Welcome to the re-launched Mental Health Nurses Section Newsletter

There’s always a bit of excitement around Issue 1 of a new periodical – and so it is, for us. 

Born of necessity after the demise of the Stop4th Nursing Information Provision Service (SNIPS), which provided our content up until July, the MHNS Newsletter will now showcase the International Journal of Mental Health Nursing. Each issue will feature a local article from the journal and the contents list. Full access to the journal is a benefit of MHNS membership. To obtain an article, please email library@nzno.org.nz with the citation of the full text article you would like. The MHNS Newsletter now be coming to you bimonthly, matching the IJMHN publication schedule. 

Committee news

The MHNS Committee met over two days on 18-19 November. Due to the Covid Alert Level in Auckland, the meeting was a blend of Zoom and face to face participation. 

Our full agenda included discussions with the MOH Deputy Director of Mental Health, Toni Dal Din, and MOH Principal Advisor Anne Brebner. Toni spoke to us briefly about reviewing guidelines for statutory officers, for the transport of special patients and for seclusion. 

But the bulk of his kōrero was about the repeal and replacement of the Mental Health (Compulsory Assessment and Treatment) Act 1992. The first phase of consultation on transforming our mental health law closes on 28 January, with further consultations to follow. Drafting of the new legislation is due to take place in 2023. The MHNS Committee will ensure that members’ voices are heard in this process.

Anne Brebner spoke about the role of the Specialist Services Team and the other parts of the Ministry which it interfaces with. A major piece of work for her team is the forthcoming Mental Health and Addiction System and Services Framework. This will guide the first major reconfiguration of the sector since the Blueprint for Mental Health Services in 1998. 

We also discussed the review of the NZNO Constitution. As one of the movers of the 2020 remit for a full and independent review, the MHNS Committee is represented on the Constitutional Review Advisory Group. The independent consultants who are assisting with the review zoomed in for this agenda item. 

The November meeting farewelled Philip Ferris-Day and James Mather, who are both stepping down to pursue new opportunities. We are appreciative of Phillip’s long service and many contributions on the Committee over the last four and a half years, and we are very grateful that James and former Committee member Cecil Williams will continue their “on the ground” assistance in preparing for the 2022 Mental Health Nurses Forum. The Committee is now: 

  • Helen Garrick (Chairperson)
  • Margaret Daniela (Minute Secretary)
  • Jennie Rae (Treasurer)
  • Brent Doncliff (Committee member/Facebook group administrator)
  • Grant Brookes (Committee member/Newsletter editor)

Committee vacancies – call for nominations

The departures of Philip Ferris-Day and James Mather mean that the MHNS Committee is now looking to co-opt two additional members. This is an opportunity to get a taste of Section leadership, for a shortened term up until the Biennial General Meeting in August 2022. We invite any new, emerging leaders to join us. Please click here for the nomination form. Nominations close 17th January 2022. 

2022 Mental Health Nurses Forum – Registrations now open

As announced by email on 1 December, the rescheduled Mental Health Nurses Forum is back on for 2022. Presented in collaboration with Southern District Health Board, this MHNS Forum is an excellent professional development opportunity for any Mental Health Nurse.

  • Date: Friday, 18 March 2022
  • Venue: Hutton Theatre, Otago Museum, Dunedin
  • Theme: “Capacity and Duty of Care”

REGISTER HERE
Click here for the forum flyer.

All details can be found on the Mental Health Nurses Section webpage. We look forward to seeing you there.

NZNO Mental Health Nurses Section Committee 

IJMHN, Vol. 30 No. 6, December 2021

Issue Information
Pages: 1471-1472 

Mental health, climate change, and bushfires: What’s colonization got to do with it?
Kisani Upward RN, BN, MPhiL Candidate, Vicki Saunders BPsych, MPH, PhD, Myfanwy Maple PhD BSW (Hons) GCTE GCAdolHlthWlf GAICD, Kim Usher AM, RN, PhD, FACMHN
Pages: 1473-1475

Understanding the factors that affect retention within the mental health nursing workforce: a systematic review and thematic synthesis 
Rosie Adams MSc, RMN, Tony Ryan PhD, Emily Wood PhD, RN
Pages: 1476-1497 

Improving the physical health of young people with early psychosis with lifestyle interventions: Scoping review
Ting Ting Hui RN, BC, MNP, PGDipMHN, MMHN, PhD Candidate, Loretta Garvey RN, BN (Hons), GCHPE, PhD, Michael Olasoji RN, BN (Hons), PGDipMHN, PhD.
Pages: 1498-1524 

An integrated review of the barriers and facilitators for accessing and engaging with mental health in a rural setting
Philip Ferris-Day RN, MMH, Karen Hoare PhD NP MSc, Rhonda L. Wilson RN, CMHN, BNSc, MN (Hons), PhD, Claire Minton RN, PhD, Andrea Donaldson PhD, MSc, BSc, BN, CATE, RCN
Pages: 1525-1538 

‘Acknowledge me as a capable person’: How people with mental ill health describe their experiences with general emergency care staff – A qualitative interview study
Katharina Derblom RN MSc, Jenny Molin RN PhD, Sebastian Gabrielsson RN PhD, Britt-Marie Lindgren RN PhD
Pages: 1539-1549 

Prevalence and severity of verbal, physical, and sexual inpatient violence against nurses in Swiss psychiatric hospitals and associated nurse-related characteristics: Cross-sectional multicentre study
Nanja Schlup MScN, Beatrice Gehri MScN, Michael Simon PhD RN
Pages: 1550-1563 

Nursing students’ attitudes towards alcohol use disorders and related issues: A comparative study in four American countries
Luz Patricia Diaz Heredia PhD, MSN, BSN, Divane de Vargas PhD, MSN, BSN, Erika Gisseth León Ramírez PhD, MSN, BSN, Madeline Naegle PhD, CNS-PMH, BC, FAAN
Pages: 1564-1574 

“Modifying” or “Retreating”– Self-management of physical health among a group of people with schizophrenia. An ethnographic study from Denmark
Birgitte Lerbæk, Rikke Jørgensen, Niels Buus, Marlene Briciet Lauritsen, Jørgen Aagaard, Julie Nordgaard, Andrea McCloughen
Pages: 1575-1587 

Towards epistemic justice doing: Examining the experiences and shifts in knowledge of lived experience researchers over the course of a mental health research training programme
Brett Bellingham, Holly Kemp BA, Katherine Boydell PhD, Sophie Isobel PhD, Katherine Gill PhD, Jo River PhD
Pages: 1588-1598 

Digital risks and adolescents: The relationships between digital game addiction, emotional eating, and aggression
Nuray Caner PhD, RN, Derya Evgin PhD, RN
Pages: 1599-1609 

Cultural issues on accessing mental health services in Nepali and Iranian migrants communities in the UK
Bibha Simkhada PhD, BA, BSc, RGN, Mariam Vahdaninia PhD, MSc, Edwin van Teijlingen PhD, MA (Hon), MEd, Hannah Blunt BSc (Hon), RMN
Pages: 1610-1619 

Exploring the experience of acute inpatient mental health care from the perspective of family and carers of people experiencing psychosis: A qualitative thematic analysis study conducted during the COVID- 19 pandemic
Lisa Wood BSc, MRes, DClinPsy, PhD, Callam Constant BSc, Alison Byrne BSc Msc
Pages: 1620-1629 

‘First tonight, the contentious new code telling nurses to say, ‘sorry for being white’: Mental health nurses’ beliefs about their Code of Conduct and cultural safety for Aboriginal and Torres Strait Islander Peoples
Luke Molloy PhD, RPN, Paul Beckett MMHN, RN, Sherphard Chidarikire PhD, RN, Matthew P. Scott BSc (Nursing), RN, Monica D. Guha MMHN, RN, Tammy Tran Merrick MPH, RN, Declan Patton PhD, RPN
Pages: 1630-1639 

Predictors of community mental health nursing services use in Switzerland: Results from a representative national survey
Christian Burr MScN, RN, Dirk Richter PhD, RN
Pages: 1640-1648 

Deliberate self-harm among adolescents: A structural equation modelling analysis
Arunothai Singtakaew RN, PhD, Nujjaree Chaimongkol RN, PhD
Pages: 1649-1663 

The role and activities of the Traveller mental health liaison nurse: Findings from a multi-stakeholder evaluation
Karin O’Sullivan BA, MA, PhD, Anne Marie Brady PhD, MSc, BSc, RGN, Carmel Downes MSc, Agnes Higgins PhD, MSc, BNS, RPN, RGN, Louise Doyle PhD, MSc, BNS, RPN, Thomas McCann McCann, BSc, MA, Brian Keogh PhD, MSc, BNS, RPN
Pages: 1664-1673 

Perceived COVID-19-associated discrimination, mental health and professional-turnover intention among frontline clinical nurses: The mediating role of resilience
Leodoro J. Labrague PhD, CHSE, CHE, Janet Alexis A. De los Santos PhD, RN, Dennis C. Fronda MAN, RN
Pages: 1674-1683

Nurses’ experiences of providing care during the COVID-19 pandemic in Taiwan: A qualitative study
Hwey-Fang Liang PhD, RN, Yi-Chen Wu MSc, PT, Chien-Yu Wu BSN, RN
Pages: 1684-1692 

A !rst-hand experience of co-design in mental health service design: Opportunities, challenges, and lessons
Rachel Marie Tindall BN, MANP (mental health), PhD, Melissa Ferris BBus, GradCertPubAdv, MAICD, Meredith Townsend, Gayle Boschert BSc (Biochem), GradDipNutr&Diet, MAICD, Steven Moylan BSc, BMBS (Hons), MPH, MPM, MBA, PhD, FRANZCP
Pages: 1693-1702 

‘You get this conflict between you as a person and you in your role…that changes you’: A thematic analysis of how inpatient psychiatric healthcare staff in the UK experience restraint, seclusion, and other restrictive practices
Michelle Mooney BSc, Ava Kanyeredzi PhD
Pages: 1703-1712 

Nursing handover involving consumers on inpatient mental healthcare units: A qualitative exploration of the consumers’ perspective
Ellen Van de Velde MSc, Ann Van Hecke MSc, PhD, Naomi Van Cleemput MSc, Kristof Eeckloo LLM, PhD, Simon Malfait RN, MSc, PhD
Pages: 1713-1725

Feature article

An integrated review of the barriers and facilitators for accessing and engaging with mental health in a rural setting
Philip Ferris-Day RN, MMH, Karen Hoare PhD NP MSc, Rhonda L. Wilson RN, CMHN, BNSc, MN (Hons), PhD, Claire Minton RN, PhD, Andrea Donaldson PhD, MSc, BSc, BN, CATE, RCN. December 2021. 
IJMHN 30(6), pages 1525-1538

This newsletter is re-posted from https://www.nzno.org.nz/groups/colleges_sections/sections/mental_health_nurses/newsletter

Newtown Union Health Service – Chairperson’s report to the 2021 AGM

Newtown Union Health Service is a not-for-profit community service providing healthcare for community service card holders, low income earners, union members and their families. NUHS is community owned and has provided affordable, accessible, appropriate, quality, not-for-profit and community based primary health care in Wellington since May 1987. Established with the support of local trade unions, two seats on the NUHS Board are reserved for representatives endorsed by the New Zealand Council of Trade Unions Te Kauae Kaimahi. Since 2013, I have filled one of these positions – serving for the last five years as the Board Chairperson. Here is the report I gave to the 2021 AGM, held earlier this month.

We were fortunate to have two fabulous guest speakers from the community at our AGM – self-described “D-Grade celebrity” Karen O’Leary, and Labour MP Ibrahim Omer

He waka eke noa”. “We are all in this together”. One year ago, in the 2019/20 Annual Report, I observed that the arrival of Covid-19 in Aotearoa had strongly shaped the year for NUHS, just as it had for the country as a whole. As we continue to play our part in the “Team of Five Million”, the pandemic has influenced our Service for another year. This influence has been felt in many ways – from driving practice innovations like a shift to virtual consultations, to opening up new funding streams or reducing international student numbers and patient enrolments at our Massey University clinic.

Patient enrolments at Massey at the end of 2020/21 were 1,524, down from 2,074 when NUHS took over the Massey clinic in May 2018. Income meanwhile was up, due to dedicated funding for Covid-related activity. This increase is the primary reason for the end of year surplus of $240,508. Excluding Covid-related activity, the end of year result would have been a deficit of $38,455. As some of these dedicated funding streams come to an end, the Board is planning for a deficit budget in 2021/22, but the Service remains in a strong financial position thanks to surpluses in each of the past five years. 

The other major environmental influence occupying the minds of the NUHS Board this year has been the Health and Disability System Review. In April, the Government released its long awaited response to the Review report. While some information about the new health system has been published by the Transition Unit, particularly about the replacement of District Health Boards by Health NZ and about the creation of the Māori Health Authority, less is known about the future of Primary and Community Care. The Board has been working with other union health services and with Tū Ora PHO to gather intelligence and strategise around how best to meet the needs of our community in the new environment. 

For our physical fixed assets, the Board was pleased this year to be able to secure the future of the premises at 14 Hall Avenue. The lease for the site has been renegotiated for another 20 years, with a right of renewal for five more years beyond that. This certainty enabled the Board to move ahead with a capital works programme. At the close of 2020/21, $328,752 had been spent on a new roof and other external remediation for the ageing NUHS building. This remediation work is expected to be completed in 2021/22, within the budget of $725,000, and should extend the life of the building until at least the end of the lease. Thinking will now turn to the future of the Broadway Clinic. 

Last year, the Board reviewed and adopted the new NUHS Strategic Plan 2020-25 and completed the update of the NUHS Constitution. This year, the focus at the governance level has been on implementing the new Constitution and revising the organisation’s governance policies.

A major change to membership criteria means that membership of the NUHS incorporated society is no longer automatic for, or limited to, enrolled patients. Under the new Constitution, membership is entirely voluntary and membership applications will be considered from supporters of the service who are not enrolled patients. This year, the Board created a membership register and an application process to manage membership applications. Under a sunset clause, current enrolled patients who have not applied to join the NUHS incorporated society will cease to be members on 28 August 2022.

At the close of the 2020/21 year, the Board was half way through revising the organisation’s governance policies. This includes development of a new process for electing the clinical staff members on the Board, in response to questions raised at the 2020 AGM. The intention is to complete the update of the remaining governance policies, and the finance policies, in the 2021/22 year. 

Collaboration with stakeholders continues to bear fruit. Joint work with Whitireia tertiary institute last year resulted in a set of four online learning packages in refugee health. This year, Nurse Practitioner Serena Moran co-presented on these packages at the Flexible Learning Association of NZ Conference. 

One of our union stakeholders, E tū, made a request for financial support for union members affected by industrial action at Lifewise. NUHS has a strong association and history with the union movement and was established with funding from trade unions. The interest from this legacy is the basis of an Industrial Action Support Fund. A $2,500 donation was made from this fund to the E Tū members. It is recorded here in the Annual Report, as required by NUHS governance policies. 

We have continued our excellent relationship with University of Otago, Wellington, contributing to medical student teaching and research. The Board acknowledges especially Dr Ben Gray, who retired in November after 27 years as a GP at NUHS but continues as an Associate Professor in the university’s Primary Health Care and General Practice Department. There he teaches alongside NUHS GP Dr Jonathan Kennedy and Nurse Practitioner Serena Moran.

2020/21 has also been another year of achievements for NUHS and our staff. Our service was a finalist for GENPRO General Practice of the Year at the 2021 Primary Health Care Awards He Tohu Mauri Ora. NUHS staff continue to be sought out for their expertise and advice, particularly around working with refugee background communities in Primary Care. 

On the Board itself, composition continues to evolve. Most notably this year, we farewelled community representative Ibrahim Omer after his election as a Member of Parliament in 2020. We congratulate Ibrahim on becoming New Zealand’s first African MP. We know he is committed to the health and wellbeing of communities like ours and we wish him all the best in his political career. 

At the 2020 AGM, Tim Rochford was elected to fill the community representative vacancy. Then in May 2021, union representative Sam Gribben stepped down, for family reasons. The Council of Trade Unions is nominating Sam’s successor. 

I acknowledge too the remaining Board members who have worked with us this year – Tāngata Whenua rep Fiona Da Vanzo, community reps Barbara Lambourn and Roger Shaw and Treasurer Julie Lamb. I am also grateful to Board Minute Taker Vanessa Gray and Finance Leader Giordano Rigutto, whose support has underpinned our collective achievements. 

Lastly, this will be my final NUHS Chairperson’s Report. I have informed the Board that after five years in the role, I will be handing over to a new NUHS Chairperson before the 2022 AGM. The strengths I see in the governance, management and staff of NUHS fill me with confidence in its future. 

Nō reira, tēnā koutou, tēnā koutou, tēnā tātou katoa. 

Grant Brookes, Chairperson NUHS Board

Ian Powell: Unionism and nursing in New Zealand

This article by Ian Powell first appeared on 24 November 2021 on Democracy Project. It is re-published here under a Creative Commons CC BY-ND 4.0  license.

In the around 35 years I worked for unions (over 30 with the Association of Salaried Medical Specialists and earlier with the New Zealand Educational Institute) I often cogitated over the distinction between unions and unionism. They are intertwined but not inseparable.

I associate unionism with collective consciousness able to lead to collective action usually, but not always, arising out of an employment relationship. The union is a structure within which this unionism is able to operate and organise.

Numbers, or more precisely density, are important for unions but membership empowerment within unions and at workplaces is unionism and more critical.

Central Otago, Helen Kelly and Karl Marx

You can have formal unions without unionism. These are, for example, unions that do enough for their members to generate a sufficient revenue stream or are employer created (or encouraged and facilitated) unions. Fortunately these types of unions are few.

However, the mentality behind them is wider. The current Council of Trade Unions President has worked with employers in the public health system to undermine the combative Resident Doctors Association by actively supporting a new competing employer-compliant union. The justification was that the RDA was not affiliated to the CTU. This reflected a narrow view of unions that has little to do with unionism.

It is also possible to have unionism without a union. I was struck by an academic article by Lloyd Carpenter published in 2013 in the Australian based Labour History under the revealing title A Petty and Spiteful Spirit on the Part of the Company”: The 1881 Cromwell Company Strike at Bendigo, Otago. It involved a lengthy and bitter strike by employed miners.

The strike was eventually defeated because of the company’s power which it was willing to exercise in the most vicious manner. The power included owning the only available housing for the miners and their families. The viciousness was and then evicting them with the assistance of the severe central Otago winter.

But the strikers won the hearts and minds of the wider public, including in Dunedin, with favourable Otago Daily Times coverage and the company soon went out of business. What struck me the most was that there was no union. It was after all rural New Zealand in 1881.

The late Helen Kelly increasingly grasped the distinction between unions as structures and unionism as a dynamic when she was President of the Council of Trade Unions. For me this was most noteworthy with her campaigning over workplace safety in de-unionised forestry. Less prominent was her similar work in the likewise de-unionised agriculture sector.

Karl Marx’s fundamental observation on the nature of the working class also comes to mind. He distinguished between a ‘class of itself’ (its existence) and a ‘class for itself’ (its consciousness of being a class). The potential for the working class to be transformational would not be realisable when its development was restricted to the former. But, should it achieve the latter, this potential becomes realisable.

This Marxian insight prompted me to distinguish between ‘unions of themselves’ (structures) and ‘unions for themselves’ (unionism). It is the difference between unions as functional institutions and unionism as a movement.

NZNO external review

All these thoughts from central Otago to Karl Marx via Helen Kelly were in the back of my mind when I recently had the opportunity to read an external review of the performance of the New Zealand Nurses Organisation (NZNO). Completed on 2 November 2020 it covered the preceding 24 months.

The review followed a period of turmoil within NZNO which included internal conflict within its governing board and increasing membership dissatisfaction, particularly over its multi-employer collective agreement (MECA) negotiations with the 20 district health boards (DHBs). This dissatisfaction led to a number of membership resignations or non-renewals with a consequential sizeable financial hit.

NZNO is important for New Zealand’s health system. Realistically it is the only union of nurses. With around 51,000 members it is by far the largest number members working in the highly unionised public health system. This high membership leads to annual revenues of around $23 million which means, relative to other health unions at least, it is well-resourced with 131 full-time equivalent staff.

The NZNO Board discussed what were then proposed terms of reference for the external review on 1 July 2020. There was much confidence that the Board would come out well in the review with a senior leader stating that “…she wants the facts to speak for themselves and she believes that the way the Board has behaved has not been anything but reputable.”

The process for the review certainly gave the impression that it was structured to achieve this outcome. It was still being fine-tuned on 1 July but the review was completed and forwarded to the Board on 2 November; a short time period given the significance of the issues being considered. But this was achieved by confining those interviewed to a small number of current and past national leaders (elected and appointed).

There appears to have been no consideration of membership views as might be reflected through sessions with delegates, branch representatives or regional organisers. This is surprising given the high level of membership disquiet with its leadership including over the handling of the above MECA negotiations during the period under review.

Governance crisis

Despite this expressed confidence within the NZNO Board, the review did not conclude that its behaviour had not been anything but reputable. Instead its ‘hit-you-in-the-eye’ conclusion was that “NZNO is in a governance crisis.” It put responsibility for this crisis fairly and squarely on the shoulders of the Board, including because of internal conflict and regular breach of Board ethics. Lack of governance capability on the Board was also identified.

Senior staff were, on the other hand, commended. In fact, then chief executive Memo Musa is praised for his leadership including being described as the person holding NZNO leadership together.

Although undertaking the review was reported to NZNO members the Board excluded them from receiving it (inevitably, however, with the passage of time it has had some circulation beyond the Board). Only its recommendations were circulated to members but without the reasoning behind them. In other words, members were allowed to know what but not why.

The Board’s defence for excluding membership access is professional sensitivity and confidentiality. But there is nothing in the review that would justify exclusion. In this context professional sensitivity is a vacuous assertion. Confidentiality does not stack up as no critical comments about individuals are made and no confidential financial or personal information reported.

There is certainly embarrassment with its conclusion of a governance crisis and Board dysfunction. But embarrassment is no justification for making the review available for members who are NZNO’s main revenue stream and to whom the Board is electorally accountable.

Riddled with deficiencies

While the review’s conclusion of a governance crisis is reasonable its text is riddled with deficiencies. If you did not know that NZNO is a union you would not have learned this from the review. While the review does briefly acknowledge that NZNO is a registered union, it puts much more emphasis on it also being an incorporated society. But for a union to be registered under the Employment Relations Act being an incorporated society is a legal prerequisite.

The review is written as if it was applicable to any non-union incorporated society and looks to the Institute of Directors as the solution to many of NZNO’s problems. There is no consideration of membership accountability or the legal good faith obligations unions have to their members under the Employment Relations Act. Further, the Institute’s understanding of the role of unions is low.

Disappointingly the review simply concludes that if governance capabilities were resolved, NZNO’s problems including membership confidence would go away. It does not consider what the governance capabilities of a governing board of a union should be and whether the governance crisis was a consequence of growing membership dissatisfaction rather than its cause.

The choice of reviewers is indicative. They were a ‘leadership development manager’ at the Canterbury-based company Brannigans Human Capital Chris Bailey and commercial corporate lawyer Guy Royal. There is no suggestion of any experience of working in or with unions, particularly those representing professionals. What this contributes to is a review operating with only a limited context thereby missing more than it saw.

The deficiencies of the review stem from reliance on structural solutions to what is essentially relational and a lack of awareness of the role of NZNO as a union including membership accountability. It is as if NZNO is seen primarily as a professional body that includes some narrow union functions such as MECA bargaining.

There is a lack of a broad view of unionism that recognises the value of collectivist approaches to many issues including those that might be considered professional and industrial (in fact, there is a big area of blurry grey between the two).

The review considers the Board to have an “evident skills gap” and proposes outside expertise to be brought in. Among its recommendations to address this is that all Board members (‘directors’) must become members of the Institute of Directors and to remain eligible for another term have completed the Institute’s ‘essentials’ courses.

In doing so it fails to consider the kinds of skills that are needed for unions or other membership driven organisations. These skills are more to do with insightful understanding of the vulnerability, needs and aspirations of members. The Institute of Directors are not sufficiently experienced in this area. Technical skills such as financial literacy can be provided by external support or qualified senior staff (or both).

Reducing membership control

The review recommends major changes to the Board’s membership which require constitutional amendment. Under its constitution NZNO currently has a governing board comprising 11 elected members called directors. Designated director positions take up 4 of the 11 – President, Vice President, Kaiwhakahaere and Tumu whakarae (assists the Kaiwhakahaere). Members also elect the other 7 members.

If the review’s recommendations were adopted the size of the Board would be reduced from 11 to 9 directors. The above 4 designated positions would remain. But there would be a new unelected position created of Chair appointed by a three-person panel. The Chair could also be a non-member and would be additional to the 9 directors.

Two additional director positions would be created to “bridge the skills gap on the Board”. As with the Chair they could be non-members and would be selected by the same appointments panel. Realistically all 3 positions could be non-members.

The proposed unelected Chair of NZNO’s governing board is pivotal to the review. The role of the Chair is described as ensuring “…that discussion and decisions are centred at a strategic level as well as to take into account operations.” Further, the Chair needs “…to ensure the Board sets a culture that is maintained by the Board and driven through the organisation.”

No punches are pulled about the intent of the proposed Chair when it is called “…the most critical position of the organisation [NZNO]” as the holder works closely with the chief executive and Board. This suggests the review believes the unelected Chair sits above the elected President, Vice President, Kaiwhakahaere and Tumu whakarae!

Reducing the Board to 9 and requiring 2 of them to be appointed means that the number of members outside the above 4 designated positions dramatically reduces from 7 to 3. The effect would be a radical reduction in membership representation on the Board and consequential reduced members’ control and leadership accountability for a membership based organisation.

NZNO a union ‘of itself’ or ‘for itself’

NZNO’s recent successful negotiation of a new MECA for its DHB employed members in difficult circumstances was largely due to its learning from the previous internally fractious negotiation that contributed significantly to the decision to commission the review.

NZNO became more membership engaged and driven which had a big spin-off impact on the effectiveness of its collective bargaining. It was a powerful lesson in membership empowerment which began to move NZNO in the direction of the more influential position of being a ‘union for itself’.

This experience therefore makes the review’s recommendations so disappointing. The review is on a different planet to that of NZNO’s collective bargaining experience. The review goes in the opposite direction. If implemented effect of its recommendations would be to ensure that an organisation endeavouring to become more membership driven would instead become less accountable to its members than it currently is.

Recently NZNO has elected a new national president and vice president (Anne Daniels and Nano Tunnicliffe respectively). They stood as a ticket on a platform, building on the MECA negotiations experience, of strengthening NZNO as a membership-driven and empowered union. Ensuring that this review does not derail this direction will be a huge challenge for them.

How it responds to the review’s recommendations will be a test of the extent to which NZNO understands itself. Is NZNO a union and, if so, is it a union ‘of itself’ or ‘for itself’? How it responds will have wider implications for the union movement in the health system at least.

Ian Powell was formerly the Executive Director of the Association of Salaried Medical Specialists for over 30 years until December 2019.  He is now a health commentator, editor of the blog ‘Otaihanga Second Opinion’, and based in Otaihanga on the Kapiti Coast.

This article can be republished under a Creative Commons CC BY-ND 4.0  license. Attributions should include a link to the Democracy Project.  

In the around 35 years I worked for unions (over 30 with the Association of Salaried Medical Specialists and earlier with the New Zealand Educational Institute) I often cogitated over the distinction between unions and unionism. They are intertwined but not inseparable.

I associate unionism with collective consciousness able to lead to collective action usually, but not always, arising out of an employment relationship. The union is a structure within which this unionism is able to operate and organise.

Numbers, or more precisely density, are important for unions but membership empowerment within unions and at workplaces is unionism and more critical.

Central Otago, Helen Kelly and Karl Marx

You can have formal unions without unionism. These are, for example, unions that do enough for their members to generate a sufficient revenue stream or are employer created (or encouraged and facilitated) unions. Fortunately these types of unions are few.

However, the mentality behind them is wider. The current Council of Trade Unions President has worked with employers in the public health system to undermine the combative Resident Doctors Association by actively supporting a new competing employer-compliant union. The justification was that the RDA was not affiliated to the CTU. This reflected a narrow view of unions that has little to do with unionism.

It is also possible to have unionism without a union. I was struck by an academic article by Lloyd Carpenter published in 2013 in the Australian based Labour History under the revealing title A Petty and Spiteful Spirit on the Part of the Company”: The 1881 Cromwell Company Strike at Bendigo, Otago. It involved a lengthy and bitter strike by employed miners.

The strike was eventually defeated because of the company’s power which it was willing to exercise in the most vicious manner. The power included owning the only available housing for the miners and their families. The viciousness was and then evicting them with the assistance of the severe central Otago winter.

But the strikers won the hearts and minds of the wider public, including in Dunedin, with favourable Otago Daily Times coverage and the company soon went out of business. What struck me the most was that there was no union. It was after all rural New Zealand in 1881.

The late Helen Kelly increasingly grasped the distinction between unions as structures and unionism as a dynamic when she was President of the Council of Trade Unions. For me this was most noteworthy with her campaigning over workplace safety in de-unionised forestry. Less prominent was her similar work in the likewise de-unionised agriculture sector.

Karl Marx’s fundamental observation on the nature of the working class also comes to mind. He distinguished between a ‘class of itself’ (its existence) and a ‘class for itself’ (its consciousness of being a class). The potential for the working class to be transformational would not be realisable when its development was restricted to the former. But, should it achieve the latter, this potential becomes realisable.

This Marxian insight prompted me to distinguish between ‘unions of themselves’ (structures) and ‘unions for themselves’ (unionism). It is the difference between unions as functional institutions and unionism as a movement.

NZNO external review

All these thoughts from central Otago to Karl Marx via Helen Kelly were in the back of my mind when I recently had the opportunity to read an external review of the performance of the New Zealand Nurses Organisation (NZNO). Completed on 2 November 2020 it covered the preceding 24 months.

The review followed a period of turmoil within NZNO which included internal conflict within its governing board and increasing membership dissatisfaction, particularly over its multi-employer collective agreement (MECA) negotiations with the 20 district health boards (DHBs). This dissatisfaction led to a number of membership resignations or non-renewals with a consequential sizeable financial hit.

NZNO is important for New Zealand’s health system. Realistically it is the only union of nurses. With around 51,000 members it is by far the largest number members working in the highly unionised public health system. This high membership leads to annual revenues of around $23 million which means, relative to other health unions at least, it is well-resourced with 131 full-time equivalent staff.

The NZNO Board discussed what were then proposed terms of reference for the external review on 1 July 2020. There was much confidence that the Board would come out well in the review with a senior leader stating that “…she wants the facts to speak for themselves and she believes that the way the Board has behaved has not been anything but reputable.”

The process for the review certainly gave the impression that it was structured to achieve this outcome. It was still being fine-tuned on 1 July but the review was completed and forwarded to the Board on 2 November; a short time period given the significance of the issues being considered. But this was achieved by confining those interviewed to a small number of current and past national leaders (elected and appointed).

There appears to have been no consideration of membership views as might be reflected through sessions with delegates, branch representatives or regional organisers. This is surprising given the high level of membership disquiet with its leadership including over the handling of the above MECA negotiations during the period under review.

Governance crisis

Despite this expressed confidence within the NZNO Board, the review did not conclude that its behaviour had not been anything but reputable. Instead its ‘hit-you-in-the-eye’ conclusion was that “NZNO is in a governance crisis.” It put responsibility for this crisis fairly and squarely on the shoulders of the Board, including because of internal conflict and regular breach of Board ethics. Lack of governance capability on the Board was also identified.

Senior staff were, on the other hand, commended. In fact, then chief executive Memo Musa is praised for his leadership including being described as the person holding NZNO leadership together.

Although undertaking the review was reported to NZNO members the Board excluded them from receiving it (inevitably, however, with the passage of time it has had some circulation beyond the Board). Only its recommendations were circulated to members but without the reasoning behind them. In other words, members were allowed to know what but not why.

The Board’s defence for excluding membership access is professional sensitivity and confidentiality. But there is nothing in the review that would justify exclusion. In this context professional sensitivity is a vacuous assertion. Confidentiality does not stack up as no critical comments about individuals are made and no confidential financial or personal information reported.

There is certainly embarrassment with its conclusion of a governance crisis and Board dysfunction. But embarrassment is no justification for making the review available for members who are NZNO’s main revenue stream and to whom the Board is electorally accountable.

Riddled with deficiencies

While the review’s conclusion of a governance crisis is reasonable its text is riddled with deficiencies. If you did not know that NZNO is a union you would not have learned this from the review. While the review does briefly acknowledge that NZNO is a registered union, it puts much more emphasis on it also being an incorporated society. But for a union to be registered under the Employment Relations Act being an incorporated society is a legal prerequisite.

The review is written as if it was applicable to any non-union incorporated society and looks to the Institute of Directors as the solution to many of NZNO’s problems. There is no consideration of membership accountability or the legal good faith obligations unions have to their members under the Employment Relations Act. Further, the Institute’s understanding of the role of unions is low.

Disappointingly the review simply concludes that if governance capabilities were resolved, NZNO’s problems including membership confidence would go away. It does not consider what the governance capabilities of a governing board of a union should be and whether the governance crisis was a consequence of growing membership dissatisfaction rather than its cause.

The choice of reviewers is indicative. They were a ‘leadership development manager’ at the Canterbury-based company Brannigans Human Capital Chris Bailey and commercial corporate lawyer Guy Royal. There is no suggestion of any experience of working in or with unions, particularly those representing professionals. What this contributes to is a review operating with only a limited context thereby missing more than it saw.

The deficiencies of the review stem from reliance on structural solutions to what is essentially relational and a lack of awareness of the role of NZNO as a union including membership accountability. It is as if NZNO is seen primarily as a professional body that includes some narrow union functions such as MECA bargaining.

There is a lack of a broad view of unionism that recognises the value of collectivist approaches to many issues including those that might be considered professional and industrial (in fact, there is a big area of blurry grey between the two).

The review considers the Board to have an “evident skills gap” and proposes outside expertise to be brought in. Among its recommendations to address this is that all Board members (‘directors’) must become members of the Institute of Directors and to remain eligible for another term have completed the Institute’s ‘essentials’ courses.

In doing so it fails to consider the kinds of skills that are needed for unions or other membership driven organisations. These skills are more to do with insightful understanding of the vulnerability, needs and aspirations of members. The Institute of Directors are not sufficiently experienced in this area. Technical skills such as financial literacy can be provided by external support or qualified senior staff (or both).

Reducing membership control

The review recommends major changes to the Board’s membership which require constitutional amendment. Under its constitution NZNO currently has a governing board comprising 11 elected members called directors. Designated director positions take up 4 of the 11 – President, Vice President, Kaiwhakahaere and Tumu whakarae (assists the Kaiwhakahaere). Members also elect the other 7 members.

If the review’s recommendations were adopted the size of the Board would be reduced from 11 to 9 directors. The above 4 designated positions would remain. But there would be a new unelected position created of Chair appointed by a three-person panel. The Chair could also be a non-member and would be additional to the 9 directors.

Two additional director positions would be created to “bridge the skills gap on the Board”. As with the Chair they could be non-members and would be selected by the same appointments panel. Realistically all 3 positions could be non-members.

The proposed unelected Chair of NZNO’s governing board is pivotal to the review. The role of the Chair is described as ensuring “…that discussion and decisions are centred at a strategic level as well as to take into account operations.” Further, the Chair needs “…to ensure the Board sets a culture that is maintained by the Board and driven through the organisation.”

No punches are pulled about the intent of the proposed Chair when it is called “…the most critical position of the organisation [NZNO]” as the holder works closely with the chief executive and Board. This suggests the review believes the unelected Chair sits above the elected President, Vice President, Kaiwhakahaere and Tumu whakarae!

Reducing the Board to 9 and requiring 2 of them to be appointed means that the number of members outside the above 4 designated positions dramatically reduces from 7 to 3. The effect would be a radical reduction in membership representation on the Board and consequential reduced members’ control and leadership accountability for a membership based organisation.

NZNO a union ‘of itself’ or ‘for itself’

NZNO’s recent successful negotiation of a new MECA for its DHB employed members in difficult circumstances was largely due to its learning from the previous internally fractious negotiation that contributed significantly to the decision to commission the review.

NZNO became more membership engaged and driven which had a big spin-off impact on the effectiveness of its collective bargaining. It was a powerful lesson in membership empowerment which began to move NZNO in the direction of the more influential position of being a ‘union for itself’.

This experience therefore makes the review’s recommendations so disappointing. The review is on a different planet to that of NZNO’s collective bargaining experience. The review goes in the opposite direction. If implemented effect of its recommendations would be to ensure that an organisation endeavouring to become more membership driven would instead become less accountable to its members than it currently is.

Recently NZNO has elected a new national president and vice president (Anne Daniels and Nano Tunnicliffe respectively). They stood as a ticket on a platform, building on the MECA negotiations experience, of strengthening NZNO as a membership-driven and empowered union. Ensuring that this review does not derail this direction will be a huge challenge for them.

How it responds to the review’s recommendations will be a test of the extent to which NZNO understands itself. Is NZNO a union and, if so, is it a union ‘of itself’ or ‘for itself’? How it responds will have wider implications for the union movement in the health system at least.

Ian Powell was formerly the Executive Director of the Association of Salaried Medical Specialists for over 30 years until December 2019.  He is now a health commentator, editor of the blog ‘Otaihanga Second Opinion’, and based in Otaihanga on the Kāpiti Coast.

This article can be republished under a Creative Commons CC BY-ND 4.0  license. Attributions should include a link to the Democracy Project.  

PSA Eco Network pushes DHB sustainability 

By Eco Network Co-convenor Grant Brookes

Pressure is mounting on District Health Boards to become more environmentally sustainable. It might not be top of mind for people when they’re needing care from our hospital and health services, or even for some health workers, but the case for change is clear – and the PSA Eco Network has been helping to make it. Health is the largest emitter of carbon emissions in New Zealand’s public sector. It is estimated that healthcare services contribute between 3% and 8% of New Zealand’s total greenhouse gas emissions.

DHBs are also major consumers of renewable and non-renewable resources and create very large waste streams. A survey of seven DHBs in 2018-19 found that they generated around 1,600 tonnes per year on average. The Covid-19 pandemic has made the problem worse. Globally, 3.4 billion single-use face masks/face shields are discarded every day.

The environmental impacts of DHBs negatively affect the health of their communities, especially the health of disadvantaged groups who are already experiencing poorer health. This was recognised early by a few DHBs, like Northland, Waitematā, Hawkes Bay, Capital & Coast and Counties Manukau, which began measuring and reducing their carbon emissions as far back as 2011. But demands are growing for all DHBs to reduce their environmental footprint – from the public, from professional organisations like OraTaiao NZ Climate and Health Council, from health workers and networks of “green champions” inside DHBs, from our unions and from Government.

Environmental sustainability, including reducing carbon emissions, was added to the Health Minister’s letter of expectations for DHB Chairs in 2018/19 and strengthened in his letter of expectations in 2019/20. This year, annual planning guidance from the Ministry of Health reminds DHBs they’re part of the Carbon Neutral Government Programme, which aims for a zero carbon public sector by 2025, and that they are required to start measuring and publicly reporting their emissions from next year.

As a result, the pace of change is accelerating. The new Taranaki Base Hospital, currently under construction, will be the first Green Star certified hospital building in the country when it opens in late 2023. By then, around 44 tonnes of soft plastic waste from Taranaki’s hospitals will be going each year to be recycled into fence posts. Northland DHB is introducing 150 electric vehicles and installing charging infrastructure. Canterbury DHB will replace its current coal-fired boilers with two new biomass boilers in early 2022.

Artist’s impression of the Green Star certified New East Wing Building at Taranaki Base Hospital, due to open in late 2023.

As well as these projects, some DHBs have recently adopted new long-term sustainability strategies. In June, Bay of Plenty DHB published its Kaitiakitanga Caring for People and Planet – A Framework for Environmental Sustainability. And in September, three Lower North Island DHBs (Capital & Coast, Hutt Valley and Wairarapa) adopted their new 3DHB Sustainability Strategy.

PSA Eco Network members contributed to that strategy, both through the CCDHB Green Champions group and in a formal submission seeking a more far-reaching vision. We have published our submission, sharing our ideas for other PSA members and health workers who might want to contribute to sustainability strategies in their DHB. And we are very keen to hear from any other Eco Network members who are active in this space. Please email us.

• First published (lightly edited) the Eco Network newsletter, 3 November 2021

Eco Network: PSA combatting climate change, James Shaw webinar 4 Nov, intro from new Auckland convenor and more

3 November 2021

Kia ora,

The PSA Eco Network convenors continue to send their aroha to everyone in these strange times, especially our members up in Tāmaki Makaurau Auckland doing the hard yards for us all on slowing down the spread of COVID-19.

In this issue 

This month’s bumper newsletter contains some pretty exciting news in the climate realm, from PSA’s own strategic goal refresh to the release of the Government’s Emissions Reduction Plan discussion document.

PSA commits to combatting climate change

Grant Brookes, Eco Network national co-convenor

After a year-long review and refresh, the PSA Executive Board has now published the updated PSA Strategic Goals 2021-17. For the first time, combatting climate change is included in our union’s overarching goals. The Eco Network advocated strongly for this change. We said that a fifth goal, climate justice, should be added and that the four existing goals for the PSA should be amended to build the narrative of the intersections between climate and workers justice.

Although the Executive Board decided to stick with the four current goals, these have been amended to integrate climate action right across the work of the union. It is now the aim of the PSA that by 2024:

  • Public and community services support a Just Transition for communities affected by climate, technology and other change
  • Public and community service workplaces are leaders of decarbonisation and digital rights
  • A just transition for public and community service workers affected by climate, technology and other change
  • We are a sustainable and decarbonised union, fit for the future of union work.

As PSA President Benedict Ferguson told the PSA Working Life Journal this month:

“Climate change is going to affect our society, the ways we work and the environment we live in. It’s important we walk the talk, and make sure we are not contributing to the problem.”

The Eco Network will continue our input on the implementation of the PSA Strategic Goals 2021-27. In particular, we plan to help in the development of a PSA-wide definition of Just Transition and to ensure that all governance structures are considering this in their planning.

You can read our submission about adding climate justice to the PSA Strategic Goals here under the ‘Documents’ tab, or click here to download.

Emissions Reduction Plan discussion document released

Briar Wyatt, Eco Network national co-convenor

Consultation on the Government’s Emissions Reduction Plan is now open until 24 November 2021. This is a step towards the widest reaching, and potentially most ambitious, climate policy this country has ever seen. Members of our rōpū have contributed to this work in numerous ways, either as Eco Network members or through their roles in public service, and it’s exciting to see this work start to come to fruition. 

We are concerned about some gaps that need to be filled in order for this government to be fully committed, to for example a Just Transition, and we will need to use our union power to call for committed approach throughout the engagement process. The PSA released a statement on the Emissions Reduction Plan discussion document when it was released, which you can read here.

The Eco Network will be working with PSA Policy to support submissions and engagement in this space, so please watch this space for more communications from us. In the meantime, you can check out the full discussion document here.

RSVP to our Emissions Reduction Plan webinar with Minister James Shaw

Join us for a PSA Eco Network lunchtime webinar at 12.30pm this coming Thursday, and hear more from Climate Change Minister James Shaw about the consultation on the new Emissions Reduction Plan. What does it mean for PSA members? And why is it important that we have our say on what New Zealand is doing on climate change?

We’ll also have a member-led discussion on our PSA submission to government, and what it should include. You can register for the webinar right here.

Eco Network promotes DHB sustainability

Grant Brookes, Eco Network national co-convenor

Pressure is mounting on District Health Boards to become more environmentally sustainable. It might not be top of mind for people when they’re needing care from our hospital and health services, or even for some health workers, but the case for change is clear – and the PSA Eco Network has been helping to make it. Health is the largest emitter of carbon emissions in New Zealand’s public sector. It is estimated that healthcare services contribute between 3% and 8% of New Zealand’s total greenhouse gas emissions.

DHBs are also major consumers of renewable and non-renewable resources and create very large waste streams. A survey of seven DHBs in 2018-19 found that they generated around 1,600 tonnes per year on average. The Covid-19 pandemic has made the problem worse. Globally, 3.4 billion single-use face masks/face shields are discarded every day.

The environmental impacts of DHBs negatively affect the health of their communities, especially the health of disadvantaged groups who are already experiencing poorer health. This was recognised early by a few DHBs, like Northland, Waitematā, Hawkes Bay, Capital & Coast and Counties Manukau, which began measuring and reducing their carbon emissions as far back as 2011. But demands are growing for all DHBs to reduce their environmental footprint – from the public, from professional organisations like OraTaiao NZ Climate and Health Council, from health workers and networks of “green champions” inside DHBs, from our unions and from Government.

Environmental sustainability, including reducing carbon emissions, was added to the Health Minister’s letter of expectations for DHB Chairs in 2018/19 and strengthened in his letter of expectations in 2019/20. This year, annual planning guidance from the Ministry of Health reminds DHBs they’re part of the Carbon Neutral Government Programme, which aims for a zero carbon public sector by 2025, and that they are required to start measuring and publicly reporting their emissions from next year. As a result, the pace of change is accelerating. The new Taranaki Base Hospital, currently under construction, will be the first Green Star certified hospital building in the country when it opens in late 2023. Northland DHB is introducing 150 electric vehicles and installing charging infrastructure. Canterbury DHB will replace its current coal-fired boilers with two new biomass boilers in early 2022.

As well as these projects, some DHBs have recently adopted new long-term sustainability strategies. In June, Bay of Plenty DHB published its Kaitiakitanga Caring for People and Planet – A Framework for Environmental Sustainability. And in September, three Lower North Island DHBs (Capital & Coast, Hutt Valley and Wairarapa) adopted their new 3DHB Sustainability Strategy.

PSA Eco Network members contributed to that strategy, both through the CCDHB Green Champions group and in a formal submission seeking a more far-reaching vision. We have published our submission, sharing our ideas for other PSA members and health workers who might want to contribute to sustainability strategies in their DHB. And we are very keen to hear from any other Eco Network members who are active in this space. Please email us.

Introducing our new Tāmaki Makaurau Auckland Convenor, Shonagh Clark

Like most Kiwis abroad, Aotearoa was the standard for clean, green and sustainable. Beaches and waterways unpolluted, natural farming, vast areas of protected forest, culturally sensitive and quality of life. Sadly, upon returning after 25 years in the Basque Country, I found a country in crisis. The only characteristic of a low wage economy was the low wages. House prices were beyond the reach of low-income families, rivers were dried up or polluted, beaches flagged as too dirty to swim in, erosion from deforestation devastating homes in heavy rains, overstocking on farms, antibiotics in livestock because of insanitary farming practices, overdependence on cars, absence of bilingual documents from government agencies, almost no bilingual schools, poor quality housing from unsustainable materials…

So, I joined the PSA Eco Network. I thought that with 80,000 members surely something would get done! We have four Eco-reps in Auckland workplaces, but it would be great to have one in every government department or agency. Let’s start making noise. Government and Industry have their part to play but the individual consumer has power, and we all have a responsibility to do our bit.

Photo description: Three generations of Clark women planting a Totara tree for Matariki

Introducing Sarah Wright – Eco Rep profile

Hi there, my name is Sarah Wright and I work for immigration at Auckland International Airport. I am the only Eco Rep at my workplace, but more people are becoming interested in the topic. We are a relatively small team who work to keep immigration risk offshore. If you have ever seen Border Patrol you may have seen what we do – or used to do, before COVID!

This is me on the only episode of Border Patrol I was on. Most people will find my colleague James far more familiar.

 Since COVID-19 arrived our role has changed, and it has given me more time to look into the environmental impact that we, as an immigration branch, are having and try to come up with solutions. I am fortunate to have managers up the chain who support what I do and some progress has been made.

Success in the workplace

At the airport many, many single use face masks are disposed of into the landfill bins each day. I approached the company Future Post who recycling used face masks into fence posts. They advised that they were only using face masks supplied by Primepac as they (Primepac) were also collecting the used masks and delivering to the Future Post plant. I contacted Primepac and set up a meeting between their sales director and one of our supportive border managers.

We have now changed suppliers to Primepac and will be recycling all our single use face masks. Very pleased with that outcome. Every step in the right direction helps.

We would love to hear of success stories from other workplaces, as well as things you’re looking to achieve. Please get in touch.