Today Minister Little announced action planned by the Government to provide pay parity for health workers. In his statement he made two conflicting statements:

“The Government is committed to ensuring health workers are paid fairly and receive parity with others doing the same or similar work, especially given the current cost of living pressures workers and their families are under”,

and then in the next breath,

“However, I have to be clear that this package will not mean significant change immediately for those working in GP practices.”

Follow-up discussions with Ministry officials reveal that there is currently no plan to provide parity payments for those nurses in general practice. Equally, the situation for nurses at community-funded rural hospitals is also unknown.

Chair of Hauora Taiwhenua, Dr Fiona Bolden, states:

“This is a totally devastating decision not only for practice nurses, but also for the whole general practice team and the communities they serve. There is ample evidence of the disparity between pay for nurses in general practice and pay for nurses who work in DHBs; you only need to look at the two MECA agreements for this.”

General practices, particularly in rural areas, are already struggling to meet the demands placed upon them. They were fundamental to the roll-out of COVID vaccination programmes throughout New Zealand, and a significant factor in getting vaccinations to target rates for rural and rural Māori populations. Yet for some reason the Minister, who in promoting the health reforms stated that there was to be a major shift in emphasis towards primary and community care, has once again ignored those efforts.

Minister Little stated in his release that “it is time to start addressing the pay rates of those health workers who don’t work for Te Whatu Ora”, but that for GP nurses there is no “real evidence of pay difference at this point.”

Responds Dr Bolden: “This will do nothing to address the continual drain of nurses from general practice to other more well paid and less demanding roles and to overseas jobs which are far more lucrative.”

The private sector collective agreement for senior nurses pay is up to 10.7% less than the agreement for Health NZ nurses with similar experience. General practice is paid by the Government for health services and those payments have not kept up with health inflation over the last decade. This lack of funding, and effective freeze on patient co-payments, has put many practices on the financial precipice. They can’t afford pay increases for their nurses without increased funding from Government.

Dr Bolden lays out the severe funding issues this decision will create for general practices:

“Where they have increased wages in desperation to attract nursing staff and to reward them fairly then it has been at a detriment to other areas of the practice. We already have a rural health worker crisis this will only reinforce that, especially as we have the ongoing work from COVID and the moving of healthcare steadily away from secondary to primary care.”

The Government commissioned a report on the sustainability of general practice funding and have been sitting on that report since July. Last week, it was quietly made public and not commented on by the Minister. That independently written report shows that General Practice in New Zealand is currently underfunded by $137M to maintain services at current, under-pressure, levels. To meet even 50% of the unmet need in the community, it needs to be funded by a further $421M.

The report writers clearly articulated that rural practices are often smaller than urban practices, provide a different mix of care, and face particularly challenging workforce constraints. They concluded that the shortfall in funding for those rural practices were likely to be much higher.

Outlining the incredible importance of general practice nurses, Dr Bolden adds:

“These hardworking, dedicated health professionals are the backbone of healthcare in the community, and they need recognition of that by at least being paid equitably to their DHB counterparts. Small rural general practices and community-funded rural hospitals do not have the financial flexibility to be able to increase their wages to the DHB equivalent.”

“With the Christmas holidays coming up, we are still expected to keep general practices open and provide 24/7 care. We hope that we can help the Minister see how untenable this is without fair pay across the sector."

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