Nursing jobs axed in Otago.

Up to 20 full-time equivalent senior nursing positions, including nine nurse educator positions, at Otago District Health Board (DHB), could be disestablished in a restructuring proposal aimed at saving $4 million a year. NZNO is fighting the proposal and the lack of consultation.

Restructuring has been underway this year, "in an effort to achieve improved effectiveness and to reduce costs," according to the DH B proposal. The executive team was restructured first, with the toss of the director of nursing, primary health and the integrated care manager positions. The senior management group was next, with seven clinical services groups reduced to four. The latest round of restructuring affects ward/unit/service management and leadership, with clinical charge nurse and nurse educator positions hardest hit.

NZNO's chief executive Geoff Annals said he was "appalled" at the DHB proposal which was "completely out of kilter" with the recommendations of the Committee of Inquiry (CoI) into Safe Staffing and Healthy Workplaces. He was also disturbed at the lack of consultation with NZNO. "This appears to be a re-run of the sorts of things we saw in the 1990s. It is very depressing, as it indicates DHBs have learnt nothing over the last 15 years," he said.

NZNO has written to DHB chief executive Brian Rousseau outlining its concerns--the lack of consultation; that the proposal flies in the face of recommendations of the CoI, particularly on the need for clinical nursing leadership 24/7; and that a number of DHB managers have claimed the costs associated with NZNO's Fair Pay settlement are behind the board's cost-savings drive. NZNO organiser Lorraine Lobb said the job losses must compromise patient care.

An affront to the profession

The DHB's chief operating officer Vivian Blake, has claimed the board was not removing staff who had direct patient contact. But Lobb denied this. "The nurses whose jobs are being disestablished are front-line nursing staff. Everybody in the DHB knows there are not enough nurses for clinical charge nurses and educators to sit in offices. The proposal to axe these positions is an affront to the profession," Lobb said. It was also ironic jobs were being axed at a time of national and international nursing shortages.

In the letter to Rousseau, Lobb said the proposal had not followed the agreed steps in the national DHB/NZNO multi-employer collective agreement (MECA) which called for reasonable notice to employees before any significant change to staffing, structure or work practices, to allow employees and NZNO to have "substantive input" into the consultation process. The letter said NZNO considered the proposal to be a breach of good faith in terms of the CoI recommendation on the need for clinical leadership 24/7 throughout hospitals.

NZNO, in the letter, also strongly objected to the claim that the cost of implementing the national DHB/NZNO MECA was behind the board's cost-saving measures.

All nurses affected

The job losses will affect nursing staff throughout the DHB. Lobb said DHB nurses were told of the proposal at meetings on September 28. This was the first those whose jobs were going had heard of the proposal. Those nurses subsequently received letters on Monday, October 2, informing them their positions would potentially be dis-established under the proposal.

Lobb said that, while 48 nurses were directly affected, it had had an impact on all DHB nurses. "Morale at Dunedin Hospital is the pits. This proposal is affecting every nurse."

NZNO industrial adviser Glenda Alexander, an NZNO representative on the CoI, said the CoI had been a high-level working party, which had undertaken a long process of consultation. "The DHB's proposal undermines that work," she said. NZNO professional nursing adviser Susanne Trim is particularly concerned at the loss of clinical leadership, and education and support available to nurses providing direct patient care. "The loss of this level of nursing infrastructure has significant implications for the quality of nursing care, professional development and ultimately recruitment and retention," she said. Trim said the proposal was reminiscent of some made during the health reforms of the 1990s. "Otago is not the only DHB restructuring and nurses are worried that gains made subsequent to the health reforms are at risk of being undermined." NZNO was to meet with senior board management about the proposal early this month.