The Nation: NZNO, NZEI and EMA
On Newshub Nation: Lisa Owen interviews NZ Nursing Organisation’s Cee Payne, NZEI Te Riu Roa’s Lynda Stuart and Kim Campbell of the Employer and Manufacturers Association
Lisa Owen: The Health Minister says there's no more money for nurses - despite a 24 hour strike this week that saw them walk off the job for the first time in three decades. It’s a similar story for primary school teachers, who are planning a three hour strike next month - their first in 24 years.
I’m joined now by Cee Payne of the New Zealand Nurses Organisation; Lynda Stuart of the New Zealand Educational Institute and Kim Campbell of the Employers and Manufacturers Union.
Good morning to
you all, thanks for joining us. Cee, can I start with you?
You’ve turned down a package of half a billion dollars, it
would have seen an extra 500 nurses added to the workforce.
What would you be happy with?
Cee Payne: Well, I think our members have given a very clear message that what needs to happen is we have to have safety for nurses in our hospitals and safe patient care. Those are the two principles, and to achieve that, there is still, we’re saying, additional investment that’s required to get that over the line with our members. There is significant concern about the number of nurses on a daily basis, particularly immediately, now, and they don’t think it can wait to be resolved. It can’t wait two further years for a solution to that critical problem of patient safety.
What was the recommendations that were made by the Employment Relations Authority in the facilitation?
Payne: Those recommendations are confidential to the parties, and it’s up to both of the parties. The member of the Authority left it with both parties to determine whether they wanted to make them public. At this stage, the DHBs and ourselves have chosen not to do that, and I think we’ll be focused on getting that around the table for bargaining, and if either party wishes to do that, then they’ll notify the other. So, at this point in time, we are saying bargaining’s continuing and we’ll be looking to get dates once we’ve got a plan and to have sat down and had a rethink and strategizing after the strike.
OK. That latest offer – it had $38 million allocated to extra staff, right?
Some of the nurses that we’ve spoken to during the week say that safe staffing levels should be dealt with outside of the pay negotiations; that it should just be a given that you have safe staffing levels. Is it possible that you would look to get some of that money re-allocated to pay?
Payne: No. Look, staffing’s absolutely critical, and that will deliver safe patient care. We’ve got some appalling statistics in New Zealand around this. We’ve had 10 years of underfunding. Our nurses are stressed to the hilt, they’re fatigued, they’re morally distressed, and they can’t deliver the care they need to deliver. And international research shows that if we continue on like we are with a whole lot of nursing cares, mis-cares, care rationing that is going on in this country, then we’re going to see a significant increase in numbers of patients having adverse events and dying.
I want to talk a bit more about that later, but let’s bring Linda in here. Lynda, you can only spend a dollar once, right? So are you concerned that the teachers might miss out if the nurses get more?
Lynda Stuart: Well, I think we stand with the nurses, we’re support the nurses, but actually, in New Zealand, we need to ensure that we’ve got a high-quality education system, and at the moment, our education system is in crisis, and our members have really spoken to that over the last little while. We’ve actually had, like the nurses have, nine years, ten years of underfunding, and that has really come to a crisis point in this country now.
But you would appreciate that there is a certain pool of money, so what should the government ditch in order to give you more money? Should it be the billion-dollar Provincial Growth Fund? Should it be the money that they’re spending on free tertiary education? You’ve got to find it somewhere.
Stuart: People elect governments in to make these decisions. What we‘ve got at the moment is we’ve got a crisis in education, we’ve got a crisis in health, and we would expect our politicians to take that seriously and to be looking at what needs to be prioritised. But we cannot continue to go on the way that we have been going. We cannot continue in situations where we do not have enough teachers in this country for a variety of reasons. We have got 40 percent less people going in to teacher training, we’ve got staff cuts at initial teacher education provisions, and we’ve got a number of things where we’re just not meeting the needs of our children in this country.
So, Kim, do you think this government has its spending priorities right? Because here you’ve got teachers and nurses saying that they want a bigger percentage of that pot.
Kim Campbell: Well, first of all, you’ve got to ask “Who owns the problem?” And one wonders why, in fact, the nurses should be concerned about patient safety. I would have thought there was a standard below which you can’t fall, and there would be someone to intervene if it was that unsafe, so I think there needs to be some agreement to how unsafe it is, and, unfortunately, the public hasn’t seen that. One would hope that would come to the surface. Likewise, if there is a crisis in education, I’m not qualified to argue whether there is or isn’t. We should get agreement on that. And then there shouldn’t be any argument about what we’re going to do about it. In terms of the government dealing with this-
So, where does the money come from though, Kim?
Campbell: Well, this is the point, and my sympathy is with the Minister of Finance, his instincts would be to pay as much as he possibly can, but of course he knows, as I know, that there’s a raft of industrial relations legislation coming their way. Pay equity is the good one. I mean, we all knew that aged care was what needed attention, and we made a significant adjustment for aged care. Fairly shortly, you’re going to have firemen and policemen coming up to say, “Well, hang on. We should be paid more than nurses and teachers”, and there is an escalation that’s going to happen. Inevitably, they’re going to run out of money. And that’s the real challenge; what do you do?
Stuart: So one of the things that we know is that, both in education and in health, we’ve got a significant number of females in those workforces, and, over time, we have seen in this country that issues like pay equity have not been addressed. We’ve got education support workers who work with our most vulnerable children. They work in our early childhood centres, transition children in to schools. They’ve been waiting for a pay equity case for over 11 years. It’s time to be fair in this country.
Campbell: There’s no argument about this, that pay equity is an issue that needs to be dealt with, but the treasury, and particularly the Minister of Finance, has to actually balance the books, and I think that’s the issue that sits there, not that it’s right or wrong. I don’t think anyone argues about the equity; finding an answer is the problem.
Payne: But our patients do know the problems. Our patients and their relatives are experiencing the problem every day. They see how busy nurses are on the floor, they know that they’re rushing-
Campbell: That’s why people are honking in favour!
Payne: Absolutely, honking continuously all day, and they’re seeing our nurses running around, and they’re seeing the cares that aren’t being provided, and when those cares aren’t provided, patients are at risk.
Owen: So, Cee, I just wondered, do you think that this government has raised your expectations in terms of a pay settlement, or did you just assume that a Labour-led government would be more sympathetic towards you?
Payne: Look, I don’t think it’s got anything to do with who’s the elected government. We haven’t taken industrial action for over 30 years; we’ve had a lot of governments come and go. The problem is—
But do you expect more from this government?
Payne: I think we expect more from whoever is the Government because the last decade has seen a severe crisis in health develop, because of the underfunding of the public health system. That funding hasn’t kept up with the increasing acuity. Patients are sicker. It hasn’t kept up with the increasing volumes that are going through. And we certainly haven’t had the reciprocal number of percentage of nurses to reflect the care that needs to be undertaken.
So, why now, though? Why has it all sort of blown apart now? If it has been building for a number of years, why under this government?
PAYNE: I think that we’ve been working really hard to try and address internally the situation around safe staffing with our Care Capacity Demand Programme. DHBs haven’t got on and done that work, and I think it’s partly because of the fear that it was going to generate figures that are going to show that there’s a real gap. One of the DHBs, just recently, that has done some of their data around the gap has shown that they need a million dollars in nursing hours to go into that work place. This work hasn’t been done because DHBs clearly over the last three decades haven’t been—not three decades sorry, one decade, haven’t been able to fund that. So do the data and then what? So the public knows there’s a problem. The public actually knows there’s a problem, we just need data.
It keeps coming back to money. So, Lynda, this Government wants to keep debt down to 20 percent of GDP; it wants to get it there in five years. Should they ignore that debt cap in order to pay you what you think teachers are worth and what nurses are worth?
Stuart: Well, what we do know is that if something isn’t done now we are going to be in a worse situation. So, actually, yes, they need to take the bull by the horns and absolutely deal with these issues. It’s not OK—
So, if that means breaching that debt goal, would you say do it?
Stuart: That’s one of the things they need to look at. And one of the things that we’ve been doing is looking at public support for teachers over the last while, and what we’ve seen is that there are hugely significant amounts of public support. Like, 83 percent of the public who were surveyed in March agreed that teachers needed a significant pay increase, 86 percent of them in June. Now, that’s not even looking at the workload issues that our people are facing at the moment.
Kim, what do you think? So, forget the debt cap, pay these groups what they’re worth?
Campbell: Look, nobody’s going to pick a fight with the nurses. Everybody supports the nurses. And anyone that’s got kids at school knows that this is the most important… But this has always been an issue. And I think probably society has capitalised on that goodwill, and also the sense of calling for people who work in that profession have, who care so much about the kids and their patients. So, I mean, maybe that needs to be addressed.
But not through raising the debt cap?
Campbell: But I think in terms of, is it, channelling the Minister of Finance? I have to say that this debt ceiling is a really important one. We don’t know what sits around the corner economically. And we all, well, I was there when we were broke as a country. So being fiscally responsible is very much an important thing to do, and they do have to make choices. And, you know, they chose to support the students, they could’ve supported the nurses and the teachers. And that was a choice they made. I think what I would do, if I was you guys, to keep the goodwill which you absolutely have, is to get a signal of what lies ahead to make sure that eventually this will be addressed. I know it’s been a long time. But there are other groups also that feel terribly disadvantaged.
Payne: How can you just ignore a problem? I mean, our data…
Campbell: I don’t suggest you ignore it
Payne: No. But the Health Quality and Safety Commission of New Zealand that collects the data demonstrated in 2014, so four years ago, three years ago, a 140 percent increase in adverse events in health. You can’t ignore a problem like that. Yes the Government does need to—
Are you saying that’s because of a lack of nursing resources?
Payne: It’s absolutely to do with a lack of staff and being able to attend to those patients. Adverse events are linked very closely to the missed care and the care rationing that goes on in our hospitals.
Campbell: What about the leaky buildings?
Payne: Nursing being the biggest workforce in there, that is a large contribution. So, nurses do need to be able to deliver the right care at the right time. If we don’t deliver the right care at the right time, we have sicker patients. We end up paying more for that as a community and a society. So it’s important that the Government does do everything it can, and I believe there is an ability for the Government to make clear decisions around funding. I mean, I don’t want to get into an aeroplane dispute. But, you know, there are choices that government makes. But the one most important case, or the two most important cases facing them, one is making sure our patients are safe in our public hospitals and that we’ve got a workforce that can—
Campbell: But is a half a billion dollars not going to do that? I mean, there’s a lot of money going on there.
So are you saying half a billion is enough and they should just take it?
Campbell: I’m not in a position to know exactly the numbers. I don’t pretend to be qualified to do that. All I know is that it’s a big number, and I know that the percentages that the nurses are getting may not redress the total grievance, but compared to what many other people are getting, it’s actually pretty generous. And, you know, plenty of companies in the private sector are lucky to get one percent. So they’re looking on saying, ‘Ooh, wow.’ The problem I’ve got with that, not begrudging nurses one cent of what they get, good on you. But the problem is the effect that’s going to have economically, because everybody else is going to have their hand out.
So is that what worries you the most, Kim?
Campbell: Terribly. Not what they’re getting.
In the private sector, you will be forced to pay more because nurses and teachers are getting more.
Campbell: Yeah, absolutely. That happens; it happens all the time. It already happened with aged care.
Isn’t that out of self-interest, then?
Stuart: It’s not OK for children in this country to not receive the support that they need to be able to reach their potential as adults. And that’s what we’re seeing at the moment. We’re seeing a lack of teachers because people don’t want to go into teaching for the variety of reasons that we’ve said.
Campbell: Is there agreement from the education people?
Stuart: But also, we are seeing that these children are just not getting the support that they need.
Lynda, Kim does raise a good point that average wage growth is expected to be around 3%. And teachers are looking for 16% over two years; how do you justify that in comparison to what the average Kiwi would be getting in the private sector?
Stuart: One of the things that our people have said really clearly is that we need to be able to attract people into the profession. Our young people in our country have got many choices that they can make on leaving school. They can go into teaching or they can go into trades, they’ve got all those choices. They don’t go into teaching. Why don’t they go into teaching? They don’t go into teaching, one, because other professions that they can go into pay more, two, because of the work load and the support that they get as teachers. Those are the real issues that we want to address. Our beginning teachers who are looking at a career framework at the moment are saying, ‘Actually, I don’t see myself in this role for five years or ten years. We went into it, I went into teaching, it was something I went into teaching as a vocation.
Mm. Lifetime career.
Stuart: It was something where I really wanted to make a difference for kids. We just don’t have our young people seeing that at the moment, and we need to change that.
Payne: It’s the same for nursing.
You know, we’ve got something like 400, approximately, new
trained nurses sitting out there in the ether who need work,
can’t get work, get no support to come in and have that
placement. It’s difficult in a crisis because nurses are
already stretched, but they need to preceptor these people,
so we’ve got to bring them in. They’re an important part
of the workforce. We’ve got people leaving the workforce
because they come in and it’s so stressful in there, young
people, with the stress in the system, can’t cope with
that. They leave, and we’ve got a high turnover happening.
We’ve got an aging workforce. We’re relying on over 45%
of our workforce being over the age of 45, I think it is as
well. Similar moves about the same pace—
Campbell: But there’s always been turning—
Payne: But they’re reducing hours because of this. They’re reducing hours. We don’t talk about— We used to talk about FTE—
Full time equivalent—
Payne: We talk about number of nursing hours, because, in fact, you can have a number of FTE on your book, but nursing hours— Nurses are reducing their hours because it’s so stressful in there. And our senior nurses are not there. We’ve got a nursing crisis.
Okay. See, that raises—
Campbell: Do the DHBs agree with you?
Payne: The DHBs know there’s a nursing crisis. I mean, they’re avoiding wanting to know the problem by not getting on and doing the data. And when they do the data, they find out, yes, there is a huge shortage, and they need to put more staff in, but they can’t get them. And that’s part of what— Pay’s about part of the solution, because we have an exodus of people going overseas to Australia—
During the strikes, some nursing staff said that the levels of workers during the strike were better than ‘business as usual’ levels. And the Health Minister has denied that in part. So what sort of difference are we talking about?
Payne: Well, I mean, I can only talk anecdotally to some of that. But I had a nurse come off the strike — she was working as a life preserving service person — and she came off, and she told everyone that there’s three people in there instead of two, which is the normal requirement. Trying to complete the LPE rosters, we had thousands of nurses on for life preserving services over the strike to make sure that patient safety and public safety was paramount. Some of those rosters — and we did say this to the minister — we were having difficulty filling them, because normally they’re filled with overtime hours. They’re not filled with real people. So it’s people working on top of that. So there wasn’t the ability to actually fill some of those rosters. We did actually manage to do that, but that’s why our members are saying that some of those rosters had more people than are normally on that shift in that unit on that day.
Lynda, arguably, no group of workers has as much public sympathy as nurses or as much power to disrupt. So what do you think that half a day of striking is going to realistically achieve for your teachers?
Stuart: Well, it’s a signal, really, that— And it may not be half a day; it may be a full day. We’re actually having those conversations with our members at the moment. What we know is that the offer that the ministry put to our members was absolutely rejected — overwhelmingly rejected. It’s now the time for the Ministry of Education and the government to really look at the crisis that we have in education, take it seriously. We’re working with our communities around us—
So it’s a warning shot.
Stuart: Absolutely is. We want to go back into negotiations. In fact, our primary teachers start negotiations again at the end of next week, and so do our principals. So we want to actually— we want to sort this out, because it’s too important for the kids of this country if we don’t.
All right. So, nurses have gone on strike for the first time in 30 years, Kim. Teachers, as you heard, planning, could even extend it out. Is this the new norm?
Campbell: You know, I have to admit that these disputes have been hovering around for quite some time. So this hasn’t just happened since we’ve got a Labour government. But one suspects that the argument you’ve heard about whether the government should be easing the purse strings certainly sits under this. Because the government’s made it plain that they want a line in the sand on the debt levels in reducing net debt. And so there’s obviously a limit to what they can do. But we have had — and I can show you the graphs — quite a long period of industrial harmony in New Zealand. You know, really, by world standards, it’s been very, very good. And when we introduce new types of nation-based what we call multi-employer collective agreements, we always had industrial disputes. I can show you the graph — it’s a one to one regression. So the question is — are we going to look forward to the— if we have this new legislation coming, that’s what we’re going to get. So you get used to this. And in a way, I have to admit, by having a strike, it does draw a lot of attention to the issue.
But the reason they’re striking now is arguably because they got a bad deal for a decade before, as both the teachers and the nurses have said.
Campbell: But what I’m struggling with here is trying to understand is it the conditions of work we’re complaining about or is it the pay or is it both?
Payne: I think it’s a bit of both, but, I mean, there is— the difference is that in that 10 years, things have got a lot harder. Patients are sicker. What we saw in one study was that patient acuity had increased by 16 percent, but nursing only by four percent—
Campbell: Technology has improved though. We’ve got better gear now.
Payne: Yeah, but people are having to use that equipment, so it doesn’t change it. At the end of the day, we’ve got a much sicker community in our public hospitals. I mean, you go back 20 years, and it’s vastly different, where more and more people were ambulant, stayed in hospital for maybe five or six days. Now, they’re in hospital for 48. For that 48, they need a lot more nursing care hours. And that’s the difference, I think. And that decade makes a difference, but while that decade was happening, it was also being underfunded, so we had two problems going on — one, increasing acuity sickness in our hospitals—
Campbell: Are you suggesting that the DHBs weren’t paying attention?
Payne: I don’t think the DHBs weren’t paying attention. They didn’t get the funding. They didn’t get the funding.
Stuart: We would say the same in education. We would say that children with needs — that’s grown exponentially. And, actually, the workload of teachers has grown exponentially as well.
All right. We’re almost out of time. Before we go, do you believe there’s no more money?
Payne: No, I don’t believe there’s no more money. And I actually think that nurses have told the public how bad it is and made this invisible problem visible. And something needs to be done about it.
And is there an appetite for more industrial action?
Payne: We will be considering whether that’s what our members want to do. That will be a decision our members make.
All right. Thank you all for joining us this morning.
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