Source: Aged Care Association
The Aged Care Association says the decision to restrict nursing student enrolments for 2027 exposes a fundamental failure in how New Zealand plans for its future health workforce.
Chief Executive Hon. Tracey Martin says reports that the Tertiary Education Commission (TEC) has instructed nursing schools to return to 2025 enrolment levels, apparently based on clinical placement capacity within Health New Zealand, raise a much bigger question.
“Why is the organisation responsible for funding nursing education relying on just one part of the health sector to determine how many nurses New Zealand should train?
“Health New Zealand is not the entire health system. It is not the only employer of nurses, and it is certainly not the only part of the health sector capable of providing clinical placements.
“Yet here we have the Tertiary Education Commission apparently using Health New Zealand’s assessment of its own capacity to inform a decision that will affect the future nursing workforce available to every other health provider in the country.
“That makes absolutely no sense.”
Martin says the situation highlights the absence of coordinated workforce planning across the whole health sector.
“Health New Zealand undertakes workforce planning for its own services. But who is bringing together the workforce requirements of aged residential care, primary care, community health, disability services and all the other organisations that employ nurses?
“Who is looking at the combined demand for nurses across the entire health system, both now and into the future?
“And who has asked those other parts of the health sector what capacity they have to provide clinical placements for nursing students?
“Because from what we are reading today, it appears those conversations have not happened or at least have not informed this decision.”
Martin says the Aged Care Association is particularly concerned that the decision overlooks the growing nursing workforce requirements of aged residential care.
“We have tens of thousands of older New Zealanders receiving clinical care in aged residential care facilities every day. Many have multiple chronic conditions, dementia and increasingly complex healthcare needs.
“We know the number of older New Zealanders requiring residential care will grow, and we know that means we will need more nurses.
“But apparently, when it comes to deciding how many nurses this country should train, the needs of aged residential care don’t feature in the equation.
“Aged residential care is health care. The only thing that changes is the address where that care is delivered. Our nurses are part of New Zealand’s health workforce, and our providers should be part of planning for its future.”
Martin says the explanation that Health New Zealand cannot accommodate additional clinical placements should have prompted TEC to engage with other healthcare providers, rather than restrict nursing enrolments.
“If Health New Zealand cannot provide more placements, then surely the logical next step is to ask who else can.
“Aged residential care already provides clinical placements for nursing students. There may be opportunities to expand that capacity with appropriate supervision, coordination and support.
“But you cannot know what capacity exists if you haven’t asked.
“And you certainly shouldn’t be making decisions about the future nursing workforce of the entire country based on the capacity of just one part of the system.”
Martin says there are also legitimate questions about the relationship between funding and workforce planning.
“TEC is the agency responsible for funding tertiary education. We know funding is constrained, and we are entitled to ask whether financial considerations are also influencing this decision.
“But regardless of whether the constraint is funding, clinical placements or both, the underlying problem remains the same.
“We do not appear to be planning for the nursing workforce New Zealand’s entire health system needs.”
Martin says the situation is made more concerning by potential changes to immigration settings following the November election.
“New Zealand First has announced a policy to replace the Accredited Employer Work Visa with a shortage-led Skilled Work Visa.
“We support training New Zealanders to meet our workforce needs. But aged residential care also relies on internationally qualified nurses and care workers to fill genuine shortages, particularly in rural and regional communities.
“If future immigration settings make international recruitment more difficult, while decisions about domestic nursing education continue to be based largely on Health New Zealand’s requirements, where exactly are aged residential care providers expected to find their nurses?
“These decisions cannot be made in isolation from one another.”
Martin says the Association wants an explanation from TEC about which parts of the health sector were consulted before the instruction was issued, and how workforce demand outside Health New Zealand was incorporated into its decision.
“We need a national health workforce strategy that brings together every part of the health system, not separate workforce plans developed in isolation.
“Health New Zealand has an important role to play, but it cannot be expected to plan for the workforce needs of organisations it does not operate.
“Someone needs to take responsibility for understanding the total demand for nurses across New Zealand, ensuring we train enough of them, and coordinating clinical placement opportunities across all healthcare settings.
“That is what genuine health workforce planning should look like.
“Until we get that right, we will continue making decisions in one part of the system that create problems for everyone else.
“If aged care fails, the health system fails. It is time our workforce planning recognised that aged residential care is part of the health system, not an optional extra.”