logo
Health staff told not to talk to each other for more than five minutes a day

Health staff told not to talk to each other for more than five minutes a day

NZ Herald20-05-2025
Health NZ Southern said it did not have a 'no talking' policy, but the issue has still not been sorted out, despite Health NZ holding an 'amicable' meeting in March.
'The PSA has not resolved the issues here,' the union told RNZ on Tuesday.
'This is an issue between members and management.'
Emails between the Public Service Association and Health New Zealand's southern district - released under the Official Information Act - detail what the union organiser said were five 'significant' concerns.
'Requirements that there be no talking during the day – other than for five minutes in the morning,' said a PSA email in February.
'This prevents members supporting each other when difficult or upsetting things arise in their work, but it also feels very uncomfortable, unnatural and unduly restrictive.
'We would be interested in discussing with you, what the intention and aim of this direction is, with a view to agreeing on a more nuanced approach.'
Other complaints were about leave applications, career progression and an outdated bonding agreement
Breaks were also an issue.
'We understand that members are not allowed to take their breaks together.
'Again, this seems unduly restrictive and uncomfortable - and we would like to discuss alternative approaches with you.'
The source told RNZ: 'It may seem hard to believe, but this is the reality.'
Asked by RNZ for evidence of any 'no talking policy' in the hospital department - and who imposed it and why - Health New Zealand said: 'Health NZ Southern does not have a 'no talking' policy, as such, this part of your request is refused... as this information does not exist.'
The emails released under the OIA show that after a meeting with the PSA in early March, southern district team leader Sue Clark told the director of quality and clinical governance solutions, Hywel Lloyd, that they talked through the issues and 'the meeting ended amicably'.
The union wanted to meet on a quarterly basis, Clark said.
A PSA email in March reflected that. 'Normally I would not start management engagement with such a list of issues,' wrote the organiser, 'and I am sorry that that is how it worked out in this case. I do think it would be useful to keep meeting regularly.'
But the complaints have still not been sorted out, according to the PSA on Tuesday, while HNZ told RNZ back in March: 'We can advise that discussions/actions relating to the matters raised are ongoing.'
The PSA said it 'understands this is a localised issue and we are working through it with our members affected'.
It worked with all members and 'many employers' to promote a healthy workplace culture, it said.
Lloyd told RNZ there had been no personal grievances or formal complaints from records and coding staff about management in the past year.
'There have not been any other concerns raised with HR in relation to Southern Clinical Records and Coding staff for the past five years'.
It was 'standard practice and part of our effective working relationships policy' to encourage staff to raise any concerns with their managers, either directly or through their union representative 'to enable the resolution of matters at the earliest stage and at the lowest level possible', Lloyd's statement in March to RNZ said.
Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

Senior doctors' union worried national health plan lacks detail
Senior doctors' union worried national health plan lacks detail

RNZ News

time6 hours ago

  • RNZ News

Senior doctors' union worried national health plan lacks detail

Health Minister Simeon Brown blamed the delay in releasing the plan on the additional audit requirement, which was "imposed by the previous government". Photo: Calvin Samuel / RNZ The lack of detail in the national health plan for how Health NZ will meet its lofty goals, or pay for them, is especially worrying at a time when the public system is under massive pressure, warns the senior doctors' union. Auditor-General John Ryan has found Health NZ's plan - which was released last week, 18 months' overdue - had failed to show how it would deliver public health services , nor how much they would cost. Association of Salaried Medical Specialists principal policy advisor Virginia Mills said the fact there was no roadmap for delivering services, or even an estimate of "unmet need", was a damning indictment on the agency. "Essentially it means he's [the Auditor-General] been unable to vouch for the plan. And that's quite concerning because we've got a health system that's under extreme pressure at the moment, and we're not confident that this plan is going to fix those issues or deliver on better health for New Zealanders," Mills said. Of further concern was the fact that the Pae Ora (Healthy Futures) Bill, currently before Parliament, included a clause scrapping the requirement for the health plan to be scrutinised by the Auditor-General at all, she said. "That would be like if you got a school report to say your child was struggling, and instead of helping your child to do better, you called the teacher and said you didn't want the report anymore," Mills said. "It seems like the Government is saying, 'We didn't like this level of independent scrutiny. Let's get rid of that legislation'." Mills said both those things were at odds with the Government's claim that it wanted greater transparency and accountability. Health NZ blamed the delays in getting out the plan on its "immature" reporting systems, but said they were now bedding in. However, Mills said it was also possible that the focus on cost-cutting (from then Commissioner now board chair Dr Lester Levy's "Reset Plan") had made future planning more difficult. In a written response to RNZ, Health Minister Simeon Brown blamed the delay in releasing the plan on the additional audit requirement for the New Zealand Health Plan, which was "imposed by the previous government". "Removing it aligns Health New Zealand's planning processes with other crown agencies and allows the system to be more focused on delivering timely, quality healthcare care for patients," Brown said. "As part of making the system more efficient and focused on patients, we are also removing bureaucratic processes and aligning Health New Zealand's planning documents with other public sector planning documents." Health NZ would continue to have its annual financial statements and statement of performance audited by the Auditor-General, as required of all Crown entities under the Crown Entities Act. His priority was "to ensure everyone can access timely, quality healthcare whenever they need it, regardless of who they are or where they live", Brown said in a statement. "That's why, for the first time, we are putting health targets into law so every part of the system is focused on delivering faster care, shorter wait times, higher immunisation rates, and real results." Those targets would be included in the Government Policy Statement on Health, to which the New Zealand Health Plan would give effect. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.

GP funding changes will worsen Māori health inequities, expert says
GP funding changes will worsen Māori health inequities, expert says

RNZ News

time10 hours ago

  • RNZ News

GP funding changes will worsen Māori health inequities, expert says

The GP funding changes are proposed to take effect from 1 July 2026. Photo: RNZ A public health expert says the government's updated funding formula for general practices will fail to address the country's biggest health inequities because it excludes ethnicity. From July 2026, GP clinics will receive funding based on factors such as age, sex, rurality, socioeconomic deprivation and morbidity. The changes are intended to replace a 20-year-old model that largely used age and sex to determine funding levels. But public health senior research fellow at Otago University Dr Gabrielle McDonald said the government had ignored expert advice to also include ethnicity, despite strong evidence it was a powerful indicator of health need. "It's illogical," she told RNZ. "Leaving ethnicity out means [funding is] not going to be allocated to those highest areas of need, which will make accessing health care more difficult for Māori and Pacific communities." McDonald said data showed Māori lived seven years less than non-Māori and had higher rates of many serious illnesses, including cancer, even when poverty and other social factors were taken into account. "There's a lot of data that shows Māori don't get as good a deal from the health system as non-Māori. We've got a system that doesn't respond to Māori and Pacific people, it's geared towards the so-called majority Pākehā," she said. The funding formula is used to allocate money to general practices based on the characteristics of their enrolled patients. A 2022 government commissioned analysis by consultancy Sapere recommended it should include age, sex, ethnicity, deprivation, morbidity and rurality. "It was very thorough and they produced a high-quality report and put ethnicity in the funding formula because there was evidence to support that. "And so the government has said, yes, that's good, we will use that formula, but they've taken the ethnicity out, which is illogical," McDonald said. McDonald said removing ethnicity would make it harder to reduce inequities in primary care, which acted as the "gatekeeper" to the rest of the health system. "We know that general practices are the backbone of any good public health service. "Measures that don't aim to reduce inequities at that spot mean you're going to be playing catch-up throughout the health system if you can't reduce inequities in accessing primary care." She said including ethnicity was "highly justified." "We know our health dollar is really scarce and it needs to be spent where it's most needed. Leaving ethnicity out means it's not going to be allocated to those highest areas of need, which will make accessing health care more difficult for Māori and Pacific communities." McDonald has been a public health physician since 2011 and is a Pākehā researcher at Kōhātū - the Centre for Hauora Māori at the University of Otago. She has worked as a doctor for about 25 years, including extensive experience reviewing child and adolescent deaths. "I've spent a large amount of time reviewing child and adolescent deaths, and the inequity is very, very obvious there," she said. "Māori and Pacific children bear the brunt of many of the negatives of living in our society and they pay for it with their lives. We've got inequity in death rates for children and adolescents in almost all areas." Minister of Health Simeon Brown says Māori and Pacific peoples, in particular, will benefit from the updated GP funding model. Photo: RNZ / REECE BAKER In a statement to RNZ Minister of Health Simeon Brown said too many Kiwis were waiting too long for a GP appointment. "The current funding model is outdated and doesn't fully reflect the needs of patients," he said. "That's why we're making changes to the way GP clinics are funded to ensure money goes where it's needed most, with the revised formula going beyond age and sex to also factor in rurality, multimorbidity and socioeconomic deprivation." GP clinics serving communities with higher health needs would receive more funding to care for their patients, he said. "The reweighted formula recognises the impact that age, rurality, complexity and deprivation have on health outcomes, and will ensure resources are targeted to those with the greatest need. "Māori and Pacific peoples, in particular, will benefit from this change." The changes are proposed to take effect from 1 July 2026. Public health physician and Otago University research fellow Dr Gabriel McDonald says data shows Māori often face extra hurdles getting the right care and the same treatment as non-Māori, even when poverty is factored in. Photo: Supplied / Gabrielle McDonald However, McDonald said she expected the government to implement a "state-of-the-art, fully fit-for-purpose formula," but that the final version "ignored the ethnicity funding factor". "We know from the data that outcomes are not the same for Māori and non-Māori, even when you take into account poverty and other factors. "Māori face additional barriers to accessing care, to accessing appropriate care, and to receiving the same level of treatment once they do access care. There's a lot of data showing Māori don't get as good a deal from the health system as non-Māori." "And then there are the determinants of health, things like poverty, level of education and other factors, which we know are not equally distributed, with Māori marginalised in almost every area." She also believed the decision reflected a wider trend in government policy. "There's a lot of pushback to talking about the needs of ethnic groups, even where there's really good reason to pay attention to ethnicity." She argued the government should adopt a complete, evidence-based mechanism for funding general practices, rather than the partial formula announced, to align with its stated goal of needs-based funding. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.

Mental Health Services inquiry findings 'really concerning'
Mental Health Services inquiry findings 'really concerning'

Otago Daily Times

time14 hours ago

  • Otago Daily Times

Mental Health Services inquiry findings 'really concerning'

By Sam Sherwood of RNZ A forensic psychiatrist with nearly 30 years experience says unless an inquiry into Canterbury's Mental Health Services prompts real change there will be "more adverse incidents". The inquiry, by Director of Mental Health Dr John Crawshaw, found "significant" problems in the service's governance, care model and resourcing. Dr Crawshaw began his inquiry under section 99 of the Mental Health Act in June 2022, after Hillmorton forensic mental health patient Zakariye Mohamed Hussein murdered Laisa Waka Tunidau as she walked home from work. Hussein was on community leave at the time of the killing. The findings, released on Tuesday, included "critical staff shortages", staffing vacancies affecting admissions and discharge processes, a "siloed culture and care model", concerns about the service's governance and delayed resourcing decisions at the regional governance level. The final report, released three years after it began, has 18 recommendations aimed at addressing the key issues. Dr Erik Monasterio, a forensic psychiatrist with nearly 30 years experience, worked at the then-Canterbury District Health Board (CDHB) for 25 years. He was the Clinical Director and Director of Area Mental Health Services for the Canterbury Forensic Service between 2015 and 2021. Speaking to RNZ, Dr Monasterio said his first impression of the report was how the recommendations were going to be "implemented and opreationalised" in a way that would lead to "improvement in functioning and a reassurance around patient safety and reasonable standards being met". Dr Monasterio said the inquiry's findings were "really concerning". Issues around governance identified in the report were "at the core" of difficulties that had arisen, he said. He said he wrote a letter in late 2016 which was co-signed by other clinical directors of the DHB's mental health services addressing "likely implications" of the change in leadership and governance structure that had been identified in the report. "I forewarned that this change in leadership structure was going to undermine the viability of the services and likely lead to adverse outcomes. "So it's very, very frustrating that those concerns were largely ignored. And some of the issues that have arisen, a significant component of the issues that have arisen, are as a consequence of that change in leadership and governance structure." Asked how unsafe Canterbury's Mental Health Services were in 2022, Dr Monasterio said a lot of very experienced staff had left. "The knowledge at every level of the institution was significantly watered down. "The processes had become watered down. So in the absence of good processes and good leadership, you just don't know what you don't know. But you know you're sitting in a situation which is potentially very risky." Dr Monasterio said he left his role over concerns he had about the "viability of the service". "To the extent that I felt I couldn't remain in the leadership position because I felt that there were acute risks, both to staff and patients and the community, and I could not enact a positive change from within the institution and as a Forensic Service at the highest level of seniority that I could achieve." He said Dr Crawshaw's report "paints a grim picture". "The issues that are identified therein, unless people can convincingly show that they have an initiative and a plan to change that, then I think it'll just continue to get worse," he said. "Unless you get this right there's going to be more adverse incidents. I don't think there's any doubt about that." Consultant forensic psychiatrist Associate Professor James Foulds, who worked at Hillmorton for seven years until 2023, told RNZ he felt the report was a "fair summary" of the problems in the mental health system. "I feel sad for the people who have been affected by the poor state of mental health services in Christchurch - not just the families of the two people who were murdered but also the many people with serious mental illness who haven't been able to get an acceptable level of care, and the health staff who have suffered from working in this environment." He said there needed to be "accountability" from senior mental health service management in Canterbury. "Some of the senior managers who were present at the time have already moved on, but there needs to be a change in the culture of the organisation and that starts at the top." Dr Monasterio agreed. "Unless you change that culture, nothing's going to change." 'Critical' staff shortages Dr Crawshaw said the "most significant and prevailing issue" concerned staffing in the clinical areas, especially the adult inpatient, community and forensic services. "In the inpatient areas, there were daily issues in ensuring minimum safe staffing levels." The divisional leadership team had "significant concerns" about the number of staff vacancies and the "relatively junior nature" of the clinical staff in some areas. There were "critical shortages" of staff in many areas of the service, particularly inpatient units. "Clinicians frequently used the phrase 'on numbers', referring to being deployed to an inpatient unit to bring up the numbers of staff on a roster to a perceived safe capacity. "The inspection team heard concerns that people were working overtime and double shifts, to meet the 'on numbers' expectation. While the magnitude of the issue was unclear, it was raised repeatedly by staff in interviews. Some staff stated that they no longer wished to do overtime and double shifts due to the level of personal stress and strain it caused them." Staff 'afraid to come to work' In relation to nursing staff, Canterbury, like other services across the country, had a challenge with a "missing middle" - nurses who were "competent and experienced but still have a long career in front of them". When the inspection was carried out there was a group of staff nearing retirement. They appeared "fatigued and were possibly experiencing burnout". Some of the new graduates had been placed in "unsafe situations". "For example, a newly graduated registered nurse spoke of arriving for a shift at the forensic mental health inpatient unit and being told that they would be the shift leader, a task they felt wholly unprepared for." Some nursing staff were "afraid to come to work" with an "unacceptably high rate" of assaults on nursing staff by patients. "Staff reports of experiencing the clinical environment as unsafe were particularly prevalent in forensic services. There, staff described how a number of senior staff had recently left, particularly from the acute medium secure unit. "This had left both a gap in staff numbers and a gap in expertise. Some staff appeared to be distressed by and angry at the situation; particularly those working in the acute medium secure forensic ward." 'Significant failings' Health New Zealand (HNZ) national director of mental health and addictions Phil Grady acknowledged the "significant failings" identified in the report. HNZ was "committed" to implementing the recommendations to "prevent the tragic events of 2022 and 2024 from happening again". "We recognise the loss and grief these families have and continue to experience and express our sincere condolences to them. We are deeply sorry for the failings in our systems. "We have reached out to these families to apologise and discuss Dr Crawshaw's report, and will remain in contact, if that is their choice, to update them on progress to implement actions from the report." HNZ accepted all of Dr Crawshaw's findings and had an action plan in place to implement the recommendations, which focused on the underlying issues related to governance, the care model, and resourcing. "We are focused on continuing to provide senior leadership oversight of planning for the service, building a framework, and ensuring there is sufficient staff with the right level of training and experience to safely and effectively deliver services." Grady said there had been "demonstrable progress" on key recommendations including establishing a clinical governance framework and increasing clinical staffing by 11 percent since 2022. Clinical decision making on patient leave was "consistent with policies" and there were weekly audits of compliance in place. "There are clear pathways both within the service and nationally within Health New Zealand to escalate and manage risk." 'We are taking action' Mental Health Minister Matt Doocey said in a statement Waka Tunidau's death was a "tragedy no family in New Zealand should ever have to experience". "The release of this report today is an important moment. It shines a light on the long-standing failings in Canterbury's mental health services, failings I've been assured, there is a robust plan in place to address. "I have been upfront that we must do better to improve the mental health system and improve outcomes, this has been my top priority from day one." He said the government inherited a "long-standing fragmented and underperforming mental health system". "And this report underscores the scale of the challenges we have been left with and continue to face." Doocey said public and patient safety "must always come first". "I have made it clear to Health New Zealand that the issues identified in this report must be addressed urgently, and that progress must be visible and ongoing. "We are taking action. I have prioritised committing additional funding for forensic services, strengthening regional accountability, and growing the mental health workforce. Because every New Zealander should be able to get the support they need, when and where they need it, and those around them should have faith that they will be properly looked after while in care."

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into a world of global content with local flavor? Download Daily8 app today from your preferred app store and start exploring.
app-storeplay-store