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Increased Primary Health Threatened By DHB Pay Gap

New Zealand Nurses Organisation
Media Release

21 July, 2006

Increased Role of Primary Health Threatened By Pay Gap With DHBs

The primary health workforce, vital to the Government’s strategy of increasing the role of primary health, is shunning the sector for jobs with DHBs, earning up to $200 more a week, says the New Zealand Nurses Organisation.

A new survey of NZNO’s primary health members released today, shows the impact of the “fair pay” settlement for DHB nursing staff last year, with increasing problems recruiting staff to primary health roles and a growing list of vacancies.

In a sector which has traditionally had low turnover, one third of NZNO members participating in the survey reported increased difficulty recruiting staff at their workplaces than a year ago. The survey reveals that 25% of primary health workplaces currently have vacancies and 60% of Iwi and Maori provider and Pacific health centres have vacancies.

NZNO advocate Chris Wilson said recruitment problems in Maori and Pacific community health were of particular concern, given the Government’s strategy called for greater emphasis on their role in improving the health of Maori and Pacific people.

Survey respondents overwhelmingly attributed these problems to the pay gap with DHBs.

But Chris Wilson said the most important finding of the survey was the increasing complexity of primary health work, with over 85% of practice nurses saying their job is more complex or significantly more complex than two years ago.

“These health professionals triage patients, suture, x-ray, plaster, take blood, vaccinate, dress wounds, administer intravenous antibiotics and fluids, and run diabetes, asthma, cervical smear and accident and emergency clinics. They daily support chronically ill patients and make decisions as to whether patients will see a doctor or require an ambulance,” she said.

Chris Wilson said other roles, such as community health workers, were increasingly important, addressing a huge range of health and wellness issues at the community level.

“The whole workforce brings vast experience and training to their job at the forefront of health prevention, saving millions of dollars through the delivery of preventative health care, but our survey shows our members feel invisible, undervalued and fed up,” she said.

The survey revealed that, while a minority of primary health employers now paid DHB rates, 87% of primary health nurses were paid less than their counterparts in DHBs.

NZNO resumes collective agreement negotiations with 650 primary health employers on 24 and 25 July. NZNO is seeking parity of pay and conditions with DHBs.

“Achieving pay parity in the sector will require additional government funding of around $22 million,” said Chris Wilson. “Clearly it is in the Government’s best interests to ensure pay parity in primary health to urgently address the issues raised in this survey.”

Below are some personal comments from primary health NZNO members who participated in the survey:

“I make very important decisions all day when I am on duty - whether a patient needs urgent care, hospital care, an ambulance or to be treated at our surgery. We are at the front line and need a knowledge base that covers every situation.”
Practice nurse

“In our surgery we treat emergency patients, triage, and assess independently, exactly like I used to do when I worked in a DHB emergency department.”
Practice nurse

“Primary care prevents hospital admission and education increases patient well-being. I use all my hospital skills and have learnt more to be able to work in this area where a broad knowledge base is required.”
Practice nurse

“There will be huge problems in staff retention if the pay gap is not sorted. I will not work where I can’t earn a fair rate of pay. Primary health nurses are essential especially as there is a huge focus on keeping patients out of hospitals. If there are insufficient nurses in primary health care then patients' health will be affected and the hospital system will be overwhelmed with unwell patients who could have been cared for in the community.”
Practice nurse

“I believe our medical center has heaps more services available and therefore a heavier workload and more paperwork than any department in a DHB. A higher standard and knowledge base is required.”
Administration worker, GP surgery

“I work in a hospital setting for $24 an hour and as a practice nurse for $19 an hour.”
Practice nurse

“I work at a significant level in the community due to complex clients and isolation. I am responsible for my actions and have no one on hand to discuss professional decisions with.”
Community health worker

“Why would we continue? Is it worth it?”
District nurse


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