Nurses will help ‘shape’ reforms: Minister

May 1, 2021

Health Minister Andrew Little has promised nurses will help “shape” profound changes mooted in the Government’s health reforms.

Andrew Little
Andrew Little

This promise comes amid warnings that nurses need to maximise their voice in planning stages, before those changes are set in law next year.


Little told Kai Tiaki Nursing New Zealand that “nurses and all health workers” would get an opportunity to shape the system and their role in it.


“My expectation is the new organisations Health NZ and the Māori Health Authority, both of which will have workforce planning and development functions, will be regularly engaged with all sectors of the health workforce to get the best out of it.”

In April, Little announced changes, to roll out over three years, which included replacing all 20 district health boards (DHBs) with Health NZ, and creating the Māori Health Authority.

The authority would be run by Māori, for Māori, with the ability to buy its own services, set policy and evaluate progress.


“Interim” versions of the organisations would work with health staff to plan how they would function. New legislation, underpinning the changes, would be in place by next April.

Other specifics, however, were still scarce on how the process would work – including funding.

‘Hutia te rito’

Acting NZNO chief executive Mairi Lucas said she wanted to acknowledge the effect of the reforms on nurses, “and the expected positive impact these should have”.

Nurses wanted to be heard, and were the “backbone” of the health system, she said. “We need to finally see equity in the way nurses are recognised.”

Lucas pointed to the Māori expression, “hutia te rito o te harakeke, kei hea te kōmako e kō?” (If you pluck out the central shoot of the flax, where will the bellbird sing?)

“If the heart of nurses is lost, where will our voices come from?” she said.

NZNO acting manager, nursing and professional services, Kate Weston, said nurses needed to maximise reform opportunities.

A “not-negotiable” would be nursing leadership at every level of the new entities – “visible nursing leadership that has actually got the authority to make change.”

Previous health reforms weren’t necessarily good for nursing – so this time, as a majority in the health workforce, they needed to “own it from the outset”.


“Where nurses have a strong voice and strong input, you tend to get improved patient outcomes.”

The Health Minister surprised many – including people in the health system – by the size of the proposed shake-up. The proposals went further than Health and Disability Review recommendations released last year.