Editorial: Pay rise for nurses best prescription

Few people will begrudge nurses a substantial pay increase. It is widely recognised they are rewarded inadequately for a job that involves excessive patient loads and long shifts, usually alternating between night and day and including periods of high stress. As the Weekend Herald reported, their case has been strengthened by the fact that public hospitals are short of 2000 nurses nationwide. So dire is the situation in some districts that operations are having to be cancelled, a legacy of experienced staff taking up better-paying nursing jobs overseas or simply walking away from the profession. Purely on the basis of supply and demand, nurses warrant a rise.

That, however, is not the prime plank of their quest for a 21 per cent pay increase. The Nurses Organisation has wedded this demand to the flaky concept of pay equity. Nurses, it says, do work equal in value to secondary school teachers and the police; their salaries should reflect that.

There is no logic to this claim, if only because rates of pay are, in the first instance, a reflection of supply and demand. Nursing, historically, was one of a narrow range of jobs into which women crowded - to the point of oversupply. That situation no longer applies. Indeed, because of poor rates of pay, a substantial shortage of nurses is impairing the smooth functioning of hospitals. Nurses have a strong case for being paid more - but in relation to others in the health sector, not teachers or the police.

It is easy to see why they are fixated on pay equity, however. A recent report by the Pay and Employment Equity Taskforce found the so-called gender pay gap was largest in the health sector. In essence, this meant nurses, 90 per cent of whom are female.

The taskforce's conclusion was accepted by a Government committed, however misguidedly, to introducing pay equity throughout the public sector. But to reduce the fiscal impact - applying it to nurses alone would cost an estimated $300 million - this is scheduled to be achieved progressively through to 2008.

The nurses know that pay equity will never get off the ground if the Labour Party loses the next election. This has galvanised them. A week ago, they voted overwhelmingly to bargain on a national basis - and threatened nationwide strikes in August if negotiations with the Government do not go their way. That, again, is a flawed approach.

For all that the nurses might relish their collective muscle, they risk a diminution of public sympathy. More fundamentally, bargaining with individual district health boards provides the only means of securing salaries that recognise variations in costs of living. It is far more expensive to live in Auckland than Invercargill; national awards never reflect that.

The nurses' claims are being pushed in a climate of increasing concern about health-sector spending. Earlier this month, a Treasury report revealed that despite a 6 per cent rise in funding in the 2003-04 Budget, the 21 district health boards performed fewer elective operations in the first half of the financial year than in the same period of the previous year. Essentially, the money was swallowed up by rises in personnel and clinic costs. The nurses' aspirations threaten to imprint that pattern more deeply.

Yet in some cases, pay rises have a valid foundation. Several years ago, junior doctors became a scarce commodity after many of them succumbed to higher salaries overseas. On that basis, they won a large salary increase. The nurses' case today bears comparison, without any need for them to dive into the murky waters of pay equity.

Best of all, as many as 5000 of the trained nurses who have quit the profession remain in this country. A salary that brought them more into line with other hospital staff might lure many back to the ward. If so, it would be a worthwhile prescription.