Kevin Rudd has assured nurses and midwives their industrial conditions will be unchanged under his new health reforms but the NSWNA remains cautious about other details.
The past few weeks have been tumultuous with the Federal Government and the states engaged in battle over national health reform.
Obviously there are major consequences for nurses and midwives, and the NSWNA and the ANF have been active to have our voices heard. I have had the opportunity on three occasions to speak to Premier Keneally and seek information, commitments and assurances on behalf of our members.
We acknowledge we have been given a reasonable hearing by the Federal Government. The ANF Federal Secretary Ged Kearney and I met with Kevin Rudd and Nicola Roxon over recent weeks and our concerns were listened to and in some instances allayed.
Firstly, we raised the issue of employment relations and bargaining. Previously, it had been unclear which tier of government would take responsibility for this in the proposed new system.
The Federal Parliamentary Secretary for Health Mark Butler has since assured us that, ‘Conditions of employment for staff and industrial relations negotiations will continue to be the responsibility of the State [Government]. The Commonwealth is not seeking any change to the arrangements that have been negotiated with different staff groups and the unique industrial arrangements that exist in each state, which organisations such as yours have fought hard for over many years.’
The Federal Government has also indicated that existing employment arrangements will remain in place in primary care, including community health, and it will be making further announcements about mental health.
The Federal Government has given an assurance that the crown employee status of NSW nurses – an important protection if a future Federal Government reintroduced WorkChoices – will not be disturbed.
Another major concern was the way the efficient price – a fundamental component of the reform – is calculated.
Mark Butler has confirmed that health unions will have input into the body that sets the efficient price of hospital procedures. He also assured us the efficient price will include the cost of nursing.
Some of our principal concerns have been answered but others have not and we remain cautious about the process and are uneasy about the impact of yet another restructure on nurses and midwives.
There is still a lack of detail about how community health will sit within the new system. It is unclear if a national efficient price will ultimately lead to uniform pay for nurses nationally. There are still announcements to be made regarding the nursing workforce.
At every opportunity we have pushed the Because we care campaign. While there has been an announcement of more money for aged care we are disappointed it is not linked to improving the wages of nurses in the sector.
The long-term benefits of reform are still there. More much-needed money will be injected into the system. There will be clearer lines of responsibility for funding. The Federal Government’s undertaking to take responsibility for increases in the cost of health is a substantial step forward.
There are still many facets of this reform and the politics that surround it yet to play out. Substantial additional funding has been secured for NSW but it comes with challenging targets and expectations for delivery.
Additional services cannot be delivered without additional nurses and midwives to meet patient need and the importance of a transparent, enforceable nurse/midwife to patient ratio is clear when activity-based funding is an incentive to do more with less.
I will be calling on both the Federal and State Governments to continue to consult with the NSWNA and the ANF as we unfold the real nuts and bolts of this National Health and Hospitals Reform process to ensure that nurses and midwives play our part in getting a better health system.
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