Nurse practitioners at their biennial conference questioned Health Minister Dr David Clark about the Government’s funding priorities for NPs and called for targeted funding to grow more rural, Māori and aged care NPs.

It was the first time a health minister had addressed a Nurse Practitioners New Zealand (NPNZ) conference and a number of NPs from across the country grabbed the chance to highlight concerns when he spoke at the conference yesterday.

Far north NP Pauline (Polly) Brennan called for more targeted funding to train more Māori and rural NPs to address needs like those in Northland where there were GPs in their 70s unable to retire because there was no-one to replace them. She also spoke out about housing needs for people returning to the north with some being unable to access insulation funding because their shack-like homes are unlined. “If they have a blue tarpaulin from the Warehouse up as part of their wall they are not going to get any insulation”.

Clark said he would make no budget commitments on the spot and a first step would be to boost the Māori RN nursing workforce; but he would look at Brennan’s call for targeted NP funding as a Government priority was to tackle health inequalities as well as address housing issues.

Bay of Plenty Aged Care NP Louise Fowler spoke up about the impact of boosting DHB nursing funding and staff was having on the already stretched residential aged care sector which struggles to hold nursing staff. She said there were real inequities in nursing staffing levels for rest home and hospital level patients and her vision was for every facility to have an NP to support and inspire new graduates and other nurses to see how ‘sexy’, complex and satisfying nursing in the aged care sector was. Clark said the marked funding disparities between the DHB and non-DHB health were an issue the Government was looking at.

Other NPs and NP interns expressed concern about support for Pacific NPs and issues with being knocked back by DHBs from pursing NP training in a secondary health specialty as the DHBs were saying training primary health NPs was the priority.  “If that is the message you are getting that is wrong in my view,” said Clark who told the conference that in his view New Zealand should be training NPs “across the spectrum” of healthcare.

Set pathways for NP and RN careers needed, says minister

Clark in his address to the conference said he had been asked to speak about health’s future but wanted first to acknowledge the challenges of the past for NPs including barriers that hindered their ability to work to the full breadth of their skills and competence.

“Initially the New Zealand health environment – including policy, regulation and legislation – simply wasn’t ready for you.  And over time many of these barriers have been broken down. And I know many of you in this room will have worked tirelessly to make that so.”

Clark said he was aware the conference audience included RN prescribers and NP interns and wanted to acknowledge the Nursing Council’s leadership in implementing RN prescribing and smoothing the transition from RN prescriber to NP.  “We need set pathways for career development for nurses.”

“However it has been disappointing to hear that some qualified NPs are not employed in that role currently,” said Clark.

“I am asking more district health boards to put more emphasis on professional development for nurse practitioners.  I want them to take a more strategic approach to nursing, career development and the employment of NPs in the future.  And I’ve had a few conversations with the Director General of Health about precisely this.”

“It’s important that health professionals can reach their full potential and work to the full extent of their skills and scope.”

He also called on NPs to share their expertise with major Health and Disability System Review (established nearly a year ago) currently underway to ensure  public health services were sustainable into the future but also to gain greater health equity for all New Zealanders.

Clark told the conference that the Government’s response to last year’s Mental Health and Additions Inquiry was due at the end of the month.

“While some things can be addressed in a relatively short-time many of the issues we face will take many years to address,” said Clark.  “As an example you can’t magic up a senior nurse overnight…and in the area of mental health I think we need quite a few more.  And I expect NPs to have a major role to play in the work around mental health and addictions.”

He also highlighted that the cost of health care remains a barrier to health equity with the last National Health Survey showing close to 600,000 New Zealanders said they couldn’t visit primary care due to cost – about 15 per cent of the adult population.  “For Māori its worse with 1 in five (20%) Māori adults saying they couldn’t visit their general practice because of cost. It’s unacceptable”.

Funding for cheaper general practice visits was put in place from December 1 and Clark said he hoped primary health NPs were already seeing some improvement in access as a result.

He ended his speech by saying he believed NPs were an incredibly valuable workforce that made a real difference to the health and wellbeing of New Zealanders.

“And you have an important role in helping the Government to achieve its priorities – particularly in achieving equity because of your reach into our communities.”

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