“Ultimately, this is about building a workforce that is evidence-based, clinically led and … fit for purpose.”
Gray said most 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 new graduates and overseas hires.
The 380 figure was based on a recently completed “business as usual” review of workforce demand.
Mandatory minimum nurse-to-patient ratios are in place in Australia and other jurisdictions. 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 since to update ratio requirements.
In June, Victoria introduced legislation 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 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 need and nurses feel 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 supports a move to investigate nurse-to-patient ratios. Photo / NZME
Labour said the planned increase was “minuscule” and despite Brown having three years to “get the basics right in the system”, hospitals remained under “huge pressure”. Patients had died waiting in an understaffed Waikato ED and Gisborne ED was critically understaffed, the party said.
The party’s health spokeswoman Dr Ayesha Verrall said, “this is not a plan, this is panic”.
“For months nurses and doctors have been warning Simeon Brown hospitals are under pressure. Patients are waiting in corridors, staffing gaps are putting pressure on frontline teams, and health workers are saying they are at breaking point,” Verrall said.
“Now, after all those warnings, Simeon Brown is doing the bare minimum. That is not getting ahead of the problem. It is playing catch-up.”
Verrall criticised what she said was “a hiring freeze while workers pleaded for action”. In August, RNZ revealed strict recruitment practices had been put in place throughout 2024/2025 amid tight economic restraints and frontline hiring decisions required the sign-off of the regional deputy chief executive.
“New Zealanders shouldn’t have to wait for a healthcare crisis before the Health Minister acts.”
The health system has been under pressure for years. This was exacerbated during the Covid pandemic and continues to peak in winter. Health NZ said the most recent winter was particularly “tough” as patient volumes exceeded expectations.
As debate over addressing pressures 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 healthcare assistants at Waitākare Hospital’s Muriwai ward walked off the job for the second time this year.
The health system and staffing will likely be an issue this election as National and Labour debate the best way forward.
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 to interpret the data.
Health NZ said the material was 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.
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 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.