“Ultimately, this is about building a workforce that is evidence-based, clinically led and … fit for purpose.”
Gray said the majority of the 380 fulltime and permanent staff Health NZ was seeking to hire would be nurses. New hires would also include healthcare assistants who offer bedside patient care.
One quarter of the new hires would be in emergency departments. Recruitment would begin immediately and likely include a mix of new graduates as well as overseas hires.
The 380 figure was based on a “business as usual” review of workforce demand that was recently completed.
Mandatory minimum nurse-to-patient ratios are in place in Australia and other jurisdictions internationally. Required ratios vary by hospital department or region.
For example, in 2015, Victoria passed a law requiring wards or sites within its public health system to have a minimum number of nurses or midwives. The legislation has been amended in the years since to update ratio requirements.
In June, legislation was introduced in Victoria to mandate 1:1 nurse to patient ratios in intensive care units and a 1:4 midwife-to-patient ratio in post-natal and antenatal wards on night shifts.
Gray said if Health NZ were to adopt the nurse-to-patient ratio model, it would be an isolated measurement but used along with other tools.
Health Minister Simeon Brown said he supported Health NZ’s move to investigate nurse-to-patient ratios, which he said was a “key evidence-based step” to ensure patients get the quality of care they needed, and nurses felt safe to deliver it.
“The way we currently calculate nursing staffing has been in place for 20 years, and it no longer reflects the needs of patients or the realities nurses face on the ward and in the community.
“This work will help make sure we have the right nurses, in the right places, to care for New Zealanders. I look forward to seeing it progress.”
Health Minister Simeon Brown. Photo / NZME
For years, the health system has been under pressure, which was only exacerbated during the pandemic, and continues to peak during winter periods. Health NZ said the most recent winter was particularly “tough” with the volumes of patients exceeding expectations.
As debate around addressing pressure in the health system has continued through successive governments, the number of nurses and their working conditions have been a theme of contention.
That has led to several strikes among nurses, including as recently as Monday when nurses and health care assistants at Waitākare Hospital’s Muriwai ward walked off the job for the second time this year.
The health system and staffing will almost certainly be a looming issue this election as National and Labour debate the best way forward. Health NZ said today’s announcement was independent of Health Minister Brown.
Last month, an investigation by the Herald revealed almost a quarter of all nursing shifts in the public health system were at some point understaffed. At Starship’s cancer ward, for example, only two-thirds of shifts were fully staffed in 2025.
The Herald obtained never-before-seen data for 739,503 hospital shifts across 615 wards in 67 health facilities across New Zealand in 2025. Health NZ and the nurses union, the NZNO, fundamentally disagreed on how that data should be interpreted.
Health NZ says it’s relatively meaningless and not useful – yet it has invested in it as its main staff monitoring system for 20 years – and can represent “five minutes or less of under-resourcing within a ward over an eight-hour shift”.
The union argues it shows patients often aren’t getting the care they need.
Earlier this morning, RNZ reported that Dannevirke Community Hospital has stopped taking new patients after several resignations. New admissions would be paused for the next 30 days after local doctors in the Tararua District raised safety concerns.
Julia Gabel is a Wellington-based political reporter. She joined the Herald in 2020 and has most recently focused on data journalism.