The President comments: ‘Powered by unity and determination’

JULY 12, 2018, is a day that will go down in New Zealand nursing history.

For just the second time, nurses in our public health system took nationwide industrial action, alongside midwives and health-care assistants (HCAs) covered by the district health board (DHB) multi-employer collective agreement (MECA). 

For me, the hours I spent picketing and marching with my fellow NZNO members that day are the proudest moments of my nursing career. 

NZNO members stood together. “Yes” voters, “no” voters and non-voters stood side by side, outside on the picket line, or inside, providing life-preserving services. 

Auckland march - Newshub frame 1 (crop)
‘An historic day: Time spent picketing and marching with my fellow NZNO members on July 12 are the proudest moments of my nursing career.’

And now, three weeks later, DHB members are being asked to vote once again. They’re deciding whether to accept DHB offer number five – the third to be recommended by the NZNO negotiating team. As I write, the outcome of the vote is unknown. But what is clear is just how far we’ve come. 

Back in November 2017, most members were being offered three pay increases of two per cent, over 33 months, and a lump sum of $350 (pro rata). 

The DHBs had agreed in principle to support a pay-equity process, but there was no definite date for completion. They said, once again, they would implement care capacity demand management (CCDM) – this time, by June 30, 2021. 

In February, after rejecting the first offer, we were told DHBs could not provide wage increases above two per cent, unless they were to resolve an anomaly like the identified senior nurse issue, or were achieved through a pay equity process. 

But in this second offer, the lump sum was increased to $1050 and a deadline of July 1, 2019, was set for a pay-equity settlement. 

Prime Minister intervenes 

When that offer was also rejected, Jacinda Ardern was moved to speak up – the first time a New Zealand prime minister had intervened publicly in our bargaining – and proposed an independent panel. Our submission to the panel set benchmarks for appropriate pay ranges – $44,500 to $56,300 for an HCA, $57,500 to $61,500 for an enrolled nurse and $64,300 to $80,000 for a registered nurse or a midwife. 

We rallied because #HealthNeedsNursing, and we marched so New Zealand would #HearOurVoices. When the third offer came in June, it was almost twice as big. The lump sum was bumped up to $2000. Pay rises ranged from 9.3 per cent to 15.9 per cent over 26 months. 

Members were allowed to vote online for the first time, which led to the highest participation ever seen in a MECA ratification ballot. 

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. Recruitment of the extra nurses has already begun. 

And now, at the end of July, after two further “reject” votes, Health Minister David Clark has put his signature to a new accord on safe staffing. The accord acknowledges that making sure there are enough nurses and midwives in our public hospitals to guarantee safety for staff and patients requires support from the Government. It strengthens commitments to deliver this by June 2021. 

The journey so far has not been easy. But every one of these advances has been powered by the unity and determination of thousands of NZNO members, who should be enormously proud of themselves. • 

Kai Tiaki cover, 7.18
First published in Kai Tiaki Nursing New Zealand, August 2018. Reposted with permission.

‘Striking for a better health system’ – Speech to Auckland NZNO rally

On 12 July 2018 nurses, midwives and health care assistants walked off the job at DHBs nationwide for the first time in almost thirty years. In Auckland, thousands NZNO members and supporters of the strike marched up Queen Street to rally in Aotea Square and listen to delegates from the city’s three DHBs – Gui Restall, Sela Ikavuka, Alys Moriarty and Joel Peeperkorn. The Chair of NZNO’s Greater Auckland Regional Council, Esther Linklater, CTU Māori Vice-President Syd Keepa and NZNO Lead Organiser Carol Beaumont also spoke. It was my honour and privilege to make this short announcement first. 



Kia ora. What a wonderful sight you all are! 

I have two brief messages to deliver. The first one is for you, the NZNO members gathered here. 

I want you to know that the whole of NZNO is behind you today. I would like to read a statement from the Board of Directors, the elected governing body of your organisation:

“We offer our solidarity and support to all our members who are on strike and picketing. We also acknowledge those who are on rosters for life preserving services taking care of the public at this time. And we thank all members for their support.”

The second message, before I hand over to our wonderful member speakers, is for the public and the government.

Today we are striking today for a better a health system for us all. This is a message from all of us to the government and the employers. And I think it’s one that they can share. I believe the government and the DHBs also want a better health system for us all. 

The government say they can’t make up for nine years of underfunding in a single Budget, and that it’s going to take time. And I think we understand, deep down, that there is some truth to that. 

But we also want the government to understand something in return. They need to move faster, and they need to start with a bigger step right now! 

The last thing is for any members of the public who are here, or watching on live streams. Today’s action, this is for you. So please show your support for our nurses today. 

Thank you. 

The President comments: ‘To strike, or not to strike? Is that the question?’

MECA meeting Kenepuru 2, 12.12.17


To strike, or not to strike? Is that the question?

Or as NZNO members in DHBs prepare to vote on their employer’s latest offer, is the question now vexing the troubled soul of nursing something deeper? 

There’s no doubt we’re living in a time when unrest is driving change, for our profession and for NZNO. As I said in last month’s issue of Kai Tiaki, members are rising up and making history.

“Never before have NZNO members in our public hospitals voted to reject an offer recommended by the national negotiating team, as they did in December”, I observed. 

“And the turnout at the March meetings saw a majority of members vote in a ratification ballot for the first time.”

To that, we can now add that more members took part in the online strike ballot last month than in any other vote in NZNO’s 109-year history. 

The past as we knew it – one of “doing more with less”, of increasing workloads and stress, and of NZNO membership as just “an insurance policy” and a person at the end of the phone – this is being swept away. Yet in the words of Joe Strummer, “the future is unwritten”. 

But as we write the future, we must attend to the soul of nursing. Fundamentally, it’s now a question of being true to who we are, as professionals and as trade unionists. 

As nurses, we have a unique language of kindness, understanding, perception and logic. Every day we bring that to the patients we care and advocate for. It is that language we now need to use for our own advocacy. 

The foundations of our profession are built on ethical integrity. We are evidence-based in thought and compassionate in deeds. 

We must now interact with each other and engage with our employers and the wider public ethically, using evidence and compassion. 

When the DHBs chose to talk to the media rather than give us time to digest their offer, we were angry. But we kept our integrity. We cannot let fear or anger undermine who we are or decide our vote for us. 

We are advocates. Effective advocates combine passion with good analysis, and carefully crafted communication. We must be that kind of advocate for ourselves and our profession. 

And we are carers. Each of us was drawn to the work of helping others because of this. 

Another name for care is solidarity. Our foremothers and forefathers who founded the union movement understood the meaning of this word. 

They were animated by the socialist spirit of looking out for others and standing together behind the collective decision, whatever it may be. As we seek change, let us also hold fast to that spirit. 

Whether we strike or not, the next steps for us may be difficult. But with care towards each other, they can be made easier. 

Struggle and adversity can bring out the worst, or the best in people. How we struggle and advocate for our profession defines who we are as a profession. 

My call to each and every one of you is this: be yourself, it is who we need most right now to win. •

(Written for Kai Tiaki Nursing New Zealand. Posted here in advance of publication in the June issue, with permission)

The President comments: ‘The winds of change now blowing’

Kai Tiaki cover, 4.18
First published (slightly abridged) in Kai Tiaki Nursing New Zealand, April 2018. Reposted with permission.

WHEN 28,000 nurses, midwives and health-care assistants voted last month to reject the second district health board (DHB) multi-employer collective agreement (MECA) offer – knowing a strike ballot would be the next step – the “no” was powerful enough to influence the course of history.

The vote was a message to stop devaluing nurses and stop failing the patients and communities who need our care. After a decade of worsening health underfunding, the vote said, “No more!”

Only once before – in 1989 – have New Zealand nurses taken nationwide industrial action. This mobilisation reshaped nursing and led to the birth of NZNO. The winds of change now blowing will also be felt beyond the DHBs.

But for every “no”, there is a “yes”. Through their vote, our DHB members were also affirming the need to restore our public health system, to recognise and fairly reward all members of the nursing team for their skilled work and to address the staffing crisis.

This “yes” belongs to everyone – people inside and outside NZNO, health-care workers and the communities we serve. All can come together to agree that health needs nursing.

Launched on March 26, #HealthNeedsNursing is the name of NZNO’s new DHB campaign. It’s an affirmation that the nursing team is the essential core of the health system. We are dedicated, caring and always there.

#HealthNeedsNursing also says that the health system itself is ailing. In a way, the rot in the walls at Middlemore Hospital is symbolic. Those in charge at Counties Manukau DHB have known for years the hospital is sick. But to remain within their undersized budget, as demanded by the previous government, they just patched holes in the walls and carried on, until the problem couldn’t be covered up any longer.

Health system sick

It’s like that for the whole DHB sector. There’s now no denying the health system is sick. It needs to be nursed back to health.

Already, our campaign is growing. Council of Trade Unions president Richard Wagstaff came to the launch, and pledged the support of the union movement.

Prime Minister Jacinda Ardern has also given a “yes”, of sorts. The morning after NZNO said “no”, she told the AM Show on TV3, “I value our health workforce. Do I want our nurses to be satisfied? Of course I do. Do the DHBs need more money? Yes.”

Public opinion

At the same time, though, she talked about barriers around “timing” and “budget allocations”. If our campaign can win strong public agreement that health needs nursing, then the pressure of public opinion can help overcome barriers for the Government.

#HealthNeedsNursing - Weeks of Action launch 2
The #HealthNeedsNursing Weeks of Action were launched on 9 April, taking the message to commuters at Wellington Railway Station.

At the same time, the campaign is also setting the pattern for a renewal of NZNO as an organisation which is open and responsive to members.

Members are making the big decisions through democratic votes. Campaign planning is taking place through cooperation between NZNO staff and member leaders, from local workplace delegates to the nationally elected board. Actions are designed to maximise member participation.

As the current surge draws more members into action, the transformation of NZNO is bound to continue apace. 

Wellington rally for good health2, 13.4.18
Wellington Hospital Rally For Good Health, 13 April.

By the time you read this, the next stage of the #HealthNeedsNursing campaign will be well under way. Rallies for good health at each DHB, from April 9-20, will also prepare us for whatever comes next.

Let’s make them big, loud and proud. •

Do online votes aid union democracy?

Union Democracy and Electronic Vote

One of the FIQ Santé convention workshops Nuku and I attended was on a topical issue for NZNO members – Union democracy in the age of electronic voting.

NZNO has limited experience with online voting. It’s been used to elect board members since 2011. Turnout in these elections hasn’t topped 14 per cent. In 2012, 11.92 per cent of members voted in the online referendum on adopting the NZNO constitution.

A one-off, localised trial during multi-employer collective agreement bargaining in 2011 saw just 6.64 per cent of members at Capital & Coast DHB vote electronically to endorse the negotiating team and the claims – well below the national average.

Such limited experience meant the FIQ Santé workshop was valuable.

The facilitator defined union democracy as: “The opportunity for any member of a trade union to develop informed opinions on the objectives of their organisation and on the means to achieve them, on the one hand, and the opportunity to express these opinions in such a way that the union is governed by the majority of these opinions expressed, on the other hand.”

This requires a formal framework of power for the union’s administration, the ability for members to influence decisions, cohesion among members and transparency and responsiveness from administrators.

FIQ Santé research has found electronic voting can lift turnout in elections, as long as members know the candidates and the voting process.

In bargaining, meanwhile, the research found the participation rate was only slightly higher for the electronic vote.

Potential disadvantages with electronic voting were also identified – possible weakening of collectivity, confidentiality issues, increased cost and difficulties maintaining up-to-date email addresses.

The workshop concluded that while electronic voting can be considered a democratic tool, it does not replace the democratic process.

Opportunities will be sought to present the full findings to NZNO staff, to help inform future planning. •


Related coverage:

Global nurses unite in Québec’

No fees at nurse-run service

(First published in Kai Tiaki Nursing New Zealand, February 2018. Reposted with permisison).

The President comments: An open letter about the MECA

It was a fortnight before Christmas, and the final day of voting at the DHB MECA ratification meetings. Kaiwhakahaere Kerri Nuku, chief executive Memo Musa and I were meeting new health minister David Clark for the first time.

In the chit-chat before getting down to the business on our agenda, Clark mentioned the MECA and expressed the hope it would be settled soon.

There was a pause. None of us across the table knew what the result of the vote was going to be. The response I came out with was simply: “Minister, there’s a lot of hurt out there”.

MECA meeting Kenepuru 2, 12.12.17
“It was the final day of voting at the DHB MECA ratification meetings” (Photo: N Tunnicliff)

When it was announced the following day that the DHB offer had been rejected, I understood.

I understood because of all the DHB nurses, midwives and HCAs who have taken the time to tell me their stories. Some of those stories stand out.

“I’ve held onto the belief that things will get better”, one nurse said recently. “I’ve done the hard yards of ‘more with less’ in good faith that eventually the rewards would come ­– a fair salary reflective of the skills, knowledge and responsibility of my profession, sufficient support and resources to do my job safely every day.

“None of this has happened. I am tired and disillusioned that we as nurses should have to continue to fight so damned hard for such fundamental basic rights.”

“We don’t feel valued”, said another, “The effort required to work within the DHB feels so immense that we feel despondent about the longevity of our career choice.

“The sustainability of our profession weighs deeply on DHB nurses. The levels of fatigue and job dissatisfaction due to the ever increasing acuity of our patients are higher than ever. We are in DHB nursing because we love the acute health arena, but are constantly considering whether we can survive it, or how long we can sustain our efforts.”

A third told me, “DHB nurses are hurting personally and professionally. We are no longer able to keep giving extra hours to poorly staffed workplaces, as it increases our own stress and health needs and those of our families – for which we, too, have to join waiting lists for treatment.

“We must ensure there are enough staff to do the work, and fund both the wages of these staff and other health service costs, or else nurses will continue to hurt and leave this great profession.”

Three nurses, three different DHBs. The story’s the same, all over.

As I write, mediation between NZNO and DHB representatives is about to get under way. By the time you read this, the mediation process will be complete.

The outcome of mediation will be presented at NZNO member meetings between March 6 and 23.

The situation can’t be blamed on current DHB leaders or on the government of the day. It’s the result of actions by their predecessors, going back many years.

But I dearly hope that the minister and the DHBs have understood that it’s time for them to do what we do for others, every day. It’s time for them to soothe the hurt. •

(Written January 2018. First published as “The president comments” in Kai Tiaki Nursing New Zealand, February 2018. Reposted with permission)

Stronger together: reflections on the DHB MECA campaign

Next week, NZNO members in DHBs around the country will start voting on a new offer from their employers. Details of the offer are available here.

It comes after members voted in May to reject the first offer, sending the NZNO and DHB negotiating teams to mediation.

It is now exactly a year since I was nominated for the NZNO negotiating team by my fellow delegates at Capital & Coast DHB. So it’s a good time to reflect on the journey to this point – both for myself, and for the 26,000 other NZNO members I have been representing.

It was a great honour, last October, when NZNO members in DHBs around the country elected me to be part of the MECA negotiating team.

And it has been an absolute privilege to work with the thousands of passionate, committed NZNO members who have propelled the negotiations to where we are today.

CCDHB visit
We’re Stronger Together

I have met many of you over the last three months, during my visits to Waitematā, Auckland, Counties Manukau, Waikato, Lakes, MidCentral, Wairarapa, Hutt Valley and Canterbury District Health Boards. I only wish my annual leave balance (and bank balance) had allowed me to visit the other ten DHBs, as well!

Some of you I saw at the ratification meetings in May. There, thousands of members turned out to vote overwhelmingly against the DHB offer – the highest level of participation in at least a decade.

Others I met in the workplace, where you collectively supported the “Go Purple” Days of Action, and where around 5,000 of you signed letters telling your DHB Chief Executive: “We are writing to let you know that we are standing strong for health.”

These actions we took together showed employers and government that we were growing stronger.

Now the negotiating team is recommending that members accept the new offer.

At the start of bargaining, I was asked to draft a set of Values and Principles to guide the team. Amongst other things, we agreed we would make decisions by consensus where possible, by majority where necessary, and that we’d accept collective responsibility for decisions reached.

But members who are deciding who to vote for in the NZNO elections also have a right to know what I think, personally.

Do I believe the offer recognises what nurses and healthcare workers are really worth? No, I do not. We need to keep our eyes on that prize.

If we focus only on how far we have to go before we reach that goal, however, we will probably be disappointed by any offer made this year. So we also need to look at how far we have come.

Up until February, the State Services Commission was insisting that pay increases must be no more than 0.7 percent. That unreasonable spending cap has been pushed aside. By working together, we have come a long way.

It is not my place, or my wish, to tell members to settle for too little.

But the new offer will deliver real pay rises, above inflation, and other improvements which will allow quality care. It can serve as a platform, to relaunch the journey towards our ultimate goal.

Despite the fact that member participation this year has been the highest in a decade, reaching that goal will take much greater participation, a change in economic and political circumstances, or both.

The negotiating team’s stated reasons for recommending acceptance now include the fact that “there is an improved wage offer and a reduced term”, and “progress has been made on addressing a number of outstanding matters”.

But there are other reasons, too. For me, personally, it is because our achievement is the result of your collective action as members, and this deserves to be recognised and valued.

Our MECA campaign also had great support from outside NZNO’s DHB Sector. Members in the Primary Health Care Sector showed their support.

Nurses at the Porirua Union & Community Health Service supporting DHB Sector members.
Nurses at the Porirua Union & Community Health Service supporting DHB Sector members.

So did other unions. “We support the decision by NZNO members to reject the offer made to them by the DHBs”, said PSA national organiser Ashok Shankar.

Even the President of the PPTA secondary teachers union, Angela Roberts, joined in our “Go Purple” Day of Action.

PPTA President Angela Roberts %22Teachers stand with nurses%22
PPTA President Angela Roberts

Where was our President?

The role of our elected leader includes being the public face of the organisation. The President’s invisibility throughout the negotiations is even more surprising, given the policy remit passed at the last AGM, that NZNO commits to supporting a new “Pay Jolt” in the upcoming DHB MECA negotiations.

“As an industrial matter, it is up to the members covered by that agreement to determine their own issues and set their own priorities”, explained the rationale attached to the remit.

“But there are also reasons why, as a matter of policy, this bargaining round will warrant a ‘whole of organisation’ commitment from NZNO.”

If you vote to elect me as your next President, I pledge to dispel the cone of silence which has engulfed our leadership. I will make your issues visible – including the issues you’ve taken action to address through the DHB MECA campaign.

And I pledge to support members whenever you join together for health. As the DHB MECA campaign has shown once again, when we take collective action we can succeed. Because together, we’re stronger.

Nurses vote to reject DHBs’ offer

The message is overwhelmingly clear. NZNO members working for District Health Boards all around New Zealand have rejected the offer made by their employer as part of negotiations for a new Multi-Employer Collective Agreement (MECA). Details of that offer are here.

It’s not just the overwhelming majority who voted against – over 82 percent. The message is reinforced by the sheer number of NZNO members who stopped work to attend meetings where the voting took place.

In many DHBs, it was the largest turnout at ratification meetings since the height of the nurses’ Fair Pay Campaign which achieved the first national MECA a decade ago. In some areas, such as Lakes District Health Board, it was the biggest turnout ever.

Lakes DHB 21.5.15
Visiting Rotorua Hospital, part of Lakes DHB

As part of the vote, members were asked to write on the back of their ballot paper the issues they want their Negotiating Team to work on and improve. NZNO staff are now busy analysing that feedback.

But over the last three weeks, I travelled to seven DHBs in order to hear member feedback first hand as well. I attended dozens of ratification meetings, in my role as a member of the NZNO Negotiating Team. And I spoke with hundreds and hundreds of NZNO members who invited me into their workplaces.

WDHB 18.5.15
At Waitematā DHB
ADHB3 17.5.15
Visiting Auckland City Hospital.
Waikato DHB 20.5.15
Waikato Hospital in Hamilton.

Some common themes emerged. Firstly, we don’t have the staffing to safely care for the ever-increasing number of sick people coming through our doors.

Secondly, while the Ratification Bulletin outlining the employers’ offer ran to 12 pages, full of detail, one number in particular jumps out – the 1 percent figure for a pay rise this year.

And the employers’ refusal to look at many of the small, inexpensive changes which NZNO had asked for is symptomatic of a general lack of respect for nurses, midwives and health workers working in DHBs.

The NZNO Negotiating Team have arranged to meet urgently with the employers this Thursday. We will be sure to take your collective, nationwide feedback with us.

NZNO members flock to DHB MECA Ratification Meetings

Meetings are now under way in District Health Boards around the country for NZNO members to vote on the employers’ offer. This week, I was invited to attend six of these Ratification Meetings.Grant Brookes at ratification meeting HVDHB 5.5.15 (crop) copy

As a member of the NZNO Negotiating Team, it is enormously encouraging to see the huge number of members turning out.

Hutt Valley was the first DHB to finish its scheduled Ratification Meetings, with all of them being held between 0900 and 1630 on Tuesday.

At times, it was standing room only, as the room filled to overflowing.

Final numbers at HVDHB showed that nearly twice as many members attended this week’s meetings, compared with the MECA Endorsement Meetings held last October.

Reports from around the country tell a similar story, with big turnouts everywhere.

The Negotiating Team does believe that this offer provides some important improvements. But it has not sufficiently addressed some of your key issues as endorsed at last October’s meetings. So we are not making a recommendation to accept it.

Last October, an article I wrote for the NZNO Blog said that “Together we can win; for ourselves and our patients“. But it went on to explain:


This remains true today.

It is now for all members to decide on whether to accept or reject the offer. Details of the meetings where you can have your say are available by clicking here. The more members who actively participate, the stronger the message.

It is vital that all NZNO members attend a meeting and cast your vote and give the Negotiating Team the clear direction we need.

The signs so far this week are that you’re doing exactly that.

DHB members: Time to vote on your MECA


Your negotiating team has done its part. We have presented your issues and claims to the District Health Boards, and received their offer in reply. You can download the Ratification bulletin summarising the offer by clicking here.

Now it’s up to all the NZNO members covered by the DHB Multi-Employer Collective Agreement to play your part.

Meetings will be held in every DHB from 4 May to 21 May. There, members will vote on whether to accept the employers’ offer, or to reject it. Click here to see the full schedule of meetings.

Your negotiating team is not making a recommendation to accept the offer. It is you, the members, who must now decide.

It’s vital that all NZNO members working in DHBs attend a meeting, cast a vote and give the negotiating team the clear direction that we need in order to take the next steps. If you can’t get to a meeting in your usual worksite, you can attend a meeting anywhere else in the country.

This is your collective agreement so your vote really does count!