Back in 1908 one of the country’s first Māori registered nurses and midwives, Akenehi Hei, struggled for a year to get the Government to fund its own plan to employ Māori district nurses to work with Māori.

Now 110 years on nurses working for Government-funded Māori and iwi health providers get paid – but have been struggling for over a decade for extra funding to close the near 25 per cent pay gap with their District Health Board nursing colleagues.

And that gap is now growing wider after a pay settlement that fell short of many stretched and stressed DHB nurses’ expectations but is looked at admiringly by many nurses working for Māori and iwi health providers, as well as their colleagues working at residential aged care facilities. Māori nurses have said ‘enough is enough’ and taken their longstanding pay and related grievances to the Waitangi Tribunal.

The aged care sector is also sounding alarm bells that the pay gap is quickening the exodus of nurses to the DHB sector and an already fragile workforce is fast heading to crisis mode.

It is acknowledged that some of the highest-needs patients in the New Zealand health system are Māori – the health statistics bear stark witness to unmet needs taking their toll – and the elderly, particularly the frail elderly requiring hospital or dementia level care.  

So why the pay gap when nobody can argue that the nursing is no less clinically challenging or the workload less than their DHB nursing counterparts?  Particularly as the three sectors are largely funded from the same pot – the Government?

Both Māori and iwi health providers and residential aged care facilities will tell you they are keen to pay their nurses more – but the different funding formulas for their sectors makes this financially unfeasible without an injection of extra government funds.

It seems simply fair that nurses should be valued equally wherever they work and whoever they care for. And it also just seems fiscally sensible to have a well-paid, clinically skilled and stable nursing workforce supporting some of the country’s highest need patients so they stay well in the community and don’t require expensive secondary care.

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