First published in Kai Tiaki Nursing New Zealand, February 2017. Reposted with permission.
Summer will soon be officially over, and 2017 well under way. It’s time to think about what the year ahead will hold.
For NZNO members, this year is filled with possibility. In 2017, we will have a real ability to make change for the better. And don’t we all need that!
Summer is often the season which reminds us most of life outside work. But when we’re run ragged through understaffing, and leave work exhausted, everyone misses out. Our friends and families don’t see us at our best. Our patients don’t get the best from us. We miss out ourselves, too, on the good things we see others enjoying.
Funding squeezes, year on year, have created an ever-increasing pressure to “do more with less”. This pressure is now being felt across the health sector.
It has pushed resident doctors in district health boards (DHBs) to take escalating industrial action, just to get rosters and staffing levels which don’t leave them burnt out, and on the edge of unsafe practice. St John Ambulance professionals can’t get the rest and meal breaks they need so they’re fit to make decisions on the job. In many places, ambulances still aren’t fully crewed with skilled staff.
Funding squeezes also mean that more and more people are missing out on the health care they need, while new grad nurses who could provide care struggle to find work. So how can we change this for the better?
Day in and day out, nurses and midwives at all levels claim the right to take part in decision-making, based on our professional expertise and experience. But in 2017, the opportunity for all NZNO members to influence the future of health will be greater, due to the alignment of two major events.
Renegotiation of the DHB multi-employer collective agreement (MECA), which expires in July, will enable close to 30,000 of us to have a say about conditions in the public health system. The general election in September allows every member to have a say about this country’s priorities – not just as an individual voter, but also as an influential member of their community.
Nursing’s full power
Professionalism gives us a voice. But it’s the synergy between professional authority, industrial strength and political enfranchisement – like the one developing this year – that releases the full power of nursing.
That’s not to say it’s going to be a walk in the park. The resident doctors are facing an uphill battle and attacks in the media. Ambulance professionals suffered 10 per cent pay cuts designed to weaken their resolve.
But public support for the doctors has been overwhelming. In a 1 News Facebook poll, 95 per cent of respondents supported their strike last month.
And the “ambos” have showed that when you stick together and stand firm, fairness can win. In mid-January, St John backed down on the pay cuts and talked about repaying all wages they’d deducted.
For us, if you’re in a DHB the first step in making change is exercising your right to attend the MECA meetings which start in May. Times and places will be advertised by NZNO delegates and organisers.
Then, in the election, NZNO won’t tell members who to vote for. But staff will produce resources to enable you to make an informed vote for a government which values health, and to support conversations with family, friends and workmates so they can do the same.
There are 48,000 NZNO members, and many more potential supporters. There is power in numbers. Chances like this may not come around again for a while, so this year we need to seize our opportunities and use our power for nursing and health. •
First published in Kai Tiaki Nursing New Zealand, December 2016. Reposted with permission.
My personal reflections on the last 12 months?
Sometimes, for what seems like ages, it can look like nothing much will ever change in the world. Then along comes a year where it’s as if someone has hit fast forward. Things are changing so quickly you wonder what could happen next.
Looking back from the cusp of the New Year, it appears to me that 2016 has been one of these times of rapid change.
It’s not just Donald Trump. Dissatisfaction with the status quo has boiled over in a series of world events which have disrupted “business as usual”, even in far-flung New Zealand.
Faced with rapid change, people have a choice. They try to can carry on, as if nothing’s different. Or they can think afresh, and come up with new ideas to fit the new reality.
‘A strange figure’
Sadly, our Government this year has chosen the former. Prime Minister John Key cut a strange figure on the world stage in November, continuing to promote the harmful Trans- Pacific Partnership Agreement (TPPA), long after most other people in the room knew it was dead.
He and his ministers also continue to trot out the old mantra of tax cuts, rather than think anew about restoring investment to fully fund our creaking health and social services.
In a peculiar turn, voters are even telling the pollsters they no longer want tax cuts. In the past, the Government could perhaps reply that it was acting in accordance with advice on tax cuts from overseas experts. But the world has moved on here, too, leaving our tax-cutting politicians behind.
At times like these, nurses have a special opportunity – and responsibility – to bring forth the new ideas that are needed.
The winds of change
Our American sister union, National Nurses United (NNU), felt the winds of change sooner than most. In August 2015, they became the first major union to endorse Democratic hopeful Bernie Sanders for United States (US) president. Echoing Sanders, NNU executive director RoseAnn Demoro observed, “This is not a conventional moment, we are fighting for the future of this country”.
“Caring, compassion, and community. These are the values at the heart of registered nursing”, said NNU. “This is true at the bedside, as nurses advocate for patients and families – and also beyond the walls of the hospital, as RNs call for environmental, racial, and economic justice in the name of public health.”
Sanders’ embrace of a “democratic socialist” label would, in any normal year, have consigned him to America’s political fringes and electoral oblivion. The fact he came such a close second in the primary contest, after winning 13 million votes (43 percent of the total) underscores just how far from “a conventional moment” 2016 has been.
Despite considerable pressure, NNU stuck to its position, even after Hillary Clinton was chosen by the Democratic Party to be its candidate. NNU’s conviction that it was in tune with the rapidly changing times was, as DeMoro put it, because “nurses take the pulse of America, and have to care for the fallout of every social and economic problem”.
When Trump secured victory after a divisive campaign, NNU ruefully observed, “This election is a reminder that in a populist moment of people yearning for change, it was not a moment for business as usual, establishment politics. If Senator Bernie Sanders had been the Democratic candidate, we would be looking at a very different outcome today.”
Although it’s largely external events which have so far disrupted business as usual in New Zealand, similar winds of change are also blowing here. Asked in a poll to choose between Donald Trump and Bernie Sanders, New Zealanders favoured Sanders by a margin of 10 to one.
But, equally, the channelling of dissatisfaction towards new migrants and other minorities is also starting to appear.
NZNO is at the forefront of some of the new thinking that’s needed. The day after the US election sealed the fate of the TPPA, kaiwhakahaere Kerri Nuku and I wrote to government support partner, United Future leader Peter Dunne, asking him to withdraw his support for the TPPA enabling-legislation. A single vote would have been enough to prevent pointless changes to 11 of New Zealand’s laws, based on a trade agreement that was dead in the water.
But I think we need to do more updating, because one conclusion I draw from these reflections on the year is that “business as usual” is a recipe for failure in rapidly changing times.
Personally, I agree with the NNU that now, “the agenda for real transformative change of our broken political and economic system is the only way to protect our nation and our planet.”
At this month’s board of directors’ meeting, I will be asking the board to start a strategic discussion about our changing environment, and how we might collectively reposition our organisation in 2017 for the new realities that 2016 has brought. •
First published in Kai Tiaki Nursing New Zealand, October 2016. Reproduced with permission.
“DID YOU notice that?” I asked.
It was near the end of the first day of last month’s NZNO annual general meeting (AGM) and conference, and I was talking to NZNO vice-president Rosemary Minto. What I was asking about was something that lasted no more than five or 10 seconds, and happened during my opening speech.
When I reported to the assembled delegates that our board of directors had reviewed NZNO’s investment portfolio, and had moved to divest any direct holdings in fossil fuel companies, the room erupted into applause.
I was momentarily taken aback. I’d thought this was a fairly dry part of my speech, and didn’t expect such a reaction. So I said to Rosemary that when something unexpected like that happens, it tells us we need to update our assumptions.
The health impacts of climate change, and the need to withdraw investment from fossil fuel extraction to shift towards a low- carbon economy – as explained by environmental group 350.org – were both put on NZNO’s agenda by a vote at last year’s AGM.
And just as they were put on the agenda by NZNO members, it was ongoing activism by members which then made the divestment happen this year. Going by the spontaneous applause during my speech, this is clearly an issue which is widely and deeply felt.
At the time of the 2015 AGM vote, large organisations in New Zealand were just starting to get behind fossil fuel divestment. The Presbyterian Church, Dunedin City Council and Victoria University voted to divest in 2014. The Royal Australasian College of Physicians and the Tertiary Education Union did the same in 2015.
Since then, Otago University has voted to divest from fossil fuels, while Kiwisaver providers, the NZ Super Fund and Auckland Council, have ditched their shares in weapons manufacturers and unhealthy food brands and are reconsidering their fossil fuel investments.
Could it be that when members call the shots, NZNO is more in tune with positive shifts in public attitudes and more able to make ethical decisions?
Member-driven
The need for organisations to be member-driven was another theme which ran through our AGM and conference.
Guest speaker Frances Hughes, who is chief executive of the International Council of Nurses, stressed the strategic direction of ICN was set by its 130 member organisations. There is no room for passive membership, she said.
President of the Canadian Federation of Nurses Unions (CFNU) Linda Silas reminded us that NZNO members pay for all NZNO activities and salaries, right up to chief executive Memo Musa. “You have to listen to your members,” she said.
It’s probably no coincidence that both speakers also talked about how their nursing organisations are now focusing on climate change as a determinant of health. This was the topic of one of the ICN interventions at this year’s World Health Assembly – the biennial meeting of health ministers, held under the auspices of the United Nations (UN).
But for NZNO members to steer this organisation, you need to know what’s going on. So another link in this chain – stretching all the way from your workplace and community to the world-shaping decisions at the UN – was provided by an AGM vote for greater transparency. From now on, the agendas and minutes of NZNO board meetings will be available to members.
Knowledge is power. And when NZNO members are empowered, then I believe we are better equipped to achieve NZNO’s strategic goals – including implementation of population health approaches which reduce health inequalities, and address determinants of health and those things that affect people’s ability to live well.
So my message to members, after our AGM and conference, is to keep on speaking up about NZNO’s direction. It’s not too much of a stretch to say that if you do, then together we can help save the world. •
Response to NZNO Consultation Request: Essential skills shortage review – Immigration New Zealand, from Grant Brookes
It is widely accepted that anti-immigrant sentiment is on the rise in developed countries. Negative attitudes towards new migrants are seen as a factor in many political developments today – from the popularity of US presidential hopeful Donald Trump, to the UK’s “Brexit” vote to leave the European Union, the growth of European Far Right parties and the implementation of harsh anti-asylum seeker policies in Australia. The powerful emotions which often accompany the immigration debate have also been used by politicians here.
NZNO is currently involved in a review of Essential Skills Shortages in nursing, being undertaken by Immigration NZ. The outcome of the review will affect how easy it is for Internationally Qualified Nurses to gain temporary work visas and possible residence in New Zealand.
NZNO members are being consulted, to inform our organisation’s input into the review. If you’re a member, you can have a say by emailing NZNO Senior Policy Analyst Marilyn Head (marilynh@nzno.org.nz) by 17 August.
In my role as President, I represent NZNO to external stakeholders. When I do this, I reflect our organisation’s agreed positions.
But I am also a member of NZNO. And in that role, since our position has not yet been decided, I would like to express my own individual views about Essential Skills Shortages in nursing. This will be considered, along with every other member’s feedback, in shaping NZNO’s input into Immigration NZ’s review.
I would like to start by stressing that in today’s world, it is especially important that NZNO’s position is based on careful, dispassionate examination of the available evidence and informed by critical social theory. Prevailing social attitudes can colour our perceptions in ways we are unaware of. This is a particular risk for those of us who benefit from prevailing social conditions, such as white privilege.
The review is considering shortages in five nursing specialties – Aged Care, Critical Care and Emergency, Medical, Mental Health and Perioperative. In each specialty, Immigration NZ has to decide three things – whether the occupation meets skill level requirements, whether it’s of sufficient scale to warrant a listing, and whether or not there is a shortage. Since all nurses are classified as skilled workers, and there are lots of us, the only real question is the third one.
To answer it, Immigration NZ has produced Preliminary Indicator of Evidence Reports (PIERS), which look at just five indicators of workforce shortage. The reports conclude that more information about these five indicators is needed to determine whether there is a shortage – from employers, government agencies, and from unions like NZNO.
As the consultation request for NZNO members points out, “there are many aspects affecting workforce supply and demand that are not reflected in the PIERS reports, and which should be considered as part of the review. Eg resourcing, recruitment and retention policies, pay and conditions, safety, quality etc.”. In addition to the ones mentioned in the NZNO consultation request, I think we also need to consider workforce projections.
As has been widely discussed, the Nursing Council of New Zealand commissioned a major report in 2012, titled The Future Nursing Workforce: Supply Projections 2010 – 2035. This report showed how factors such as ageing and increased life expectancy among the general population are expected to increase the demand for healthcare. It observed that the nursing workforce is ageing, and predicted that over 50% of our present workforce will retire by 2035. It concluded that under a “business as usual” scenario, the nursing supply will remain adequate until 2020 but then begin to diverge from health demand, resulting in a shortage of 15,000 nurses by 2035.
More recently, these projections have been questioned by the Office of the Chief Nurse and Health Workforce NZ (HWNZ), who this year published some results from their own workforce modelling (see coverage in Nursing Review, “Nursing Shortage Forecast Cautiously More Optimistic In Short Term“). Their updated forecast notes a sharp rise in the number of registered nurses being educated in New Zealand since 2010. It predicts that the growth in the nursing workforce as a whole is on track to match population growth by 2025. But it is still predicting steep declines in the proportion of aged care, Māori, Pacific and enrolled nurses required to meet projected demand.
And crucially, this (slightly) more optimistic overall picture is based on the assumption of internationally qualified nurses (IQNs) continuing to make up 26 per cent of the RN workforce, including 50 per cent of the RNs in residential aged care and all continuing care (elderly) settings by 2025.
While they’re outside the narrow scope of Immigration NZ’s review, these workforce projections would not provide evidence for removing the five nursing specialties from Essential Skills Shortage lists.
There are two other arguments which have been raised for removing nursing from the lists, which also lie outside the current scope. The first is the impact of immigration on new graduate employment opportunities.
New grad employment is an issue which is very dear to me. It breaks my heart that only 54% (677) of the 1285 Registered Nurses who graduated last November got jobs through the December intake of the Nurse Entry to Practice (NETP) Programme. The disappointment and hardship suffered by each of the 568 unsuccessful new grads, after years of sweat and rising debt, is only compounded by the stress of all the RNs I know who are working short-staffed and needing more help, and the waste of taxpayer’s money spent on three years of underutilised higher education. I would support removing nursing from Essential Skills Shortage lists, if it reduced this misery and waste.
NZNO has committed to ensuring that there’s a NETP place for every new graduate nurse, by 2018 at the latest. And to be eligible for a NETP place, a new grad nurse must be a New Zealand citizen or permanent resident. IQNs cannot apply, so immigration has no direct impact on new grad employment.
It has been said that ongoing migration of IQNs undermines efforts to make Aged Care a priority area for voluntary bonding, since almost half of the IQNs currently working in New Zealand are employed in this sector. Adding Aged Care to the list of “hard-to-staff” specialties would provide financial incentives for New Zealand Registered Nurses (NZRNs) to work in this area, and would be valuable for new grads and workforce planners alike.
But whether or not they’re eligible for the voluntary bonding scheme, according to NZNO new grads in Aged Care still deserve to be employed under the NETP Programme. And as mentioned, these positions are only open to New Zealanders.
This means, essentially, that in NZNO’s view there should be no direct competition for jobs between IQNs and new grads – in Aged Care, or any sector of the health system.
In fact, depending on the specialty, IQNs must have three to five years post-registration experience in order to apply for a work visa under an Essential Skills Shortage category. So while there is some competition for jobs with more experienced NZRNs, the positions which IQNs are taking are not positions which a new grad could fill.
Therefore, reducing the IQN intakes under current Essential Skills Shortage categories would not improve new grad employment prospects in any significant way. What’s worse, continuing to focus on immigration distracts us from real solutions to new grad unemployment.
Last year, delegates to NZNO’s AGM voted for a resolution: “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”. To address new grad unemployment woes, attention could turn instead to this positive alternative, and to NZNO’s new “Shout Out For Health” campaign for a health system fully funded to employ the nurses needed.
The other argument for making it harder for IQNs to obtain work visas, which is outside the scope of the current review, relates to concerns around the “cultural awareness” of IQNs. Some within the profession openly doubt the ability of IQNs to care for patients in New Zealand in a culturally safe way.
In response I say simply this: according to the 2013 Census, nearly 40 percent of the population of Auckland was born outside of New Zealand. That’s well over half a million people. The most common overseas birthplaces reported were in Asia.
It is my view that cultural competency must be seen at a workforce level, as well as at the level of the individual practitioner. Viewed from this perspective, IQNs do not detract from cultural safety, they add to the ability of our profession to care for our culturally diverse population.
NZNO has long advocated for Māori and Pacific nursing workforce strategies which will see the proportion of these nurses matching the ethnic composition the population. So there is some precedent for this approach. And just as in Māori and Pacific workforce development, the proportion of nursing students from other ethnic minority backgrounds currently being trained in New Zealand is also too low to meet population needs. Our input into the Immigration NZ review should therefore recognise the valuable cultural skills which IQNs bring.
None of this, of course, replaces the Nursing Council’s specific cultural safety requirements for every IQN to understand the health and socio-economic status of Māori, and to practise in accordance with the Treaty of Waitangi. As for all tauiwi, education will be required for an IQN to meet this competency. And this may take time. But despite the lack of previous knowledge of the Treaty, there are reasons to believe that IQNs from major source countries may be well predisposed to learning – including shared historical experience of being colonised by European powers, and a common experience of discrimination on ethnic grounds.
In conclusion, it worth noting what is at stake in this review. As at 30 June 2016, there were 8,371 NZNO members who identify as Indian, Chinese or other Asian ethnicities. These are our fastest-growing membership categories. Many of them will be IQNs on temporary work visas, which last a maximum of 30 months. If the nursing specialties are removed from the Essential Skills Shortage lists, then our fellow union members who’ve been in work for less than two years could lose their jobs, and be forced to leave the country.
It is my view that evidence does not support the removal of nursing specialties in Aged Care, Critical Care and Emergency, Medical, Mental Health or the Perioperative environment from Essential Skills Shortage lists, and that arguments in favour of doing this are contradictory or flawed.
Above all, at a time of rising hostility and public debates over whether there are “too many immigrants”, it is important to recognise and value the special contribution that IQNs make to nursing in New Zealand.
If any other NZNO member would like their feedback considered as part of NZNO’s submission to Immigration NZ, as noted above they should email NZNO Senior Policy Analyst Marilyn Head (marilynh@nzno.org.nz) by 17 August.
First published in Kai Tiaki Nursing NZ, August 2016. Reposted with permission.
For many of us, world affairs aren’t something we think about much as we get on with everything that needs to be done at work, and at home. But lately, for better or worse, global events seem to be impacting more than usual on our daily lives. Some of us woke up after the United Kingdom’s “Brexit” vote to find our KiwiSaver balances were suddenly lower than expected.
Meanwhile, amidst all the hub-bub and noise of the United States presidential elections, it seems the Trans-Pacific Partnership Agreement (TPPA) has been defeated, in its current form. The TPPA would have undermined health here in Aotearoa. But thanks to a people’s movement, with America’s largest nursing union, National Nurses United (NNU), at its core, it looks likely our professional aspirations to deliver the best possible care will be protected for now.
Even the biggest issue we face as health-care workers – safe staffing – has been the subject of international connections. As reported in the July issue of Kai Tiaki Nursing New Zealand, NZNO last month hosted the leaders of the Canadian Federation of Nurses Unions (CFNU).
The main purpose of their visit was to study how our care capacity demand management (CCDM) programme works, as a mechanism to deliver safe staffing in district health boards (DHBs). But they also talked with me about Global Nurses United (GNU). GNU is a new international network of nursing unions from 19 countries. CFNU and NNU helped establish it in 2013.
It was founded to “step up the fight against the harmful effects of austerity measures, privatisation and cuts in healthcare services” and to “work collectively to guarantee safe staffing and the highest standards of universal healthcare as a human right”.
The leaders of GNU were also opposed to the adverse effects of income inequality, poverty, maldistribution of wealth and resources, and the ravages of climate change.
The “austerity” mentioned refers to the way governments have responded to the global financial crisis. Austerity involves cutting government spending, including health spending, in the belief this will boost economic growth.
In this country, the erosion of core government health expenditure means there is now a shortfall of $1.2 billion, compared to the 2009/10 year. This is one reason why attempts to implement CCDM in a timely way have struck so many road blocks.
To address this, NZNO is launching a major new campaign, Shout Out For Health. We’re aiming high – the goal is a fully-funded health system, where we’re properly resourced to provide care we’re proud of. Shout Out For Health will strengthen our DHB MECA campaign next year and put a strong case for health during the 2017 general election. It’s something that all NZNO members can take part in.
But as we push against austerity and for safe staffing, we can also look to joining with others around the world doing the same. As they say, “act locally, think globally”.
Last September, delegates at NZNO’s annual general meeting (AGM) voted to “review our international affiliations before AGM 2016, in order to expand our global connectedness with nursing unions and professional associations in a cost-effective manner.”
That review, completed in June, talks of the potential for NZNO to become part of GNU. I believe we share many of the same nursing and union values as other GNU members. We’re already working on many of the same issues. It would be more effective if we did it collectively. And joining GNU is free.
Today we celebrate NZNO’s accreditation as a Living Wage employer. The announcement is confirmation from the Accreditation Advisory Board that NZNO has met all the criteria to wear this badge of honour.
The impact of today’s announcement won’t be felt by anyone directly employed by NZNO. They are already paid above the current Living Wage of $19.80 an hour.
But the decision to become an accredited Living Wage employer means all our contracted staff get this rate, too. So it will be felt by people like Yong, who cleans the NZNO National Office after hours.
Yong has told me that she works two cleaning jobs – both for minimum wage. She starts at a motel at 8.45am in the morning, and finishes at NZNO at 9pm at night.
Yong has now received her first pay at her new rate, and was so happy that she could buy better food at the supermarket, instead of the cheapest food. Her dream is that now she might be able to go home to China to visit her father, who she hasn’t seen in four years.
She wanted me to write this, she said, so everyone could understand how much NZNO’s decision means.
It has been a long journey to reach this point, with plenty of debate and discussion along the way. So it’s fitting today to look back on how we got here, and pay tribute to the NZNO members who kept us moving forward.
It’s now over four years since the Living Wage was launched in Auckland, in May 2012. NZNO was one of the first organisations to sign up to the statement of principle:
“A living wage is the income necessary to provide workers and their families with the basic necessities of life. A living wage will enable workers to live with dignity and to participate as active citizens in society. We call upon the Government, employers and society as a whole to strive for a living wage for all households as a necessary and important step in the reduction of poverty in New Zealand.”
Our support was based on our understanding – as nurses, midwives and healthcare workers – that poverty and inequality are a root cause of much ill health. Some of us, especially those in aged care, and Māori and Pasifika members, knew this from personal experience of low pay.
Back in 2012, economists calculated that the Living Wage needed to live with dignity and participate as an active citizen in society was $18.40 an hour.
In the DHB elections the following year, NZNO asked candidates to support the idea that all DHB staff should get at least the Living Wage, which by 2013 had been recalculated as an hourly rate of $18.80.
At this time, we were coming to understand that it wasn’t enough to just agree with the Living Wage in principle. We should also contribute to the organisation which was working to make it a reality. In August 2014 NZNO took its place alongside other organisations as a full member of Living Wage Movement Aotearoa NZ Incorporated.
What propelled us along was growing support for the Living Wage among NZNO members.
Using the Nursing Matters manifesto, we’d been calling on voters and politicians from all parties in the 2014 general election to see a Living Wage for all as fundamental to a fair and healthy society.
Those of us who attended the DHB MECA endorsement meetings in late 2014 then showed our support by voting overwhelmingly for a set of claims which included progress towards the Living Wage (which by then meant at least $19.25 an hour) for HCAs.
When we couldn’t get agreement on this from employers, members expressed their frustration and reaffirmed their belief in the Living Wage at DHB MECA ratification meetings around the country.
By 2015, awareness was growing further. If we were asking our health sector employers to pay a Living Wage, then NZNO needed to walk the talk and do it, as well. That awareness culminated in a vote at last year’s NZNO AGM. Delegates from across New Zealand decided, by a large margin of 85 percent to 15 percent, to set a deadline of today - 1 July 2016 – for NZNO to become an accredited Living Wage employer.
There are also some NZNO members who deserve special mention, for helping our organisation to reach this goal.
They include people like Maire Christeller (left), a Primary Health Care nurse and workplace delegate, who has been involved in the Lower Hutt Living Wage Network since the beginning. She helped to spread the message to other NZNO delegates in the Hutt Valley, and has also lobbied for Hutt City Council to become a Living Wage employer.
Kathryn Fernando is a delegate at Capital & Coast DHB, who joined me on last year’s “Mop March” to Wellington City Council, aimed at extending the Living Wage to contracted council workers, like cleaners and security guards.
Litia Gibson works at Porirua Union and Community Health Service. She has led the nursing team’s support for their workplace paying the Living Wage (even if they aren’t accredited yet).
Kieran Monaghan is a Primary Health Care nurse and a leader of the Living Wage Movement in Wellington. It was his tireless efforts last year – presenting on the Living Wage at the NZNO Greater Wellington Regional Convention, getting the issue into Kai Tiaki, writing for NZNOBlog, and drafting the successful remit for the NZNO AGM setting a deadline for accreditation – which helped us take the final step.
As NZNO President, I have spoken of the need to strengthen union values within our organisation, as we continue to sharpen our professionalism – values like social justice, equity and solidarity.
By walking the talk on the Living Wage today, I believe we’re doing just that.
Kei te tū ahau ki te tautoko i ngā mihi ki te Kaihanga. Koia rā te timatanga me te whakamutunga o ngā mea katoa.
Kei te mihi anō ki a Manaia, ki a Whangārei-te-rerenga-parāoa hoki.
E te tiamana, tēnā koe Melinda. Ngā mihi ki a koe mō tō pōwhiri.
E ngā rangatira, Kerri, Memo, e ngā kaimahi me ngā kaiārahi nēhi katoa, tēnā koutou.
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.
Kia whakamārama ake tātou i ngā tikanga ngaio me ngā ahumahi o te nēhi, tēnei te kaupapa o te hui. Nā konei te whakataukī, “Ma te huruhuru, ka rere te manu”.
Write it in the sky, write it in the land, write it in the heart of the people. The greatest thing is love.
I stand to support the acknowledgements to the Creator, the beginning and end of all things. I also greet Mount Manaia, and Whangārei-te-rerenga-parāoa, the gathering place of whales.
I greet the Regional Council Chair, Melinda. Thanks to you for your invitation. To the chiefs, Kerri and Memo, to the staff and all the nursing leaders, greetings.
Who am I?
I hail from Dunedin. I grew up at the foot of Mt Cargill and by 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.
Increasing the understanding of the professional and industrial nursing issues is the purpose of this convention. As the proverb says, “Adorn the bird with feather so it can fly”. In sharing it, I also acknowledge the mana whenua of Ngāpuhi, to whom this whakatauki belongs.
=======
My invitation to attend today contained a request for me to give a brief presentation on my role and priorities as President. Ten minutes, tops – brief indeed.
But I am grateful for the topic, and the opportunity to explain, because I believe that the the role of President as I have come to know it, is not well understood.
So what is the role of NZNO President? What does it entail? What should the President do, and what can they not do?
Many of you will remember a number of people who have filled this role, over the years. And perhaps you will picture one of them, when you think of the role. Because of this, it can be hard to separate the role from the person, and see it for what it is.
Also, the role changed in a major way in 2012, when it became a full-time position under the new NZNO Constitution.
I am the seventh person to hold this position, and the second full-time President.
The current role has a Scope of Activities (which is a bit like a position description). It says:
“The President (in partnership with the Kaiwhakahaere) is responsible to the Board of Directors and… to all members through the Annual General Meeting of NZNO.”
“The President (in partnership with the Kaiwhakahaere) is the governance leader of NZNO and co-chair of the Board of Directors. In essence this is a job share situation requiring negotiation between the President and Kaiwhakahaere as to the performance of their shared responsibilities.”
“The President is vested with… authority vested in the Board as a whole and… has no authority independent of the authority of the Board as a whole.” Because it is the Board of Directors which holds constitutional authority in NZNO, the upcoming elections to the Board are very important.
“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.”
I think it’s important to spell out these points, because while I am accountable to all members, there are aspects of NZNO which are outside my scope – at least in my individual capacity – under the current model. I think that a better understanding of this would lead – amongst other things – to more congruence between member expectations and role performance by the President.
So, what then is within my scope, and what are my priorities as President?
The Scope of Activities states that, “The President shall prepare an Annual Work Plan setting out their activities for the forthcoming year for approval by the Board”.
My Work Plan has three main areas of responsibility – Governance Leadership/Rangatiratanga, Membership Engagement/Whanaungatanga and Stakeholder Relationships. I’d like to share a few parts of the plan which I have prepared, which I believe show my priorities.
Within the area of Governance Leadership/Rangatiratanga, I have highlighted the need to be a spokesperson for NZNO where appropriate – to be the public face of the board and members.
I’ve heard a lot from other members – over may years – that they want more visibility from their co-leaders.
There have been two parts to this – being visible and accessible to members, and then making your issues visible to others.
During the election campaign I pledged that if elected, I would be accessible and available to you, in person in your locality or via email and social media. And I would make your issues visible, to decision-makers and to the public they’re accountable to.
This is why, for instance, I have travelled to 17 out of the 20 DHB districts over the last year, to meet with members in their workplaces. And after talking yesterday with your NDHB Director of Nursing, Margareth Broodkoorn, there is agreement that I may come again to visit members here.
Sometimes the wish for greater public visibility of NZNO has been expressed as an explicit desire for more media airtime. This is hard. It has always been the case that we have little influence over what the media covers, and how they choose to cover it. And the problem has only grown worse as journalism has been progressively run down in this country. So while I have had some small successes in getting your issues on TV and radio and in the papers, it is the view of the NZNO Media Advisor that we should focus more on channels where we can get our messages out reliably – especially through blogs and social media.
This is shaping how I express my priority of greater visibility for nursing and NZNO.
A second priority for me is increasing member participation in NZNO. This priority falls under the area of Membership Engagement/Whanaungatanga, in my President’s Work Plan.
I know that actively participating in NZNO membership structures means voluntary work, on top of long hours in paid employment or study – and often after caring for family members as well. At times, you may also see little evidence that your input has been valued. Perhaps this is why participation is lower than it needs to be, to maintain the health of NZNO as a member-run organisation.
Concern about this state of affairs led Kerri and I to call, in March, the first ever summit meeting of the chairs of all Regional Councils and TR regions, the NSU and Colleges and Sections. The meeting identified barriers to member participation, and some possible solutions. In the second half of this year, we will start to develop change proposals arising from this meeting.
My hope that as members are heard and supported, and as members see themselves and their views reflected in our direction, that more and more of you are encouraged to write that submission, or attend that meeting – even after another long day.
Another of my priorities is strengthening NZNO’s bicultural relationships.
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. I want to work with Te Poari to support *all* NZNO groups to work on this issue. Our bicultural relationships are just like the other relationships in our lives. Even when they’re going well, we need to keep nurturing them, if we want them to remain fulfilling.
The fourth and final priority as President, which I’ll share with you today, is one which I expressed in my first media release as NZNO President, last August: “I look forward building NZNO’s dual identity”, I said, “as a professional association and registered union”. This is also built into the structure of my Work Plan, where I share responsibility for maintaining Stakeholder Relationships with the the Council of Trade Unions, as well as with other professional nursing bodies.
There has been a tendency to see our trade union identity as a problem. I pondered about this tendency in Kai Tiaki last November. I’d like to read excerpts from my column, to illustrate this priority.
“I wonder if [seeing our union identity as a problem] derives from a view that professional and industrial issues somehow belong to separate, even opposing dimensions”, I said. “Perhaps there’s a related belief that greater attention paid to one dimension means less attention for the other.
After all, NZNO staff are organised into separate professional and industrial teams. One team focuses on strategies to strengthen confidence in nurses in support of greater status and authority, in line with other powerful professions. It works closely with members belonging to NZNO’s colleges and sections.
The other team focuses on strategies to promote fairness at work, for all. It draws on the power afforded by employment rights and the caring work we collectively perform. This team provides close support for workplace delegates.
The idea that they’re somehow in competition leads to arguments about the right “balance” – or worse, advocacy for one strategy, over the other…
[But] professional and industrial realities are not opposing dimensions, but inseparable parts of a whole…
Strategies should not be based on one part of our reality, or the other, but on the shared goal we’re trying to achieve.
I believe that in the broadest sense, the goal we are pursuing as NZNO members is the wellbeing of people…
Viewed from this perspective, our industrial and professional (and political) strategies become mutually reinforcing approaches…
By proudly embracing our dual identity as a professional association and registered union, NZNO members can achieve our common goal together.”
So that’s my ten minutes up. Thank you for your time. I look forward to talking with you more over the course of the day.
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.
———————
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.
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.
Kei te tū ahau ki te tautoko i ngā mihi ki te Kaihanga. Koia rā te timatanga me te whakamutunga o ngā mea katoa.
Kei te mihi anō ki a Maungatapu, ki a Maitahi (Maitai) hoki.
E te tiamana, ko Joan, me te mangai-ā-rohe o Te Rūnanga o Aotearoa NZNO, ko Chanel, tēnā kōrua. Ngā whakawhetai ki a kōrua mō tā kōrua pōwhiri.
E ngā rangatira, Kerri, Memo, e ngā kaimahi me ngā kaiārahi katoa, tēnā koutou.
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.
Kia whakamārama ake tātou i ngā tikanga ngaio me ngā ahumahi o te nēhi, tēnei te kaupapa o te hui. Nā konei te whakataukī, “Whakamanatia te tapū te ihi te wehi o te whānau”.
To Ranginui above, Papatuanuku below and the people in between, I speak.
I stand to support the acknowledgements to the Creator, the beginning and end of all things. I also greet Maungatapu and the River Maitahi (or Maitai).
I greet the Regional Council Chair, Joan, and the Rūnanga rep, Chanel. Thanks to you for your invitation. To the chiefs, Kerri and Memo, to the staff and all the leaders, greetings.
Who am I?
I hail from Dunedin. I grew up at the foot of Mt Cargill and by 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.
Increasing the understanding of the professional and industrial nursing issues is the purpose of this convention. As the proverb says, it’s “To enhance and restore the mana and tapū of the whānau”. In sharing it, I also acknowledge the multiple iwi who belong to this place, and who share this whakatauki.
———————
My invitation to attend today contained a request for a ten minute update from the President – enough time for just 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.
CCDM was created and sustained by all of us who took part in DHB MECA campaigns over the last 10 ten years.
Nelson Marlborough DHB has now recommitted to rolling out the programme. The Inpatient Unit at Wairau, and Ward 10, have recently completed the first phase of implementation (Mix and Match).
But CCDM will only succeed to the extent that nurses, through NZNO, remain a force for change within the programme. Your impact and visibility will be vital – especially now in Local Data Councils.
Here at Nelson Marlborough, we are aware of the DHB’s well publicised deficit against its annual plan and its savings drive. We are aware of long delays in filling some nursing vacancies. And we are aware of barriers delegates can experience in being released to participate in the programme. But we will continue to be that force for change.
At some DHBs, we have been told explicitly that CCDM was halted due to budget constraints.
This is the next area where nurses, collectively, must have impact and visibility if we are to influence the health of our communities. This impact must go beyond DHBs, across all sectors.
Government spending on health has failed to keep up with increasing costs and population pressures 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.
Finally, we’re going to hear later this morning about the future of primary and community healthcare delivery in Top of the South. The title of the discussion document produced by the Top of the South Health Alliance which underpins the coming shifts, “Challenge and Opportunity”, accurately sums up the situation for nurses.
As the document mentions, the challenges and opportunities are being shaped by the updated Draft New Zealand Health Strategy. This draft is currently before cabinet, awaiting final changes and approval.
But the version released for consultation late last year makes it plain why we must be a force for change here, too, to influence the health of our communities.
As the NZNO submission noted, the familiar language of public health can be found in the Draft Strategy – especially near the start. It talks about “equity”, “people power”, “clinician-led collaboration”.
But this familiar language conceals an “unrealistic framing of inequity which is expressed almost entirely in terms of ethnicity and overlooks poverty, location, access to health care and other factors leading to health disparities”. You may be aware that Nelson Marlborough DHB is set to lose millions of dollars next year due to similar thinking around the population-based funding formula.
The Draft Strategy also reflects a “dominance of IT ‘solutions’… Overreliance on IT risks exacerbating inequity and diminishing the role of [nurses], unless alternative opportunities for establishing therapeutic relationships are available”.
Above all, the Draft Strategy radically advances a commissioning model, one based on contestable funding and competition by public and private providers for service contracts which reward a narrow range of outcomes. Although it has escaped the notice of most commentators, the same radical thinking is unfortunately present in the recently-released review of Child Youth and Family.
“The experimental social investment model proposed by the Strategy… risks destabilising Aotearoa New Zealand’s universal public health system, and potentially moving it towards an insurance-based health system”, like the United States. But while the updated New Zealand Health Strategy opens the door to “devolving State provision of services to community and private providers”, it is up to us whether we go through that door.
In the feedback captured by the Working Groups and contained in this Top of the South Health Alliance document, I can see the impact of nurses. You are visible in the sections headed, “Our ideas”, “Big ideas”, influencing the design of primary and community care.
I urge you to keep it up, and to be – here, too – that force for change.
(Photo credit: Jacqui Bennetts. Can be removed, on request).
Ka tangi te tītī
Ka tangi te kākā
Ka tangi hoki au
Tīhei mauri ora!
Kei te tū ahau ki te tautoko i ngā mihi ki te Kaihanga. Koia rā te timatanga me te whakamutunga o ngā mea katoa.
Kei te mihi anō ki Te Poho o Tamatea, ki a Ōtākaro me Opawaho.
Ki ngā mate, haere, haere, haere. Rātou te hunga mate ki a rātou. Tātou te hunga ora e huihui mai nei, tēnā koutou.
E te tiamana, ko Cheryl, me te mangai-ā-rohe o Te Rūnanga o Aotearoa NZNO, ko Ruth, tēnā kōrua. Ngā whakawhetai ki a kōrua mō tā kōrua pōwhiri.
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.
Kia whakamārama ake tātou i ngā tikanga ngaio me ngā ahumahi o te nēhi, tēnei te kaupapa o te hui. Kei te hoki mahara ki te whakataukī, “Mō tātou, ā, mō kā uri ā muri ake nei”.
As the muttonbird calls, as the kaka calls, so will I speak.
I stand to support the acknowledgements to the Creator, the beginning and end of all things. I also greet the Port Hills, the River Avon and Heathcote, and those who have passed on.
Let the dead bury their dead. To the living who are meeting here, greetings. I greet the Regional Council Chair, Cheryl, and the Rūnanga rep, Ruth. Thanks to you for your invitation.
Who am I?
My name is Grant Brookes, son of Don and Helen, descended from those arriving on the ship, Cornwall.
I am Pākehā, from Dunedin where the mountain is Mt Cargill and the river is the Water of Leith.
Increasing the understanding of the professional and industrial nursing issues is the purpose of this convention. So the saying returns to memory to express this: “For all, and for the children who will follow”. In sharing this whakataukī, I acknowledge the mana whenua of Ngāi Tahu, to whom it belongs.
So greetings, greetings, greetings to you all.
—————
I was originally asked along today to spend ten minutes reflecting on my past year. I can imagine a talk on that topic which is pretty uninteresting. Readings from my diary, perhaps, with a slideshow of my holiday snaps?
But it’s sometimes said of the Māori conception of time, that it’s about “walking backwards into the future”. “Ka mura, ka muri”, they say. The past remains present as we go forward. The people and events which have gone before always guide us.
So in that spirit, I will talk a little about my past year – our past year – to show how the past guides me as I lead this organisation into the future. I hope that this is more interesting than my personal reminiscences of times gone by.
For me, it’s definitely been a year of firsts. First time as NZNO President, obviously. I’m now nearly seven months into that. I think that some of the things which I’ve been part of over the past year, along with you, are influencing NZNO today.
Twelve months ago this week, I was meeting in Wellington with DHB representatives, as part of the NZNO MECA negotiating team. It was also my first time in bargaining for a collective employment agreement. That day, we received the employers’ first offer, and we decided to not recommend it.
Some of you may recall how 82 percent of members voted to reject that offer, and to step up the collective action which eventually delivered an improved offer with real pay rises, above inflation, and other improvements to allow quality care.
I also voted no to the first offer. Then the Capital & Coast delegates got around the wards at Wellington Hospital. We got members to sign the joint letter to our Chief Executive, and encouraged them to take part in the Go Purple Day. These past events live on, for me.
It is a truism of the union movement that if you want to make change, then voting once every three years is not enough on its own. This is the case inside NZNO, just as it is on the national and local political stage.
We showed last year that when NZNO members act collectively, we can make change.
That’s why my first message as newly elected President, on August 7 last year, said that “As your next NZNO President, I will support members whenever you join together for health.”
And while pay in the DHBs has been settled for now, there are many other issues where we still need to join together and make change.
Also twelve months ago this week, I had just returned from my first NZNO Regional Convention outside of Wellington. It was the one in Dunedin, organised by Southern Regional Council. I went on to attend three more.
In a democratic member-run organisation like NZNO, leaders have a responsibility to lead, but ultimately our direction is set by the membership through the representative structures, including Regional Councils. I carry my memories of last year’s Regional Conventions. These remind me of my commitment to strengthen the member voice in NZNO.
I know that actively participating in Regional Councils and other membership structures means voluntary work, on top of your long hours in paid employment or study – and often after caring for family members as well. But I hope that as members are heard and supported, and as you see your views reflected in our direction, that more and more are encouraged to write that submission, or attend that meeting.
In a couple of weeks’ time, on April 21, it’s the anniversary of the 2015 Canterbury Regional Convention. That’s also the day I launched my blog, at www.nznogrant.org. In my first post, I pledged to “make your issues visible… to get nursing onto the agenda for decision-makers, and for the public they’re accountable to.”
This past pledge will remain, because members are still telling me that this is what they want from their leaders. And I believe this pou, this stake planted in the ground last year, is one of the things which is starting to influence NZNO already.
In June, the eyes of the world were focused on Washington, as President Obama wrestled with US law-makers to get “fast track” authority to sign the Trans-Pacific Partnership Agreement (TPPA). I wrote at the time that “we need leaders who will strengthen our stand for nurse power against the TPPA”. Some of my first duties as President included speaking to local government and public meetings in Wellington about the health impacts of the TPPA. This past stays with me, too, and as President I will continue to stand on your behalf against investment regimes and corporate influences which undermine public health.
Also in June, I made my first visit to Canterbury DHB. I went to Hillmorton, Christchurch Hospital and Burwood, and met some of you then. Later I visited The Oaks residential aged care facility. And yesterday I met more of you, at Hillmorton and Christchurch Hospital again, and also at Christchurch Women’s. I did this because of a pledge, made in April, to be accessible to members. “I will be available to you”, I said, “in person in your locality or via email and social media”. This commitment to you will also remain, and guide my leadership of NZNO.
In August, in another milestone, I worked with NZNO Media Advisor Liz Robinson on my first media release as NZNO President. “Nurses elect new President”, it said, and went on to talk about how I would “work with joint NZNO leader, Kaiwhakahaere Kerri Nuku, and with newly-elected Vice-President Rosemary Minto in the organisation’s bicultural co-leadership model”.
“I am… excited about working within a bicultural model”, I said. “I see the ambitions of health workers, our desire for a healthy New Zealand and our understanding of the social determinants of health relating closely to our obligations under Te Tiriti o Waitangi.”
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 who work alongside each other.
But, as we were reminded at last year’s AGM and conference by guest speaker Dr Heather Came, we’re still not completely there yet. In my short time as President, we have already seen changes to the 2016-17 NZNO Annual Plan, to better reflect the bicultural relationship underpinning our organisation. This year will also see the launch of cultural competencies which will make NZNO more responsive to Māori members and Māori health needs. As part of practising co-leadership, I want to support Te Poari in achieving more of their goals.
There are two final areas, however, where our shared history over the last twelve months weighs down upon our future. These represent things which must be overcome, and put right.
Firstly, as that media release in August said, “nurses are working in a difficult and constrained environment. The impact of years of underfunding is now being felt in the health sector.”
Government spending on health has failed to keep up with increasing costs and population pressures 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. My proposal to make health funding a key campaign priority for NZNO in 2016-17 has been accepted, so there is hope that we can act collectively and turn around this trend.
Finally, that first media release from last year also said that I “look forward to building NZNO’s dual identity as a professional association and registered union.”
Those of you in the DHB Sector might recall the PowerPoint slides shown near the end of the MECA ratification meeting last August. These gave some of the context for the negotiating team’s decision to recommend the employers’ offer. In an unusual step, they mentioned the turnout of the ratification meetings in May, which voted overwhelmingly to reject the first offer. Some members had felt that given the strong vote on the first offer in May, the negotiating team should have recommended rejection of the second offer and planned for industrial action. But while is was a vote of 82% against in May, that was 82% of the two-fifths of members who attended a ratification meeting. So even if a vote for industrial action was desirable at that time, there were doubts about whether there was sufficient support among members to make successful action possible at that time.
And yet the DHB Sector is where our membership is highest. It’s where our delegate networks are strongest. If there were question marks over our ability there, it shows a need to strengthen union values across all sectors, and at all levels of our organisation.
Building NZNO’s dual identity means developing confident workplace leaders and delegates who are well-trained and well-supported.
I believe that in the broadest sense, the goal we are pursuing as NZNO members is the wellbeing of people. And we are people too, just like our patients, whānau and communities. Viewed from this perspective, our industrial and professional (and political) strategies become mutually reinforcing approaches, instead of being pitted against each other.
It can be hard to uphold these truths sometimes, I know. Our allies and external stakeholders tend to pull us in one direction or the other. Some of our union allies, for example, are suspicious of “professionals”. And some health sector leaders don’t trust unions.
But we shouldn’t let external forces define us. We should stand on our own whole reality, and reject attempts to divide it. By proudly embracing our dual identity as a professional association and registered union, NZNO members can achieve our common goal together.
So that’s a few reflections on my past year, on our past year, and how this lives on in NZNO today.
I look forward to meeting and talking with you, over the course of the day. Thank you.
E ngā mana, e ngā reo, e ngā karangarangatanga maha e huihui nei, tēnā koutou.
Your Choice. Your Voice | Grant Brookes for NZNO President 