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Nearly 14,000 New Zealanders have signed a petition calling for an end to the pay disparity between the country’s registered nurses who work in aged care and their counterparts in public hospitals.

“Registered nurses who work in aged care in New Zealand earn on average at least $10,000 a year less than nurses who work in public hospitals,” says the petition to Dr David Clark, New Zealand’s Minister of Health.

“That’s not because they are any less skilled or important, but because of years of underfunding of rest homes by successive governments and undervaluing of the care of older people.”

There are more than 5000 aged care registered nurses in New Zealand.

The push for better pay comes as the skill and leadership of the country’s aged care nurses have been credited as an important reason for New Zealand’s low fatality rate from COVID-19.

Only 21 people have died from COVID-19 in New Zealand. Most of the deaths were concentrated in two aged care facilities. The overwhelming majority of homes had no casualties.

Experts say that staffing issues were an important factor in the facilities that experienced outbreaks and low staffing levels must be an important part of any review into coronavirus outbreaks in New Zealand rest homes.

“Quality care requires more staff and more time. Higher staffing ratios will also provide more room for flexibility when crises occur,” said Dr Katherine Ravenswood, from Auckland University of Technology.

National stopwork is the culmination of a wage freeze and broken promises of improved staffing.

Over 30,000 nurses and midwives conducted a 24-hour national strike in New Zealand public hospitals on 12 July after rejecting a fourth pay offer from their employers.

It was the first strike by New Zealand nurses in 30 years.

Cee Payne from the New Zealand Nurses Organisation (NZNO) said the combined District Health Boards (DHB), negotiating together for a multi-employer collective agreement, had not offered enough to compensate for “10 years of broken promises”.

“The issues faced and reported by our members have arisen from a decade of severe underfunding of our public hospitals which have failed to keep pace with growing community need, the ageing population and workforce, and increased costs,” she said.

Pay talks have been dragging on for over a year.

The District Health Boards’ offer was three pay rises of three per cent staggered over 18 months plus a lump sum of NZ$2000 with some limited funds made available to the DHBs to hire extra staff.

The NZNO was claiming pay increases of 12.5 per cent to 15.9 per cent.

The Labour Minister for Health David Clark said he was sympathetic to nurses’ feelings which he said had been building over the nine years of the previous National government.

“Their frustration is under-standable. I think everyone agrees nurses should be paid more than they are now, but it takes more than one pay round to address nine years of neglect.”

Strong support from health professionals and public

Nurses received widespread support for their action from doctors, nursing experts and the public.

Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS), said senior doctors were concerned that their nursing colleagues had been put in a position where last-resort strike action was considered necessary.

“Nurses are a skilled, dedicated workforce and the fact things have deteriorated to this point reflects a crisis of leadership in our public health system.”

He said years of “deliberate government under-funding” had taken its toll, resulting in the devaluing of nursing both by the government and the District Health Boards.

Nurses were a vital part of the public health system and “don’t deserve to be treated as a balance sheet liability”, he said.

Nursing experts also recognised the dire state of health after nine years of National government when health spending and wage growth were virtually frozen.

“Nurses are burnt out, anxious and morally distressed. If DHBs and government are serious about addressing nurses’ concerns then they must address both pay and conditions, which includes the wider culture of healthcare,” said Dr Helen Rook from Wellington’s Graduate School of Nursing, Midwifery and Health.

Empty promises on staffing bred distrust

In 2004, NZ nurses withdrew a claim for mandated nurse-to-patient  ratios after they were promised a committee of inquiry to develop a national safe staffing model. Implementation of the model was to start “no later than 2006”.

“More than a decade later most public hospital nurses are still waiting for that safe staffing model to make a difference to the number of nurses on their ward,” reported the NZ Nursing Review.

Safe staffing has been on the table of every collective agreement negotiation since 2004 “but progress has been painfully slow”, it says.

Only one District Health Board (out of 20) has fully implemented the tools that calculate how many nurses are needed on each ward.

The broken promises around staffing have been a key reason for the erosion of trust by nurses in their employers says NZNO organiser, Cee Payne.

“(Nurses’) experience over the last 10 years is DHBs haven’t delivered on what they’re saying around safe staffing,” she says.

Professor Jenny Carryer, Massey University School of Nursing, says the dire state of health has come about because the DHBs and the previous government had seen nursing as “a cost to be pruned” rather than as a resource.

“There is a constant drive to reduce nurse staffing to levels which mean nurses are under constant stress and making critical decisions in a sea of distraction, whilst trying to prioritise those actions which will ensure people are safe,” she said.

NZ aged care nurses campaign for pay parity

A decade of neglect leads to NZ nurses’ strike