ANI O'BRIEN: Scaremongering unions have a bad case of amnesia

What NZNO's own figures reveal about the health system crisis

I am not here to dispute the reality that New Zealand’s hospitals and wider health system is struggling. Nurses are burnt out, patients have to wait too long, and our resources are never enough. Nothing in this essay is intended to pretend this is not the case. However, I am going to challenge the particular political narrative that our health system has fallen apart all of a sudden under this government due to unprecedented underfunding and understaffing because that just isn’t true.

New Zealand’s health system has been teetering around crisis point for decades and under successive governments, and every three years we seem doomed to play a game of who’s fault is it. However, this term, the usual script has been turbo boosted by a seriously effective campaign to embed a particular narrative from the start that could be cashed in on at the end. In this first essay, I am going to outline the current story of the state of our health system and then, in a follow up, I will step you through the masterclass in misinformation achieved by the Public Service Association and New Zealand Nurses Organisation, and other unions.

Over the past few months New Zealanders have been treated to article after article of medical disasters and health system failings. Many of them relate to things that happened several years ago and that the coroner is only now reporting on, but that bit never makes the headline. Others are real failings, but they are unfortunately so ordinary that we have experienced them regularly for years. Patients being treated in corridors? Google it and you’ll find an almost annual renewed interest in the phenomena going back years. Emergency Department wait times? Same. Wards understaffed? Tale as old as time.

This past week we have seen particularly upsetting reporting relating to the haematology and oncology ward at Starship Children’s Hospital where cancer treatments have had to be rescheduled. Accompanying the stories have been descriptions of nurses who are frightened by staffing pressures and feel like they cannot provide a high enough standard of care for their patients. This is a highly emotive subject that very few people would be unmoved by. Kids. Cancer. Systemic failings.

Unfortunately though, our natural empathy for the children battling cancer and their parents makes us ripe for manipulation. Or at least presents an opportunity for political leverage. Labour’s health spokesperson Dr Ayesha Verrall has accused the Government of putting children’s lives at risk because in her view they are choosing not hire more nurses. She does this knowing that when she was Health Minister she encountered similar situations. The nurses’ union, New Zealand Nurses Organisation (NZNO), likewise describes the staffing situation as evidence of deliberate short-staffing by Health New Zealand. And the news media dutifully follows with salacious headlines and articles that have lifted entire sections directly from an NZNO press release.

It is totally reasonable that anyone reading the headlines about overcrowding, exhaustion, delays, deterioration, and a health system in crisis might conclude that our hospitals have been neglected (or worse) by Christopher Luxon and the Coalition Government. However, there are some rather inconvenient facts that disprove this and some of them can be sourced from NZNO’s own records.

The same Starship oncology ward now at the centre of the staffing controversy was operating below its staffing target for approximately three quarters of shifts in 2023, when Labour was in government. That year, Ward 27B recorded 791 shifts below target, according to figures publicised by NZNO in May 2024.¹ By 2025, under the Coalition Government, the number of understaffed shifts had fallen to less than a third. This year, the ward had an exceptionally bad August and hit 85%, but has since dropped back down again to 73% in September and for the first two weeks of October it was at just 33%. August was an anomaly. In fact, four additional staff have recently started and another seven are expected to start over the next three months.

Despite having access to this same complete data, when the NZNO put out a press release last week, they chose to leave out the rapid recovery after August.² RNZ reproduced the same data, but after the rather convenient framing was pointed out, updated their graph to include September and October.³

Not only did the NZNO present the staffing levels in a way to obscure that they had already rapidly improved, but they made it about this Government despite staffing levels being worse under the last according to their own data! It was this that prompted me to think more deeply about how the unions have framed up a narrative around our health system these past few years. Of course, I know like everyone does that the unions are inextricably tied to Labour and they will always approach things with their interests in mind, but this becomes problematic when the media treats them as if they are apolitical and agenda-less beyond higher wages for their workers. In cases like this one where the news media reproduces data and a fully formed story uncritically, we can see the enormous power the unions have to paint a picture for New Zealanders of what our public service looks like.

Suspicious that the unions have constructed a much more embedded and effective crisis narrative around one of our longest standing governance issues, I decided to dig into the data and the press releases and try to establish the truth from the spin. What I found was, as I have already said, a system that has entrenched long term problems. But, I also found that the measurable national picture based on data and records is far less uniformly bleak than the unions, Labour, and the media would have us believe. In fact, some health indicators have improved substantially in the past few years. Others remain stubbornly problematic, and in a few areas there has been continued deterioration.

I could take you back decades for a meander through the bigger picture of our beleaguered health system, but we all know this is already going to be far too long so I have decided to focus mostly on the Coalition Government and the 2017-2023 Labour Governments. There is certainly enough in the last almost decade for us to look at.

To begin with, let’s travel back to 2022 when Jacinda Ardern was Prime Minister and Andrew Little was Minister of Health. In May that year, NZNO launched Maranga Mai! which was a nationwide campaign to secure political commitments, increased funding, better pay, and safer staffing. NZNO chief executive Paul Goulter may be very quick to blame the woes of the health system on the Coalition now, but at the time he blamed decades of poor planning, inadequate funding, and neglect for a nursing workforce suffering serious shortages and poor morale.

By July 2022, things had got scratchy between the union and Labour and NZNO were demanding that Andrew Little acknowledge a national health crisis.⁴ They even accused him of making inaccurate and disparaging comments about organisations raising concerns. A week later, the union followed up by publishing the results of an appeal to their members that had attracted more than 2,700 responses in just two days. Of those responses, 70% described the system being in crisis, while 29% said things were passed crisis point.⁵

This moment of fractiousness between usual allies illustrates that the language of impending system collapse, frontline exhaustion, and patients at risk is not something that has appeared as a result of a uniquely awfully Coalition Government starving the system of resources. It is to the union’s credit that the same arguments being directed at Simeon Brown were being directed at Andrew Little four years earlier. The only difference is that they never call for Labour to be voted out whereas that is their call to action when National is in charge.

A little later in 2023, when Dr Ayesha Verrall was Health Minister, nurses working in Ward 5 of Gisborne Hospital took industrial action against the Labour Government due to staffing and patient safety concerns. Health New Zealand went to the Employment Court in an unsuccessful attempt to prevent the action and the nurses proceeded to strike on 24 May 2023.⁶

Dr Verrall is now Labour’s health spokesperson and she has spent the past term attempting to prosecute Dr Shane Reti and then Simeon Brown for the same circumstances she herself was in charge of before the change of government. She has been unrelenting in her attacks on staffing levels, patients being treated in corridors, and overcapacity Emergency Departments. It is like politicians think the slate gets wiped clean at each election and their own records no longer matter. The change of government might have removed the responsibilities from her and plopped them in the lap of Reti and Brown, but the problems are essentially the same. The Gisborne example is particularly interesting because it was about the same issues that are being reported on in relation to the Starship today.

Further exploration led me to the report commissioned by NZNO in August 2025 called ‘How many more nurses does New Zealand need?’.⁷ Infometrics researchers analysed approximately 1.69 million nursing shifts across 59 hospitals between January 2022 and November 2024 using Health New Zealand data. This timeframe straddles the end of the Labour Government and the beginning of the Coalition Government.

The report findings show that hospitals experienced an average daily aggregate shortfall equivalent to 631 nursing FTEs per shift in 2022, rising to 684 in 2023, and falling to 587 in the first 11 months of 2024. To refresh your memory, the election was on October 14th 2023 and Coalition Government was sworn in on November 27th.

So again, the NZNO’s own data and behaviour demonstrates not a worsening of conditions under the Coalition, but rather in this case an improvement. Yet, in the past term, the union has consistently presented the issue as one relating directly to what they characterise as spending constraints and frontline cuts.⁸ “We have an impoverished health system that continues to be eroded by the Coalition Government’s spending restraints and frontline service cuts,” NZNO chief executive Paul Goulter said, in May 2024. His press release went on on to say “Mr Goulter said this is what failure to properly fund health looks like on the front line and that the data shows we simply cannot afford any further service or funding cuts.”

Conversely, the Coalition Government has made a song and a dance of the five national health targets. Simeon Brown goes on about them at Question Time with admirable (if monotonous) persistence. And, after a proper look through them I can understand why. The figures are published by Health New Zealand and are credible and measurable. They also show clear as day that there has been a lot of improvement in our health system. Comparing the April to June quarter of 2026 to that of 2025.

Health New Zealand reported improvements in all five national targets.⁹ The proportion of patients on the elective treatment waitlist who waited less than four months increased from 63.9% to 72.6%. To clarify, “elective treatment” doesn’t mean “optional” or suggest it is somehow cosmetic. It means planned treatment that doesn’t require emergency intervention eg. hip or knee replacements, cataract surgery, or getting tonsils removed.

Patients receiving a first specialist assessment within four months also increased from 62% to 66.1%. Likewise, the proportion of emergency department patients admitted, discharged, or transferred within six hours increased from 73.9% to 76.3% and in relation to cancer treatment it bumped up from 86.3% to 87%. Across Health New Zealand’s quarterly performance framework, 19 of 25 measures showed year on year improvement.

So, not total success and the crisis certainly hasn’t been solved, but the results certainly don’t back up the idea that the health system is experiencing total decimation under this Government.

If we zoom out and look back across the entire 2017-2026 period regarding Emergency Department performance the data similarly does not fit with the unions’ narrative. In April to June 2018 (the Ardern Labour Government took office at the end of October 2017), 89.5% of patients were admitted, discharged, or transferred within six hours. By the end of Labour’s six years this was at 71.1% (April-June 2022/23).¹⁰ Labour can point to Covid-19 to explain some of the deterioration, but remember that we were locked in our homes and much more reluctant to go to hospital for other things during that time too. It was not all pandemic-related. Regardless of the causes, the Coalition Government had that number back up to 76.3% in April to June 2025/26.¹¹

Now let’s look at diagnostic waitlists. According to a Health New Zealand’s September 2026 report, the number of patients waiting for CT scans fell by 48% in the year to June 2026 and the MRI waiting lists fell by 33%.¹² Coronary angiography waiting lists fell by about 29% and the combined reported diagnostic waitlist dropped by 21%. Additionally, the Diagnostic Boost Programme delivered 89,039 additional procedures during 2025/26, smashing its target by more than 14,000.

I have given you some of the highlights, but the whole system clearly isn’t where it needs to be. The Government’s own targets show just how far there is to go. At 72.6%, although much better, the elective treatment stat remains well below the 95% target for 2030. The issue I am looking at here is not that there is something wrong with the unions criticising government performance. My observation is that inadequate performance and improving performance are not mutually exclusive. Things can be getting better and in fact be much better than they were under the last government, and still not be good enough.

The same can be said to be true of funding. More funding is great, but that doesn’t mean it will ever be enough. If you listen to Labour and the unions you might think that the Coalition Government has stripped funding out of the health system and is starving it of resources. I mean, the say basically that regularly. But, again the actual evidence, the data, does not support those claims.

According to Ministry of Health figures, health funding for 2026/27 totals $33.031 billion up from $30.476 billion in 2025/26.¹³ That’s an extra $2.6 billion or an 8.4% increase. However, not all of that money goes directly into things like treating patients because it includes spending on hospital buildings and equipment etc. The funding available for day to day operations including paying staff increased by 5.7% and funding for services delivered by Health New Zealand increased by 6% though.

For some historical perspective, Labour’s first budget in 2018 allocated $18.2 billion to health. They increased this each year and in 2023 their final budget had $26.5 billion for health. The Coalition has continued this trend and increased funding with each budget. There has been no “slashing” or “cutting”. We can argue about whether the size of increases was substantial enough and bring things like inflation into the equation, but it is completely false to say that any budget over the past three terms has taken health funding backwards.

The Coalition also inherited Labour’s new split health system. Considerable amounts of money had been spent on health reforms and recruitment and the system was under immense financial pressure. Even though the Coalition quickly disestablished the Māori Health Authority a lot of the staff were absorbed back into the wider system and they could not unspend what had already been spent. Consequently, in June 2024, Health New Zealand introduced recruitment restrictions and regional approvals processes that were meant to bring staffing expenditure under control. Some non-patient-facing role recruitment was paused, but there was never a halt on frontline hiring.¹⁴

The unions have frequently described this as a “hiring freeze”. Ad nauseam. They turned getting extra sign off before hiring into a conspiracy not to hire any nurses. Health New Zealand are unfortunately operating in the same world as the rest of us and when things are tight you make sure your spending is strictly necessary. This technicality, however, has formed the basis of a great deal of the scaremongering narrative being propagated by the NZNO and the Public Service Association.

And my goodness, the unions love to weaponise a technicality. Everyone in the country has probably heard Labour and the unions’ outrage that “only 54 new nurses” have been hired in the past two years. In order to get that number they are comparing the workforce of approximately 29,404 nursing FTEs in March 2024 to 29,458 in March 2026. Technically 54, right? Yes, if you choose that specific sliver of time in order to exclude the recruitment surge that occurred just before March 2024 that saw thousands enter the workforce. It also doesn’t take into account that recruitment was continuing but retirements and resignations were offsetting it.

The true picture of health this term is not what either side would prefer. Labour and the unions want to be able to portray the Government as being responsible for the crisis due to austerity and mismanagement, while Christopher Luxon probably wishes he could have waved a magic wand and fixed everything. The reality is the Coalition inherited significant workforce shortages, saw a substantial increase in nursing employment in the first six months of its term, then presided over a period of limited net growth. It continued to increase the health budget and improved several important health measures, while some individual departments have struggled to recruit staff.

There are still significant issues.

Both sides have access to the same data, but they are shaping and presenting it to New Zealanders in vastly different ways. One side has an interest in highlighting improvements and increased spending, the other in highlighting failures. If we return to Ward 27B at the Starship we see this in action. Health New Zealand Auckland Group Operations Director Dr Mike Shepherd has characterised the issue as a time of “high demand” and “very high staff sickness”.¹⁵ He says that while nursing shortages have forced some cancer treatment delays it is a matter of about 20 chemotherapy cycles out of 600 being delayed a few days. A spokesperson for the minister further explained that two bone marrow transplants had been moved “slightly”, but were going ahead. The picture painted by Health New Zealand and Simeon Brown is one of (unfortunately) routine juggling of resources and staff due to flu season and existing pressures.

On the other hand, NZNO Kaiwhakahaere Kerri Nuku said “Health Minister Simeon Brown can argue oncology services are being postponed not suspended but such semantics are unlikely to be important to whānau with children with cancer.” What’s more Nuku made the extraordinary accusation that the short staffing was “deliberate”.¹⁶ If the NZNO has proof that Health New Zealand and the minister are deliberately putting children with cancer at risk they should present it because otherwise it is a pretty revolting claim.

Nuku has worked for more than a decade and a half at NZNO and is hardly a dispassionate observer of the Coalition Government. Her penchant for hyperbole extends far beyond the usual complaints about nursing shortages. In her regular commentary posted to the NZNO website she makes clear that her view is not that the Government is simply making policy decisions she does not agree with. No, no, no. She says the Coalition is engaged in an assault on women’s rights, undermining the independence of the nursing profession, and pursuing an agenda to erase Māori from legislation. She has accused the Government of using a “dog whistle designed to whip up racism”, alleged that health workforce data is being “fudged” and facts “massaged” and even declared that ministers are “selling multi-million dollar citizenship to the billionaires who are burning the world to the ground”.¹⁷ Nuku’s criticism on the NZNO site covers colonialism, climate policy, landlords, parliamentary democracy, and international conflicts. She even claimed “This Coalition Government punched women in the face”.¹⁸

These perspectives are delivered to thousands and thousands of nurses every week. They work hard in challenging conditions and then are fed a steady diet of blame centred on austerity, cuts, and deliberate underresourcing. Most nurses will take an ordinary amount of interest in politics, that is not much interest at all. Consequently, their union is able to be their primary source of political information and what they are being served is highly highly politicised and partisan.

After examining the historical record and current performance data, I am convinced that the New Zealand’s healthcare debate is suffering from serious lack of proportion. The problems exist and some are distressing for patients and their families, but on the whole they represent the daily challenge of running an under pressure health system. However, the unions, Labour, and the media are being extremely selective in what they focus on and how microscopic and hyperbolic they get with certain stories.

The government of the day has a responsibility to explain how its decisions are addressing the problems whether they inherited them or not. They certainly cannot hide behind the previous government’s failings forever. But the Opposition and the unions should act ethically and morally in their criticism. Scaremongering about cancer treatment is not, in my view, ethical. They should highlight problems but proportionally and in context.

Neither under nor overplaying the state of our health system helps New Zealanders. After decades of struggle we need political will and consensus to effect change. Taking turns to be defensive and critical every few years is politics but it is not what is best for this country. What the unions are currently doing is putting their own political interests above the people of New Zealand. They are powerful organisations and their own documents make it clear that they regard influencing public opinion as an important part of their work.¹⁹ The PSA has explicitly committed itself to campaigning for a change of government and NZNO has been less explicit though its intents are obvious.²⁰

Journalists have a responsibility to do better than reproduce the claims of unions by publishing their press releases verbatim. They should be verifying their claims and examining context. The same scrutiny should obviously apply to ministerial press releases. Everyone is acting in their own interests particularly in this election period. New Zealanders deserve better than being spoonfed the hyperbolic assertions of Labour-aligned unions without disclosure or challenge.

In my next essay, I will examine more deeply how the NZNO, PSA, and Labour have communicated our healthcare problems, the political objectives documented in their own publications, and the extent to which news coverage has tested their claims.

1

https://www.nzno.org.nz/about_us/media_releases/artmid/4731/articleid/6776/official-nurse-unsafe-staffing-figures-genuinely-alarming

2

https://nzno.org.nz/about_us/media_releases/artmid/4731/articleid/7293/starship-oncology-ward-short-staffed-85-of-all-shifts-in-august?

3

https://www.rnz.co.nz/news/health/1927376/starship-hospital-s-cancer-ward-three-months-away-from-full-staff-after-chemotherapy-delays

4

https://nzno.org.nz/about_us/media_releases/artmid/4731/articleid/6491/nzno-calls-for-urgent-health-sector-conference-on-crisis

5

https://www.nzno.org.nz/about_us/media_releases/artmid/4731/articleid/6492/2700-heartfelt-pleas-to-health-minister-by-members-of-nzno

6

https://maranga-mai.nzno.org.nz/gisborne_safety_strike

7

https://www.nzno.org.nz/Portals/0/publications/Report%20-%20Infometrics%20report%20how%20many%20more%20nurses%20does%20New%20Zealand%20need%20August%202025%20FINAL.pdf

8

https://www.nzno.org.nz/about_us/media_releases/artmid/4731/articleid/6776/official-nurse-unsafe-staffing-figures-genuinely-alarming

9

https://www.healthnz.govt.nz/news-and-updates/more-new-zealanders-receiving-the-right-care-when-they-need-it

10

https://www.beehive.govt.nz/sites/default/files/2025-09/Report%20Card%20-%20Shorter%20Stays%20in%20Emergency%20Department%20%281%29.pdf?

11

https://www.healthnz.govt.nz/news-and-updates/more-new-zealanders-benefiting-from-a-stronger-health-system?

12

https://www.healthnz.govt.nz/news-and-updates/radiology-boost-helps-more-patients-access-diagnostic-tests-sooner

13

https://www.health.govt.nz/about-us/new-zealands-health-system/vote-health/budget-2026/health-funding-trends

14

https://www.rnz.co.nz/news/health/1055811/documents-reveal-health-nz-hiring-crackdown

15

https://www.newstalkzb.co.nz/on-air/heather-du-plessis-allan-drive/audio/dr-mike-shepherd-health-new-zealand-auckland-group-operations-director-on-starship-delaying-cancer-treatments-amid-nurse-shortage/

16

https://www.rnz.co.nz/news/health/1918105/auckland-s-starship-hospital-delays-some-cancer-treatments-due-to-nurse-shortage

17

https://nzno.org.nz/about_us/our_leaders_speak/kaiwhakahaere/artmid/8390/articleid/6978/kaiwhakahaere-kerri-nuku-our-government-doesn%E2%80%99t-want-us-to-be-involved-in-the-world-but-it%E2%80%99s-coming-for-us?

18

https://www.nzno.org.nz/about_us/our_leaders_speak/kaiwhakahaere/artmid/8390/articleid/6887/kaiwhakahaere-kerri-nuku-a-bit-of-w%C4%81hine-m%C4%81ori-inspiration-as-we-fight-for-all-women?

19

https://www.nzno.org.nz/Portals/0/Files/2026/NZNO%20Maranga%20Mai%21%202026-2027%20Approved.pdf?

20

https://www.psa.org.nz/te-mahinga-ora/te-mahinga-ora-july-2026?

Ani O'Brien writes at Thought Crimes