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More recognition for nursing wanted.

The Ministerial Review Group (MRG) Report correctly identifies the major problems and barriers to innovation and efficiency in health and health professionals' willingness to meet them, according to NZNO. In a comprehensive response to the report, NZNO generally supports its recommendations and says they are closely aligned to those of the 2006 Safe Staffing Healthy Workplaces Committee of Inquiry Report.

But it calls for a stronger commitment to nursing and is disappointed that what the profession can and is doing in terms of innovative care is not acknowledged. "We acknowledge the government's genuine commitment to nursing and its desire to include the nursing voice in clinical management ... But it is not enough to use the term 'clinicians' to imply a shared powerbase between doctors and nurses, while real governance and business structures virtually exclude the expert input of nurses. New models of care require new governance structures with substantive representation from the largest, most flexible, scientifically trained and skilled health professional group, if they are to deliver the innovation and efficiency gains envisaged," NZNO's submission states.

NZNO pointed out the Ministry of Health had strengthened its nursing advisory contingent to just three, "but the medical voice in almost every sphere of influence, from Pharmac committees, to primary health organisations (PHOs), and indeed in this report, is overwhelming. The result is that risks go unnoticed, while opportunities for the spread of innovation are stifled."

The lack of a nursing perspective on the MRG meant the serious risk of the impact of the rapid rise of the unregulated workforce had been overlooked in the report.

NZNO supports commitment to a nationally planned and funded health system, led by health professionals (in collaboration with management) and focused on patient-centred care. But it has reservations about the establishment of a national health board, separate from the Ministry of Health, and concerns that the costs of transition could divert money from frontline services. It is also concerned that such a board could potentially be politically less accountable.

NZNO supports the establishment of a national health workforce board and is pleased the MRG has recognised the current reliance on overseas trained health professionals and the associated problems with recruitment, registration and retention. "However, the report is less robust around the wider ethical, industrial, public safety and sustainability issues this very heavy reliance poses," according to NZNO.

NZNO supports the proposed National Quality Agency but has reservations about expecting it to be ultimately self funding. "Experience in the aged-care sector shows clearly that voluntary adherence even to sector agreed minimum quality standards is rare," the submission states.

NZNO acknowledges the success of Pharmac in delivering the best value for money spent on pharmaceuticals and sees great merit in applying the same principles to the national procurement of other essential supplies and equipment.

NZNO supports the rationalisation of PHOs to optimise efficiency and reduce waste but is cautious about rationalisation on the basis of enrolled numbers alone. This would likely increase rather than reduce disparities, by making "access" PHOs, which serve disadvantaged communities, less viable.

NZNO is concerned there is no commitment to partnership with Maori or recognition of Tiriti o Waitangi responsibilities in the report. "It is important to articulate the fundamental principles of equity, partnership with Maori and acknowledgment of the broader socio-economic determinants of health in any document pertaining to health in Aotearoa New Zealand."

NZNO would Like a commitment to consistent employment practice and pay parity across all health care providers, to boost productivity and reduce inequitable health outcomes.

NZNO's response to the report was largely developed through a focus group of members and staff who examined the report in detail. The submission is available on

The Government has received more than 100 responses to the report and the feedback is available on
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Title Annotation:NEWS AND EVENTS
Publication:Kai Tiaki: Nursing New Zealand
Geographic Code:8NEWZ
Date:Oct 1, 2009
Previous Article:Correction.
Next Article:One generic scope, en as title and education at level 5--NZNO.

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