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

Extra money for health is welcomed but it falls short of meeting health needs and investing in the health workforce needed to meet health targets, say nursing and health leaders. They also question increasing tobacco tax without increasing investment in quit-smoking programmes and social supports needed to encourage people to quit.

Dr Mark Jones, a College of Nurses spokesman, says the extra $400 million year for district health boards will allow DHBs to extend their stroke to a "doggie paddle" but isn't enough to equip them to "swim against the tide of every increasing demand". (See 26 May 2016 Budget summary story in 'Newsfeed' for Budget details)

Jane McGeorge, acting CEO of the New Zealand Nurses Organisation, says that while NZNO welcomes the shift to social investment overall, there is still a significant shortfall in health funding, including investment in the workforce to support health initiatives.

The New Zealand Council of Trade Union analysis had calculated pre-Budget that district health boards would need an extra $551 million to maintain the current services, meaning yesterday's announcement of $400 million extra could be regarded as a funding shortfall.

Jones says the extra money going into primary health care simply isn't enough as it will all be swallowed up by the under-budgeted demand for providing children under 13 with free access to GPs and nurses. 

Anne Brebner, president of the College of Mental Health Nurses, says that the College would have liked to see more funding allocation to primary care to focus on practical ways for people to access mental health and addictions support earlier. She says there is an urgent need to support programmes and a workforce that target improving the physical health of people with mental illness, plus enabling easier access for people with mental health issues.

Rural General Practice Network chief executive Dalton Kelly says that the Budget provides no silver funding bullets for rural health but there should be trickle-down benefits from some of the health initiatives announced.

Jones acknowledges it was a difficult balance to distribute funding between people who need treatment right now (such as elective surgery) and preventing people getting sick in the first place, but he believes there is a real need for funding to support the return of healthy eating and health action (HEHA).

NZNO president Grant Brookes says that the government's ability to find funding to cover the extra costs of free GP visits shows the government can find more money "when it suits", which is why the underfunding of DHBs is"even more disappointing".

McGeorge says NZNO welcomes the shift to more social spending – particularly for protecting vulnerable children and in Whānau Ora, but the lack of cost pressure or extra funding for national child health services seems at odds with the focus on supporting children. She says NZNO would also like to see more active investment in the role of nurses in children's teams working with vulnerable children.

Also welcomed by NZNO was the increased funding to Pharmac but McGeorge notes that the extra yearly funding decreased rather than increased over the following four years, when it might have been anticipated that demand would grow because of the ageing population.

The first steps towards a bowel cancer screening programme are seen as positive, but NZNO believes the national rollout should be sooner rather than later and also requires investment in training staff such as nurses to meet the demand for increased endoscopy.

Jones says the bowel screening funding is edging a national rollout closer to the starting line, but questions whether New Zealand will be ready with the staff and resources to deal with the treatment demand resulting from screening.

Training

Cost pressure funding for health workforce training in the Budget is welcomed, says McGeorge, but there is a need for a greater investment in workforce training, particularly to ensure that every new graduate can obtain a funded place in a new graduate programme. Brookes describes the lack of investment ensuring every new graduate is properly supported into the workforce as "a failure of will".

Jones says from a purely nursing perspective there is a need to ensure that funding for ongoing education for nurses keeps pace with demand. He says the new nurse practitioner (NP) training scheme is a case in point and is an innovation that shouldn't be allowed to fade due to a lack of ongoing funding or DHBs not having the Budget security to create positions for the NPs being trained.

McGeorge says elective surgery increases are positive but again there needs to be investment in workforce training, including NPs, to ensure it does not put pressure on the existing workforce. There also needs to be more fair and effective formulas for ensuring equal access to surgery across the regions.

Tobacco

Jones believes that driving up the price of tobacco is not the answer to helping people quit smoking – particularly for people who smoke as "their one escape from the awfulness of their housing and general social circumstance".  He says what is needed is to adopt an interconnected health and social care strategy to help people choose not to smoke as their escape.

McGeorge says NZNO supports the rise in tobacco tax but questions why there isn't a matching increased investment in tobacco control and smokefree advocacy programmes, such as Smokefree Nurses Aotearoa.