Kia ora,

My name is Grant Brookes. I'm standing for election to Capital & Coast District Health Board.

The most trusted profession have put their trust in me, electing me President of the New Zealand Nurses Organisation. Now I'm asking you to put me at the top of your list of DHB candidates this October.

I am committed to:

  • Fences at the top of the cliff, not ambulances below
  • Reversing the decline in our health funding
  • Money for health improvement, not CEO pay rises
  • Putting the "care" back into Aged Care
  • Whānau Ora – family well-being for all

  • Having stood for the Board in 2013 and narrowly missed out, I now aim to become part of a fresh, like-minded team with the energy to meet today's health challenges.

    You can find out more About me and My priorities by clicking on the links, or by contacting me on 021 053 2973, or emailing grant_brookes at paradise dot net dot nz.

    Putting the care into aged care

    Aged care is in crisis. It’s headline news. In August, pay cuts of up to $100 a week for staff at Ranfurly Rest Home and Hospital in Auckland were the lead story on Campbell Live (When your employer proposes a pay cut). In early September, an inquiry into shocking neglect of elderly residents at Wellington’s Malvina Major Home was on the front page of the Dominion Post (Rest Home failed all its residents, Ministry says)
    Although the mainstream media reported these as isolated issues, in reality they are the tip of an iceberg.
    The systemic crisis has been clear for at least the last three years. In 2010, opposition MPs Sue Kedgley and Winnie Laban led an alternative inquiry into aged care, after National Party members of the health select committee blocked a formal parliamentary inquiry.
    And it was confirmed last December by the Caring Counts report, published by the Human Rights Commission. This found that the predominantly female workforce in aged care – many of whom are new migrants – and the elderly people they look after are undervalued and discriminated against. 
    The situation for support workers, often working alone to help elderly people in their homes, is largely invisible. But it’s probably even worse.
    Aged care in New Zealand is suffering the ravages of neoliberal capitalism. Today’s crisis flows from the privatisation and deregulation of the sector over the last 25 years.
    Up until the 1980s, rest homes were mainly run by charities. But by 2010, over two thirds of residential facilities were privately owned and run for profit.
    The industry is dominated by multinational corporations, banks and private equity firms. A third of the beds nationwide are provided by six large chains.
    One of them is Ryman Healthcare. Ryman owns the Malvina Major Home, of Dominion Post fame, where a confused elderly woman was repeatedly left lying in her own faeces.
    In the 1980s and 1990s, there were legal minimum staffing levels for homes like this. But in 2002, deregulation removed minimum staffing requirements.
    Ryman Healthcare receives $800 million a year from the taxpayer. How much of this goes straight into the pockets of investors is unknown, as the company is not obliged to account for this public money.
    It is known, however, that on night shifts they employ just one or two nurses to look after the 200 residents at Malvina Major. Is it any wonder that residents are sometimes neglected?
    The aged care crisis has been the focus of a decade of campaigning by the three unions representing in the sector – the Nurses Organisation, the Service & Food Workers Union Nga Ringa Tota and the PSA.
    But the proportion of workers who belong to a union, while higher than the private sector average, is much lower than in the public health system.
    In 2006, union density across aged care averaged 20 percent. This has weakened the ability of workers use industrial action to press for change.
    Despite this, aged care has featured prominently in strike statistics in recent years, winning modest improvements (or limiting the deterioration) for workers and residents in some places.
    Grant Brookes picketing with aged care workers in Upper Hutt in 2012

    But given the relative industrial weakness, the unions have also turned to political campaigning. Because District Health Boards administer the funding contracts with aged care providers, elected members of the DHBs do have some influence.
    The PSA is lobbying DHB candidates to commit to pay justice for contracted out home support workers, including equal pay with those directly employed by the DHBs.
    The SFWU is calling on DHB candidates to support its Living Wage campaign, and its minimum hourly rate of $18.40.
    And the Nurses Organisation is asking candidates to sign a pledge, including commitments to the Living Wage and equal pay for nurses and caregivers in aged care compared with their DHB counterparts.
    Standing as a candidate for Capital & Coast District Health Board, I am proud to continue my years of involvement in the battle for aged care by supporting these union campaigns.

    Guest editorial in Tobacco Control Update

    (Thanks to The Smokefree Coalition, for allowing me to contribute a guest editorial to the latest issue of Tobacco Control Update).


    Staff at Te Whare O Matairangi recently celebrated a birthday. On 2 July, Wellington's refurbished Mental Health Recovery Unit, where I work, turned one.
    The $7.8 million, state-of-the-art facility at Capital & Coast DHB has enabled the development of a new model of care – less restrictive, more collaborative and more home-like.
    Importantly, 2 July was also the first anniversary of our Unit going smokefree.
    The journey to smokefree status was not all plain sailing. When planning for the new unit began in 2009, a majority of staff were opposed to the idea. Some nurses believed that doing away with designated smoking areas in the ward would lead to increased incidence of violence, restraint and seclusion.
    Others felt it was paternalistic to enforce abstinence on service users who were detained under the Mental Health Act, and unable to go off the premises to smoke.
    One nurse wrote to the Human Rights Commissioner, seeking an opinion on whether a ban would breach patients' statutory rights.
    However with the support of management, staff and consumer advocates examined the research and worked through the difficulties. Over a three year period, we came up with a set of policies and procedures for a successful transition.
    Issues do remain, such as the relative unpopularity of patches compared with e-cigarettes as a mechanism for NRT among our client group, and the need for more organised activities to replace smoking.
    The incidence of tobacco use, among staff as well as service users, is falling. Admission to the psych ward is no longer synonymous with days spent puffing and clouds of second-hand smoke.
    The smokefree journey also confirmed to me the ability of staff to successfully drive positive change in the DHB.
    Sadly, the expertise and practical knowledge of clinicians is too often lacking in health sector governance. A desire to bring this expertise to the board table has impelled me to stand for election to Capital & Coast DHB this October.
    As a nurse, I think decision-makers need to know the realities of care at the bedside and in the community. From this perspective, smoking cessation makes perfect sense as part of an "ambulance at the top of the cliff" approach to healthcare, which aims to keep people well and prevent avoidable illnesses.
    It's equally clear, from where I sit, that we need to put the care back into aged care and strengthen local democracy, not remote health bureaucracy. Nurses also know that health is based on whānau ora – family well-being.
    Contracting out and privatisation might make sense to the accountants, but clinical experience frequently tells otherwise.
    I hope to be successful in the local elections this year, for the well-being of our district. And in so doing, I hope to set an example for other nurses to follow.

    Video: Grant Brookes speaks as Health First candidate for Capital & Coast DHB

    Candidates for Capital & Coast District Health Board were invited to speak at Newtown Community Centre, Wellington, on 14 September 2013. Grant Brookes is the Health First candidate.