4.5 The Pacific Pay Gap: healthcare The healthcare industry (including social assistance and care work) is the fourth-largest employer of Pacific peoples as of June 2022, comprising about 10 percent of the Pacific workforce or approximately 18,400 workers.153 The sector is the most significant employer for Pacific women, as 22 per cent can be found in healthcare and social assistance.154 The healthcare sector is increasing and projected to continue to expand.155 The healthcare industry has seen steady growth in its Pacific workforce from 2012 and, after a brief decline in 2017, has sharply risen after the 2017 care and support workers’ pay equity settlement.156 In 2021, the median hourly earnings from main job of Pacific men in health and social care was $26.50 compared to $35.96 for European men, representing a 26.31 per cent pay gap. For Pacific women, the median hourly earnings were $24.50, which represents a 31.87 per cent gap when compared to European men’s earnings.157 Pacific healthcare workers are overrepresented amongst low-skilled and low-paying occupations within the sector, primarily occupying low-level administrative roles.158 Even amongst professional roles, Pacific healthcare workers are concentrated in the lower-paying and more precarious or insecure occupations.159 For instance, 77.8 percent of Pacific healthcare workers are nurses and 8.6 percent are doctors compared to 54 percent and 15.4 percent of the total New Zealand healthcare workforce, respectively.160 Likewise, non-Pacific healthcare workers are 71 times more likely than Pacific healthcare workers to be in the >$100,000 income bracket.161 Critically, Pacific workers likely comprise the largest proportion of the unregulated healthcare workforce who are often engaged in insecure and low or unpaid work, with no formal support from an organising body such as a registered council.162 The Pacific Health Workforce Service Forecast defined unregulated health workforce as:163 those people who have direct personal care interaction with clients, patients or consumers within the health and disability sector, they may be paid or unpaid, and are not subject to regulatory requirements under legislation or other means. The scope of care that this workforce provides is not strictly defined, and can include social, practical (including information, coordination, advice and cultural support) and advocacy services that support the full continuum of care. The aggregate effect of low pay, employment insecurity and structural racism produces negative socioeconomic effects for Pacific healthcare workers. Notably, Pacific workers in the healthcare industry have an in-work poverty rate of 8.6 percent, significantly higher than all other ethnic groups.164 Again, as with the construction and manufacturing industries, the major concern of Pacific peoples regarding their overrepresentation in low-paying and less-secure healthcare work is for their ability to contribute to the wellbeing of their family and community adequately.165 This issue is heightened for Pacific healthcare workers in particular given the large size of the unregulated workforce.166 153 Ministry of Business, Innovation & Employment, Pacific Peoples in the Labour Market – June 2022 Quarter, 1. 154 Cochrane and Pacheco, Empirical analysis of Pacifi, Māori and ethnic pay gaps in New Zealand, 6. 155 E tū, E tū in 2030. 156 Itinteang, “Pacific Workforce Indicators,” 7. 157 Based on Household Labour Force Survey data (2021) 158 The Southern Initiative, Ministry of Business, Innovation & Employment, and Auckland Co-design Lab, Pacific Peoples’ Workforce Challenge, 10; Pacific Perspectives. Pacific Health Workforce Service Forecast Report to Health Workforce New Zealand and the Ministry of Health. Wellington: Pacific Perspectives, 2013, 50-52, 56, 62. https://www.health.govt.nz/system/files/ documents/publications/pacific-health-wsf-june-2014.pdf. 159 Pacific Perspectives, Pacific Health Workforce Service Forecast, 52, 56, 62; Came et al., “Ethnic Pay Disparities,” 77-78. 160 Pacific Perspectives, Pacific Health Workforce Service Forecast, 44. 161 Came et al., “Ethnic Pay Disparities,” 77. 162 Pacific Perspectives, Pacific Health Workforce Service Forecast, 50-51. 163 Pacific Perspectives, Pacific Health Workforce Service Forecast, 43. 164 Plum and Pacheco, In-work Poverty in New Zealand, 18. 165 New Zealand Human Rights Commission, Talanoa, 25. 166 Pacific Perspectives, Pacific Health Workforce Service Forecast, 50-51. Pacific Pay Gap Inquiry Literature Review 25