A little over two weeks ago, amendments to the Health and Safety in Work Act (2015) were passed and will be enacted in April 2027. This bill was passed despite unions, health and safety professionals, employer groups and even ACC themselves, warning the amendments would lead to more harm.
Robust health and safety legislation is essential to keeping us safe at work. But we are not safe. When we are not safe, nor are those we care for (She knows where her son’s body lays — now she wants safety for workers like nurses – Kaitiaki Nursing New Zealand).
We know having sufficient nurses with the right skills, knowledge and experience to meet patient need in every part of the health system, saves lives and reduces avoidable harm. Our NZNO strategic plan Maranga Mai! includes the demand for legislated culturally safe nurse-to-patient ratios underpinned a fit for purpose Care Capacity Demand Management tool. The relationship between safe nurse-to-patient ratios and patient outcomes has been researched for decades. When nurses have too many patients to care for safely, there is an increased likelihood of avoidable patient harm. Tragic deaths in ED department wait rooms around the country support NZNO’s call for an independent inquiry that will provide critical transparency not only for the family involved but also for maintaining public confidence in the health system. Frontline staff continue to provide exceptional care despite difficult circumstances, but many are working in environments where shortages have become the norm rather than the exception.
We know avoidable harm in health care is costing increasing numbers of patients’ lives, their livelihoods, and costing the country more than $2.4 billion every year. That cost could be much greater as many who experience harm do not report it or when they do, many claims are rejected. This, in a context where ACC claims for patients harmed by their health care has more than doubled in the last decade. Yet serious harm complications reported to the Health, Safety and Quality Commission by Te Whatu Ora recently, was the only factor that Te Whatu Ora highlighted, stating there has been a sustained reduction in reported harm events. Such a statement in a context where serious harm reports in 2024/25 more than doubled from the previous year, is indicative of the pervasive attempts of Te Whatu Ora to suggest there is nothing there to see.
We know too when there are too few nurses and too great a patient need nurses are forced to decide who gets timely, culturally safe care, and who doesn’t. Those decisions take a toll. Moral harm occurs when nurses witness, perform, or are complicit in actions that conflict with their core values. In health care, this often involves situations where patient care is compromised due to systemic constraints, workplace policies, or leadership failures. Moral harm is a critical psychosocial risk. Removal of psychosocial risk from the Health and Safety in Work Act list of critical risks will reduce employers’ requirements to monitor and reduce the risk, going forward.
In June last year, Minister of Health Simeon Brown promised the Government was bringing “transparency and accountability” back to the health system. Transparency and accountability are founded on systemic collection and review of relevant data to identify what’s going on and why, then creating systems, with our NZNO members, to prevent harm occurring. This requires an ingrained safety culture that focuses on prevention through processes that support recognition of potential mistakes before they happen. Ultra-safe industries such as aviation are always checking, always asking questions, always looking for ways to prevent harm before it happens.
The New South Wales Code of Practice recommends systematic collection and review of data that can provide insights into psychosocial risks. Emphasis is placed on talking to workers and recognising that workers generally know which parts of their roles are most hazardous.
ASMS recommended to Worksafe in 2023 that “Worksafe acknowledges Māori workers are likely to face additional psychosocial risk factors than non-Māori, including experiencing racism and a lack of cultural competence and cultural safety in workplaces.
Addressing the resulting systemic issues that are now being experienced across the hospital, primary health, aged care and Māori/Iwi providers, would go a long way to walking the talk on transparency and accountability. Preventative strategies would counter the sense of betrayal felt by most workers, when the Health and Safety in Work Act amendments were passed and create a more sustainable long-term approach to reducing avoidable harm for patients and nurses alike.
Change is needed at government level to counter the “nothing to see here” approach to one that is transparent and accountable. Now is an ideal time to consider which political party will stand with us and not against us, so that we, alongside our friends and families can make an informed choice on 7 November 2026. Enrol. Vote.