From nurse education, clinical, or workforce issues through to healthy living, Nursing Review has it covered.

Nursing leaders have praised the energetic-but-retiring Health Minister, Tony Ryall, for a number of his initiatives but reserved judgment on others.

Mr Ryall announced last week that after 24 years in parliament, the last six as health minister, he is to retire at the next election, which is just short of his 50^th birthday.

“I am looking forward to being part of New Zealand’s dynamic future in the private sector,” Ryall said on announcing his retirement.

Memo Musa, chief executive of the New Zealand Nurses, said Ryall recognised the importance of nursing which showed in his strengthening of the Office of the Chief Nurse, having nurse leaders on the National Health Board, and increased nurse involvement in district health board policy.

But he added that overall nurse workforce planning and development – apart from “silo” initiatives like reinstating the enrolled nurse role, the ACE graduate employment system, voluntary bonding scheme, some advancement of nurse prescribing, and the Safe Staffing Healthy Workplaces Unit – had not progressed.

He also said public hospitals and DHBs had been placed under a tight financial squeeze and the “blunt performance improvement approach” had been driven at the cost of public health and population health approaches. Musa also did not believe the proposal to merge the Nursing Council with other health regulatory agencies was in the “long-term interests” of nursing or public safety.

Professor Jenny Carryer, executive director of the College of Nurses, said Ryall had made some “excellent attempts to support innovation” and to better use nursing’s potential.

“But even a Minister of his energy and commitment was unable to override the grindingly slow bureaucratic processes that make change so desperately slow and cumbersome.”

She said Ryall had impressed her as a minister who stayed “very, very close” to what was going on, but she would have liked him to have “examined and critiqued the activities of Health Workforce New Zealand more closely”.

“It seems clear there have been gains made in delivering acute services more effectively,” Carryer added.

“But I have some personal concerns about the seeming corporatisation of primary care, the reduction in community participation in health services, and the very, very slow implementation of the nurse practitioner role.”

”On track to financial ruin”

Ryall said in 2008 the health system was “on track to financial ruin, but we’ve turned that around”.

“My more business-like approach has provided more services and better care for patients within a tight budgetary environment. 

“I am particularly proud of achieving record elective surgery, faster cancer treatment, and more effective preventive healthcare for New Zealanders.”

Rural General Practice Network chair, Dr Jo Scott-Jones, says Ryall will be “sorely missed” because of his keen interest in rural health issues, including the review of rural support funding and making the voluntary bonding scheme more rurally-focused and including primary care nurses.

"Tony has been the bright, neck- tied face of the Ministry of Health. He will be a hard act to follow as a skilled manager of contentious issues,” says Scott-Jones.

Ryall said many people underestimate the importance of the health sector which amounted to one-tenth of the economy with the public sector alone directly employing 70,000 people.

“And we have a very vibrant private sector too, with innovative and successful New Zealand companies like Fisher & Paykel Healthcare. There’s a wide group of NZ Health IT and medical device manufacturers whose innovation and expertise is developing technologies for here and abroad.

Ryall joined parliament in 1990 as a 26-year-old backbencher, took his first ministerial posts in 1997 -1999 under Jenny Shipley’s cabinet, became opposition health spokesman in 2005 and then Minister of Health in 2008 (and also initially Minister of State Services and then Minister for State Owned Enterprises).

The Massey University business studies and accounting graduate is based in Tauranga with his wife Kara and has two children Maisie (16) and Llewellyn (12).