3 October 2023

By Fiona Kingsford, Whānau Āwhina Plunket Chief Executive

As we count down to the election with all eyes on the political leaders dishing out little sweeteners on the campaign trail to entice the undecided voter; there’s been much focus on rising crime, the cost-of-living crisis, and the poor state of housing. When it comes to healthcare, much of the focus is on our overrun hospital system; Emergency Departments brimming, wait lists for surgery never-ending. But the problem simmering away that no one seems too keen to talk about is the underfunding of primary and community care.

The lack of pay parity for nurses and healthcare workers is seeing much needed valuable staff leave for higher paying jobs in our hospitals, hampering our ability to provide vital care and support that is designed to keep people well and out of the ED waiting room.

Our Plunket nurses, kaiāwhina and community Karitāne see around 290,000 tamariki every year. As a charity, and Aotearoa New Zealand’s largest health and wellbeing support service for whānau with tamariki under-five, we play a vital role in keeping our community healthy.

Right now, we are short of 35 nurses and nine kaiāwhina or community Karitāne. With these vacancy rates, the reality is we are potentially missing 140 visits to whānau with tamariki under-five every day.

That’s 140 opportunities to identify health issues early, link whānau up to other health and social support services they may need to give pēpi the best start in life - lost.

The research is crystal clear. The first 2000 days lay the foundation for a child’s entire future; it is a critical period that impacts lifetime health and wellbeing. Evidence shows that by investing in whānau both antenatally and in the early years of life, we can make the biggest difference to lifelong and intergenerational wellbeing. So where is the investment in our nurses, kaiāwhina and community Karitāne who are crucial to pēpi getting the best start in life?

It’s gut wrenching when nurses exiting out the door say things like “I have really enjoyed my time with Plunket, however I am struggling to meet everyday living costs for my family with my current salary.” Or when the nurses and healthcare worker job applications dry up when they learn the pay difference.

Who could blame them for looking elsewhere? Our nurses are paid on average $11,000 or 13 percent less than Te Whatu Ora. The difference for kaiāwhina or community Karitāne is up around $16,000.

I’m in awe at the kaimahi who choose to stay. In South Auckland, one of our most impacted areas, multiple teams are pitching in trying to cover the staffing gaps, and some nurses are carrying double caseloads supporting 1000 whānau. But the reality is, we are having to prioritise seeing babies and our most vulnerable whānau first. That means sometimes, we can’t get to whānau with older tamariki on time and sometimes they miss out.

Our frontline kaimahi are highly skilled and dedicated to supporting whānau in the early years. They establish a rapport with whānau, some have clients that they’ve supported over many years as they raise their whānau. It is pretty soul destroying for them having to explain to whānau why this time round, they can’t guarantee they’ll be able to provide the same level of support, see their child for their age-related development checks because they are so short staffed. On the back of that, is the community criticism that Plunket is not delivering – another blow for the frontline.

We are totally committed to the health reforms – improving the health and wellbeing of all New Zealanders by focusing on keeping people, their whānau and their communities well and out of hospitals – not just caring for them when they get sick. Plunket exists to support whānau in the early years so that every pēpi has the best start in life.

We are one health system. Our nurses and healthcare workers need to be remunerated equally. The additional amount of funding required to pay our workforce parity with equivalent Te Whatu Ora roles is approximately $10 million. This increases to $12 million from 1 April 2024 when the Te Whatu Ora workforce received their contracted 3% increase.

The next government needs to commit to pay parity for our workforce. It is an investment in the next generation, supporting tamariki to start well. Every child in New Zealand deserves that.

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