Nurses’ Union Chief Critiques Government’s Health Strategy

Paul Goulter, the chief executive of the New Zealand Nurses Organisation (NZNO), has publicly criticized the New Zealand government for what he describes as a dysfunctional health system and deteriorating relations with its workforce. Goulter attributes these issues to a fundamental lack of strategic vision and adequate resources, which he believes are crucial for resolving the ongoing health crisis.

Government’s Piecemeal Approach to Health System

According to Goulter, the government’s current strategy resembles a piecemeal approach rather than a cohesive plan. “The government has failed to get to grips with providing the necessary funding and resourcing for our health system,” he stated. He expressed concern that the absence of a clear vision could indicate an inclination towards privatizing parts of the health system, a trend he views as concerning. “Privatisation of the whole system, or at least major parts of it, is a pretty arid vision and certainly not supported by the evidence from countries which have gone down that path like the US,” he remarked.

Goulter highlighted calls from members of the Act Party for increased privatization of public health assets. While he refrained from categorically stating this was the government’s overarching policy, he acknowledged a visible trend towards privatization that could fundamentally alter the landscape of healthcare in New Zealand.

Challenges in Primary Care and Funding

Addressing primary care, Goulter identified several critical issues, particularly concerning health outcomes for Māori and Pacific communities, as well as access for rural populations and disabled individuals. He underscored that the primary challenge lies in establishing a sustainable funding model. “Fixing that funding model would go a long way towards shoring up the health system as a whole,” he asserted.

The recent announcement by the Labour Party regarding independent, fair pricing for general practitioners has been seen as a step forward, although Goulter pointed out that general practices are not the only component of the primary health system that requires attention.

Despite ongoing negotiations with the government for over a year, Goulter noted that the previous collective agreement expired in October 2024 with no resolution in sight. The NZNO had previously taken strike action under the former Labour government, and tensions have continued to escalate, complicating negotiations.

The relationship between the NZNO and the government has deteriorated, with Goulter emphasizing that the core issue stems from differing perspectives on how the health system should operate. “Should the health system be based on budget or be based on need? Nurses are really clear about that. Health system staffing should be based on need, not on budget,” he stated. He criticized the government for its commitment to budget-based staffing, which he believes is fundamentally misaligned with the needs of healthcare.

Goulter explained that the government’s tight control over budgetary resources has significantly hindered progress in negotiations. He clarified that the challenges are not solely the fault of health ministers or bargaining agencies but rather a systemic issue. “What the government has consistently shown is their inability to allow the people who actually employ nurses or employ firefighters or employ teachers to receive the funds they need to fix the immediate problems,” he said.

He characterized the situation as one where employing agencies exist in a “weird shadow land,” aware of what is needed yet unable to deliver due to funding constraints. “We go through episode after episode of essentially shadow bargaining, but really make no progress about it, and the workforce gets more and more irate about that,” he added.

Goulter concluded by warning that the impact of these disputes extends beyond immediate concerns. The ongoing anger and frustration from the workforce will not dissipate quickly, indicating a deeper crisis in the relationship between healthcare workers and the government.