Congratulations On Ratios and Better Pay

Judith Kiejda and Brett Holmes (back right and front right) signing the agreement with NSW Health
Judith Kiejda and Brett Holmes (back right and front right) signing the agreement with NSW Health

Public health system members vote ‘Yes’ to nurse-to-patient ratios and 9.7% payrise.NSWNA Branches in public health sector hospitals and facilities have overwhelmingly voted ‘yes’ to the Government’s staffing and pay offer. 90% of the votes were in favour of the offer, which will deliver nurse-to-patient ratios in the public health system award, 1,400 FTE extra nurses and payrises of 9.7% over three years.

NSWNA General Secretary Brett holmes said public health system nurses and midwives are to be congratulated on these outstanding achievements – won after a hard-fought campaign by members and the NSWNA.

‘What we’ve achieved is a major reform of staffing arrangements in public hospitals, which will significantly improve patient care and reduce nursing and midwifery workloads,’ said Brett.

Following the vote by Branches, the association signed the agreement for the new public heath system award with NSW health and formally ratified the award in the Industrial relations commission on 23 February.

NSW will now join Victoria and california with the power to enforce nurse-to-patient ratios.


90% VOTE ‘YES’

Under NSWNA rules a Branch vote is weighted according to the number of delegates a Branch is entitled to. There are 240 Public Health System Branches. 207 submitted a valid vote. 186 voted yes, 21 voted no. When weighted according to entitled delegates it produced a 90% ‘yes’ vote.

What we have won


The new Award will deliver 9.7%

payrises to public health system nurses and midwives over the three-year agreement. This comprises 3.9% back paid to 1 July 2010, 3% from 1 July 2011, and 2.5% from 1 July 2012.

The pay rise will provide the majority of full-time Registered Nurses and Midwives (RN Year 8) with a weekly rise of $129.00 by 1 July 2012. Full-time, 5th year and thereafter Enrolled Nurses will receive an increase of $88 per week.


Nurse-to-patient ratios are now embedded in the Award for surgical/medical wards, palliative care, rehabilitation and acute adult inpatient mental health.

An estimated 188 additional nurses, dedicated to resuscitation areas, will be employed across 34 of the State’s larger Emergency Departments to provide specific guaranteed levels of resuscitation staffing.

Staffing arrangements have also been strengthened in community health and community mental health services, although nurse-to-patient ratios were not offered in these areas. ‘The NSWNA will be working very hard with members to prepare a renewed campaign to get maximum faceto-face, nurse-patient hours for community and community mental health,’ said Brett.

Staffing standards in operating theatres will also be updated to ACORN 2008, with a guaranteed minimum of two nurses, plus an anaesthetic nurse, in each theatre.

Birthrate Plus will be adopted as the staffing model for midwifery services in maternity/birthing facilities.


Recruitment has now started for the new nurses needed to meet the new higher staffing levels under the Award. NSWNA officials are now meeting with NSW Health to determine the implementation program.

The additional nurses will be delivered progressively between March this year and June 2013.

The Association will be sending members more information about the commencement of ratios as the details are agreed.

Research demonstrates that the number and type of nurses providing care has a huge impact on patient safety and health outcomes. Over recent decades the quality of health care in NSW has been compromised by not only declining nursing numbers per patient, but also the declining proportion of care provided by Registered Nurses (ie. skill mix).

Few unions in the world, let alone Australia have been able to do anything effective about reversing this trend. The NSW Nurses’ association achievement in getting agreed standards concerning nurse-to-patient ratios is a major one. Having settled baseline standards for staffing in the form of ratios, the challenge now becomes enforcing those standards and improving the skill mix.

The provision in the award specifying that management replace missing or departing nurses on a ‘like for like basis’ is important. Equally the right of nurses in the award to demand ‘spot checks’ to ensure the new arrangements are honoured is critical. It is vital the campaign continues; the rights to preserve skill mix contained in the award need to enforced and improved. Success on this matter will be vital for ensuring a healthy future for the nursing profession and the health care system in this State.