New Zealand Nurses Organisation - Speech notes
HealthKia ora koutou katoa
Thank you for inviting me here to celebrate International Nurses Day, which is tomorrow May 12, and which also happens to be Florence Nightingale’s birthday. It is a pleasure to take time to recognise the great contribution that nurses make to the health of New Zealanders. I’d like to extend greetings to Nano Tunnicliffe, Kerri Nuku, and Siloma Masina.
I know that many of you here today are senior nurses who have given much to our health system; and for that I would like to extend my thanks. Nurses are hugely valuable to our health system, and you are deserving of the high respect in which you are held. There are currently just over 47,000 nurses practising in New Zealand, including 1,000 additional nursing positions in DHBs that have been created since November 2008. These are encouraging figures.
The theme of International Nurses Day this year - Increasing Access and Equity – is an important consideration for any national health service. It is certainly a key objective here in New Zealand. We want the best and the most appropriate health care to be available to all New Zealanders, when and where they need it. As you are all well aware, smart and effective use of our nursing resources is central to increasing access and equity in New Zealand’s health system.
The two speakers you will hear from shortly will speak about increasing access and equity from the perspectives of Maori and Pacific communities, but to complement their insights I’d like to cover the various initiatives that the Government has introduced to support nurses and other health professionals, and to help make our health service more accessible and more appropriate.
Clinical Leadership
You, as health professionals, are the ones who best understand what is working well; what needs more development; and what the practical barriers to better services are. You know where the gaps are, and you have ideas about how to close them.
That’s why promoting clinical leadership - supporting health professionals to have more say in the leadership and regulation of their profession - is one of the cornerstones of the Government’s health policy.
Health professionals are use to working in a multidisciplinary way to plan and deliver patient care. The leadership model that supports a doctor, nurse and allied health leader to work alongside managers to plan, deliver and evaluate service delivery builds on the clinical model and is particularly sound. This model brings clinical as well as organisational expertise into the service delivery arena. Recent additions to the Ministry of Health Executive Leadership team of a Chief Nurse and Chief Medical Officer reflects the Ministry’s commitment to clinical leadership.
Primary Care
Primary health care services play a huge role in increasing access and equity and improving the health of all New Zealanders.
In 2009 the Government launched ‘Better Sooner More Convenient’ – a vision for the future of primary health care expressly intended to make services more accessible for all New Zealanders, and to further develop health system capacity.
Nurses are vital to maximising the potential of the primary care sector. For example, nurses have successfully been reducing the burden of vaccine-preventable diseases. Three years ago the national immunisation rate for Maori children was just 64 percent. By the end of 2010, this had increased to 85 percent, just 3 percent short of the current rate for the total population of under two year olds. The immunisation coverage rate is expected to reach 90 percent for two year olds by June 2011.
Nursing leadership is also particularly valuable in the management of chronic conditions. Demographic trends show we have to manage the growing burden of chronic conditions and the financial pressure they place on the health system. To strengthen primary care, we are working to maximise the contribution registered nurses can make.
For example, the success of the Long Term Conditions Management Programme at West Coast PHO has largely been driven by nursing input. This programme, established in 2009, provides structured support for people to remain in their own homes while being more engaged with managing their own conditions. Elsewhere, nurse-led clinics have been established, with nurses working autonomously as part of a larger primary health care team to care for people closer to home. I understand that nurses around the country have also taken the lead on cardiac risk assessment in general practice.
In March 2011, we approved regulations allowing prescribing by suitably qualified nurses practising in diabetes health. The Nursing Council of New Zealand can now authorise individual nurses who meet the criteria, and last month, four demonstration sites began around the country, funded by Health Workforce New Zealand.
Nurse Practitioners
In primary and in secondary care, nurse practitioners are a perfect example of nurses embracing new innovations in order to increase access and equity.
Since the Nurse Practitioner scope of practice was introduced, 91 nurses have stepped up to this challenge and have become qualified to assess, diagnose, and manage patient care in their chosen specialty. 68 of these practitioners are currently authorised to prescribe.
Voluntary Bonding
I have already mentioned there are 47,000 practising nurses in New Zealand, and that the number of nursing graduates is increasing yearly. One of the Government’s priorities has been ensuring that we have enough of the right health care professionals in the right places at the right time. The Voluntary Bonding Scheme is now in its third year. This year, the scheme has been extended to include graduate nurses moving into positions in aged care and mental health. Graduates can receive more than $14,000 if they are willing to work in these areas for the full five years.
The response from nurses has been encouraging. In the first two years of the scheme we accepted 1,049 nurses who had graduated between 2005 and 2009.
The first intake of nurses will now be halfway through their minimum three-year bonding period, and if they continue to work in hard-to-staff specialties, they will be eligible for their first payment next year.
Maori and Pacific nursing workforce
A key part of ensuring equity in our health system is making sure that services are appropriate. Having a strong Maori and Pacific representation in our nursing workforce is an important part of this. Currently about 6% of the nursing workforce are Maori, and only about 3% are Pacifika. We need many more, and fortunately the future picture looks more positive. Looking at 2009 student enrolments in Bachelor of Nursing degrees, 11.3% were Maori, and 5.6% were Pacifika.
The Ministry of Health's Pacific Provider and Workforce Development Fund has been actively recruiting Pacific students to consider nursing as a career; 60 additional nursing and midwifery places were funded in 2010 and another 60 for this academic year. The Ministry’s Pacific Programme Implementation team is working with the Counties Manukau DHB to fund two Pacific Nurse Practitioner training positions.
Earlier this year, the Manukau Institute of Technology launched its Bachelor of Nursing (Pacific) programme, with an initial intake of 27 Pacific students for the degree programme.
In 2009 the Ministry of Health commissioned a national Māori nursing and midwifery workforce development programme - NgāManukura ōĀpōpō, developed within the Auckland DHB. The programme is designed to support the retention, recruitment and continuous development of Māori nurses and midwives practicing in New Zealand, with a particular focus on clinical leadership and professional development.
Close
For many people who have contact with nurses, be it in hospital or in the community, your role is one of the most important in providing quality health care. I thank you for your dedication and professionalism, and once again, it is a pleasure to be here to celebrate with you today.