joyce is expected to make a significant pre-Budget announcement. Later today, he is likely to signal increases in government spending, including some increased investment in health. (edit: Steven Joyce’s subsequent announcement here: ‘Government to allocate $11b in new capital‘)

It is natural for politicians to take credit for popular announcements. But as we listen to Minister Joyce talking about increased investment in health, we need to remember that we helped to make this happen too, through our own collective action as unionists, in partnership with health consumers and the wider community.

I know that many of us today can feel powerless to effect real change. But we need to remember what Prime Minister Bill English told Newshub, when he was asked what he thought about the YesWeCare campaign. He said, “Discussions are under way right now about the next Budget. So yeah, we do pay attention to the views of people on the front line because they’re a pretty good measure of what’s happening.” We have already made a difference.

So we know what works. Now we need to step it up.

Earlier this month, Kerri Nuku and I launched the latest phase in the Shout Out For Health campaign – an open letter to New Zealand voters. It asks everyone to make health funding their first priority this election. The letter is in your registration pack, and online at NZNO Blog.

The main goal between now and the election is to get as many signatories to the open letter as possible, both online and on hard copy. Signed letters are now starting to arrive in Wellington from all over the country. They are being gathered up for use in a pre-election event. We will hear more about the letter this afternoon.

NZNO staff and member leaders are also starting to distribute Shout Out For Health leaflets and bumper stickers. Wrist bracelets are coming soon. We ask you to use these resources to start conversations in your community about health funding being an election issue. Primary Health Sector members in particular are being asked to investigate hosting community meetings on health funding through the next few months, as the DHB members start to be involved in their own MECA negotiations and campaigns.

Have conversations about enrolling to vote and taking positive action for health funding – spreading the word through stalls, meetings, leafleting, writing letters to the editor and meeting MPs from all parties – including a group of MPs who we’re meeting at this venue, once the formal part of the Convention is over.

Members wanting to take action can ask their local staff and member leaders for support.

Shout Out for Health is about empowering you, the NZNO members, to carry out your own campaign ideas.

But something else I have heard clearly while meeting with members at work this month is that nurses are tired. It’s hard to find the energy to participate in campaigning activities.

So Kerri and I are leading another piece of work, along with the Board, to improve volunteer sustainability, member engagement and leadership development within NZNO. To begin with, we have decided to reinstate the training day for new chairs and treasurers of Regional Councils, Colleges and Sections.

This month and next, a small number of focus groups will be held, to find out from members what else would enable you to get more involved in NZNO’s many and diverse areas of activity. Some of you took part in a focus group over lunch. Once the results are analysed, then resourcing will be allocated in the NZNO budget, to support our volunteers. Next steps will be discussed at a meeting for all chairs at the NZNO AGM in September.

Sustainability and leadership development may also extend to greater support for Board members. At present only two of NZNO’s Board members – the President and Kaiwhakahaere – receive remuneration from NZNO. AGM this year will be asked whether the other Board members should also be remunerated. So that’s something to think about between now and then, and something to talk about with your AGM delegates, in the Regional Councils, Colleges and Sections, Student Unit and Te Rūnanga.

Together – NZNO board, members and staff – we can achieve our vision. The challenge is large. But with nurses at the forefront, we will transform care.

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

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