Local Health Boards have been given the nasty responsibility of implementing New South Wales and Queensland state government budget cuts.
It took numerous tragedies in our health systems, plus the cathartic government inquiries that followed, and years and years of campaigning by nursing unions, to force state governments in New South Wales and Queensland to start properly funding health.
The Garling inquiry in NSW, and the Bundaberg Hospital Commission of Inquiry in Queensland, had their origins in terrible misfortune.
Some good came out of those tragedies with an official recognition that there was a lack of resources in health and initial steps were made to remedy this situation.
Relatively new conservative governments in both these states seem to be ignoring these painful lessons, and have embarked on a back-to-the-future strategy of significant cuts to their health budgets.
NSW Health Minister Jillian Skinner has told the NSW Ministry of Health and Local Health Districts to make more than $3 billion in savings.
A significant portion of this total ($775m) is to be found from a “labour expense cap”. Having put an additional $900m in to pay for 30,000 extra hospital admissions and 50,000 extra ED presentations, a reasonable person would conclude nurses, midwives and other health workers are being asked to do more with less support and staff.
Minister Skinner claims any savings ($2.2 billion) will be redirected into “frontline” health services. Nurses are entitled to view this with grave concern as we are already seeing “voluntary redundancies” being offered to senior nurses.
In Queensland, Liberal National Party Premier Campbell Newman has announced 4000 health jobs will go and a total of 14,000 positions are to be axed from the Queensland public service in one year (see Job carnage at Queensland Health ).
These cuts were preceded by a Commission of Audit headed by former federal treasurer Peter Costello who, somewhat amusingly, described himself as “independent”.
Predictably, he blamed the previous government for fiscal profligacy before recommending the obligatory dose of harsh medicine. The consequent attack on Queensland health service jobs received strong endorsement from federal coalition shadow treasurer, Joe Hockey.
It is important that we join all these dots for it clarifies our challenges.
Conservative governments across the world profess the aim of small government service and big business interests, they are determined to shrink the public sector and, build budget surpluses at the expense of hard working public sector workers.
This has serious implications for safe patient care and the working conditions of nurses and midwives. We need to be wary of accepting our “medicine” on the basis that the budget demands it, while promises of roads and railways delivered by big business at a profit, are given priority over health and education.
Our response will need to be measured and organised.
Professional unity will be critical to achieve our goals.
Over the past few years we have allocated substantial resources to raising public awareness of the value and relevance of nurses and midwives’ work and we will continue to do that.
Our alternative vision of an efficient and effective health system, with a key role for nurses and midwives, needs to be underpinned by empirical evidence.
We appreciate the sterling work done by local researchers of high calibre such as Professor Christine Duffield from UTS and her colleague Professor Di Twigg of Edith Cowan University in Western Australia, particularly on the relationships between workloads, skill mix and quality and safety (see page Better staffing saves lives – and money ).
The NSWNMA shares with the wider professions the essential goal of maintaining a robust nursing and midwifery workforce with the capacity to provide safe, high quality, responsive and professional nursing and midwifery care.It is critical that all those who care about our public health system stick together and that we take the public with us in the face of these ill-judged government attacks.
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