3 Aug 2022

DHBs not in 'targeted consultation' over Green List nursing question

1:50 pm on 3 August 2022

The government never directly consulted with district health boards over whether it should offer international nurses the same "straight to residence" that migrant doctors will get.

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Plunket, Family Planning and the Nurses Organisation are among the groups which were not consulted (file image). Photo: 123RF

Instead, it held discussions with a Health Workforce Advisory Board, which has a DHB representative.

The government has stressed health boards' input was critical in the May decision to make nurses wait for two years for residence, compared to immediate applications for doctors, engineers and scientists.

Plunket, Family Planning and the Nurses Organisation are among the groups which were not consulted, and which have been calling on the government to change its policy in order to attract international nurses.

It has now also emerged that independent contractors on six-month fixed term contracts can also become residents immediately. The fast-track jobs also include multimedia specialists, food technologists and IT workers and they are expected to be granted residence within six weeks of applying, from next month.

An Official Information Act response shows only two groups were consulted on the nurses' place on the Green List, although one of them - the Aged Care Association - has since denied it was.

"At the direction of government, The Ministry of Business, Innovation and Employment (MBIE) engaged in a short period of targeted consultation with a number of stakeholders on the Immigration Rebalance proposals, including those for the Green List," said immigration policy manager, Andrew Craig. "The groups that were included in consultation that had interest in nurses were the New Zealand Aged Care Association (NZACA) and the Home and Community Health Association.

"Discussions with the Health Workforce Advisory Board, which has a representative from DHBs to represent DHB workforce interests, were also held. Ministerial consultation on the proposals occurred as a matter of course, and included both the minister and Associate Minister of Health."

RNZ asked last week for clarification of what, if any, input the DHBs' representative had and received a further statement today. It clarified that it asked NZACA and the HCHA about the Rebalance proposals generally, which included mentioning that nurses were intended to be provided a work to residence pathway through the Green List.

"MBIE officials only consulted directly with Ministry of Health on including nurses on the Green List," Craig said.

"Discussions were held with the Health Workforce Advisory Board, which has a representative from DHBs to represent DHB workforce interests, however DHBs were not directly consulted."

RNZ has again asked for which DHBs the prime minister was referring to that had requested nurses to be in the 'work to residence' category.

Retention problems

The Ministry of Health used district health board vacancies, exit rates from professions, 10-year forecasting models, Patient Flow Indicators and the advice of chief clinical officers to provide advice to MBIE.

The government highlighed retention problems as one of the main reasons nurses should be treated differently. An April email shared with the Prime Minister and the health minister Andrew Little, shows how many that amounted to - four percent of New Zealand-trained nurses left the profession in 2020 and six percent of internationally qualified nurses. For midwifery that rose to 6 percent and 10 percent respectively.

Ardern told RNZ nurses would have to wait two years for residence. "And the reason for that is we did have raised with us by some DHBs the concern about whether we were retaining everyone that was coming in as a nurse."

In the email supplied to RNZ under the Official Information Act, immigration told the prime minister and health ministers it applied a "high bar to provide a straight to residence offer, given that once residence is granted, any undesirable outcomes like leaving the occupation that permitted residence in the first place cannot be influenced by the immigration system".

But immigration lawyers say a mechanism does exist to do that - putting conditions on visas to keep migrants in certain geographical areas or professions.

A parliamentary answer from Immigration Minister Michael Wood to National's Erica Stanford shows officials did not put that option to his predecessor Kris Faafoi.

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