Chief Ombudsman John Allen found the agency acted unlawfully in refusing to release information.
Photo: 123RF
The nurses’ union says Health NZ’s attempt to suppress information about under staffing in hospitals was politically motivated.
Chief Ombudsman John Allen found the agency acted unlawfully in refusing to release the information, which showed more than a third of shifts were under-staffed.
Nurses Organisation strategic researcher Nathalie Jacques – who fought for more than a year to have the information released – said her request for information in April 2024 came at a time when Health NZ’s finances were under intense scrutiny.
It’s forecast $1.7b deficit was partly blamed on “over-recruiting” nurses ahead of budgeted numbers.
“The data didn’t align with the public narrative – narrative around funding and staffing,” Jacques said.
“The other thing was obviously we were in bargaining, and one of the factors in our bargaining with Te Whatu Ora – and the main issue that nurses are going on strike over tomorrow and Thursday – is safe staffing.”
The data on “shifts below target” was derived from the Care Capacity Demand Management, which calculates the number of nurses needed in each department based on how sick patients are and how many of them there are.
Hospitals that showed staffing levels persistently lagging behind patient needs were supposed to recruit more nurses.
Previous collective contracts had safe staffing levels baked in, but Health NZ has removed this from its current offer, saying it was an operational matter.
Jacques said she had previously received full data sets for 2022 and 2023, so it appeared the delays with the 2024 data were politically motivated.
“With the recruitment pause, freeze, it’s become quite contentious to preserve it.
“Nurses want to have some enforceability around staffing, because it’s critical for safe patient care.
“Care Capacity Demand is an accurate picture of who is turning up at the hospital and what they need – it’s a more accurate picture than what is budgeted.”
Health NZ initially said it needed more time to collate the data – but after four months it declined the request, saying it could prejudice contract negotiations.
In response to the union’s complaint, Chief Ombudsman John Allen has found the agency acted “unreasonably” and unlawfully in withholding the information.
The timeline
30 April 2024: Nurses Organisation strategic researcher Nathalie Jacques requests “Shifts below Target” reported for 2024 by district, and information related to how Te Whatu Ora is analysing and responding.
28 May 2024: (the day the response is due), Health New Zealand extends response time until 26 June 2024, to “carry out consultations”.
26 June 2024: Health New Zealand advises it has made a decision on request and collated most of the information but some has yet to be finalised. It says it will endeavour to respond by 12 July.
From 15 July 2024: Jacques contacts Health NZ several times querying the delay, and requesting the information.
5 August 2024: Health NZ responds to say it is still waiting for the information from the business unit.
12 August 2024: Health New Zealand apologises for the delays and refuses Jacques’
request under section 9(2)(j) of the OIA, “to enable it to carry on, without prejudice or
disadvantage, negotiations”.
However, despite the belated backdown, the union asked the Ombudsman’s office to continue its investigation into Health NZ’s “illegitimate grounds for refusal, and the delay and obstruction”.
“As we would expect to request the same information in future for different reporting periods, it’s important for us to have the process closed off formally with a clear finding from the Ombudsman about how this should have been handled,” Jacques wrote at the time.
Health NZ said it had apologised to the Nurses Organiation of its handling of the Official Information Act request.
National clinical director Dr Richard Sullivan said the “shift below target” data highlighted by the New Zealand Nurses Organisation was “not a proxy for understaffing”.
“It is a ‘moment in time’ measure, that is often capturing just five minutes of an eight-hour shift. Using this data in isolation to claim that wards are under-staffed and unsafe is misleading.
“Health NZ is absolutely committed to ensuring that we have the right staff and skill mix to deliver quality, safe patient care.”
Health NZ used a range of tools to determine the mix of staff rostered on a particular shift and the professional judgment of frontline leaders.
“For this reason, we don’t believe the current tool, which we don’t believe is used by any other country as a national tool, is fit-for-purpose.”
Patient safety measures such as in-hospital deaths, surgical site infections and in-hospital falls had been stable or improved over the last five years, he said.
“Right now, I believe the biggest risk to patient outcomes is the waiting lists for elective surgeries, first specialist appointments and the time it takes to be seen in emergency departments.
“We are actively working to reduce our waitlists, and the numbers are coming down as we boost services right across the country, but the ongoing strike action by nurses is impacting on this work.”
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