Labor promises shift-by-shift ratios starting 1 July   

The Liberal-National Coalition government refuses to improve the safety and care of patients with guaranteed ratios.

Last year, NSW Labor promised to introduce a new ratios system in NSW. At the heart of their plan was the introduction of shift-by shift ratios, equity for most rural hospitals with their metropolitan counterparts and the extension of 1:3 ratios to emergency departments and paediatrics.

The ALP’s policy for the March 2019 state election retains these key features beefed up by a number of new improvements announced by opposition leader Michael Daley.

Labor has now promised:

  • 5500 extra nurses within a mandated shift-by-shift nurse to patient ratios system
  • All maternity units will get ratios of 1:3
  • Additional staff will be provided for “specials”
  • When there are uneven numbers in the calculations of ratios – the number of nurses rostered will be rounded up.

In community health and community mental health Labor says it will improve accountability and transparency around staffing arrangements.

It will require all health services to publish the number and percentage of shifts replaced to cover nurses and midwives taking annual, sick, long service and parental leave.

The Liberal-National Coalition has promised to fund an extra 5000 nurses over the next four years but steadfastly refuses to improve nurse to patient ratios.

In office since 2011, the Coalition has repeatedly rejected improved ratios under three leaders including the current premier, Gladys Berejiklian.

Nurses and midwives in cities and rural areas have consistently told the NSWNMA their highest priority is a stronger ratios system.

The public has backed NSWNMA campaigns for safe ratios on every ward and every shift and there is overwhelming international evidence that ratios save lives, reduce errors and keep skilled staff in the system.

The Coalition has ignored both the public and the experts.

Labor has promised to legislate for a better system of minimum ratios in both city and regional NSW. 

Michael Daley pledges Labor will deliver thousands more nurses in regional NSW through new nurse-to-patient ratios in A, B and C hospitals, that 
bring their staffing levels up to city ones.

This will improve patient care in about 60 separate hospitals – most of them outside Sydney, Wollongong and Newcastle, he says.

 Where the parties stand on RATIOS


  • Introduce a new mandated, shift-by-shift ratio system starting 1 July 2019 enshrined in law through the Award
  • Fund an extra 5500 nurses and midwives
  • Introduce 1:3 ratios in EDs, paediatrics and maternity
  • Bring regional staffing levels up to city levels
  • Fund additional staff for “specials”
  • A fully funded plan


  • Support increased nurse-to-patient ratios and skills mixes that ensure patient safety, better health outcomes, high recruitment retention, continued professional development and adequate training of staff. 
  • Have not published a plan or a funding mechanism
  • Provide sufficient funding for the priority areas of midwifery and mental health nursing especially in rural areas. 


  • Has consistently rejected ratios.
  • Health Minister Brad Hazzard was particularly critical of the Labor Opposition’s promise to introduce 1:3 nurse-to-patient ratios in emergency departments.
  • Has promised to fund 5000 extra nurses and midwives over the next four years.


  • Support increased nurse-to-patient ratios however, have not published a plan or funding mechanism.