Health Minister David Clark says he understands health workers’ hopes for better salaries under the new Government but the reality was that “not everyone’s expectations will be met”.

Clark was responding to questions from Health Central about New Zealand Nurses Organisation members rejecting the 20 district health boards’ pay offer of roughly two per cent a year, amidst expectations that the incoming Government may be more open to funding a more “respectful” offer.

The minister said he would not comment on the negotiations – that are due to go to mediation at the end of the month with NZNO not ruling out industrial action if a better offer was not reached – or wished to pre-empt the mediation outcomes.

“But I can understand firstly why those nurses might have hopes of better things. This is a government that wants to see a more sustainable health sector. We don’t intend to run it down like our predecessors did. We want to ensure there are healthy workplaces and safe staffing and more sustainable funding over time.”

He said he needed to better understand why the NZNO negotiating team thought the initial pay offer would be accepted by members and why it was rejected.

“But the public also has an expectation based on the priorities outlined and the promises made that there will be more services delivered.”

“So the money that we pledged to put into healthcare won’t all go into salary raises,” said Clark.

Not everyone’s expectations will be met. I think that is the reality and I think we need to be upfront about that,” he said. “But a Labour government recognises the need to have a sustainably funded workforce and the need to make sure we have safe staffing and healthy workplaces.”

Action on mental health front while Inquiry proceeds

Prime Minister Jacinda Ardern and Clark yesterday announced the Ministerial Inquiry into Mental Health and Addictions which is due to report back to the Government in late October.

Clark said in the interim it would be moving ahead with other actions including putting nurses into every secondary school in the country.

“Because there’s good evidence that works.”

He said he couldn’t pre-empt any Budget announcements but the school nurse initiative was expected to be rolled out after the coming Budget. Lowering the cost of GP visits by $10 was another one of the actions that could help address the issue of access to health care which many Kiwi’s had reported as a problem – particularly those from lower socio-economic backgrounds, said Clark.

But he said the broader questions of how to best redirect the mental health resources that were currently in the system, would be a question for the review.

For mental health professionals currently stretched by the increased demand for mental health services he said DHBs would be better funded and there was an expectation that some of that money would be ringfenced for mental health to ensure that the “care that New Zealanders deserve and expect will be delivered”.

“I think the only reason our health system is in the good shape that it is because of the good grace of the workforces that have been subject to underfunding over the last nine years.”

But he added that it would take time for extra money committed by the new Government over the next four years to be put back into the sector to help build back-up the mental health and other health workforces.

“If we’re going to retain staff and build those workforces we are going to have to address issues like safe staffing environments and healthy workplaces.”

“For those people who have hung in there and gritted their teeth for nine years and I guess the difference now there is actually hope that there’s a Government that has clearly run (an election campaign) and got a mandate for putting a lot more money into health than the previous government.”

Scrapping public health service and setting new Health targets

The Prime Minister Jacinda Ardern told reporters at the Labour caucus retreat at the weekend that it was scrapping the National Government’s Better Public Services targets – that included new antenatal and reducing child hospitalisation targets.

Clark has said along with dropping the Better Public Service targets he would be looking at a new set of Health targets than the current six (which include improved access to elective surgery, shorter stays in emergency departments, and childhood immunisation targets).

“I’ve been critical of the near exclusive focus in health on short term elective (surgery) targets in public reporting,” said Clark.

“I want to see meaningful changes in public health outcomes and that will require a broader and better set of accountability measures.”

He said the elective surgery targets in particular have lead to public hospitals focusing their energies on delivering high numbers of additional surgeries and getting there by virtue of doing more skin lesion removals and Avastin eye injections.

“If you look at the bigger DHBs like Counties Manukau, Auckland and I think Waikato and the Bay of Plenty and possibly Northland – where the populations are growing the number of elective surgeries – if you take out skin lesion removals and eye injections – has actually dropped in recent times.”

He said such actions by DHBs points to the “unintended consequences of setting targets without looking at the bigger picture of population health outcomes”.

We’re less interested in dressing things up and more interested in real results and ensuring that NZers get affordable access to quality health care.

“My job as Minister of Health is to defend the interests of the patient. I’m not there to represent any particular workforce but to ensure the best outcomes for the public patient and that involves ensuring that the workforce is sustainably funded and we have healthy workforces and safe staffing level.

“That’s what makes people want to continue working in the sector. Because everybody actually gets into healthcare because they want good outcomes for patients. My job is about facilitating the environment that achieves that goal that people go into the sector.”

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