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December 1, 2023

Health professionals strike over patient ratios

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The continued refusal by the NSW Liberal-Nationals government to mandate more reasonable nursing/midwifery patient ratios has prompted a 24 hour strike by health professionals on September 1 from 7am. 

According to the NSW Nurses and Midwives’ Association (NSWNMA), increasing patient ratios for NSW public health staff ‘would ensure the delivery of safe patient care, something our communities desperately need’.

By comparison, nurse/midwife patient ratios for Qld, Victoria and the ACT are mandated by their governments. Additionally, staff are paid more in Qld, which puts pressure on border shires such as Tweed and Byron.  

Ratios has been an issue as far back as February this year; at the time, representatives from the Byron Central Hospital’s NSW Nurses and Midwives’ Association told The Echo, ‘If the ratio system had been in place for nurses and midwives in NSW prior to the covid pandemic, we would at least have had some padding in the system. Now we are down to the wire. Every shift means that we have the increasingly terrifying prospect of not having the time to provide safe care to our patients in line with our registration responsibilities’.

Mute minister Hazzard

Following the announcement of the September 1 strike, The Echo asked NSW Health Minister, Brad Hazzard (Liberal), ‘Why the government won’t accept the request for mandated nursing midwifery patient ratios?’ 

His office handballed the question to NSW Health, and a spokesperson replied, ‘The NSW Government announced the largest workforce boost in the nation’s history in the 2022–23 Budget with a $4.5 billion investment over four years to recruit 10,148 full-time equivalent staff to hospitals and health services across NSW’. 

‘This is on top of the 9,599 FTE nursing and midwifery staff the State government delivered between 2012 and 2021. 

‘We thank our staff for their incredible efforts to keep the community safe. The work they have done – and continue to do – to care for the people of NSW is remarkable. 

‘Safe and effective staffing involves more than just numbers of staff, it is about making sure there is the right number of staff in the right place at the right time. 

‘The current “nursing hours per patient day” system used under the Nurses Award in NSW Health is a far more flexible ratio that enables hospitals to increase staffing, where needed, to ensure safe and effective care. 

‘The flexible ratio system used in NSW Health is a multifaceted approach and considers the numbers of patients, their complexity, acuity and care needs whilst allowing for the professional judgement of nurses and managers to adjust staffing levels to reflect the changing care needs of patients. 

‘This contrasts with the rigid ratio framework of the NSW Nurses and Midwives’ Association, which is based solely on the number of patients per shift’. 

The NSW Health spokesperson added there is ‘significant pressure’ on NSW hospitals owing to high numbers of COVID-19 and flu cases.

‘Local health districts are addressing these challenges in several ways, including increasing bed capacity in hospitals where possible; ensuring all available clinical staff are deployed to the care areas with the highest demand; and improving the timeliness of discharge for patients. 

‘If an illness or injury is not life-threatening, we encourage people to visit their GP or call Healthdirect Australia on 1800 022 222, which is a 24-hour telephone health advice line staffed by registered nurses to provide fast and simple expert advice on any health issue and what to do next’. 

All about the money

Liz McCall, representing the Byron Central Hospital NSWNMA branch, described the NSW Health reply as being ‘all about the money’. 

She said, ‘To add insult to injury, the Health Department now plan to extend out the Hospital Care Assistant (HCA) initiative that was supposed to only be used during covid’. 

‘This is yet another category of low paid staff who aren’t even nurses or midwives, providing support to patients with no education. This is fraught with danger’. She says in Victoria, nursing and midwifery scholarships and undergraduate/postgraduate tertiary study funding is available. 

‘They understand the gravity of the situation, and are acting accordingly. And, they already have ratios’. 


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