Labor abandons nurse-to-patient ratios in favour of safe staffing levels

NSW Labor’s long-held support for mandated nurse-to-patient ratios will be abandoned in favour of minimum and enforceable safe staffing levels in public hospitals,with an initial focus on emergency departments.

In itssecond health policy announcement this week,the opposition has committed to an extra 1200 nurses and midwives,in addition to the state government’s additional recruits outlined in the June budget,within the first four years of a Labor government.

NSW nurses protesting outside Parliament House in March

NSW nurses protesting outside Parliament House in MarchLouise Kennerley

“Experienced nurses and midwives are either dropping their working hours or worse,leaving the system altogether.”

Chris Minns

The $175 million policy would be designed to maintain safe nursing or midwifery staffing levels on a shift-by-shift basis,based on an area of care or speciality type,as well as treatment spaces or beds.

Safe staffing levels would start in emergency departments and would then be rolled out into other areas including ICUs,maternity wards and multipurpose services in a staged approach and in consultation with healthcare professionals.

Nurse-to-patient ratios,along with increased pay,have been central to the NSW Nurses and Midwives’ Association demands of the government,which has resulted in statewide industrial action.

Labor this week also committed to an additional 500 paramedics in regional and rural NSW.

Labor has taken a staff ratio policy for nurses to two state elections butdecided in May not to support an upper house inquiry recommendation to mandate increased staffing levels.

NSW Health currently uses a patient ratio system of “nursing hours per patient day”,which was introduced following strikes under the previous Labor government.

However,under Labor’s plan,the changes would be implemented by converting the existing nursing hours per patient day staffing requirement into minimum and enforceable safe staffing levels within the Public Health System Nurses’ and Midwives’ (State) Award. The minimum levels would not be legislated.

Labor this week alsocommitted to an additional 500 paramedics in regional and rural NSW after a damning parliamentary inquiry found the state’s strained ambulance service was particularly stretched.

NSW Labor leader Chris Minns said the health system needed structural repair.

“Experienced nurses and midwives are either dropping their working hours or worse,leaving the system altogether because they’re not supported enough in the workplace and see the workloads as untenable,” he said. “These changes will see more health staff retained,working in areas that need them the most,and it means better outcomes for patients and the level of care they will receive in NSW.”

Opposition health spokesman Ryan Park said:“Our health system doesn’t have a recruitment problem,it has a retention problem because our hospitals are overstretched and under-resourced.”

Victoria legislated a minimum of one nurse to four patients in 2001. In 2016,the Queensland government endorsed a minimum of one nurse to four patients for morning and afternoon shifts and one nurse for seven patients for night shifts in the state’s public health services.

Shadow Treasurer Daniel Mookhey said the policy had been formulated through negotiations with the union.

“NSW Labor has spent the better part of seven months sitting down respectfully at the table,negotiating in good faith with the workforce,” Mookhey said. “It shows what’s possible when you’re prepared to listen to our health care heroes instead of insulting them.”

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Alexandra Smith is the State Political Editor of The Sydney Morning Herald.

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