Crisis in hospital maternity services part of wider health emergency

People have been speaking out about the crisis in hospital maternity services across Aotearoa / New Zealand. Our services are under strain from cost-saving measures — this is impacting our communities. Things need to change.

Coverage in the media has highlighted the difficult experiences for people using these vital services. Mothers should be given the resources when they need them. This is one of the most important moments in families lives. Financial constraints should not be taking resources away from these profoundly essential services.

In Auckland District Health Board (ADHB) currently there are 22.5 vacancies in maternity services. In Waikato DHB there is a need for an extra 22 midwives. This shortage is also reported at Capital and Coast DHB, Canterbury DHB and Counties DHB. This is becoming endemic in our health system today and is placing strain on families and healthcare workers equally. Why is this the case?

As with many areas in the health sector, unsafe working environments have become the norm, from junior Doctors rostering practices to staffing Ambulances with only one crew member. Positive movement on these issues has been down to workers taking action. Without this worker led fight-back — the cost-cutting would continue. The main reason for this is that the New Zealand health system needs $1.85 billion to get back to equivelent 2009 funding levels. Our health system has been subjected to progressive austerity measures from successive governments. Are staff vacancies just another part of the cost-saving measures?

Vacancy management has been identified as a method of achieving efficiencies according to Auckland DHB board minutes in December 2016. Alisa Claire (ADHB CEO) states from an OIA release concerning this issue:

Any efficiency savings are delivered in the context of maintaining high quality care while at the same time delivering services in a cost efficient and productive manner

This statement raises serious concerns and appears disingenuous considering maternity services at ADHB have 22.5 vacancies according to the latest Hospital Advisory Committee minutes. Is this the definition of delivering services in a cost efficient and productive manner?

Underfunded services can also lead to toxic work cultures and unsupportive environments. This has a flow-on effect on perpetuating vacancies. There are reports of work environments where there is a lack of support for staff, creating conditions for stressful work environments where bullying can become rife. Many midwives are leaving the profession after less than a decade due to stress and negative staff culture. As many will testify — it is often easier to leave a workplace than to change a bullying culture. This is a sad reality and something that will take concerted action and resources to turn around.

Given all of this, we need change. Care rationing and chronic underfunding puts mothers, babies and families at risk. These issues have been developing for years — and many workers in the health sector have been calling for change. But health workers are often unable to speak out due to professional backlash. That is why members of the community speaking out is so important. It has taken members of the public — which the health system exists to provide services for — to speak out, to make this an issue. We need people in our communities to speak up for better services. As caregivers and workers in this system, we want the best for those we care for. We feel the pressures of not being able to give that care. We see the staff shortages. And we know the crisis in maternity services is just another example among many.

We need change in our health system. We need to collectively fight back. We need a properly funded health system. Health Sector Workers Network believe that the pathway to achieving this is through building solidarity in our health sector. Collectively, people can demand services that function to truly respond to social need, provide healthy work environments for workers and flourish for communities.

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