Hospital based training plan under fire

Profession rejects patch up scheme for more ENs.

The federal government’s plan to establish new schools in hospitals to train enrolled nurses has been roundly criticised by the nursing profession as an ill-conceived, pre-election patch up.

Responding to what he admitted was a ‘desperate’ shortage of nurses, Prime Minister Howard announced his government would fund 25 schools in public and private hospitals to train an extra 500 ENs a year.

Howard said students with Year 10 school qualifications would be eligible to enrol for the courses, which would usually take about 18 months.

The return to hospital-based training for nurses represents ‘old time thinking from a worn out government’, said Brett Holmes, General Secretary of the NSW Nurses’ Association.

‘The government is obviously out of touch with the needs of a modern health system,’ Brett said.

‘Nurse training moved to the tertiary sector almost a generation ago because the profession understood it needed highly trained nurses capable of delivering the highest quality care.

‘Australia needs more university-trained nurses with on-the-job experience.’

Howard admitted the government failed to consult with the nursing profession before devising the plan.

Asked by a reporter if the profession had been consulted, Howard replied: ’Well there was a lot of consultation with health professionals. There wasn’t consultation with the nurses’ federation, and I’m disappointed that they’ve come out against it, although I noticed that the AMA has expressed its support and also the private hospitals have expressed their support.’

Leading nurse educators criticised the plan.

They included the Acting Dean of Nursing, Midwifery and Health at the University of Technology, Sydney, Denise Dignam, who accused the government of ‘attempting to play on the nostalgia of the public for hospital training’.

She said hospitals were no longer places where patients spent long periods recovering, needing the kind of basic care on-the-job trainees could deliver.

Her comments were supported by the Executive Director of the Royal College of Nursing, Rosemary Bryant, who said the government was arbitrarily imposing a new system onto the existing enrolled nurse training system, which was working well in the TAFE sector.

She said funds to pay for hospital-based schools would be better spent on more TAFE places for enrolled nurses, more clinical placements for student nurses or more places for nursing students at university.

Brett Holmes said that as well as providing more university places the Howard government should have done more to attract qualified nurses back to the health system.

‘More than 30,000 registered nurses – over 10% of the workforce – refuse to work in the profession because of poor wages and working conditions,’ he said.

‘The federal government’s response to this dire statistic is to promote WorkChoices, a system tailored made to cut wages and make working conditions more onerous.’

Labor leader Kevin Rudd likened Howard’s plan for hospital-based schools to the government’s scheme for Australian Technical Colleges, established in opposition to the State-based TAFE system.

‘After three years and more than half a billion dollars, the Australian Technical Colleges have not produced a single graduate. And on the government’s own figures, these colleges will produce fewer than 10,000 graduates over the next five years in the face of a shortage of over 200,000 skilled workers,’ he said.

Scheme won’t fix a decade of neglect

Even if it goes ahead, the federal government’s plan to train an extra 500 enrolled nurses a year is a drop in the bucket compared to the health system’s unmet needs.

Back in 2004, the Howard government was provided with an Australian Health Workforce Advisory Committee Nursing Workforce Planning Report, which warned that over the next decade Australia will need up to 13,500 new registered nurses and 5,734 new enrolled nurses each year to meet the demand for nursing services.

Despite this report, 2,408 applicants were turned away from registered nursing courses at universities last year because there were not enough places.

Federal underfunding of university places remains a core part of the problem.

Jan Brown, coordinator of the nursing program at University of New England, argues the government should put more money into nurse education ‘considering that nurses are the backbone of the health system’.

‘The government could put more money into nurse places and more scholarships. They could abolish HECS or drastically reduce it for students. That would really make a difference,’ she said.

It is not just nursing that’s suffered from the Howard government’s decade of neglect of higher education. Recent studies show that:

  • Since 1995, Australia is the only OECD country to cut public investment in tertiary education (by 7%). Other OECD countries increased their investment by an average 48%;
  • Since 1998, more than 300,000 Australians have been turned away from TAFE;
  • Since 2001, almost 150,000 eligible applicants have been turned away from Australian universities.