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, 6.52 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).

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)

Promoting the voice of members inside NZNO

A recent survey has shown that members have little awareness of the work being done by NZNO’s membership committee, despite the fact it has been around for five years. By NZNO president Grant Brookes

Membership Committee
L-R:  Committee vice-chair Joan knight, Victoria Santos represents colleges and sections, Former NSU representative Phoebe Webster.

NZNO’s membership committee was established in 2012 to provide the board of directors with further insight into the views and needs of NZNO’s diverse members. Five years later, the committee’s role is still not well understood by those it seeks to represent.

That’s according to a survey conducted at the NZNO annual general meeting (AGM) in September. Over 86 per cent of respondents – who included college and section, regional council, Te Rūnanga and National Student Unit (NSU) representatives – did not think other members knew anything about the committee.

Committee vice-chair Joan Knight believes this is symptomatic of a wider problem – one the membership committee is determined to address.

Many members are unaware of the structures through which members govern NZNO, and how the different parts of the organisation work together to achieve our common aims.

“When I first became a workplace delegate, my rationale was ‘paying back’,” Knight said. “I was grateful for the assistance of our previous delegate and the organiser during workplace change.

“But involvement in the workplace, our local regional council, and subsequently on the board opened my eyes to the depth and breadth of the organisation and introduced me to governance.”

Knight is now serving her second term on the committee, representing the Top of the South Regional Council.

The committee comprises representatives from all regional councils, plus two representatives elected by the NSU and two elected by colleges and sections.

The current chair is Sandra Corbett from Hawkes Bay/Te Matau a Māui Regional Council.

The president and vice-president also sit on the committee, but to help ensure the views and needs of members flow upwards to the board (rather than vice-versa), we are not entitled to vote.

Newly graduated nurse Phoebe Webster has recently stepped down as one of the NSU reps. “In my first year of studying, I decided to become involved with NZNO so I could help represent the students within my school,” she said. “This evolved into a wish to help represent and contribute to the views and concerns of student nurses nationwide within NZNO on a national level. For me, this was part of a larger objective to pay ‘forwards’, giving back to a wonderfully rich, diverse profession which I am excited to soon become part of.”

Victoria Santos is an internationally qualified nurse (IQN) from the Philippines. She works as a prison nurse and belongs to the New Zealand College of Primary Health Care Nurses NZNO.

“I am a voice for colleges and sections – a voice of advocacy,” said Santos. “Being an IQN on the committee means I can discuss issues about migrant nurses and their concerns. And since Department of Corrections nurses feel so isolated, I am their voice on the committee too.”

The membership committee has been working in partnership with Te Poari on a new system of direct democracy within NZNO. This would allow “one member, one vote” on matters relating to NZNO policy and rules. These decisions have, up until now, been made by various delegate groupings at our AGM. Knight and kaiwhakahaere Kerri Nuku co-lead the voting strength working group.

The committee and Te Poari have also jointly produced a new structure diagram, showing how the various parts of NZNO fit together and how members can get involved.

The committee will be seeking member feedback on both these projects next year, including at the 2018 regional conventions.

Once these two projects are completed, the committee hopes members will be more aware of how they can all participate in NZNO structures (including through the committee itself), and how we can achieve our goals together. •

First published in Kai Tiaki Nursing New Zealand, December 2017. Reposted with permission. 

‘Struggles we must face’ – Joint NZNO presentation on the Global Nurses United international panel, Québec City

Kaiwhakahaere Kerri Nuku and I represented NZNO at meetings in Québec from 27 November – 1 December. We attended a meeting of the Executive Committee of Global Nurses United, and spoke on an international panel hosted by the Québec nurses’ union, FIQ Santé. I spoke first, followed by Kerri, on the topic: “How do your government’s policies affect the care that your members provide and what struggles must you face? What will be your battles over the next few years?” Financial support from FIQ Santé, which enabled our attendance, is greatly appreciated. 


Us two.jpg

Kia ora, koutou.

Greetings, to you all.

It is customary in our young country, when beginning a formal speech at a meeting, to start with an introduction which acknowledges one’s connection to the natural and spiritual world of your birthplace, to a shared experience of migration and to a collective identity based on ancestry. This custom has been adopted from the indigenous culture of the Māori, the tāngata whenua or people of the land.

Nō reira, ko wai ahau?

Ko Kapukataumahaka tōku maunga

Ko Owheo tōku awa

Ko Cornwall tōku waka

Ko te Tāngata Tiriti tōku iwi

Ko Grant Brookes taku ingoa, ā, ko te perehitene ahau ō te Tōpūtanga Tapuhi Kaitaiki ō Aotearoa.

To translate: The sacred mountain overlooking my birthplace is Kapukataumahaka, and the sacred river is Ōwheo. My ancestors arrived on board the ship, Cornwall. My tribe is known as the People of the Treaty, which means I am not indigenous. I reside on the land by right of the 177-year old Treaty of Waitangi between the Māori peoples and the British Crown. My name is Grant Brookes and I am the co-president of the New Zealand Nurses Organisation.

It is then customary to pay respects to the tribe on whose land we are meeting. So I would like to acknowledge that the land on which we gather is the traditional and unceded territory of the Abenaki and Wabenaki Confederacy and the Maliseet.

This biculturalism – embracing the twin perspectives of the of the indigenous and non-indigenous peoples – is today reflected (to a greater or lesser extent) across New Zealand’s health sector. And it is embedded in the structures of our union, as reflected in the two co-presidents you see before you.

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It hasn’t always been customary for non-indigenous people to start speeches this way. New Zealand is a colonial settler society. After signing the Treaty of Waitangi in 1840, the British Crown and colonists proceeded to ignore it. Māori land, cultural treasures and authority were alienated over following decades through military force and other means. Respect for Māori customs is being restored today through reconciliation for these Treaty breaches.

The initial health impacts of colonisation were devastating. A pre-contact Māori population of up to 150,000 was reduced to 42,000 in little over a century. Our other co-president, Kerri Nuku, will speak shortly about our union’s current battles to improve Māori health status and about government policies affecting the care that our Māori members provide.

Before I turn to the set questions, I would like to briefly explain the structure of the New Zealand health system.

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Since 1938, the system has been organised around a core of “socialised medicine”, which resembles the UK National Health Service. The government owns and funds most inpatient and outpatient hospital services, including mental health facilities, and all emergency, intensive care and preventive health services.

Care rationing and waiting lists for non-urgent procedures have become a feature in recent decades, leading to a small private health insurance market. During the period of neoliberal ascendancy in the 1980s and 90s, parts of the public health system – such as elder care and some disability support services – were privatised.

General Practice was excluded from the state-owned system at the outset, and it has largely remained a private business ever since – along with dentistry. Government subsidies, however, fully fund free access for children and part-fund GP visits for adults. Prescription drugs are also subsidised.

Total health spending is 9 percent of GDP. Public spending, generated through general taxes, accounts for 80 percent of this total (Mossialos et. al., 2017).

From this overview it can be seen that government is the ultimate employer of the majority our members and that government policies greatly affect the care that all our members provide.

Two months ago, the New Zealand general election delivered a change of government. Many of the policies of the former conservative government are being reversed. In some cases, where the new Labour-led coalition government has pledged to adopt our policy priorities, we may face struggles to ensure they deliver on their promises in a timely fashion.

Current rapid change means it is difficult to see what our battles may be over the next few years. So I will briefly mention five of the immediate priorities we have raised with the new government.

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1. Reinstate health funding to levels able to provide the same quality and quantity of health services for our population as at 2009/2010.

Under the previous conservative administration which took office at the end of 2008, government health funding failed to keep pace with population growth and inflation, leading to a cumulative funding shortfall of $1.4 billion. Effectively a 9% cut in operational funding over 8 years, this has meant that our members have been providing care to more people with no corresponding increase in workforce size. The new government has pledged to restore funding. We will battle to make this happen sooner, rather than later.

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2. Ensure safe staffing levels and workloads throughout… all health care services

Nurses comprise half of New Zealand’s health workforce. As the largest single group, our members have borne the brunt of the funding cuts of the last 8 years. Unsafe staffing levels, unmanageable workloads and long hours have become the norm in the care our members provide.

We have collaborated in developing a unique local model to ensure safe staffing levels, called Care Capacity Demand Management, as an alternative to legislated ratios used overseas. CCDM relies on a tripartite approach to calculate and adjust staffing levels in the public health system based on patient acuity. Our big battle now is to get this model implemented.

In privatised sectors such as aged care, where a tripartite approach cannot be guaranteed, we will push for mandatory standards for minimum safe staffing levels and skill mix in residential facilities.

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3. Full employment for all new nursing graduates

Research shows that employment experience in the first few years post-graduation is a critical factor in retaining nurses in the profession long-term. The New Zealand health system offers a supported Nurse Entry to Practice programmes (NEtP), with enhanced mentoring and educational opportunities. Last year, however, only 62 percent of nursing graduates secured NEtP positions. Many of the others were reduced to voluntary, part time or casual jobs ie. precarious work. We will battle for a NEtP place for every new grad.

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4. Fair employment laws

The previous government amended New Zealand’s industrial relations law seven times in 9 years – each time reducing union rights and workers’ rights.

These changes have reinforced structural barriers to fair and balanced employment relationships that, in the rapidly changing labour market, have led to increased job insecurity and persistent low growth in wages, despite growing productivity.

The struggle we will wage, along with the other affiliates of the New Zealand Council of Trade Unions, is not only to roll back these changes – which the new government has agreed to – but to strengthen the pre-existing framework.

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5. Health workforce planning

It is projected that half of all nurses will retire over the next 10 to 15 years. An improvement to long term workforce planning is urgently needed to meet projected shortages and to ensure that the workforce is culturally, ethnically and gender representative, enacts Treaty of Waitangi articles, and meets international obligations for ethical recruitment and self-sustainability.

I will now hand over to Kerri to speak more about our struggle for workforce planning – especially to ensure that it is culturally representative of the population.

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There are many workforce issues due to funding constraints and I want to focus on one specific area, identify the impact funding constraints has on community and our responsibility as advocates and finally trade agreements

1. Pay inequities

Significant pay disparities of up to approximately 25% exist for nurses working with Primary Health Organisations, especially with Indigenous Health Care services. These disparities occur even in cases where staff have professional qualifications and affect the workforce predominately working within Indigenous service providers who are predominately female.

Pay disparities seem to be the unintended consequence of how the government funds healthcare, which fails to address the differences in infrastructure and investment required specifically within indigenous healthcare service providers versus other larger health providers. This issue affects an indigenous workforce.

These entrenched pay inequities are now affecting the retention and recruitment of nurses in these areas. We will continue to lobby within Aotearoa New Zealand government and raise a complaint to the interventions to the Human Rights Commission and United Nations in New York and challenged the application of our government to ILO Conventions 169 and 149.

2. Community impact

Health funding is imperative to ensure that the we are responsive to the changes in population health needs. Our population (like others) is constantly in a time of change demographics, health demand. However what we have seen is the opposite that is systemic barriers to access health services, escalating social, economic and health disparities has seen an increase in poverty, homelessness and over the years we have seen the emergence of diseases of poverty.

As a union we must ensure that health is central to all government policies and that these policies are integrated to address the global challenges of climate changes antimicrobial resistance and unfair work, trade and immigration patterns.

3. Trade agreements

Achieving the UN Sustainable Development Goals, including reducing inequality within and between countries, requires international trade and economic integration agreements to be free of provisions that have the potential to erode government’s rights to act in the best interest of the population and environmental health.

In Aotearoa we promote a coherent system of global health law to further multilateral cooperation in advancing global health equity, by developing and implementing strategies to achieve the sustainability development goals.

We will ensure that no international agreements compromise New Zealand’s ability to control and lower the prices of pharmaceuticals and other medical supplies: to carry out public health programme or maintain and expand the public funding and public provision of health on a non-commercial basis.

To conclude, we cannot estimate that nursing is in a crisis, nurses are overworked and under respected and appreciated. Health is a human right and not a privilege and we have an important role to play in advocacy for our populations. Our challenge as a union is to progress policies, while bringing along the public, to keep alert to the changes in the environment, remain relevant and ensure as a union we continue to engage and grow members in solidarity. Be brave and courageous to take action.

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Global nurses unite

Kai Tiaki Oct 2017 cover
First published in Kai Tiaki Nursing New Zealand, October 2017. Re-posted with permission.

A NEW chapter is about to be written in the story of NZNO. Next month, we will take our seat at the annual meeting of Global Nurses United (GNU) for the first time. NZNO will be represented at the meeting – in late November in Quebec, Canada – by kaiwhakahaere Kerri Nuku and me.

GNU was formed in 2013. Its founding meeting was hosted by National Nurses United (NNU), the largest union and professional organisation for nurses in the United States (US).

Nursing leaders from 14 countries in the Americas, Africa, Asia-Pacific and Europe came together around a four-point declaration, expressing shared commitment to safe staffing and universal health care, and opposition to the harmful effects of climate change, inequality, health cuts, privatisation and other neoliberal policies.

Since 2013, GNU has expanded to encompass nursing unions from 20 countries. NZNO joined this global network last year. Belonging to GNU complements our relationships with the world’s professional nursing associations, maintained through the International Council of Nurses.

This year’s GNU meeting is hosted by the Fédération Interprofessionnelle de la Santé du Québec (FIQ), a union grouping covering 66,000 nurses, respiratory therapists and clinical perfusionists across Canada’s French-speaking province.

Even flying economy class, international meetings can use up a lot of NZNO members’ money. But for this trip, the FIQ has signalled NZNO’s valued role within GNU, by offering to cover all our accommodation costs.

The benefits to NZNO members of participation in GNU were highlighted at our annual conference last month by guest speaker and NNU co-president Jean Ross.

Jean Ross02
NNU Co-President Jean Ross was a guest speaker at the NZNO Conference last month.

The world is more interconnected than ever, Ross said. Problems and solutions for nurses are now global. Protecting health-care workers and patients from new epidemics like Ebola takes international cooperation, she pointed out (see also, ‘Advocating for patients and communities’, p11).

Emerging health problems related to climate change must also be tackled globally. Multinational corporations are increasingly influencing our health system – including through the expanding telehealth and e-health sectors. Public-private partnerships, with global giants like Serco running our hospitals, could be the next frontier. These challenges, too, call for a coordinated global response.

Jean Ross32
A message of international nursing cooperation was delivered by NNU Co-President Jean Ross.

The Trans-Pacific Partnership Agreement (TPPA) is a case in point. It was US pharmaceutical companies who pushed the intellectual property provisions which would protect profits, but limit access to life-saving treatments for New Zealanders. And long before President Donald Trump finally pulled the US out of the deal, it was campaigning by NNU which helped to undermine congressional support and delay negotiations.

Kerri Nuku and I head to Canada to strengthen such international efforts, and to lay the groundwork for ongoing working relationships between GNU and NZNO staff. In doing so, we are responding to Ross’s vision.

“Our imperative”, she told conference delegates, “is to build the kind of global solidarity that can go toe-to-toe with the global financiers and the corporations that want to profit off people’s illnesses and, instead, create a different kind of globalisation.

“The collective power of nurses can create a new kind of world – a world of compassion and community and caring.” •

‘Overcoming the headwinds’ – Presidential address to NZNO AGM 2017

NZNO AGM 2017 Presidential address IMG_6851

 

Whakarongo rā

Whakarongo ake au ki te tangi a te manu, e rere runga rawa e

Tui, tui, tui, tuia

Tuia i runga, tuia i raro, tuia i roto, tuia i waho

Tui, tui, tuia

Kia rongo te ao, kia rongo te pō

Tui, tui, tuia

Tihei mauri ora!

Ko te kupu tuatahi, ki to tātou kaihanga, nāna nei te kākano i ruia mai i Rangiātea.

E te iwi kāinga, tēnā koutou. Koirā Taranaki Whānui ki Te Ūpoko o Te Ika te tangata whenua.

E te maunga e tū mai rā, tēnā koe Pukeauta.

Ki te Awa Kairangi, tēnā koe.

E ngā mate, haere, haere, haere. Rātou te hunga mate ki a rātou. Tātou te hunga ora e huihui mai nei, tēnā tātou.

Ko te wā mō te hui taumata o te Tōpūtanga Taphui Kaitiaki o Aotearoa, ā, kia whakaterehia tō tātou waka te kaupapa.

He waka eke noa. Nā konei, mā te titiro ki muri, ka mārama te titiro ki mua.

Ka maumahara ahau ki te whakataukī: mā te tika o te toki o te tangere, me te tohu o te panaho, ka pai te tere o te waka i ngā momo moana katoa.

Nō reira, e rau rangatira mā, e nga manuhiri tūārangi, tēnā koutou, tēnā koutou, tēnā tātou katoa.

======

I listen

I listen, where up high, a bird flies

Its cry rings out

Sew, stitch, bind it together

From above, from below, from within, from outside

Sew and bind it together

During the day, and the night

Sew, stitch, bind it together

My first word was to the creator, who sowed the seed from the realm of beginnings, and endings.

I greeted the tangata whenua, Taranaki Whānui ki Te Ūpoko o Te Ika. Greetings to their sacred mountain and river.

Greetings to those who have passed on, since we last gathered here together.

We have lost great leaders from our NZNO whānau over the past year.

Shortly after our 2016 AGM I received the sad news that Stephen Pugh had passed away in Hamilton. Many of you will remember Steve and his Welsh lilt, which added music to our AGM debates up until his last appearance here in this room in 2015. Steve was a perioperative nurse. He served as chair of the Midlands Regional Council of NZNO, as the Midlands rep on the Membership Committee and as a worksite convenor, leading his fellow NZNO delegates at Waikato DHB. I will always remember Steve for the strong union values he brought to the DHB Sector National Delegates Committee.

A month later, Sharon Williams died in Christchurch. Sharon worked at Burwood Hospital, starting in 1988 as an enrolled nurse and later becoming an RN. She was worksite convenor from 2001 until 2007. During 2013 I had the privilege of working alongside Sharon on the Board of Directors, and the following year on the Membership Committee, where she was inaugural vice-chair. But for years before, Sharon had been an active member of the Canterbury Regional Council and, from 2009 to 2011, served as Regional Council Chair. My condolences to the delegates from Canterbury. Ka aroha ki a koutou.

On the same day, in Wellington, Helen Kelly died of lung cancer. Helen trained as a primary school teacher but soon stepped up to represent her colleagues as a leader of their union and professional body, the New Zealand Educational Institute Te Riu Roa. When she was elected President of the Council of Trade Unions in 2007, Helen became the first woman to lead New Zealand’s trade union movement – our movement. In the words of Industrial Services Manager Cee Payne, Helen “loved being with our members and would take every opportunity to stand with them”. Our tūpuna rangatira stands with us still.

This year, another great leader departed from us.

Mina Timutimu, of Te Atiawa and hapū Ngāti Rahiri, began her career as a surgical nurse in 1951 before completing her midwifery training ten years later at St Helen’s maternity hospital, here in Wellington. Minu was appointed kaumātua of the New Zealand College of Midwives in 1996 and became an inaugural member of the Midwifery Council in 2003. She dedicated her working life to Māori mothers and babies. She was a visionary kaitiaki, leading the profession down the bicultural pathway over 25 years.

Those who have gone before, are with us today. So now I greet those gathered here, among the living.

It is time for the hui taumata, the highest meeting of NZNO. The purpose of the meeting is to steer our waka. It’s a waka we’re all in together, and we’ll hear more about this waka shortly from the Membership Committee and Te Poari. But for now, by looking back, the view ahead will become clear.

At this time I remember the ancient saying: “by designing and shaping the keel of the waka to perfection, your canoe will overcome obstacles”.

So to the many leaders, and guests from afar – greetings, greetings, greetings one and all.

=========

When I look back over the last year, I see that our waka’s progress towards some of the goals contained in the NZNO Strategic Plan 2015-2020 has been buffeted by strong headwinds.

President's address (to be amalgamated with final slides)

Our organisation – our members, and staff – have paddled hard for Improved Health Outcomes. But headway has been slight in the “implementation of population health approaches which reduce health inequalities, address determinants of health and those things that impact on people’s ability to live well”.

We have pursued of our goal of Skilled Nurses, one where “all graduate nurses, Enrolled Nurses and Midwives… have access to a funded Entry to Specialist Practice or Nurse Entry to Practice Programme position”. But progress – in the words of Associate Professional Services Manager Hilary Graham-Smith – has been “glacial”.

And we have steered towards a Strong Workforce, but getting “employers to implement systems for safe staffing in the workplace” remains a far-off shore.

In other areas, such as advocating for pay equity to promote a fair society and healthy communities, we’ve made the most of favourable conditions and have come a long way. The Chief Executive will shortly highlight some successes in achieving our goals as an Effective Organisation.

Scanning the horizon for approaching weather systems, and developing strategies to navigate the challenges, is the responsibility of the Board of Directors. At the start of last year, the Board recognised that underfunding was emerging as a strong wind impeding our progress and voted to make health funding a campaign priority for NZNO for 2016/17.

This has been implemented by NZNO staff and by member-leaders — some of you are in the room today — as the #ShoutOutForHealth campaign. It’s been our karakia to calm the headwind, whakataka te hau. Through #ShouOut and our collaboration with the broader #YesWeCare coalition, we have helped to make health the number one issue for voters in this year’s general election. That’s according to the latest Newshub-Reid research poll.

Back in April, Kerri Nuku and I launched the #ShoutOut Open Letter on Health Funding. You’re invited to join us outside Te Papa at lunch time tomorrow for the next campaign activity, displaying the 5,000 signed letters and boxing them all up, to keep health funding in the public eye this week.

Turning our attention to 2018, there are two key events which will influence how we achieve the goals in our NZNO Strategic Plan.

Thursday of next week is the last scheduled day of bargaining for the DHB MECA. Fuelled by member participation, the MECA campaign is propelling us forward towards our strategic goals.

But before Thursday, of course, comes election day. Climatic conditions will definitely be affected by this.

NZNO has published a manifesto outlining our priorities for health in this election, titled Nursing Matters. We have evaluated the policies of eight political parties against these priorities and published the results in Kai Tiaki, to enable an informed vote for health.

President's address (to be amalgamated with final slides)2

But it is up to you, your families and your communities to turn out and cast that vote, for your chosen party.

As we were reminded yesterday, on Suffrage Day, voting matters. It mattered to Kate Sheppard, Meri Mangakāhia and the 32,000 other women who took action in 1893 to demand it.

President's address (to be amalgamated with final slides)3

The right to vote is a taonga which our foremothers and forefathers fought for, and handed down to us. It is the foundation of a democratic system, one which also includes other checks and balances on the exercise of power. Democracy brings scrutiny, accountability and protection from leaders making decisions which are unsupported by evidence, or harmful to the common good.

And just as this true for our country, so it’s also true within our own organisation.

Soon we will begin voting on remits which members have put to refine our rules and determine our strategic direction.

The AGM also reviews and ratifies the strategic policy decisions made by your Board in the last year. This happens because AGM delegates from years gone by voted to add these checks and balances into our NZNO Constitution. In 2015, a proposal by the previous Board to remove them was voted down.

This annual meeting is where, in between the triennial elections for the NZNO Board and Officers, members exercise democratic control in this member-run organisation. It’s where we are accountable to you.

There is, however, room for improvement in our democracy. Problems with NZNO’s current voting system will be discussed after lunch, in a presentation from the Voting Strengths Working Party.

A variety of proposals will be put forward, for consideration by all members over the next year. No decisions will be made today. But I ask everyone to listen closely to the various options, and evaluate each of them against the stated goal of creating a “more democratic and equitable process”. The changes we make in 2018 will shape the democracy which we pass on to the next generation.

The 2016/17 NZNO Annual Report also contains an update on implementation of the four policy remits passed last year. Three of those remits have been fully implemented, or are in process.

The fourth, submitted by the Cancer Nurses College, was that: “Clinical Supervision be provided for nurses as per NZNO guidelines and that this should be included in the MECA”

As stated in the 2016 AGM documents: “The remit committee acknowledges the cancer nurses’ wish to have these remits go forward to the AGM although there is a mechanism for including items raised by and important to members who are covered by the DHB MECA.”

“Clinical supervision for nurses as per NZNO guidelines was not included in the claims for DHB MECA bargaining”, says the Annual Report. “This was not identified as a priority by members covered by the DHB MECA.”

I have met with the Cancer Nurses College Committee, to discuss this further.

There are also four policy remits passed at the 2015 AGM still in various stages of implementation. Two years ago, delegates to this meeting voted that: “College and Sections banking systems need to be reviewed and policy formulated to reflect modern electronic banking practices and technologies”. Implementation of this remit is progressing.

You voted: “That new policy be developed to publish the Kai Tiaki in electronic format to align with current technology”. Kai Tiaki will become available in an electronic format following a recently completed review of NZNO’s communications.

You voted: “That NZ Nurses Organisation delegates be given training and support to run MECA Endorsement and Ratification meetings”. As reported in last month’s Kai Tiaki, this was not implemented for the endorsement meetings in May, but following action by the Board it will be implemented in time for upcoming ratification meetings.

In 2015 you voted: “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”.

As I reported here last year, no specific campaign was launched, although some generic campaign activities continued. After last year’s AGM, I again raised this with the Board and presented a supporting letter from NSU/TRT. Given the glacial progress towards our strategic goal, I will continue to advocate for the full implementation of this remit.

Finally, I also remain committed to delivering on pledges I made to members during the last NZNO President election and in my inaugural address:

President's address (to be amalgamated with final slides)4

• To “be accessible to members”, online and in your locality

• To ”make your issues visible… [in] the media”, including on social media

• To “strengthen NZNO’s bicultural partnership”

• To support more members “to actively participate in NZNO membership structures”  – even though, I acknowledged, this means “voluntary work, on top of long hours in paid employment or study – and often after caring for family members as well”.

President's address (to be amalgamated with final slides)5

On this last point, the two co-leaders have commissioned a project to strengthen volunteer sustainability, member engagement and leadership development, after meeting last year with Chairs of Regional Councils, Colleges and Sections, Te Rūnanga and NSU/TRT.

The first fruit of this project to strengthen our waka will be the reinstatement in November of the annual training day for new Chairs and Treasurers. Focus groups were held earlier this year to identify other measures to support participation by our volunteer member leaders. Some of you would have taken part. Over the lunch break, we will update Chairs on themes and next steps in the project.

Here today, we are designing and shaping the keel of our waka to perfection. Working together, our canoe will overcome all obstacles.

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

At this election, rise like lions!

First published in Kai Tiaki Nursing New Zealand, August 2017. Re-posted with permission.

There are now just a few weeks to go. The country is counting down to the general election, to be held on 23 September.

Health is political, and never more so than in 2017, when the impact of underfunding became intolerable for healthcare workers and the public we serve.

Every day we speak out about being short-staffed, about the sheer volume of admissions, referrals and presentations, about the lack of resources or risks to patient safety.

More often than not, it seems, our voices are ignored. We’re even told that there is no underfunding or resource shortages, so we’re either imagining things or it’s our fault our workload is unmanageable.

But at election time, at least, the politicians have to listen to us.

For the last couple of years, people around the world have been using the ballot box to express their rejection of ruling elites and establishment politicians. This populist wave has brought down the mighty, catapulted political outsiders to centre stage.

NZNO does not advise members who to vote for. But since kaiwhakahaere Kerri Nuku and I launched NZNO’s Open letter to New Zealand voters in April, we have been encouraging every member to “shout out for health”, to help make health funding the top priority this election.

NZNO is publishing a manifesto containing other policies, too, because health outcomes are fundamentally determined by access to social and economic opportunities: a liveable income, safe and decent work, affordable housing, education, adequate and nutritious food, and clean, healthy and sustainable environments.

Regardless of who wins the election, we’ll be urging the next government to prioritise:

• A sustainable, fully utilised nursing workforce

• Investment in public health

• A primary health care approach to improving population health

• Oranga Tamariki – the health and well-being of children and young persons

• Safe clinical environments

• Fair employment

• Social and health equity, within Aotearoa, the Asia-Pacific Region and globally

Voting once every three years will not be enough, on its own, to achieve our ultimate goal — a health system where every patient knows that when they need care, they will see the right health professional, with the right skill, in the right place, at the right time.

Other kinds of activity are needed, too, like writing letters, making submissions, getting to meetings and joining protests. But as the populist wave overseas has shown, for better or worse voting does make a difference.

One of the most unlikely scenes it has produced was this year at Glastonbury, the United Kingdom’s famous annual rock music festival. A youthful crowd of around 120,000 cheered as a 68 year-old, grey-haired politician read from a 200 year-old poem.

The poem Jeremy Corbyn chose to read is also my all-time favourite. So my message to NZNO members, from now until the election, is the same:

Rise, like lions after slumber

In unvanquishable number!

Shake your chains to earth like dew

Which in sleep had fallen on you:

Ye are many—they are few!”