NSWNA welcomes stronger clinical leadership role – May 2009


The NSWNA welcomes the State Government’s decision to beef up the clinical leadership role of Nursing and Midwifery Unit Managers.

The NSW Government has responded positively to the Garling Report recommendation to bolster the clinical leadership role of the Nurse/Midwifery Unit Manager. It has been made the centrepiece of the Government’s Health Action Plan for NSW, which they are calling Caring Together.

The plan also emphasises the importance of increased ad-ministrative support for nursing and midwifery managers by employing clinical support officers.

These were recommendations we made very strongly in our own submissions to the Garling Inquiry and we are pleased the ideas were picked up by the State Government.

The Government’s action plan out-lines the areas of clinical leadership these nurse managers are expected to provide and should help ensure the role stays clinically focused.

The new clinical support officers should lessen the burden of administration. Over the years increasing amounts of paper work have diverted NUMs/MUMs from patient care and staff leadership and, in some cases, compromised the quality of health care delivery.

The NSWNA also welcomes the establishment of an independent Community and Clinicians Advisory Council to provide advice directly to the Minister for Health and the Director-General on the implementation of this action plan.

It is also encouraging to see that an independent audit of the progress of implementation of Caring Together will be commissioned by the NSW Government and analysed by an independent panel.

A problem with terminology
While the Association supports in general the changes proposed we have concerns about the use of the term Nurse/Midwife In Charge. In particular we are not happy about the loss of ‘Manager’ from the title and the lack of consultation in regard to the implementation of these initiatives at a local level.

The display of full name and phone number of nurse and midwifery managers on posters could in some circumstances pose a risk to safety and could be counter-productive if they are bombarded with community enquiries without resources to deal with them.

We believe it would have been more prudent to have prioritised the recruitment of the clinical support officers and other initiatives designed to alleviate the Nursing/Midwifery Unit Managers workload and increase their ability to provide clinical supervision and management instead.
Coalition response to Garling

The NSW Coalition has released a policy document on health – Making it Work – which gives us a glimpse at the State Opposition’s approach to health reform. (see page 17).

The Coalition has picked up a key analysis in the Garling Report: the breakdown in relations between management and clinicians in our public hospitals. The State Government too starts from this point. It is to be welcomed that both the main parties recognise this key problem if we are to move forward in our public hospitals.

The Coalition proposal to publish information about health service management has merit. But while the State Government pledges to implement the bulk of Garling’s 160-odd recommendations, the Coalition centres on governance and is strangely silent about his operational recommendations.

Making it Work is a thin document. Its centrepiece is the abolition of the Area Health Services, which would be replaced by smaller health districts. It proposes bolstering the power of the medical profession in hospital management. Nurses are scarcely mentioned.

Nurses will be understandably wary of yet another major restructure of the health system with all the chaos and dislocation that goes with it. It is also questionable whether a return to old style hospital boards is a viable model for an increasingly large, complex and highly technical health system.