NZNO — Tōpūtanga Tapuhi Kaitiaki o Aotearoa professional services manager Mairi Lucas said she was concerned at the proposal.
“We see this as another threat to nurses, the loss of leadership and the dilution of their roles.”
The proposed clinical leadership restructure, released this month, would merge 18 health districts into 14. The move would see the loss of four directors of nursing (DONs) — a role that often includes midwifery.
‘We see this as another threat to nurses, the loss of leadership and the dilution of their roles.’
The DONs would be replaced by part-time “nurse leads” in the four affected areas, while midwifery leadership shifts into one of four new regional “chief” roles, alongside other high need areas like mental health.
The move comes as an under-pressure Te Whatu Ora strives to save $2 billion and follows repeated promises by Te Whatu Ora commissioner Lester Levy that clinical staff would not be affected. But Lester told RNZ last week the clinical cut proposal was an “operational matter” and “overall” frontline expenditure would not be cut.
The proposed district merges are: South Canterbury with Southern; Midcentral with Whanganui; Capital, Coast and Hutt Valley with Wairarapa; and Bay of Plenty with Lakes.
Four district medical and allied health leadership roles would also be lost in the merger, with similar part-time roles replacing them.
Te Whatu Ora chief clinical officer Richard Sullivan, told Kaitiaki the aim was to “strengthen the clinical voice in decision-making” and ensure more consistency in clinical leadership around the motu.
Asked how cutting four frontline nurse leaders would strengthen nursing’s clinical voice, a Te Whatu Ora spokesperson said it would not be commenting further while consultation was underway.
The change would see 14 clinical nurse officers (CNOs), 14 chief medical officers (CMOs) and 14 chief allied health, scientific and technical officers reporting to the four new regional “chiefs” in each of the four regions — Northern, Te Manawa Taki, Central and Te Waipounamu.
No nurse ‘chiefs’?
However, nurses and doctors are omitted from the new lineup of regional “chief” roles — which comprise midwifery, mental health & addiction, kahu taurima (maternity/early years) and oranga hinengaro (Māori health).
‘We need your feedback. This is your opportunity to have a voice, and we need your voice.’
Acting as a “conduit” between national and local managers, the new chief roles were intended to ensure health services reached those populations most in need, particularly in maternity/early years and mental health and addiction, Te Whatu Ora’s internal consultation document states.
The chiefs would report to a national office, newly split along clinical and hauora Māori lines — a bicultural partnership proposal is being consulted on separately.
The restructure would improve “quality, access and equity” for hospital and specialist services, which still largely operated like the old district health boards, the proposal states.
‘We see this as another threat to nurses, the loss of leadership and the dilution of their roles.’
“Moving to a partnership leadership model with clinical leaders working in partnership with managerial/operational leaders, is a crucial step forward in transforming how we work both regionally and nationally. ”
‘Changes and impacts’ – chief nurse
At the online unveiling, Te Whatu Ora’s national chief nurse Nadine Gray acknowledged there would be “changes and impacts” at a district level, particularly for nursing, medical and other local clinical leaders.
Te Whatu Ora is urging people to feed back on the proposal, saying it is far from a “done deal”.
“I’ve heard a few of you talking about proposals for change being done deals – they’re not,” national chief midwife Laura Aileone said. “We need your feedback. This is your opportunity to have a voice, and we need your voice.”
The proposed restructure is out for a four-week internal consultation with Te Whatu Ora staff, till November 5 , with plans to finalise and implement by the end of the year. Affected staff were advised before the release.
NZNO chief executive Paul Goulter said anything that diminished senior clinical nursing leadership would be “concerning”.
A Te Whatu Ora spokesperson said staff had been provided with a link or could view the proposal on their local intranets. Feedback can also be provided to: [email protected]
Te Whatu Ora commissioner Professor Lester Levy. Photo: Stuff Ltd.