Nurses sceptical National's bonding scheme will fix shortage

Nurses say National's idea of paying off a chunk of new graduates' student loans will not help fix the country's shortage.

And the Health Minister has labelled the opposition's pitch to nurses as "tokenistic", saying increasing overall pay rates is the answer.

National's policy would see nurses' students loans reduced $4500 a year, for up to five years, as long as they stayed working in the New Zealand health system.

"If we look at the greatest number of workers that we're short in any one sector who are at that interface of life-threatening conditions, it's nurses and midwives," Dr Shane Reti, National health spokesperson, told Morning Report on Monday.

"The 4000 nurses roughly that we're short - 3000 in public and at least 1000 in private - that's the area that's really sort of holding back the health system, that's really hurting us at the moment that we want to address."

Reti said the idea had backing from nurses they spoke to in focus groups while developing the policy.

"There's three points of impact," he explained. "The first is we're hoping that with a programme like this, that we'll see more nurses or more people enter nursing, firstly.

"Second, those nurses who are struggling with cost of living at the moment who haven't pushed out this student loan component that you can use towards cost of living, which is just over $300, maybe if they know there's some relief at the end of the programme, they might get some relief here now.

"And then of course, those nurses who then graduate, they come out for those five years, we'll give them student loan relief ... up to five years afterwards if they stay in the system."

While this would not financially benefit anyone who did not have a student loan or was already working, Reti said they would benefit from having more colleagues - so less having to do overtime, for example.

Asked if nurses could just get paid more, he said "pay equity and pay parity are in the pipeline in this current government at the moment, and so that will address those issues, or some of those issues around pay equity and pay parity".

Reti said there were other policies still to come targeted at the health sector.

'You haven't changed the environment'

Nurses Organisation kaiwhakahaere Kerri Nuku told Morning Report the lack of resources was driving staff out, and another bonding scheme would not do much to stop that.

"You haven't changed the environment, which is the problem at the moment. So we've got short-staffing, lack of investment in nursing, unable to give quality of care because of that, etcetera, etcetera. So, this doesn't change the environment that they're going into.

"People are burdened, they're burned out, they're tired, they're unable to give the quality of care that patients deserve. They're going home broken because of that, so it's more than just the pay."

She said figures had shown past and existing incentives to stay in healthcare, post-graduation, have not worked. The Te Whatu Ora website said "historical workforce data" showed a 27 percent higher retention rate for nurses on the voluntary bonding scheme than those who were not.

Nuku had a more radical suggestion for incentivising people into the nursing sector.

"If we're in a crisis, why aren't we making learning free? If we're in a crisis, we could even look at options of earn as you learn."

Health Minister Ayesha Verrall said that was in the works.

"Te Whatu Ora is actively working on that proposal right now," she told Morning Report. "We think it's a great idea to keep people who are either nurses in training or those who have come into the health system as part of the Covid-19 response."

As for making nurse training free of charge, Verrall said it already was free for the first year - like any other tertiary study. But extending that for specific courses was "outside my portfolio", she said.

"I think in terms of the priority we give to issues, my focus across the health workforce is making sure we settle these major problems of lack of pay equity, and so raising pay is absolutely the government's first priority. I'm eager to get onto the position where we can start talking about... measures that support people through the training pipeline."

She agreed with Nuku of the Nurses Organisation that another bonding scheme targeted at student loans would not be effective.

"Raising their pay not only helps them pay their student loan, but shows them that they'll be valued and have the opportunity to progress throughout their career. It makes nursing more attractive for graduates and that's what we've done.

"Secondly, that scheme only rewards those who are able to see through their training, and we know that there's substantial drop-offs in nursing trainee numbers when they hit the time for their placement."

'Extremely disingenuous'

Reti also defended a claim he made on Friday that 19,000 nurses had quit the health workforce since Labour took over in 2017.

"Almost 19,000 nurses have left over the last five years under Labour," he claimed in a release, at a rate that "has been steadily [increasing] each year".

Verrall said he failed to note that 19,000 figure included nurses who had simply changed roles, and were still in the health workforce.

"I put out her full press release and that disclaimer on Friday," Reti protested. "I think what's important here, what we should really be focusing on, is the trend - that increasing trend."

Attached to Reti's release on Friday was Verrall's written response to his parliamentary question, in PDF format. It noted that individuals may have been counted more than once if they had split roles, or held roles in more than one district; and included " people who leave one district to work in another".

Verrall said it was not possible to break down the numbers any further, claiming she told Reti before he released the figures that they "do not reflect the number of people leaving the health system … yet he put that out in a press release nonetheless anyway".

"That was an extremely disingenuous reply there from Dr Reti."

Verrall said the number of nurses overall in New Zealand was rising - 4100 more over the last five years in Te Whatu Ora alone, and "an increase in practising certificates to 65,490".

But she acknowledged the country was still thousands short, which she partly put down to the pandemic.

"I do accept that we have nursing vacancies that we need to fill, and the most effective way that we can do that is to pay nurses what they're worth. That's why the government has recently made a pay equity interim payment to nurses that puts up their salary...

"That not only incentivises young nurses to come into the profession, but it keeps more senior nurses working and makes us competitive with Australia. Our base pay rates for the first time ever are the same as Australia's, so it's incredibly important that we've made that progress rather than the tokenistic [offer from National]."