Let’s change the rules on staffing

The current rules on staffing in our public health system are clearly not working. Our 2018 ratios campaign aims to change that.

For many, many years NSW nurses and midwives have tried to work positively and constructively with employers to find a way to determine staffing levels that would deliver exemplary patient care in a sustainable way.

In 2002 we won a reasonable workloads clause in our Public Health System award that established rules for staffing that were supposed to deliver realistic workloads for nurses and midwives while maintaining high quality and safe patient care.

Nurses and midwives were committed to these rules and to making them work. But by 2008 it was obvious to us that they weren’t delivering the reasonable workloads nurses and midwives wanted and needed.

This led to our first campaign for ratios between 2008 and 2011. That tremendous campaign delivered a historic win when an outgoing Labor government agreed to ratios determined by a nursing hours per patient day formula calculated in wards or units over a week. The incoming Liberal government honoured that agreement.

Ratios were introduced into a large part of the public health system but there were still many areas that missed out. Since then we have campaigned with purpose to have ratios extended more broadly into the rest of the health system. NSW Health and the state government have refused to work with us to that end.

Over the last seven years the government has failed to employ anywhere near enough nurses and midwives to ensure safe patient care. Without a change in workforce strategy and without a change in the rules things will get worse. By 2030, the government’s own data predicts a shortfall of 8,000 full-time registered nurses and midwives in NSW.

On our side we have followed the rules and tried very hard to make them work. We have consistently put forward feasible, evidence-based proposals to build on what we achieved in 2011 and to improve and extend the system. Improvements that would be, first and foremost, for the benefit of patients.

But our efforts and our goodwill have not been reciprocated. In six hospitals we have analysed closely we found that patients were deprived of 26,000 nursing hours they were entitled to under the current rules. And this, in only six to 12-month periods.

We need a more transparent and accountable system

We remain committed to ratios. We know they are vital – that they are literally a matter of life or death. We know they save lives. But changes need to be made to the current rules so they work as they were intended.

A key goal of our 2018 Public Health System claim is to make the system more transparent and accountable. To this end, we believe ratios should be calculated on a shift-by-shift basis and based on the actual number of patients requiring care.

We will continue to fight to have ratios extended into clinical areas which missed out first time around. It is both logical and necessary to build on the base we established in 2011.

It wasn’t easy to win ratios in 2011. We campaigned long and hard to achieve them. Since then the
state government has resisted against even having a dialogue about the need to strengthen and improve them.

So it’s up to us to be united in our cause, to convince the public to stand with us and to compel the government to acknowledge the facts – the rules need to be changed in order that we can deliver safe care. 

This year International Nurses Day, held on 12 May, has a theme of “Nurses and midwives are voices to lead. Health is a human right”.

I wish you all the best on this significant day and let’s respond to that rallying call and join together to fight for the rights of our patients and for the public health system they deserve.