October 2017 April 2015 | Page 6

Te Puawai and able to be directly and fairly funded.    That the enrolment process is urgently reviewed to ensure primary health care services are accessible for all. That the recent hasty funding formula review is revisited to specifically assess the degree to which the funding formulae support appropriate deployment of nurse services. That alternative models of employment of primary health care nurses be actively developed in partnership with the sector To District Health Boards  That all DHBs are required to have a Director of Nursing with direct primary health care responsibilities  That all DHBs are required to support a primary health care nurse development team structure designed to build capacity and guide developments across primary health care nursing services.  That focused investment in postgraduate education occurs well beyond the current inadequate amount of money moved from the CTA to DHBs for post graduate and post registration nursing education. This will require DHBs to lobby on behalf of nursing.  That formal funding of graduate places in PHC settings must be made available as a matter of urgency. This will require DHBs to lobby on behalf of nurses in order to achieve DHB goals for a sustainable PHC workforce.  That the development and implementation of nurse practitioner © Te Puawai roles in boundary spanning roles: family nurse practitioners, older person’s health and child health are implemented as a priority  That alternative models of employment of primary health care nurses be actively developed in partnership with the sector Readers can see that there are some “achieved’s” that can be awarded. But if we were to conduct a further revision we might well produce virtually identical recommendations in 2015 and then again in 2020 and probably beyond… Personally this begins to feel pointless and tedious and a gross abrogation of our responsibility to those who are clearly not having their needs for primary health care met. It has been exciting in the last few weeks to see a growing chorus of disquiet amongst some PHC nurse leaders who recognize the stagnation that is occurring despite no reduction in the rhetoric, the meetings, the earnest documents, and the investment in the status quo. What will we do with this energy and impetus? What are the mechanisms by which we can say clearly that serious change is required? and that it is long overdue and the huge potential inherent in nursing continues to be squandered. In 1998 we produced a document entitled Releasing the Potential of Nursing Ministerial Task Force, ( MoH 1998). We saw it as being a long slow evolution towards a better alignment of nursing services with community need. I have now come to the view that evolution has not and will not solve anything. A revolution is needed towards the goal of investing in health rather than investing in the status quo. College of Nurses Aotearoa (NZ) Inc 4