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Nursing in New Zealand

Chief Nurse Newsletter, July 2008

Greetings colleagues,

July was pretty much taken up with a study tour to the United Kingdom in the company of my immediate colleague at the Ministry – Gabrielle Roberts (Snr. Policy Analyst for Nursing) and four practice nurse leaders. These were:

Debbie Davies, Nurse Coordinator Practice Development, Mid Central DHB and Chair, New Zealand College of Practice Nurses.
Wendy Findlay, Practice Nurse Professional Advisor, Southland Primary Health Organisations Vice-Chair of the National Committee of the College of Practice Nurses, and member of the Ministry Primary Health Care Advisory Council.
Rachael Calverley, Practice Nurse Wanganui, member of the College of Practice Nurses national committee.
Varina Flavell, Practice Nurse, Central Family Health, Whangarei, executive representative for Te Runanga O Aotearoa and NZNO.

More information on the tour and the work we've been doing to respond to requests for information in the lead up to the election is below:

Royal College of the United Kingdom’s Practice Nurse Association 25th anniversary conference, Cardiff

The opportunity to host this tour presented itself as a result of my being invited to act as a chair for the Royal College of the United Kingdom’s Practice Nurse Association 25th anniversary conference to be held in Cardiff, Wales. Now there’s a mouthful! Seriously though, this was a truly significant event in that it marked progress from the days when, in the UK, practice nurses were generally seen as just a pair of hands assisting GPs in their work, with no real need for decent conditions or professional development, to the situation today where a national career framework is in place, practice nurses lead the delivery of a substantial proportion of primary health care, and utilise skills such as prescribing to ensure people receive timely care from the most appropriate practitioner. All very commendable. I was particularly pleased to be invited to the event given the time I had spent working with the Royal College of Nursing in laying out the policy framework in partnership with government and GP leaders to enable all these things to come to fruition.

Tour details

So to the tour. We determined that it would be useful to take a group of nurses to Wales to both participate in the conference, and also to investigate the nature of primary health care nursing provision in that country. A more detailed report will be posted on this site in due course, but suffice to say we were warmly greeted at a range of GP practice sites in a variety of settings. We had the opportunity to visit Local Health Boards (LHBs) - an approximate equivalent of our PHOs - and understand how they configured themselves to assess the health care needs of their communities and contract for the best delivery solutions to address them. This included having robust governance systems with community and multidisciplinary representation, and the wherewithal to engage with all providers to ensure true quality care was being delivered, with the possibility to deploy salaried nurse and GP teams to take over failing practices. Although our time there was limited, it was clear that LHBs were well able to take an overview of how care was being delivered across their area of responsibility and work with providers to bring the best possible service to their population.

In addition to meeting with service providers and their support agencies, we had the opportunity to meet with representatives of the Welsh government. I was particularly pleased to meet with my counterpart, Rosemary Kennedy, the Chief Nurse for Wales. Rosemary described how her team engaged with colleagues within government providing the necessary nursing input to policy development. This particularly included a strategic input to workforce planning with her team being responsible for working with the health sector to identify the nature and kind of the future workforce and commission the appropriate places within the educational system. We were also fortunate to attend the first meeting of a ‘task and finish’ group Rosemary had convened to determine the future model of primary health care nursing in Wales. The group were on a tight schedule and we were honoured to be asked for our opinions as to how the service might be configured.

Anyway, more detail as to our analysis of the study tour and findings will be forthcoming. Of course nothing stood still whilst we were away and the ‘wonder’ of e-mail kept us in touch with work back home, anchored by team-member Christine Andrews. It will not have escaped your attention that we are in the midst of heightened political debate and the requests for information from all politicians interested in health policy and its impacts are increasing. You may be interested in this process.

Providing Advice to the Minister

There are several ways in which we provide information and advice in supporting the Minister of Health. The Official Information Act (OIA) sets out the framework for the release of information to the public. We have a set process for dealing with these requests that entails a straightforward release of appropriate information to the person(s) making an application within a given timeframe. From the Government – generally the Minister’s office – we may receive ‘briefing requests’. As the name suggests, such a ‘BR’ requires provision of information around a specific subject with an analysis of implications for health care policy and impact. Next we have the vehicle of an ‘health report’. The ‘HR’ is a more detailed analysis of a particular policy issue and will generally contain some recommendations for consideration by a Minister. HRs can be a two way process, in that they provide a mechanism through which we can provide information on a matter as requested by the Ministerial team, or provide commentary, advice and recommendations if we believe this might be useful to the governmental policy making process. Last, but by know means least in terms of their significance, are ‘parliamentary questions’. PQs might be provided in writing or asked of the Minister(s) during debate. PQs can be quite probing of specific information and aspects of health policy and governmental implementation thereof.

So, there are a range of means through which I and colleagues within the Ministry can be engaged in the governmental and political process. We work to provide the best possible range of information, analysis, and advice and of course do so with reference to a strict code of political impartiality. Our intent is to ensure that all information is accurate and able to be used to best effect to improve the health of New Zealanders. In our specific case that would be through an explanation and analysis as to why nursing is important and the support needed for our profession to make the best possible contribution to the health of our nation. The processes of OIA requests, BRs, HRs, and PQs may well be time consuming and at times pressurised, but at the end of the day they are essential means of ensuring those who are making significant decisions about our health system, and nursing’s place within it, are as well informed as possible. So now you know!

Keeping nursing issues centre stage

The nursing workforce is core to a well functioning modern health system. Keeping nursing issues centre stage is vital as we examine changes to models of care and creative approaches to service development and improvement. Supporting innovative nursing models is critical. Nurses are making, and can continue to make, an important and exciting contribution to the many priorities and pressures our health system faces. I look forward to working with you to achieve this.

Take care,

Mark Jones
Chief Nurse

Page last updated: 8 August 2008