PRIMARY HEALTH CARE GROUP UPDATE

Jenny Carryer
RN,PhD, FCNA(NZ), MNZM

A further update on the ongoing processes related to revising the recommendations of Investing in Health (Moh, 2003) and the re-establishment of the Primary Health Care Nursing Expert Advisory Group to the Ministry of Health.

As reported in the last edition of Te Puawai, a strategy group comprised of representatives from both NZNO and the College of Nurses Aotearoa (CNA) met on March 6th 2007 to review the recommendations arising from:

• MoH evaluation of the Care Plus Programme
• The Management of Life Long Conditions workshop hosted by CNA and College of Practice Nurses, NZNO
• The report of the National Health Committee on Meeting the needs of people with chronic illness
• The original goals and recommendations of the document Investing in Health (2003).  We wished to use these documents as a basis for our deliberations.
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A draft document was produced by the initial strategy group and circulated widely for submission.  Overall the submissions largely supported the revised recommendations. Concerns raised in the submissions centred around three areas including: the cessation of GP employment of practice nurses in favour of salaried employment to PHOs / DHBs; the reframing of Care Plus as a nurse-led service; and patients enrolling with PHOs rather than with specific GPs.

On July 20th representatives of many nursing groups concerned with primary health care met to progress work on the initial document entitled A revision of recommendations from Investing in Health (2007).  As reported in the last edition of Te Puawai the group included nurse leaders from PHOs, DHBs, College of Nurses, College of Practice Nurses, NZNO and the General Practice Nurse Alliance Group.  The day was jointly hosted by NZNO PHC Nurses Council and the College of Nurses and independently facilitated by Annette Milligan.  The 30 nurses present reviewed the comprehensive independent analysis of the 81 submissions and agreed that with the exception of some very minor adjustments, all but three of the recommendations had been well supported.  The group then turned its attention to revising those three areas which as predicted had generated the most division of opinion.  Those three recommendations now reflect the outcome of that post submission review process and very minor adjustments have been made to some other recommendations.
In addition three new recommendations to the Ministry of Health were added as follows:

• That the Ministry of Health Expert Nursing Advisory Group on primary health care be urgently reconvened;
• That the resource devoted to nursing in the MoH be increased;
• That in order to ensure succession planning, a senior nurse advisor position is created to support the Chief Advisor. 

The revised document was agreed to by both organisations and presented to Mark Jones (Chief Advisor Nursing) and copied to both the Minister of Health and the Director General of Health and is now available on the relevant websites.  
On November 7th, 2007 the Ministry of Health announced the membership of the group following a call for nominations.  Almost 60 people were nominated for the Expert Advisory Group and 10 were selected. They are:

Christine Andrews, Ministry of Health (ex officio)
Nardia Brooke, Northern District Support Agency
Sheree East, Director of Nursing, Nurse Maude Association
Julia Ebbett, Hawkes Bay PHO / Tu Meke PHO Care Plus Coordinator
Meg Goodman, Middlemore Hospital, PHC Nurse Specialist
Karen Hoare, Department of General Practice, Auckland University
Jane Lane, Quality Manager and Director of Nursing, Rotorua General Practice Group
Rose Lightfoot, CEO, Te Tai Tokerau PHO
Fiona Osten, Team Leader, Newtown Union Health Service
Helen Pocknall, Director of Nursing, Wairarapa DHB
Dr Nicolette Sheridan, Senior Lecturer, School of Nursing, Auckland University

The Ministry commented that “The Selection Panel were looking for a range of expertise and a range of practitioners.  They wanted to include somebody with good understanding of tikanga Maori, a DHB Director of Nursing, at least one academic and somebody working in the private sector.  They did not want Group members to be representative of any professional group or association, nor was it important for nominees to have a large number of people supporting their nomination.”
College of Nurses’ nominee Julia Ebbett is on the group but the College is extremely disappointed that our strong Maori nominee, Margareth Broodkorn is not there.  Margareth was strongly supported by the Maori caucus, has intimate experience of delivering primary health services in Northland and has multiple personal and professional strengths.  In addition there is concern that none of the key drivers or leaders of the process for revising the Investing in Health recommendations is present for continuity given that progressing the recommendations is a key task for the Group.
The College is however delighted that the advisory group is at last established and wishes the group and all of its members well in carrying out this important work.