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December 1, 2023

NSW Health: industrial action ‘in defiance of orders’

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Tweed nurses and midwives during Thursday’s strike, are struggling as staff cross the border for better conditions. Photo supplied

NSW Health has responded to Thursday’s industrial action by the NSW Nurses and Midwives’ Association (NSWNMA) saying it was in defiance of orders from the NSW Industrial Relations Commission (IRC).

The previous Thursday, 25 August 2022, the IRC ordered the NSWNMA and its members to cease organising and refrain from taking industrial action on Thursday 1 September.

It also ordered that the Association must not authorise or encourage members of the union to organise or take industrial action.

Nurses and supporters strike for staff to patient ratio quotas in NSW. Photo supplied.

NSW Health deeply thankful

A NSW Health spokesperson said that NSW Health recognises and is deeply thankful for the outstanding commitment and tireless efforts of healthcare workers throughout the COVID-19 pandemic. ‘The NSW Government and NSW Health have engaged in extensive and ongoing discussions with the NSWNMA.

‘On 17 August 2022, the IRC made a new award covering Nurses and Midwives at NSW Health. The award facilitated a 3 per cent increase to wages and conditions, comprising of a 2.53 per cent wage increase and a 0.5 per cent superannuation increase.

‘These increases are in addition to the one-off $3,000 thank you payment announced in June 2022 in recognition of the work of health workers during the pandemic.

Byron Hospital staff trike for on Thursday. Photo Jeff Dawson.

More than just numbers of staff

The spokesperson said that 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 which 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.’

NSW Health says that on the day of the actions 970 healthcare workers were in isolation owing to to positive COVID-19 status, exposure to COVID-19, and/or while waiting a negative result.

Tweed nurse Kristin Ryan-Agnew says ratio’s are mandated in Queensland, Victoria and South Australia. Griffith Uni has completed a formalised study on Ratio’s and shown a 50 million saving to the budget. Photo supplied.

Decision to defy the IRC strike order 

Byron Central Hospital NSWNMA branch A/Sec/delegate and NSWNMA Executive Councillor, Liz McCall, said the decision to defy the IRC strike order was discussed at length by the Council of the NSWNMA. ‘We made the decision to proceed with the action taken on behalf of our communities as we know that the inadequate staffing algorithm – Nursing Hours Per Patient Day (NHPPD) and subsequent shortfalls in both staffing levels and skill mix is unsustainable regarding the provision of safe patient care.

‘NSWNMA branches Statewide agreed (94 per cent voting yes ) for strike action.

‘All facility NSWNMA branches ensured that night duty staffing levels would be provided across all shifts to ensure patient safety.

Ms McCall said that the NSW Ministry of Health and Local Health Districts were concerned with this level of staffing was telling. ‘This is what every health facility contends with every night, while being told that is adequate. Do they really think that all patients sleep during the night and not require nursing care? If that is the case, they are deluded.’

Life preserving care was maintained

Ms McCall said the Association appreciates nurses and midwives have a duty of care to patients. ‘Life preserving care was maintained. The Ministry of Health and Local Health Districts (LHDs) have developed “adapted models of care” with very low staffing levels and non-nursing classifications, which the Premier claims to be a “strong coping health system”. These models could have been a guide to what the NSW government considers acceptable levels of care.’

General Secretary of the NSW Nurses and Midwives’ Association, Shaye Candish, said the NSW government’s refusal to acknowledge the systemic issues in our public health system has led to this situation. ‘They need to stop ignoring our concerns and have meaningful discussions about future-proofing our health workforce with a commitment to nurse-to-patient ratios on every shift, in every hospital and health service.

Lobbying for Ratios is not a new thing. Lismore midwife Heather Ryan in 2018. Photo Tree Faerie.

A professional obligation to advocate for patient safety

This is not a new issue. NSW nurses and midwives have been pleading with NSW Health and the government for years to get ratios right.

‘Nurses and midwives have a professional obligation to advocate for patient safety and that is what we are doing. Our health workforce has been neglected and their working conditions are abhorrent, prompting thousands of nurses and midwives to leave in droves,’ said Shaye Candish.

‘It’s time NSW caught up with the rest of the country and provided these highly skilled professionals with the support they need to deliver the clinical healthcare our communities deserve.’

Border communities

Border communities are suffering because of the close proximity of better conditions in Queensland. President of the Tweed Branch of the NSWNMA, Kristin Ryan-Agnew, said the numbers of staff lost over the border is staggering. ‘This is further compounded by the seniority of the staff. Wards are being managed with one in-charge and approximately six new grads each shift. Educators are being allocated patient loads every day. This means there is no support.’

Ms Ryan-Agnew said currently a first-year RN in Queensland earns 14.03 per cent more than a year one RN in NSW. ‘This equates to  $9,188 per year. Add this to the differences to salary sacrifice. Queensland keeps 100 per cent – NSW nurses keep 50 per cent. That equates to $9,000 per year. Queensland nurses also have an $1,800 per year education allowance. NSW gets $0!

Tweed Hospital staff striking for an increase in staffing ratios in 2018. Photo supplied.

Ratios saves money

‘Ratio’s are mandated in Queensland, Victoria and recently introduced in South Australia. Griffith Uni has completed a formalised study on Ratio’s and shown a 50 million saving to the budget.

‘With recent gains in Queensland 4 per cent over the next two years, 3 per cent the years after and a 3 per cent cost of living allowance, NSW nurses are going to be so far behind, we will not be able to staff the new Tweed Valley Hospital.

Liz McCall said nursing and midwifery are labour-intensive professions, 24 hours a day. ‘The NSWNMA branches provided adequate time for the LHDs and individual health facilities to organise extra staffing by way of casuals, agency staff or managers working in a clinical capacity. Indeed, anecdotally from many comments from across the State, the staffing levels were better than those normally experienced. 

Our actions are for our communities

‘We would argue that our actions are for our communities, and the only way to achieve nurse/midwife:patient ratios, proven by the best available contemporary. evidence as the best way to provide safe patient care, and already in place in Queensland, Victoria and the ACT. 

‘We will not be dictated to by privileged men in suits in Sydney who think they know better. They do not.’

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  1. What would be the point of having a ‘legal ‘ strike , or protest ?
    If citizens are allowed to ‘legally’ conduct themselves in a manor that suits ‘business as usual’ , nothing will ever change .
    So good on them all, if you want to improve the country you have to break a few laws, and if the government introduce draconian laws then-
    “in for a penny , in for a pound ” you may as well earn your two years in gaol / $22,000 fines.
    Cheers, G”)

    • “If the injustice is part of the necessary friction of the machine of government, let it go, let it go: perchance it will wear smooth–certainly the machine will wear out… but if it is of such a nature that it requires you to be the agent of injustice to another, then I say, break the law. Let your life be a counter-friction to stop the machine. What I have to do is to see, at any rate, that I do not lend myself to the wrong which I condemn.”
      ― Henry David Thoreau, Civil Disobedience and Other Essays

  2. Have been ward nursing for 32yrs. The state of nsw health system through the eyes of a nurse – excessive workloads,every shift every day short staffed,missed meal breaks, administration every shift pressuring nurses to do double shifts 16- 18hrs,seeing my colleague’s anxiety and emotional fatigue,wondering which nurse will resign next. No support, no recognition from management.


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