Today’s announcement by Minister of Health, Hon. Andrew Little, confirming additional funding to support pay parity for nurses employed in aged care, hospices and Māori & Pasifika health providers is good news for those providers and the communities they serve, but is a further snub to the country’s hard-working front-line general practice nurses according to the General Practice Owners Association of New Zealand (GenPro).
Speaking about the funding announcement, the Minister justified the differential treatment of general practice nurses by saying that there was no evidence of pay disparity between general practice nurses and their [Health New Zealand] Te Whatu Ora-employed, hospital-based counterparts.
GenPro Chair Dr Tim Malloy says the Minister’s continuing disrespect for general practice nurses is adding to the workforce crisis currently undermining family doctor (general practice) services and directly impacting patients as well as demand upon the wider health system. “It is incredibly insulting that essential front-line general practice nurses are again being treated inequitably compared to their counterparts elsewhere in the system and that will add further fuel to the fire that is leading to an increasing exodus of nurses and an increasing risk to the future of family doctor services”.
The evidence that there is a nursing pay disparity undermining family doctor services is compelling, and, according to GenPro, covers multiple independent sources, including:
- The actual MECAs* – the nationally agreed employment terms and conditions for nurses employed in general practice compared to the terms and conditions for those employed by Te Whatu Ora in hospital-based positions
- Industrial action – taken by NZNO members on Thursday 27 October 2022 is support of pay parity
- Section 14 Contractual Notices – between June and August 2022, dozens of separate Section 14 Contractual Notices were issued by individual general practices taking the unprecedented step of warning the government of significant risks to services as a result of underfunding (Issued partly in response to a 1 July 2022 funding increase of only 3% compared to CPI rates of 7.3%
- The findings of the Government’s own general practice funding review – Dated July 2022 (but only released in November 2022) which stated that general practice services are not funded adequately to deliver care for patients, which is a serious deficiency in a core part of New Zealand's health system. In addition, it observed that, the situation is consistent with constraint in general practice services, with difficulty in recruiting and retaining staff, and with rising barriers to access.
Dr Malloy says that feedback from GenPro’s members continues to support the 21 November 2022 publication of its own ‘On The Brink’ report and Open Letter to the Minister which highlighted the critical risk to patient care and impact upon hospital ED departments. “Multiple difference sources, including the Government’s own independent review, point to the same conclusion regarding general practice underfunding and the pay disparity for general practice nurses. I despair and question just how much evidence you need before you take action to protect patients and essential front-line health services”, he said.
GenPro’s ‘On The Brink’ report outlines a 9-point plan to address the sustainability of family doctor services including asking for fair pay for family doctor teams, pay parity for nurses, better support to increase the workforce and fair contractual terms for family doctor businesses.
MECA – Multi-Employer Collective Agreement The nationally agreed terms and conditions of employment for those nurses working in:
- DHB/Te Whatu Ora-employed hospital positions: https://www.nzno.org.nz/groups/health_sectors/dhb
- General practice positions: https://www.nzno.org.nz/primaryhealth
|
DHB MECA |
PHC MECA |
Difference |
|||
Per hour Sept '21 $ |
Per Annum FTE $ |
CURRENT PHC RATES |
To DHB Sept '21
Rates % |
Per Annum FTE $ |
||
Rates 1 Sept '20 $ |
Per Annum
FTE $ |
|||||
Step 7* |
39.88 |
83,190 |
36.02 |
75,138 |
10.72 |
8,052 |
Step 6 |
38.80 |
80,937 |
36.02 |
75,138 |
7.72 |
5,799 |
Step 5 |
37.75 |
78,747 |
34.96 |
72,927 |
7.98 |
5,820 |
Step 4 |
34.25 |
71,446 |
31.74 |
66,210 |
7.91 |
5,236 |
Step 3 |
32.57 |
67,941 |
29.84 |
62,246 |
9.15 |
5,695 |
Step 2 |
30.82 |
64,291 |
27.56 |
57,490 |
11.83 |
6,800 |
Step 1 |
28.68 |
59,826 |
26.14 |
54,528 |
9.72 |
5,298 |
Notes:
1 * No previous PHC Step 7 - comparison is to previous Step 6
3 Excludes Pay Equity and Retrospective Pay Equity Lump Sums
The Government Review into General Practice funding can be downloaded from the Department of the Prime Minister and cabinet website here: https://dpmc.govt.nz/publications/proactive-release-future- capitation-funding-approach
On The Brink: Saving New Zealand’s family doctor service can be downloaded here: https://www.genpro.org.nz/docs/onthebrink.pdf
GenPro’s Open Letter to the Minister can be downloaded here: https://genpro.org.nz/docs/openletter21- nov-2022.pdf