“The health frontline is made up of nurses, health-care assistants and kaimahi hauora across all sectors in crisis, and. . . significant funds were needed in the Budget to address staffing and pay issues,” Goulter said.
NZNO had been “very clear” on this, yet the Government seemed “oblivious to the fact that it cannot have a robust and workable health system when there are chronic staffing issues that are worsening every day”, Goulter said.
Finance Minister Grant Robertson announced on Thursday May 19, $11.1 billion of new funding to run the health system over the next two years, plus $76 million for “workforce development” over the next four years — an amount Goulter described as “loose change”.
There was no mention of nursing wages or conditions, or how the Government intended to address the widening pay gap between nurses who work for district health boards (DHBs) and those in other sectors, Goulter said. “That is just going to perpetuate health inequities and staffing problems for non-DHB providers.”
“There is an increasing risk of essential health staff leaving New Zealand for overseas.”
NZNO kaiwhakahaere Kerri Nuku said it was “disheartening” with no investment in a “sustained public health response”.
Nuku said funding for workforce development across the Māori health workforce appeared to be “too small to address the wage parity issue” for nurses in Māori health providers.
“‘Māori and iwi health will continue as the poorest cousin in the health system. That’s a tragedy, really.”
Council of Trade Unions (CTU) policy director and economist Craig Renney said the changes in funding for health — especially longer-term funding — were “welcome and necessary” but did not go far enough to boost the health workforce.
“We have concerns that the money. . . will not prove sufficient to properly target need. $76 million of funding will provide part of the solution but not the whole amount,” Renney said in the CTU analysis.
Budget documents show a multi-year approach to health system funding “designed to support longer-term planning”.
There were more than 4000 nursing vacancies, difficulties finding enough mental health staff and widening gaps in pay between the public and private health sectors, Renney said. “There is an increasing risk of essential health staff leaving New Zealand for overseas.”
Nor was it clear how the money would be provided as the wording allowed for both training and development. “This might mean no new staff at all.”
“Māori and iwi health will continue as the poorest cousin in the health system. That’s a tragedy, really.”
The CTU was also concerned there was no extra funding for the health service reorganisation, due to launch this year, to follow last year’s $486 million. Health reforms were “expensive and time-consuming”, Renney said. “But the lack of even contingency funding being made available for reorganisation means that we have questions about how the costs of service redesign, above the $486 million already provided for, will be managed.”
More ‘secure and sustainable’ funding
Renney said moving from an annual to a two-year funding cycle may help the sector attain a “more secure and sustainable footing” over time, alleviating deficits. “However this will rely on the Government getting the funding right at each stage.”
However, the $168 million provided for the new Māori Health Authority (MHA) over four years appeared “small” in the grand scheme of things, he said.
While it brought the total investment into the MHA to $254 million — or $63.5 million per year, “in the context of a $20 billion+ system, this might appear to be a small amount of funding — around 0.3 per cent of health service purchasing,” Renney said.
Historical under-investment meant that essential hospital and other health infrastructure had not been in place to deal with challenges such as COVID, Renney said.
$11.1 billion over two years for paying off deficits and operating a newly restructured health system, including:
- $1.8 billion annually in 2022/23 for cost pressures including $520 million to clear historical debt.
- $1.3 billion per year for operational support will follow in 2023/24.
Other health spending includes:
- $76 million to grow the health workforce.
- $1.3 billion for health infrastructure such as hospital buildings.
- $202 million for mental health services.
- $191 million for Pharmac over two years.
- $166 million for road ambulances.
- $90 million for air ambulances.
- $168 million for the Māori Health Authority over four years.
- $70 million for Pasifika health over four years.
- $488 million for primary care.
- $1.2 billion for COVID-related public health.
For more details over coming days, see the CTU website.