Patients, nurses and midwives at Sydney’s Northern Beaches Hospital continue to be disadvantaged by the privatisation of public healthcare services a decade ago.
Northern Beaches Hospital (NBH) at Frenchs Forest is a unique 486-bed facility run as a public-private partnership created by a former NSW Liberal/National coalition government.
Despite community outrage at the privatisation, NBH opened in 2018 to replace public health services provided at Manly and Mona Vale public hospitals.
The coalition government closed Manly Hospital and kept Mona Vale Hospital open with residual services only.
Healthscope operates all NBH beds – private and public – and employs all nursing and midwifery staff. The NSW government effectively buys clinical services for public patients from Healthscope.
All patients in ED are treated as public patients. They can choose to be admitted to the hospital as either a public or a private patient. Around 80 per cent of patients remain public across the hospital – including maternity services.
AWARD DOES NOT APPLY
Nurses and midwives at NBH were initially employed on a ‘Copied State Award’, which was a copy of the Public Health System Nurses’ and Midwives (State) Award 2018. This agreement protected Nursing Hours Per Patient Day (NHPPD) at NBH for up to five years OR until a new enterprise agreement was negotiated. During enterprise bargaining negotiations in 2020, Healthscope attempted to push through an agreement which would have removed NHPPD early, this was subsequently voted down. In November 2021, negotiations concluded with a Yes vote, protecting NHPPD on public wards in a Memorandum of Understanding (MOU).
After the MOU expired in October this year, Healthscope moved to further undermine these staffing levels, which were already below those applying at other public hospitals.
Healthscope announced in November it would replace the NHPPD measurement with Labour Hours per Patient Day (LHPPD) in the public wards from 3 January 2024 – bringing them into line with staffing levels in private wards.
Healthscope said the LHPPD measurement would include “all positions directly or indirectly supporting patient care in the ward/unit environment. At NBH this includes the NUM, CNE, CNC and ward clerks.”
FEARS FOR PATIENT SAFETY
NSWNMA General Secretary Shaye Candish said that under the expired MOU, NHPPD were calculated solely on the basis of nurses and midwives providing direct clinical care.
The MOU excluded clinical nurse educators, specialists, and consultants, along with nurse unit managers, from the NHPPD calculation.
“They were entitled to be rostered as supernumerary (in addition to minimum staffing levels) and free to attend to their clinical leadership, education, and supervisory duties,” Shaye said.
“Failure to renew the MOU staffing arrangements represents a risk for nurses, midwives, other hospital staff and members of the public who rely on NBH as their local public hospital.
“NBH should be in public hands. The Northern Beaches community deserves a hospital that is run solely in the interests of the public – not those of a private operator.”
The NSWNMA NBH branch called on Healthscope to maintain the MOU arrangements shortly before it expired in October.
A branch resolution said it had already raised multiple staffing concerns with Healthscope and “fears for what will happen to staffing, patient safety and quality of patient care once these protections (under the MOU) are removed.”
“The community of Northern Beaches deserve a public hospital with the same level of staffing as other similar public hospitals,” the branch said.
NBH nurse and NSWNMA branch president, Robyne Brown, said, “We feel the public are being short-changed by the staffing arrangements at NBH.”
“It may be a flash, relatively new hospital but feedback from members suggests it is certainly not staffed adequately across all areas.
“Members are worried that NBH staffing in public wards and units will fall further behind NSW public hospitals now that the MOU has expired.”
ED POSITIONS SLASHED
Robyne said that even before the MOU expired, Healthscope cut four 12-hour day shifts from the emergency department despite the fact that the acuity of ED presentations had increased.
“There was no prior consultation with the NSWNMA and affected nurses,” she said.
The ED job cuts are at the centre of a long dispute between the NSWNMA and the NBH executive over ED staffing and safety including excessive workloads and inadequate breaks, and how this impacts patients.
Shaye Candish said the NSWNMA used work health and safety legislation to access the ED and consult with and survey affected nurses.
“The survey revealed serious and imminent risks to the health and safety of nurses in ED,” she said.
Campaign led by NSWNMA defeated five privatisations
The former NSW Liberal/National Coalition government intended NBH to be one of many public hospitals to be handed to private operators as public–private partnerships.
However, the Coalition did not count on the strength of public opposition to privatisation.
Led by the NSWNMA, public protests blocked hospital privatisations at Maitland, Goulburn, Wyong, Shellharbour and Bowral.
In 2017, The People’s Inquiry into Privatisation produced a scathing report, which found that health privatisations had resulted in:
reductions in care hours for patients
a lack of government accountability
reductions in nurse staffing numbers and appropriate skill mix
profit motives outweighing the delivery of quality care
erosion of pay and working conditions for staff
cost blow-outs
a decline in quality of services accessible to the public.
The operator of NBH, Healthscope, is owned by giant Canadian company Brookfield Asset Management, which manages over US$850 billion in global assets.
Brookfield Asset Management has received international media attention over allegations of tax avoidance via the use of offshore tax havens.