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Importing overseas nurses is a major factor in driving down wages and pay equity in the aged care sector, says nurses union NZNO.  The hard-hitting discussion paper on nurse migration also advocates halving New Zealand's reliance on overseas nurses by 2030.

The New Zealand Nurses Organisation document that looks into the "unsustainable and fluctuating import" of internationally qualified nurses (IQN) also calls for a 'fair playing field' for wages and conditions and a single agency for the recruitment of overseas health professionals.

Memo Musa, NZNO chief executive said the organisation supported migrant nurses as a vital part of the New Zealand workforce but wanted to see greater self-sufficiency and sustainability for the New Zealand nursing workforce.

New Zealand has the highest dependence on migrant health professionals of any OECD country with about 25 per cent of the nursing workforce overseas-trained. Last year the Nursing Council registered 1134 IQNs of which 643 (55%) were from the Philippines and 232 (20%) from India.  In the same time period 1841 New Zealand-trained new graduate nurses were registered.

NZNO is calling for New Zealand to gradually reduce the proportion of IQNs in the workforce to meet the WHO global health resources strategy goal of halving the current reliance on IQNs by 2030.  Including better long-term nursing workforce planning and the employment of all new graduate nurses in a funded NETP programme.

Monina Hernandez, president of the Filipino Nurses Association of New Zealand, said she would be consulting with the association’s leaders and the association would be preparing a full submission in response to the discussion document.

Musa said many IQN coming to New Zealand went into aged care facilities in positions that were not well supported or paid.  “Nursing in New Zealand must become a fair playing field with wages and conditions that attract New Zealand nurses on an equal basis with international nurses."

The 11-page IQN discussion document said it was concerning that statistics indicate about 40 per cent of the IQN cohort work in the residential aged care sector where the average RN salary, according to a recent Immigration New Zealand report, was $40,900 – a lot less than the current DHB new graduate starting salary of $49,500.  It said the pay gap was one of the major pay reasons for skill shortages in the sector – the other being heavy workloads and responsibility.

"The inescapable conclusion is that immigration is a major factor in driving down wages and pay equity in this sector," the report says.  "It is not acceptable that skilled IQNs are discriminated against or exploited in this way, or that immigration is used to undermine New Zealand employment conditions and relations."

NZNO in 2014 called for all nursing categories to be removed from Immigration New Zealand's Essential Skills in Demand (ESID) list citing that recruitment difficulties in the sector were due to inferior employment conditions and not shortages. The entry criteria was tightened for acute hospital nursing categories there was no change for aged care nurses because of ongoing shorages in the secto 

The document also calls for a 'coherent immigration strategy' that focuses on ethical and sustainable recruitment of IQN including a focus on retention of IQNs, offering greater job security and ensuring the rights and protection of IQNs according to the WHO Code of Practice on the International Recruitment of Health Personnel.

It says NZNO "vigorously opposed" the Government's decision in October last year to tighten of the points requirements for skilled migrants to gain residency which is estimated to halve the number of aged care IQN nurses eligible for residency. It said this, along with other proposed changes, would fuel turnover and adversely affect retention of IQNs.

Musa added that DHBs also appeared to lack commitment to supporting New Zealand nurses into senior positions and appeared to be misusing the accredited employer gateway to recruit international nurses into top-level vacancies 

“NZNO advocates for a comprehensive overview of nursing supply and demand to reduce overreliance on migration and underinvestment in nurse education and employment to ensure a stable self-sustainable workforce," said Musa. 

The 11-page IQN discussion document advocates for:

• Long-term nursing workforce planning to avoid volatile swings in labour demand and supply including employment of all new graduate nurses in NETP programmes.
• The development of a stable, self-sustainable nursing workforce consistent with International Council of Nurses (ICN) policy including strategies for retention of IQNs.
• Ethical recruitment of IQNs according to the WHO Code of Practice on the International Recruitment of Health Personnel.
• The development of New Zealand health sector English language and cultural competency tool
• A single agency for overseas recruitment of health professionals
• And alternative pathways to registration for Pacific nurses living in New Zealand to help address the health needs of the Pacific population.