A Plunket spokeswoman Jen Riches last week confirmed that Plunket was proposing disestablishing 53 positions in the Central region’s – which covers the North Island south of Auckland – and replacing them with 34 positions.  The positions relate to administrative, leadership, and community services roles with Plunket’s government-funded Well Child nursing services not included in the Central region restructuring proposal but the New Zealand Nurses Organisation (NZNO) says Plunket does propose moving from four clinical services manager (i.e nurse leader) positions to two.

This month Plunket chair Christine Lake has also sent out a public appeal seeking “urgent support to raise $150,000 by 5^th March 2018 so Plunket can keep life-changing community programmes running”.  She said childcare and parenting groups were not easily accessible in high need communities and Plunket trained and supported volunteers with the skills needed to develop playgroup and manage other programmes that led to “more supportive, connected communities”.

The Central region proposal follows Plunket consolidating its regional societies into a single entity last year. Riches said Plunket was focused on providing a “consistent range of community services” to families across the country including how to “best support consistent and equitable service delivery” in the central region where Plunket would be serving around 19,00 new babies and their families in the coming year.

The proposal is for 53 staff to have their roles disestablished and to be replaced with 34 roles – 18 of these to be re-confirmed roles, 15 contestable roles and one newly created role.  Riches said the proposal was “by no means a decision” and there was still some way to go before decisions were made.

Chris Wilson, NZNO’s industrial advisor for the primary health care sector said it was currently in a “robust consultation” with its affected members before making a submission to Plunket.  She said a number of the job changes were due to the Central Region proposing reducing the number of operating areas to two.  She said this included reducing the number of clinical services managers (nurse leadership positions) from four to two while having the same number of clinical leaders and nurses to manage.  The proposal also included reducing the number of administration team leaders from 6 to two and a reduction in administrator roles.

Wilson said it appeared the changes would lead to less people managing more staff in a centralised structure.

“Our initial concerns would therefore be sustainable workload management for the staff affected and equitable access for rural and smaller communities to appropriate Plunket services.”

In late 2016 Plunket voted at its national annual general meeting to consolidate its 14 area societies into a single national charitable trust by the end of 2017 to enable Plunket “to deliver more equitable outcomes for its community services” and manage its property more efficiently.  Lake said at the time that while Plunket delivered Well Child services in most part of the country.  through its Ministry of Health contracts, its other services – such as parenting education programmes and play groups – were “not being universally provided because of a lack of local volunteers and fundraising”.  She said as a charity Plunket relied on the effort and generosity of supporters to keep delivering its services that weren’t funded through government contracts.

NB article updated at 3pm January 29 to include NZNO comment

O’Malley, who has been Chief Nursing Officer for seven years, is to become Plunket’s first Chief Nurse in March, in a role reporting to Plunket chief executive Amanda Malu.

O’Malley said it was a coincidence and “unfortunate timing” that her announcement followed shortly after Director General Chai Chuah’s resignation. She added that she had a “great deal of respect for Chai and his vision for the future” and was not leaving because he was leaving. “Sometimes great opportunities come up and you need to grab them with both hands.”

O’Malley said she was very much looking forward to working with the Plunket leadership team on their strategic vision as it was a “perfect fit” with her own health philosophy.

“My belief in the New Zealand Health Strategy – and in particular that we can make better inroads into improving people’s health by paying attention to the early years – is reflected in Plunket’s vision for the first 1000 days of life,” said O’Malley. That it was also a nurse and consumer-led organisation also fitted well.  She said she would bring with her to Plunket a wealth of knowledge about how the machinery of Government worked and how policy was developed.

O’Malley said she had mixed feelings about leaving her current role as she had loved her time at the Ministry. Some of the highlights were the coming into effect in January of the long-awaited Health Practitioners (Replacement of Statutory References to Medical Practitioners) Act – which removes legal barriers to nurses and nurse practitioners working at the top of their scope – plus the development with the Nursing Council and NNO (national nursing organisations) Group of the now three levels of nurse prescribing.  Also the creation of the ACE new graduate job system which meant there was now a database of new graduate job hunters which had helped employ more new graduates as vacancies arose.

“There are lots of good things to celebrate and time really for me to move on to something new,” said O’Malley.

She said once it was known in the New Year about the appointment of an acting Director General she would be keen to ensure that the Chief Nursing Office position remained at the executive level of the Ministry and reported to the Director General.

“Because nursing is the largest workforce and it is, I believe, the workforce that if better utilised will take us into the mid-Century.  So we need a strong leader at the top,” said O’Malley.

Plunket chief executive Amanda Malu said the appointment to O’Malley to the new role recognised the importance of the nursing profession to Plunket.

New Zealand Nurses Organisation Chief Executive Memo Musa acknowledged the hard work Chief Nursing Officer Jane O’Malley had done to increase nursing input into Ministry of Health policy and congratulated her on her new appointment.

Musa said  that during Jane’s seven years of service she had overseen an increase of resources at the Ministry to ensure the advice from the nursing profession is effective and timely.

“We want to see more nurses at the top table of policy discussion and development, and there is still more to do to make sure nursing is fully utilised to its full scope in order to care for people, whānau and communities and improve health outcomes,” Musa said.

“We look forward to working with Jane in her role at Plunket as she works to advance and promote the hard work nurses do in their delivery of world class nursing services to mums, whanau and babies.”

Professor Jenny Carryer, executive director of the College of Nurses said O’Malley had been instrumental in ensuring nursing’s contribution to health policy was stronger than it had been “for a long time”.

“The size and positioning of the Office of the Chief Nursing Officer under her leadership has finally been positioned in a way that enables appropriately significant input,” said Carryer.  “Jane has worked so hard across so many fronts and her contribution has been huge.  Her passion for child health will be well matched in her new position and the College of Nurses wishes her well.”

O’Malley was the director of nursing for the West Coast District Health Board when she was appointed to the Ministry of Health role – then called Chief Nurse – in 2010.  She had also been a president of the New Zealand Nurses Organisation (from 2001-2005) and is a former clinical nurse manager and nursing academic.

Parliament is today to sit under urgency to debate the Families Package (Income Tax and Benefits) Bill.  The bill would bring into effect the package announced yesterday that aims to bring 88,000 children out of poverty through a combination of higher Accommodation Supplement changes, more generous Working for Families scheme, a “Best Start” payment for parents of young babies, and a “Winter Warmer” grant for beneficiaries and superannuitants.

Memo Musa, chief executive of the New Zealand Nurses Organisation said nurses had seen an increase of child illness due to poverty and damp, poor living conditions so welcomed the package’s increases – particularly the Winter Energy Payment.

“Increasing money directly to families may well be the difference to having to access a health professional for some illnesses because affording healthier food or extra medicines and adequate, quality clothing can help to prevent illness.”

“Kiwi kids suffering from preventable illnesses are often linked directly to living in poverty. Increasing minimum wage, reduced health check fees, increase in parental leave and the Family Package are all key steps to reducing illness that nurses are saddened to see on a daily basis,” Memo Musa said.

Radha Balakrishnan, Plunket’s chief strategy and performance officer, said with Plunket nurses seeing 9 out of 10 babies born in New Zealand they see first-hand the impact of poverty and poor housing on child health – “particularly on Māori and Pacific communities who bear the brunt of this burden on our children”.

“We welcome Government action to level the playing field, and address the inequity of health and wellbeing outcomes among New Zealand’s tamariki and whanau,” she said. “We will be looking for further action to tackle systemic issues that are having an unacceptable impact on children’s health.”

Paula Bennet, National’s spokesperson for children, described the Government’s package as bluster and said National’s Families Income package was projected to lift 50,000 children out of poverty on April 1 2018 and it had committed to a further package in 2020 that would have had a similar effect.

“Labour has reverted to type by throwing billions of dollars at poorly targeted hand-outs, including over $3000 baby bonuses that go to everyone, irrespective of whether they need it or not, said Bennett. “During our term in Government, the number of kids in material hardship fell by nearly 40 per cent to 135,000 in 2016.

Andrew Becroft, the Children’s Commissioner, described the package as “really positive steps” as raising family incomes, enabling warmer and more support for the first year of a child’s life would contribute to improving outcomes for children.

He said the office would be monitoring whether the projected aim of raising 88,000 children out of poverty by 2021 was successful through its ongoing Child Poverty Monitor (which has just received continued funding from the JR McKenzie Trust for a further three years). “We look forward to seeing the significant improvements in the wellbeing of children that this package promises.”

Associate Professor Susan St John, the economics’ spokesperson for the Child Poverty Action Group, welcomed the package as a “long overdue response to the disastrous child poverty experienced since the 1990s”.

“But there are still some complex issues and CPAG would welcome working with Government on ways to simplify and extend the package,” said St John. “We would especially urge the Government to help the very worst-off children who are still excluded from the full package.”