It is still a case of ‘wait and see’ for what the Government has tagged to try and resolve the nurses pay deal without a winter strike – but the Budget does bring more nurses in schools.

In a big but not bold Budget for health there is an extra $1.5 billion for health next year – the largest chunk a $750m boost to capital expenditure to repair and fix leaky, mouldy and run-down hospital buildings but also a $549m boost to district health board operating funds and $100m to help support DHBs in deficits (see Budget details at a glance in this Health Central article)

The Budget doesn’t include any signals about funding allocations for the current stalled pay negotiations between the 20 DHBs and the New Zealand Nurses Organisation(NZNO) with final recommendations from the Independent Panel, set up to try and resolve the dispute without a winter strike, due at the end of the month.

Finance Minister Grant Roberston said this morning to Radio New Zealand that he could understand the frustration of nurses but while the parties were still in negotiations it could not reveal the funding tagged for the deal. But the Government’s ‘Tagged Contingencies’ fund to cover wage negotiations and other financially sensitive initiatives has set aside an extra $46m for the rest of 2017-18 and an additional $360m for 2018-19.

Memo Musa, chief executive of NZNO, said there was a ‘decent increase’ in health spending but there was still away to go to make up for 10 years of neglect. “This budget shows a roadmap to rebuilding the health service from the foundations up, literally”. He said he hoped the extra funding would also give DHB management “some room to spend on increasing the nursing workforce”.

“We welcome the focus on primary health care funding and increase in spending through the expansion of the nurses in schools programme, now accessible to another 240,000 students at decile 4 schools, is excellent as is the pilot programme of counselling for 18 to 25 year olds who need to access it,” said Musa.

Professor Jenny Carryer, executive director of the College of Nurses Aoteroa, said extending funding for nurses in schools to include decile 4 public secondary schools can only be called a good move, but there should really be appropriately paid and supported nurses in every school.

She said there was quite a discrepancy in the pay, working conditions and access to professional development between nurses paid through Vote Health in low-decile schools and nurses paid via Vote Education.

“This is a step in the right direction, but given the fragility of youth health and rapid rise in mental distress and sexual health issues, it is just a very, very small start in the right direction.”

Carryer was also frustrated that the Budget stated that the extra primary health funding was to reduce GP fees and did not make clear that the increase in capitation funding was for the whole general practice team, including nurse practitioners (NPs), practice nurses and other health professionals.

“Why do we have a brand new minister still talking about GP fees? NPs will get the funding so why don’t we talk about the general practice team not just GPs?  Why do we keep one workforce invisible in the public eye?”

She said it was understandable that any allocation for safe staffing and fair pay in DHBs was not made public. “They couldn’t do anything else at this stage really.”

Overall she said what she was looking for in this Budget was signs that the Government had the courage to do some things differently and this hadn’t happened in this Budget.  She said she realised that a lot of basic investment needed to be ‘topped-up” in this Budget and she was glad that had been done

“But I’m hoping going forward that the coalition Government has the courage to be a lot more courageous about doing some things differently.”

NZNO Kaiwhakahaere Kerri Nuku welcomed that funding for National Māori Health services, that are for services for or by Māori, had increased by over $4m. She added that the Healthy Homes Guarantee and the Warmer Homes programme were excellent initiatives to protect vulnerable families and to address respiratory illness, particularly in children.

NZNO president Grant Brookes said the focus on child poverty, warm housing and housing affordability, combined with the overhaul of the welfare system was “most welcome” along with the focus on increasing access to government support entitlements.

Labour’s election promises included delivering nurses in all public secondary schools, not just expanding to decile 4, plus an extra 100 Plunket and Tamariki Ora nurses, but these were not funded in this Budget.

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