Ratios under threat

Clare Bolton, RN, and Pam Barrett, NUM.
Clare Bolton, RN, and Pam Barrett, NUM.

The State Government’s plan for a comprehensive attack on the working conditions of nurses is becoming clearer.Last Year the O’Farrell Government passed laws that capped the wage increases of public health nurses at 2.5% and rendered the NSW Industrial Relations Commission powerless as an in-dependent umpire in wage negotiations.

Now the government has introduced more new laws that are a clear attack on the right of nurses and other public sector workers to take legitimate industrial action or be represented by a trade union.

It has also laid the groundwork for an attack against award conditions covering staffing, including nurse-to-patient ratios.

Health Minister Jillian Skinner has written to the NSWNA confirming that the interim Schott Report is the Coalition’s “roadmap” for public sector reform. Premier Barry O’Farrell endorsed the report, which his government commissioned.

Former investment banker Kerry Schott undertook an Expenditure and Management Audit of the NSW Public Sector and, among other things, advocated the removal of conditions such as ratios from the award. Other staffing arrangements in the public sector that are up for grabs include teacher-to-pupil ratios, police authorised strength and fire fighter crew per appliance.

“The government welcomes the release of the report as a roadmap for reform to deliver a more productive and responsive NSW public sector. Until such time as the final report has been released and the government has fully considered its recommendations it would be premature to be definitive in regard to the adoption or otherwise of (its) recommendations,” Jillian Skinner wrote.

NSWNA General Secretary Brett Holmes says this “non-answer” should set off alarm bells among NSW nurses.

“A key element of the campaign for nurse-to-patient ratios was that ratios were mandated and embedded in the award. This was to protect them from political interference and managerial whim. With the proposed changes it will be a manager’s call how a ward will be staffed. There will be no compulsion to make safe patient care the priority when allocating resources,” he said.

“This report’s recommendations will see a return to the bad old days when decisions that impacted safe patient care were determined by Treasury officials with no knowledge of the reality of life on the wards of our public hospitals.

“If this is implemented it could be the end of ratios forever. This is a critical point and there is a small window of opportunity to stop it. We need to convince MPs that it is not in their interests for this to go through.”


The government has already introduced legislation into parliament that if passed will impose the most draconian penalties in Australia for industrial action, including an 11-fold increase on current penalties.

Currently the maximum penalty for a union in breach of an order made by the Industrial Relations Commission is $10,000 for the first day of an offence and $5,000 for each subsequent day.

Under the new law it will increase 11-fold to $110,000 for the first day of an offence and $55,000 for each subsequent day. Any further breach – such as further bed closures – would attract a fine of $210,000 for the first day and $110,000 for each subsequent day.

These extreme penalties compound a unique situation that exists in NSW. In other states, and at the federal level, industrial laws allow “protected industrial action” free from the threat of such damages. There is no such clear right to strike in NSW.

Brett Holmes says that if these laws had previously existed the NSWNA would have been massively fined for actions such as the mass meeting of nurses held at Homebush on November 24, 2010, which had a crucial impact in winning nurse-to-patient ratios.

“That statewide strike came from a sense of frustration at the intransigence of the NSW government. If we had not taken the action, we would not have got the government to talk about nurse-to-patient ratios. We would not have won the funding for another estimated 1400 nurses. It would have been a travesty of justice, given that nurses are always seeking better outcomes for patient care when they take industrial action,” he said.

The strike and mass meeting at Homebush was the first time in 10 years that the NSWNA had defied an order from the IR Commission.

The government has also introduced changes to the Industrial Relations Act that allow employees to choose which union to join.

“This is a part of a strategy to destabilise the union movement and encourage demarcation disputes, splinter unions and employer-sponsored unions,” Brett said.



LET YOUR LOCAL MP know that this is unacceptable. You can go to www.nswnurses.asn.au and send a message to your local MP online.

WRITE A LETTER to your local newspaper about the importance of ratios for patient care. A sample letter is available online at www.nswnurses.asn.au/topics/33602.html

DON’T GET MAD – GET ACTIVE! Contact your Branch Organiser at the Association if you’d like some brochures to distribute or download one at www.nswnurses.asn.au/topics/33602.html


‘I’m really angry’

Pam Barrett, a NUM in Acute Medical and Coronary Care at Tweed Hospital, says nurse-to-patient ratios are already making a difference in her hospital and it is infuriating to think the government would take them away.

“Ratios are in the process of being rolled out now. When we won them people felt satisfied that something positive may happen – that you wouldn’t walk off the shift frustrated anymore.” Pam says the prospect that the government would remove them from the award has provoked a strong reaction.

“People are stunned. I have eight first year grads on my ward. One said to me ‘I had my first vote and I voted for Barry O’Farrell and now I am totally disillusioned. This government is taking away what I moved into nursing for’.”

Pam says she is equally stunned that the government would contemplate taking away an award entitlement.

“I’m really angry. I believe in the community of Tweed. I’m angry that my community will get a raw deal. Nurses in the Tweed will take a strong stand on this. They strongly believe in ratios and that they are about safe patient care. Even the doctors believe in them. We will be asking our local National MP Geoff Provest what he is going to do to protect our community.”


‘I’m not surprised’

Rosalie Menadue, RN, works on a ratio ward at Concord Centre for Mental Health. She says ratios have already made a marked difference.

“It’s safer all round for staff and patients. Ratios mean improved care continuity within and across shifts, in addition to better continuity when patients are discharged. We have time to make the contact with community nurses or GPs. Before it was difficult to have time to do the follow up.

“There is a change of atmosphere. There is more time for inductions. There is more time to mentor new grads. There is more time to support each other. It feels safer for everyone – nurses and patients. We can offer support to the adjoining ward, which doesn’t have ratios, when incidents occur. Rosalie says she wasn’t totally surprised but still felt shocked that the government would consider rolling back ratios.

“I felt horror. I couldn’t believe they would even think about removing those safety provisions from an award. People are talking about them. Now that we’ve experienced ratios we don’t want to lose them.

“After they capped our wages and attacked our access to the independent umpire it was always possible they would go after our award conditions.”


‘Wow, this is what work should be like’

Clare Bolton, an RN in the ICU at John Hunter Hospital, says nurses in the Hunter Valley love ratios.

“Some wards like the general surgical and the neuro ward are renowned for their high acuity and for being heavy and busy. Nurses didn’t have meal breaks and had to stay behind after shifts to hand over notes.

“Now they’ve got ratios they are saying ‘Wow, this is what work should be like.’ NUMs and staff are saying it is a different world.”

Clare is flummoxed that the O’Farrell Government would think about a reversal.

“Why, when you’ve got something that is working well, when the research says it is better for staff, patients and visitors, why would you take them away?

“The quality of the public service doesn’t matter to him. He doesn’t care about the quality of care that nurses, teachers and police provide. “Nurses at John Hunter will fight this. They will really arc up and say ‘No’.

“At John Hunter we not only had to fight for ratios but we also had to fight against balanced rostering. Barry O’Farrell and Jillian Skinner shouldn’t think we have forgotten that. If they try and take ratios away it will be the straw that breaks the camel’s back.”



The O’Farrell Government has revealed its plan of attack against public sector conditions in stages:


The government’s first assault on public sector conditions started within a few months of winning a landslide election in 2011, despite no mention of its radical anti-worker industrial relations policy during the election campaign:

  • Public sector wages were unilaterally capped at 2.5%.
  • The NSW Industrial Relations Commission was reduced to a rubber stamp in public sector wage negotiations.

The Workplace Relations Centre at Sydney University has calculated that if the new laws had been enacted in 2001, a public health system RN8 would be $12,232 a year worse off.


  • An 11-fold increase in penalties for unions contravening dispute orders made by the Industrial Relations Commission. Penalties will rise from $10,000 for the first day of a first offence to $110,000, and $220,000 for repeat offences. These are the most draconian penalties for industrial action in Australia
  • Changes to the Industrial Relations Act to allow employees to choose which union to join. This is intended to destabilise the union movement and encourage demarcation disputes, splinter unions and employer sponsored unions.
  • Laws that ensure the government can terminate excess public servants who do not have permanent jobs as a result of internal restructures.

In addition, the government commissioned a report, The Schott Report, that recommends certain conditions be removed from awards, such as:

  • Nurse-to-patient ratios
  • Teacher-to-pupil ratios
  • Police authorised strength
  • Fire fighter crew per appliance.

Premier Barry O’Farrell immediately gave his tick of approval to the report.