March 25, 2025

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Global decline in drowning deaths, but vulnerable people still at risk

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The World Health Organisation (WHO) has published its first-ever report on drowning prevention, revealing a significant 38% drop in the global drowning death rate since 2000.  

The report underscored the effectiveness of practical interventions by governments across the globe, as well as the WHO’s recommendations. However, the report also highlighted that drowning remains a major public health issue, with more than 30 people estimated to drown every hour and 300,000 drowning deaths recorded in 2021 alone. 

The report indicated that almost half of all drowning deaths occurred among individuals below the age of 29, with a quarter of these deaths involving children under five years old. Children without adult supervision are particularly vulnerable to drowning. 

The report also found that, despite the overall decline, progress in reducing drowning deaths has been uneven across regions. The WHO European Region saw a 68% reduction in drowning death rates between 2000 and 2021, while the WHO African Region experienced only a 3% decline, maintaining the highest drowning death rate globally at 5.6 deaths per 100,000 people. 

This difference in rates of decline correlated with the likelihood of regions having national strategies having national prevention strategies. The report found that only 15% of countries in the African Region had a national strategy, compared to 45% in the European Region. 

WHO Director-General Dr. Tedros Adhanom Ghebreyesus praised the decline in drowning deaths but stressed that every drowning death is one too many. “This report contains crucial data for policy-making and recommendations for urgent action to save lives,” he stated. 

If current trends continue, more than 7.2 million people, primarily children, could die by drowning by 2050.  

However, the WHO noted that most of these deaths could be prevented through government and community-based interventions. These interventions include installing barriers to prevent child access to water, providing safe places away from water for preschool children, and teaching school-aged children basic swimming, water safety, and rescue skills. 

‘We are not being supported’

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“I’m a proud employee of North Shore Private. I stood by you. For three years I wore a N95 mask – do you know what that’s like in PPE? … I did that for you – and where are you behind me now?”

With those remarks, nurse and midwife Carol Cooke reminded the Ramsay Health Care board of directors of its responsibilities to the company’s nursing staff – and their vital role.

Carol was among the NSWNMA members who spoke from the floor during Ramsay’s annual general meeting at the Sheraton Hotel in Sydney on November 26.

She said she had been at North Shore Private since before the hospital opened 26 years ago.

“From the coalface, I want you to know that your patients are not getting the best care,” Carol told the nine directors seated on the stage.

She held up her Ramsay certificate for 25 years’ service, adding, “But I’m not being supported.”

She said Paul Ramsay, who founded the now-global company in Sydney in 1964, used to  work with the nurses.

“He would give us whatever equipment we wanted, and we were well staffed.”

Today, however, “I start at 7am and I finish at 7:30 at night. I don’t get breaks. I answer the phone, I admit patients, I get water, I change flowers, I support women in labour.”

“I want you to know that when I come to work not only am I caring for your women and your babies, I also have lives in my hands.

“Open your eyes”

“I’m your patient safety and without me and all my team here you would not have safe practices and it’s getting unsafe on every shift.

“Without nurses, your patients will not come.

“You’ve got to be really worried that outside in the street you have got nurses who have taken time off to be here unpaid to let everyone know that we are hurting, our patients are hurting, our patient safety is down, our ratios are very poor.

“You need to open your eyes and talk to people like me because I am the eyes and the hands to the doctors.   

In reply to Carol, Ramsay chairman David Thodey, a former CEO of Telstra, said, “We are very conscious of the work you do and how dependent we are on what you do every day.”

Thodey said, “We want to find a way through this [industrial dispute] and the only way we can do this is by talking, so let’s keep that dialogue going.”

He added, “If there’s anything in terms of patient care or in terms of staff care that you’re worried about, please let us know.”

Carol was followed by Deanna Hayes, NSWNMA branch secretary and delegate at St George Private Hospital, who said she had been nursing at St George Private for 23 years.

“You said we need to keep talking; we’ve been in this protracted enterprise bargaining for 20 months already,” Deanna told Thodey.

“We’ve told them [Ramsay management] stories from the floor from representatives from all over NSW … and we still can’t convince you that this is what we need.

“You say that Ramsay is living by their mantra of people caring for people. This certainly isn’t obvious to your workforce.

“Ramsay have refused to acknowledge their valuable staff – most of whom have university degrees – in a cost-of-living crisis and we are the people who keep your business making profits.

“When will Ramsay finally agree to our reasonable demands around a pay rise that reflects that we are valued and agree to clauses to allow us to provide safe staffing for your patients?

Ramsay offer voted down for a third time

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It seems the management of Ramsay Health Care won’t take no for an answer.

In the dying days of 2024,  Ramsay Health Care made another unsuccessful attempt to force a substandard enterprise agreement (EA) onto their NSW nursing and midwifery workforce.

The company put its preferred EA to a vote of employees for an unprecedented third time.

And for a third time, nurses and midwives voted ‘No’.

In this latest ballot, which closed on 17 December, 79 per cent of eligible employees voted, and 55 per cent voted ‘No’.

The vote followed a 24-hour strike by nurses and midwives at 17 Ramsay hospitals across the state on November 26.

Believed to be Australia’s biggest private sector health strike, it was part of an ongoing campaign in support of a 20 per cent wage increase over three years and safer staffing levels.

The Ramsay campaign is a major part of an unprecedented level of industrial action over pay and conditions at private providers, including Healthscope in NSW.

General Secretary Shaye Candish said the November 26 strike followed 20 months of talks and 18 bargaining meetings involving a NSWNMA team that included union officials and hospital branch delegates.

She said the NSWNMA campaign of strikes and work bans had forced the company to lift its pay offer from 9 per cent over three years in the first vote, to 16 per cent over three years in the most recent ballot.

However, negotiations fell through late last year when Ramsay backed away from safe staffing clauses that had been agreed in principle.

Lack of progress on ratios or safe staffing led the NSWNMA bargaining team to recommend a ‘No’ vote to members for a third time.

“A majority of members voted to support this recommendation despite a very strong push by Ramsay management to persuade staff to vote yes, including dangling an offer of backpay close to Christmas,” Shaye said.

“Last financial year, Ramsay turned over almost $900 million in profit. We know they can afford to pay our hardworking nurses and midwives what they’re worth, by funding a pay rise that addresses inflation and cost of living pressures,” she added.

The NSWNMA wrote to Ramsay seeking to re-open negotiations in February.

Standing up to corporate greed

During the November 26 strike, about 600 Ramsay staff closed Elizabeth Street in Sydney’s CBD as they marched from Hyde Park to the Sheraton-on-the-Park Hotel where the company was holding its annual general meeting.

About 80 Ramsay nurses who are Ramsay shareholders entered the AGM wearing their NSWNMA scrubs, while the rest rallied outside.  Two NSWNMA member shareholders asked questions of the Ramsay board  (see story page 8).

Some long-serving Ramsay nurses and midwives are shareholders because the company’s late founder Paul Ramsay awarded shares to his employees in the early 2010s.

Ramsay nurses from the Illawarra, Southern Highlands and Shoalhaven regions boarded buses to join the Sydney rally.

Among them was Carlie Morgan, secretary of the NSWNMA branch at Wollongong Private Hospital.

She told the rally, “I have never felt prouder. Proud to be a nurse, proud to be associated and working with so many strong and resilient people, and proud to be standing here in solidarity with you all to show Ramsay how we stand up to corporate greed.”

When interviewed by WIN TV News, she said, “We thought we were making progress in negotiations and we managed to reach a bit of a verbal agreement regarding some safe staffing clauses. However, when we met with Ramsay again that offer was revoked.”

Renae Maher, NSWNMA Branch President at Albury Wodonga Private Hospital, said, “As a female-dominated workforce, we need  to close the gap. We need ratios, we need fair pay.”

She added, “We need our staff on the border not going across to Victoria where they got a 28.5 per cent pay increase over four years. We are losing staff.”

Backpay owed to thousands of Ramsay nurses

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Commission upholds NSWNMA case against Ramsay over miscalculated annual leave.

The NSWNMA has achieved an historic win in the Fair Work Commission (FWC) that will deliver backpay to thousands of current and former Ramsay Health Care staff this year.

The Association estimates Ramsay’s total backpay liability to be well over $10 million.

Some nurses could be owed several thousand dollars after the Commission agreed with the NSWNMA that Ramsay had been miscalculating annual leave payments for up to six years.

Thousands of nurses will now need to be backpaid for shift and weekend penalties they would have received if they hadn’t taken annual leave.

NSWNMA General Secretary Shaye Candish said Ramsay decided not to appeal the decision to a full bench of the FWC.

Shaye said it was too early to know exact backpay amounts but a full time, shift-working RN could receive more than $1000 per year for up to six years.

“We understand that Ramsay needs to review about two million payslips,” she said.

“It could take several months for Ramsay to calculate backpay for all affected current and former employees.”

The union took Ramsay to the FWC because it believed Ramsay had been miscalculating payments to staff while on annual leave due to a misinterpretation of the Ramsay enterprise agreement (EA).

The case centred on the interpretation of EA clauses which dealt with the calculation of annual leave loading, shift payments and allowances while staff were taking annual leave.

The NSWNMA argued that clauses 8.1.19 and 8.1.20, when read together, meant that nurses who take annual leave should be paid shift and weekend penalties they would have earned had they not been on leave.

The union also argued that nurses who take annual leave should additionally receive annual loading of 17.5 per cent or the average of allowances and shift penalties from the previous six months.

Ramsay argued that the EA had been written ambiguously and meant something other than what the words said.

The company asked the FWC to have the agreement varied and rewritten to reflect their interpretation.

FWC Deputy President, Thomas Roberts, found that Ramsay’s case should be dismissed and the EA not varied.

He also found the NSWNMA’s interpretation of how annual leave is paid was correct.

The NSWNMA says backpay should go back to 2018, though Ramsay has yet to respond to the Association on that point.

Healthscope threatens Christmas pay packets

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Australia’s second-largest private hospital operator, Healthscope, has docked the pay of some nurses and midwives who it claimed had refused to perform non-clinical duties and data entry.

Just before Christmas, nursing staff of at least two Healthscope NSW hospitals – Newcastle Private and Norwest Private – were threatened with pay cuts of up to  30 per cent.

Healthscope, which pays its NSW nurses less than their counterparts in Queensland, has refused to seriously negotiate with the NSWNMA on improved pay, staffing ratios and other conditions.

Healthscope NSW nurses are 2.4 per cent behind NSW public sector wages. Also, they do not have salary packaging and so have significantly lower take-home pay.

NSWNMA members decided to implement work bans at seven NSW Healthscope hospitals – Campbelltown Private, Lady Davidson Private, Nepean Private, Newcastle Private, Northern Beaches, Norwest Private and Sydney Southwest Private.

Healthscope then issued a notice threatening to cut pay by 7.5 per cent across the board.

It withdrew the notice after the NSWNMA took the issue to the Fair Work Commission.

Harsh penalties

On the day bans were due to be implemented (13 December) the company issued a revised notice with harsher penalties applying to a more specific list of nursing roles and work units.

For example, Healthscope estimated a direct care RN in an emergency department spends 200 minutes per shift on non-clinical duties and 10 minutes per shift on data entry.

The company therefore decided a ban on non-clinical duties (such as cleaning, moving beds, emptying bins and making beds) and data entry should be punished with a total pay cut of 29.17 per cent.

In another example, Healthscope estimated a surgical ward speciality coordinator spends 90 minutes on non-clinical duties and 60 minutes on data entry and should suffer a total pay cut of 31.25 per cent.

The NSWNMA’s Healthscope campaign committee, which includes member representatives from all affected hospitals, called a meeting on 13 December and decided to call off the work bans.

ICU nurse Sheridan Brady, president of the NSWNMA branch

at Healthscope’s Northern Beaches Hospital, said the campaign committee did not want nurses and midwives to risk losing a large chunk of their pay – especially leading into Christmas.

“This is an act of corporate greed by Healthscope,” she said.

By threatening to dock pay, Healthscope was admitting that nurses and midwives were routinely expected to perform tasks other than caring for patients.

“We are not cleaners or wardsmen or kitchen hands … we should not be sacrificing precious nursing time with our patients,” Sheridan said.

When The Lamp went to press it was unclear how many nurses and midwives had their pay docked.

Some nurses subject to pay cuts seemingly did not participate in bans while nurses who engaged in partial bans were docked the same amount as others who fully implemented all bans.

Sheridan said early indications were that amounts deducted ranged up to $125 dollars per shift.

Questionable numbers

“We don’t know how Healthscope came up with their numbers,” she said.

“For example, at Northern Beaches ICU they estimated our non-clerical activities at 35 minutes per shift but we don’t actually do any of those activities.

“We don’t know how they decided which members took part in the bans, or to what extent they took part.

“Some people who initially said they would take part in the bans decided not to do so for safety reasons on the day – for example, the urgent need to move a bed in the theatre – but they were still docked.

“There was a lot of anger over the pay cuts with members asking; can we walk out now?

“However, the law says a union must give three days’ notice of protected action to the Fair Work Commission otherwise any strike would be unprotected.

“Industrial action by the employer – such as Healthscope’s pay cuts – only requires one day’s notice.

“Had Healthscope given us three days’ notice the bans may or may not have gone ahead.”

Intimidating behaviour

She said some members reported instances of intimidating behaviour by Healthscope.

“Some managers were asking nurses and midwives whether they were union members and whether they were opting in or out of protected action.

“It didn’t happen at every hospital or in every unit but some staff were made to feel very uncomfortable.

“People were upset because it really does show how little Healthscope value their nursing workforce.

“If you want to come to an agreement with your staff then alienating your entire nursing workforce seems a very odd way of going about things.

“It’s not as if there is a glut of nurses and if you mistreat one you can easily replace them with another.”

The Fair Work Commission is scheduled to hold a two-day hearing on the Healthscope pay cuts in early March.

Private equity sickens our healthcare services

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In October 2024, Australia’s second-largest private hospital operator, Healthscope, started charging customers of certain health funds including Bupa a $100 gap fee for overnight stays.

Healthscope told patients if they were upset by the additional charge they should switch health funds.

Patients thus became the meat in the sandwich in a battle between the funds and Healthscope, owned by the private equity (PE) arm of giant Canadian firm Brookfield.

Rachel David, Chief Executive of Private Healthcare Australia, the peak body representing private health funds, described the Healthscope fee as “a deeply unethical move”.

“Targeting patients is a new low. I have never seen a hospital group do this before,” she told The Australian newspaper.

David said Brookfield was “holding privately insured patients hostage and trying to bully health funds into paying them more so they can increase profits”.

“Brookfield was only ever in the Australian hospitals market for the short term,” she added.

“It is trying to squeeze out as much profit as possible before it abandons Healthscope hospitals, potentially making private healthcare unaffordable in the process.”

In November, Healthscope cancelled its funding arrangements with Bupa and a collective of not-for-profit insurers.

This affected more than six million people, the Australian Financial Review reported.

No government bailout

Brookfield paid $4.1billion for Healthscope in 2019.

Its investment has not yielded the expected profits so Healthscope wants health funds to pay a bigger share of treatment costs.

The insurers said they and their customers should not have to pay for Brookfield’s poor commercial decisions.

Healthscope then launched a PR  campaign against the insurers.

The Australian Financial Review described the PR blitz as “a warning to patients that hospitals will close, surgery waiting lists will grow, patients may have to travel further for rehabilitation, and out-of-pocket expenses will rise if insurers don’t pay more for procedures”.

Health Minister Mark Butler has commissioned a review of the health of the private hospital sector and Healthscope appears to be hoping for government help.

However, Butler told the Australian Financial Review in December there was “no silver bullet or government-funded bailout on the cards”.

Saddled with debt

Rachel David’s description of Healthscope as a short-term investment points to the major flaw in the PE investment model (private equity refers to investment in businesses that are not publicly traded on stock markets).

PE firms don’t use a lot of their own money when they buy companies.

Instead, they borrow money from institutional investors (including superannuation funds) to buy businesses for the purpose of selling or publicly listing them on the stock market within a few years.

Investors are promised fat profits.

These transactions are funded by debt but it is the business being bought – not the PE firm – that takes on the debt.

According to The Australian, Brookfield has loaded up Healthscope with about $1.6 billion of debt.

Healthscope must pay this back to a syndicate of at least 25 lenders at a time when the industry is struggling with higher costs.

A common PE tactic is to sell the target company’s physical assets such as real estate then rent the properties back.

This can extract a fast profit for the PE firm but often burdens the target company with high rents.

When Brookfield bought Healthscope, it sold Healthscope’s properties to NorthWest Healthcare and Medical Properties Trust for about $2 billion combined.

One of Healthscope’s new landlords, Medical Properties, has since sold the Healthscope properties it owned to another company, to which Healthscope must pay rent.n

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