8. Question No. 8—HealthDr SHANE RETI (National) to the Minister of HealthQuestion No. 8—Health8. Dr SHANE RETI (National) to the Minister of Health: How many of the 1266 internationally qualified nurses that he stated in the House last week had arrived in New Zealand since 1 January 2022 have been employed since 1 January 2022 to work in the health system and how many nurses have left employment over the same time frame?Hon ANDREW LITTLE (Minister of Health): To the first part of the member's question as I indicated earlier I've been advised that 1231 internationally qualified nurses rather than 1266 have arrived in New Zealand since 1 January this year. Those nurses have arrived under one of two visas: the critical purpose work visa or the Accredited Employer Work Visa. But it should be noted that internationally qualified nurses have arrived in New Zealand since that time under other visas too—principally the visitors' visa. Part of the criteria to have been granted either of the work visas is to have an offer of employment or be enrolled in a competence assessment programme—that is to say all 1231 of the nurses who have arrived will have held an offer of employment or are undergoing the Nursing Council of New Zealand registration process. To the second part of the member's question I've been advised that the employment data held by Te Whatu Ora - Health New Zealand on leavers is not collected in a way that differentiates between internationally qualified nurses and domestically qualified nurses. What I can say is that from the quarter ending 31 March this year to the quarter ending 30 June this year there was a total of 3627 nurses who started employment with Te Whatu Ora - Health New Zealand and in that same time period there were 2686 nurses who voluntarily left employment with Te Whatu Ora - Health New Zealand. And for completeness I have to say that the number of those who left also includes people who left one district under the old district health board regime to work in another district because district health boards were different employers and it's not possible to identify and exclude movements between districts. I have to say also this is another reason why we need to upgrade the data system across Te Whatu Ora - Health New Zealand an investment that this Government is making.Dr Shane Reti: Point of order. The primary did not ask how many nurses had been offered employment but how many had been employed and the Minister did not answer that.Hon ANDREW LITTLE: Point of order Mr Speaker.SPEAKER: Can you speak to the point of order that—Hon ANDREW LITTLE: Sorry yeah. The answer was the 3627 nurses who started employment which looks suspiciously like who have been employed since" to me.SPEAKER: OK so it has been answered.Dr Shane Reti: Are staffing shortages in our emergency departments (EDs) contributing to increasing numbers of patients waiting more than 24 hours in ED and if so why are nurses not on the fast track to residency?Hon ANDREW LITTLE: A number of things there—first of all nurses are on the Green List of immigration for this country. It has never been easier to come to New Zealand as a nurse either to come here with an offer of employment or to come here to do a competency assessment programme and to be employed as a nurse which explains why the number of registrations as recorded by the Nursing Council shows that since November last year 4300 internationally qualified nurses have had registration in New Zealand. In relation to the pressures in emergency departments there are a number of reasons for those pressures: increased numbers of people turning up needing the services of our EDs because of challenges in primary care principally after-hours and urgent care; plus also what is happening in aged residential care and the fact that it is not as easy to discharge some particularly elderly patients from hospital into those beds as it once was. I'm confident however that the leadership and management of Te Whatu Ora - Health New Zealand is doing everything they can to work with all parts of the sector to relieve those pressures.Dr Shane Reti: Does he agree with the advice received by the Minister of Immigration suggesting a fast track to residence could perpetuate a growing reliance on migrant health workers and if so can he tell New Zealanders what exactly is the problem with migrant nurses filling vacancies in New Zealand hospitals when there are no Kiwi nurses available?Hon ANDREW LITTLE: There has never been a problem in the New Zealand health system of employing overseas qualified nurses. We have a lot of them both in our public health system and also in the private health system principally in aged residential care. As well as recruiting through immigration to meet the immediate needs and the immediate vacancies in our system we also have to make sure that we are growing our domestic pipeline of domestically trained nurses and we are also doing that.Dr Shane Reti: How does he explain statements from Rob Campbell the chair of Health New Zealand who said last week that it would be helpful for us if nurses were on the day one fast track to residency?Hon ANDREW LITTLE: Mr Campbell and I work very closely together to make sure that Te Whatu Ora - Health New Zealand the organisations whose board he chairs is doing everything it can to fill the nursing vacancies that we have either through immigration or through supporting other initiatives to grow our domestic pipeline of nurses.Dr Shane Reti: Why is it on his watch that not only are increasing numbers of people waiting more than 24 hours in EDs but there is also a 50 percent increase in people waiting more than 48 hours; and as these wait times have increased can he name one week recently when an ED disaster has not been in the news? Hon ANDREW LITTLE: I want to approach that issue very carefully because the member is leaping to a range of conclusions that cannot be sustained. What I can say is that on my watch the number of people turning up to EDs has grown phenomenally so that for successive months we've had more than 100000 people in a month turning up to EDs across New Zealand and that is the product of a range of factors but it is mostly the product of years and years of under-investment in our health system by the members opposite when they were in Government. They hate to be confronted with it—they hate to be confronted with it. But one day some brave member of the National Party is going to rise to say they got it wrong and they should have invested more. They know they can't because their policy is to cut taxes and cut spending on essential things like health services.Dr Shane Reti: What is the waiting time for anger management?SPEAKER: In so far as the Minister has responsibility.Hon ANDREW LITTLE: We have a health system that is facing extraordinary pressures and I was very pleased during the weekend to spend some time with about 220 front-line health workers—anything from intensive care specialists to ED specialists to nurses to all sorts of people; leaders in our health system who seriously want to work with the Government on finding the solutions. The thing they were most disappointed about was when I told them that in order to host an event here I had to write to every single MP to come along and only two other MPs turned up—my colleague Dr Ayesha Verrall and my colleague Liz Craig. Nobody from the Opposition who had spent weeks talking about how much they cared about the health system bothered to turn up to join 220 of our hardest-working health leaders to talk about the solutions to the challenges that we've got."