More nurses make the difference

Tracey Meacham
Tracey Meacham

Tracey Meacham was driven out of the Victorian public health system by Jeff Kennett’s scorched earth policy, came back when ratios were introduced and is now perplexed by the Baillieu Government’s attempt to roll them back.Tracey Meacham has some bad memories of working as a nurse in Victoria under Jeff Kennett.

‘It was very stressful, full of pressure and hard work and conditions were unsafe. We just didn’t have enough nurses,’ she says.

At the time, Tracey was working at the Peter MacCullum Cancer Institute as an oncology nurse. The pressures and the risks finally drove her out of the profession.

‘It wasn’t a decision I made easily. It was difficult. I thought I’d chosen the wrong career. I had colleagues leaving and making other career choices. They too found it too hard and too stressful,’ she says. ‘There weren’t enough of us to give good patient care. I had fears for patient safety. I also had fears for my national registration. It was on the line if safety wasn’t right.’

Tracey says she was aware that if something went wrong she would be held personally responsible.

‘You’d be drawn over the coals. You’d end up taking the blame. So, you found yourself powerless, that you were pushed into a corner and the only choice you had was to resign.’

It became too much for Tracey and after 10 years as a nurse, she left.

‘I went off and had a family, worked in a sandwich bar and in family day care looking after kids. But I missed nursing. You don’t go into nursing. It chooses you. I really missed it.’

Six years and a change of government later, an advertising campaign that extolled the virtues of improved working conditions, with ratios, rekindled Tracey’s desire for the profession.

‘It was splashed all over the papers ‘Come back to nursing. Ratios have been introduced.’ They offered refresher courses for six weeks. It was fantastic. The government was using ratios to get people back. And we did come back.

‘When I walked back in the door I thought ‘this is the place for me.’ I noticed that ratios made a difference. I found it safer and I felt supported.’

Tracey says she is stunned that the government now wants to take it all away.

‘It’s crazy. I can’t believe here we are today fighting for ratios. 10 years ago it got us all back. Now we are defending them again. It makes me very sad.

‘There’s no other workforce that has to fight so hard for community safety. It doesn’t seem fair.’

Tracey says she and many others are prepared to resign en masse if that is the only way to bring the government to its senses.

‘It’s a huge decision. It’s very out of character for me to do this but I feel very passionate. I look at nurses before me and wonder what is the legacy I will leave behind? I have to fight. Resigning is about taking a stand. If we lose ratios we’ll never get them back.’

Tracey says NSW nurses should be appreciative and protective of what they have won.

‘You can’t take ratios for granted. Celebrate and talk about them. They keep management honest. It means they have to keep staff levels up and safe. Ratios need to be talked about and be part of the language.’

So far in the current campaign

May 2011

The cabinet of the Victorian Liberal government signs off on a secret plot to provoke the state’s nurses into industrial action so it can force them into arbitration, cut nurse numbers and replace them at hospital bedsides with low-skilled ‘health assistants’.

July 2011

ANF serves a ‘log of claims’ on each of the public health services that make up the Victorian public health sector. This log took the form of the current EBA, with amendments to reflect improved ratios, new ratios and various improvements in wages and conditions.

October 2011

The Australian Electoral Commission (AEC) undertakes the largest protected action ballot in Australian history. More than 30,000 ANF members received a ballot paper and more than 98% of nurses and midwives approve the proposed industrial action, allowing protected action including bed closures.

9 November 2011

The Age newspaper publishes a story regarding lock out plans of the Baillieu Government.

12 November 2011

Protected industrial action commences, including bed closures and bans on paperwork.

16 November 2011

Fair Work Australia hands down a decision ‘suspending’ protected industrial action for 90 days from 17 November, rather than terminating as sought by the government.

24 November 2011

More than 10,000 ANF members, family, friends and the community rally in Bourke Street Mall and march to Parliament House.

December 2011

More than 30 rallies held outside Victorian metropolitan and regional hospitals.

16 December 2011

Statewide ANF members’ meeting decides to give individual consideration to resigning en masse from Victorian public health system, in light of risks to registration, duty of care and deterioration of employment conditions.

16 December 2011

ANF members deliver petition containing more than 40,000 signatures to Minister David Davis following a march to his office from Dallas Brooks Centre.

The gestation & birth of Victorian ratios: a timeline


Life in Victoria’s hospitals became very tough after the election of the Kennett Liberal Government. Within two years of being elected, Kennett had slashed permanent employment in the public sector. About 16% of those in the health workforce lost jobs. Incredibly, the government argued that there was an over supply of nurses and eliminated 2000 nursing positions. This slash and burn of nurses’ positions occurred during a period of steeply increasing demand in public hospitals.


By the end of the 1990s, when Kennett had allowed hospitals to staff as they wished, with flexibility, there were more than 1300 vacant permanent nursing and midwifery positions and 400 hospital beds closed every day.


The election of the Bracks Labor Government created the political opening for the introduction and implementation of nurse-to-patient ratios.


Victorian nurses include nurse-to-patient ratios as a centerpiece of their enterprise bargaining campaign. The ANF argues that the use of agency nurses is driving committed permanent nursing staff to leave the health sector and that this will undermine the professional integrity of nursing and the supply of nurses overall. When the ANF puts it case to the Australian Industrial Relations Commission (AIRC), testimony from nurses, about their workloads, is so compelling that even employers begin to acknowledge the need to address the issue of workload and its influence on nurse professionalism and patient safety. The ANF convincingly argued that a system-wide problem of work intensification called for a system-wide solution. On 31 August 2000, the AIRC ruled that nurse-to-patient ratios represented the most effective response to both the workload and staffing crises facing the Victorian health sector. The Bracks Government agreed to fund nursing positions to comply with the outcome of the arbitration proceedings, allocating $198 million to fund ratio positions. In 2001 another $300 million was set aside.


With the Victorian Labor government still in power, ratios were renewed in Enterprise Bargaining Agreements (EBAs) negotiated in 2004 and 2007, but only following sustained pressure from nurses.