Not long ago our clinical manager came to me with an all-too-familiar story. One of our registered nurses wouldn’t be returning from maternity leave. She loved her job, the place where she worked and the people she worked with but she could earn $10,000 a year more by working in a public hospital and she needed the money.
The government-generated pay gap between nursing positions in public hospitals and those in aged care facilities is seriously eroding the ability of rest homes right across the country to continue offering first-rate care. The situation has been worsening since 2018, when nurses working in public hospitals were awarded a significant and well-deserved salary increase.
However, this increase was not extended to the funding rest homes receive from District Health Boards – a per bed, per day rate based on the level of care specified by DHBs for anybody admitted to an aged care facility.
The result? We’ve lost six nurses to District Health Boards recently. And when you’ve got a young family to provide for who can blame them?
“So? Just pay your nurses more!” is the response I often get when I tell this story. It’s not as simple as that. There’s a reason that most retirement village developers don’t build aged-care facilities unless or until they absolutely have to. They’re staggeringly expensive.
We can, and do, subsidise our Care facility to some extent through the money we earn from our independent-living retirement accommodation. But this income needs to subsidise the entire facility, not just staff salaries. And as a community-owned and operated charitable business there is a limit to how much we can charge, and the elderly of our community can afford, for retirement accommodation.
And we’re the lucky ones. Most aged-care facilities across the country rely wholly or largely on capped government funding and run a very lean operation.
Daily, aged-care nurses look after more than 36,000 of NZ’s most vulnerable. This work is no less important, skilled or demanding than nursing in public hospitals. They have significant clinical responsibilities, leading teams of healthcare workers to look after frail people who often have multiple co-morbidities, without the support of the expert medical teams available in hospitals.
The cost to Government of funding pay parity for aged-care nurses would be around $70 million. Budget 2020 has injected $4.37 billion into District Health Boards so there can be no financial excuse not to invest in aged-care nursing and older New Zealanders.
As Northland Age editor Peter Jackson wrote recently:
“The disparity in registered nurse pay rates goes beyond unfair. It is unconscionable, severely impacting on homes' ability to provide non-negotiable levels of care that are dictated by the Ministry of Health, yet are not adequately funded… what happens when (one day) that level of care cannot be provided? Will standards be reduced, or will the public health system take over?
“The former would be unacceptable, the latter impossible.”
