Redundancies are regressive -October 2009

Several area health services have implemented plans for voluntary redundancies of experienced nurses. This is a money-saving move that ignores the longer-term needs of the health system.

The past 12 months have seen a raft of reports into the state of our health system. In general, these reports have been of a high quality and make good suggestions to remedy the current problems in the system.

All these reports highlight the importance of experienced nurses in the delivery of safe, quality patient care. They are backed up by overwhelming amounts of clinical research.

The NSW Premier Nathan Rees made it clear in his first few weeks in the job that frontline nursing positions would not be touched in any restructure. This has been echoed by a succession of health ministers.

But the past few months have seen an emerging and alarming disconnect between the theory of what needs to be done and the actions of our area health services, with several offering voluntary redundancies to experienced nurses.

Making experienced nurses redundant to remedy budgetary shortfalls ignores the longer-term needs of the health system, which depends on nurses with a high level of skill and experience.

It is regressive. It is myopic. It is reckless.

Health workforce planning has been a fiasco for more than a decade. There simply has not been enough nurses and doctors coming out of our education system to meet the increasing demands of the health system. We now have a national body set up by COAG – Health Workforce Australia – that recognises at the peak level the importance of health workforce planning and management. But what is happening on the ground is redundancies and the substitution of these experienced nurses with more AiNs in the acute care sector.

What is not clear is whether this is part of a bigger plan by all governments – state or federal – to resolve nursing workforce shortages by proceeding down the path of larger numbers of lower-paid, less skilled and unlicensed health workers.

If it is, it would be contradictory to the government policies that focus on recognising the high-level skills of nurses and midwives, as evidenced by the current Federal Government’s commitment to provide nurse practitioners and eligible midwives with access to the PBS and MBS.

The opportunities for nurses at the top levels of the profession are welcome. But they should not come at the expense of important nursing positions at lower levels. Not all registered and enrolled nurses want to take the step up to the next level. In fact, many nurses and midwives still get intrinsic reward from providing essential care.

NSW Health denies there is a redundancy program. The redundancies are, it says, merely workforce adjustments. We will see. We will not allow these measures to be introduced by stealth.

The Association has had some success in exposing these strategies to public scrutiny through the media. We will continue to insist on consultation to gauge the genuineness of the area health services’ intentions.

What is paramount for us is preserving patient safety and the welfare of the nursing staff who will be left to shoulder the increasing workloads that will result from a reduction of experienced nursing staff.