New Zealand is losing nurses because of immigration rules that make them feel "unwelcome and in a permanent state of temporariness", the Government has been warned - a situation that piles pressure on a workforce contending with thousands of vacancies during a pandemic.
The NZ Nurses Organisation has written to Immigration Minister Kris Faafoi asking for urgent reform to help fill a "critical shortage" of nurses, made worse by the Covid pandemic.
The current rules "risk losing a large number of health professionals when we can least afford to", the Nurses Organisation warned in the letter, which it has released to the Herald.
One major problem is the difficulty nurses on temporary work visas have in moving to a residency visa, the union, which has more than 50,000 members, told Faafoi.
"Highly skilled and in-demand professionals who wish to make New Zealand their permanent home are unable to purchase property and are made to feel unwelcome by a system that keeps them in a permanent state of temporariness rather than giving them the certainty they need to plan for the future.
"The success of the Government's response to the Covid-19 pandemic is dependent on our nursing workforce. It is therefore crucial that all possible actions are taken to ensure we retain and support the workforce we have.
"Many internationally qualified members of NZNO are becoming frustrated with current immigration settings and some have left New Zealand as a result."
The appeal will increase pressure on the Government to make changes. Last week the Herald revealed ICU leaders wanted similar immigration and MIQ reforms, because internationally sought-after critical care nurses couldn't get into the country, even after accepting job offers. Others already here were leaving because of visa uncertainty.
More than a quarter of New Zealand's nurses are from overseas, mostly from the Philippines and India. Staffing shortages are long-standing and there are currently more than 900 unfilled nursing vacancies in rest homes and about 1500 in DHBs, NZNO noted in its letter to Faafoi.
The Covid pandemic "has exacerbated the situation both by severely limiting the supply of international qualified nursing professionals and by increasing the demands on the workforce to contribute to managed isolation and quarantine, testing, contact-tracing and vaccinating as well providing intensive care for people with Covid-19".
NZNO asked Faafoi to consider three proposals: that applications for visas for partners of New Zealand-based health workers be reopened after being paused because of the pandemic; that expressions of interest for the skilled migrant category for health workers be restarted; and that all skilled migrant and residence from work applications by health workers be prioritised.
"Immigration alone will not enable New Zealand to meet our health workforce needs," NZNO wrote in its letter, from industrial services manager Glenda Alexander. "However, until we have a comprehensive plan in place to grow our own health workforce, immigration remains a key source of people with the diversity of skills and experience we need to maintain our health services."
NZNO sent the letter on September 8 but has not had a response beyond acknowledgement of receipt.
A spokesperson for Faafoi told the Herald that, "with regards to healthcare workers waiting on residency, the Immigration Minister has confirmed he will have more to say on that issue very soon".
On the issues raised around ICU nurses, Faafoi's spokesperson said such workers could enter New Zealand through a dedicated border exception for critical health workers, which covers all registered health practitioners and other health and disability workers.
"This is a fast- tracked process as applicants don't need to prove that their skills are not readily obtainable … most border exception requests are processed within five working days. However, some may take longer depending on the volume and complexity of requests. Requests from employers and agents for approval in principle to bring a critical worker to New Zealand generally take two weeks.
"Once they have a visa, these individuals still need to secure a space in MIQ. There is no manual allocation for MIQ rooms for health sector workers and demand for spaces remains high."
National has been strongly critical of the current immigration regime, calling for visa categories to be reopened and residence applications prioritised for critical healthcare workers, as well as offering residence class visas on arrival to experienced nurses.
Last week the Herald reported on how immigration issues are affecting critical care nurses who hospitals want to hire to plug existing staffing shortfalls, and to help increase capacity to prepare for any increase in Covid-19 patients.
Overseas ICU nurses are struggling to get into the country because of visa issues and no available MIQ places, the Intensive Care Society said. Some critical care nurses who are already in New Zealand on visas are leaving for much higher paid jobs in Australia and elsewhere, after immigration delays meant they couldn't plan ahead.
"It is a sellers' market at the moment; these people are in demand all around the world. For instance, Australia is actively looking to recruit more intensive care nurses to be ready for border reopening. And we need to be doing the same," said ICU doctor Craig Carr, who is the New Zealand regional chairman of the Australia NZ Intensive Care Society.
Health Minister Andrew Little has previously acknowledged the "extraordinary pressure" on health workers, who are "not only having to deal with and adapt to responding to the Covid virus, but also it is an understaffed system. There are a large number of vacancies."
In response to the ICU nursing issue, Little said the Government was focusing on getting healthcare workers across the border with exemptions, "and that is happening", with that group making up 43 per cent of people coming in.