A nursing educator says now is the time to boost the number of Māori nurse practitioners.
Māori make up nine percent of nurse practitioners, compared with 17 percent of the population (file image). Photo: 123RF
Nursing schools have united to call for doubling the numbers, but health officials say the current funding that has already significantly increased numbers, will continue as it is.
Māori make up nine percent of the 612-strong practitioner workforce, versus 17 percent of the population.
The national coordinator of training Josephine Davis said that was too low, even though the approach was proven to produce skilled medical professionals committed to staying in their Māori or rural communities.
"We're not able to increase it at the numbers that we know we need to, to get a nurse practitioner workforce that looks like our population percentages," Davis said.
"We've got [health] reforms ... coming into effect. If we're not going to do it now, when are we ever going to do it?"
Only two percent of nurse practitioners (NPs) are Pasifika.
A Te Whatu Ora Health New Zealand spokesperson said their overall numbers had grown by 15-24 percent each year since 2017.
Decisions about further investment in NPs would be made by the government, Te Whatu Ora and the Māori Health Authority Te Aka Whai Ora, the spokesperson said.
"In the first few months, we will be working on initiatives to expand workforce, implement national initiatives to support catch up on specialist services and strengthen public health services.
"Providers will also experience more flexibility in funding and/ or changes in regulations to allow them to grow more workforce and shift tasks to other professions [such as kaiawhina, or non-regulated health roles] so their scarce clinical skills can focus on those who need it most."
It would shortly publish an interim national health plan.
"This two-year plan will include a suite of actions to address any variation among districts and build a platform for greater consistency," the spokesperson said.
It would be superseded by the country's first-ever national health plan, in 2024.
RNZ asked the Māori Health Authority to directly comment on the nursing schools' joint proposal to expand training. It did not - the request was submitted via Health NZ because Te Aka Whai Ora does not have its own media requests channel.
Nurse practitioners cheaper to train than GPs
Most of the training is delivered under a $2.3 million a year contract, that includes $750,000 for Māori, who made up 20 percent of the 2022 intake - 11 enrolled nurses out of 50 total.
Another 30-40 nurses largely pay their own way to get a Masters degree to become a practitioner.
They do only two-thirds of the clinical hours of the others.
Co-leader of the nurse practitioner workforce programme Dr Sue Adams said they would "never offer general practitioner training which is just two-thirds of another programme".
"The broken record that we need more GPs is actually a nonsense when we could be investing in, at a much lower cost, the training of NPs.
"It was so disappointing to receive such an inadequate response to our request to extend what is a relatively meagre amount of funding to ensure all registered nurses across Aotearoa have access to a national programme of NP education and training."
Auckland, Victoria and Otago Universities hold the 2020-2024 training contract, following a pilot in 2016.
"We argued at the time that this was the wrong approach, that we needed a truly national approach to it," Adams said.
But the Ministry of Health "don't seem to get it. They didn't go for that".
That struggle now seemed set to carry on with Health NZ.
Davis said trainee numbers were capped too low despite the NP approach fitting well with Te Tiriti principles.
"The potential of all our schools of nursing coming together, willing to work together, we've never had that before," she said.
Te Whatu Ora said the ministry was "pleased to see the universities involved working collaboratively together".
Davis said without a boost now, nothing would change for years, since nurse practitioner training usually took four years.
A secondary track to becoming a NP has been via the now-defunct district health boards.
But Adams said their questions to the ministry showed it was not tracking how DHBs spent the $28,000 per trainee.
"In many DHBs this money is used for several postgrad nurses and doesn't reach the NP," she said.
"Their funding has created a very inequitable system."
That post-graduate nursing funding has now been transferred to Te Whatu Ora.
"This is a great opportunity to immediately pull back that money that is allocated supposedly for nurse practitioners," Adams said.
"Let's put that all together and let's make a really substantive programme where all nurse practitioners get the same training."