Public Hospitals Archives

Further evidence of the unsustainable strain on public hospital emergency departments (ED) has prompted angry calls for the NSW government to stop risking patients’ lives and introduce reliable shift by shift staffing ratios.

The NSW Nurses and Midwives’ Association (NSWNMA) issued the warning after Bureau of Health Information (BHI) data for January to March 2022 showed patients waited longer for ambulance transfers, for treatment in ED, and to be admitted to a ward, despite less attendances overall than the same quarter in 2019.

NSWNMA Acting General Secretary, Shaye Candish, said as the Omicron variant ran rampant in the community, patients requiring triage category 2 ‘emergency’ care waited longer for ED treatment compared to any January to March quarter on record.

“The latest hospital data reinforces what we were hearing from members at the time about the incredible pressure they were working under, not long after the NSW government took their ‘let it rip’ approach in mid-December,” said Ms Candish.

“Members tell us that pressure and the strain on the health system continues today, with the winter peak well and truly upon us.

“According to the BHI results, barely a quarter (25.8%) of patients who were treated and admitted to hospital spent less than the benchmark of four hours in the ED. Alarmingly, one in 10 of them spent over 18 hours and 29 minutes in ED.

“How can the NSW government continue to call this ‘world class’ care? Our state desperately needs a transparent nurse-to-patient ratios system to improve staffing, reduce workloads and help manage the ongoing demand.”

NSWNMA Acting Assistant General Secretary, Michael Whaites, said calls for one nurse to every three ED treatment spaces (1:3 in ED) would go a long way to curb the rising number of patients who are leaving without even being seen.

“A record 55,305 patients left EDs during January to March either without being seen, or before finishing treatment, that’s the worst it’s ever been and it must be addressed,” said Mr Whaites.

“One in 10 who arrived by ambulance also waited almost an hour (54 minutes) to be transferred to ED staff. This is the opposite of the level of safe care patients in NSW deserve.

“The volume of COVID-19 patients requiring hospitalisation during the January peak put enormous strain on the entire public health system. Meanwhile, almost 20,000 (18,627) elective surgery patients had waited longer than clinically recommended by the end of the quarter.

“The NSW government can start to fix this now by introducing shift by shift staffing ratios, because clearly its preferred staffing method is no longer fit for purpose and our health system will continue to suffer until change occurs.”

The widespread practice of privatising public hospitals and health services across Australia is putting nurses’ professional obligations at risk; has had a detrimental impact on the quality of our healthcare system and has blown out taxpayer-related costs, according to a major public inquiry.

The People’s Inquiry into Privatisation will today launch its report, Taking Back Control: A Community Response to Privatisation, after visiting cities and towns in every state and territory over the past year to speak with affected community members.

Key issues identified as a result of health and disability privatisation outlined in the report include:

Reductions in care hours for patients/clients
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

Submissions from nurses to the inquiry also raised concerns regarding risks to the nursing profession and their professional obligations, such as duty of care, if health and disability privatisations continued to occur.

Registered Nurse, Robyn Brown stated to the panel: “Our public award includes staff-to-patient ratios. So, as public nurses, we enjoy a better staff capacity than a private hospital would and we have a bigger registered nurse ratio to the AIN [Assistants in Nursing] ratio than the private hospitals. We are concerned that patients are not going to be treated the same”

The NSW Nurses and Midwives’ Association (NSWNMA), a partner of the People’s Inquiry, is well aware of the impact privatisation is having on its nursing and midwifery members.

“In a concerted effort, we’ve managed to prevent three of six hospital privatisations in NSW over the past three years, but the secrecy that’s surrounded the new public-private partnership for Northern Beaches Hospital is alarming,” NSWNMA General Secretary, Mr Holmes said.

“To be now less than a year from its planned opening and staff at nearby Manly and Mona Vale Hospitals still don’t know what their conditions are, or even if they’ll have a job to go to, is outrageous policy-making on the run by the NSW Government.”

The deterioration of ageing and disability services under a privately operated model was raised by Chairperson of the Hunter Disability Support group, Graham Burgess at the NSW hearing: “No other country in the world can hold a candle to the superior quality of ageing and disability care services that are in New South Wales…[but] once you dismantle an organisation that took over 35 years of concentrated effort, of taxpayers money, to build it to the near perfect model that exists throughout Australia today, or certainly throughout New South Wales. That cannot ever be rebuilt.”

Australian Nursing and Midwifery Federation Northern Territory Branch Secretary, Yvonne Falckh, echoed concerns of the damage privatisation is having on the health sector and in particular, the decline of quality care in Justice Health.

“The nurse-to-patient ratio under private management meant there was at least half the number of nurses employed than what was urgently needed. The fact that the prison guards had to give out the medication is a whole gamut of problems. There were times where nurses were expected to deliver care with scripts written on pieces of paper. No right protocols, no policies. They were putting their registration at risk numerous times.”

“Under government control, at least there are protocols, policies, procedures. When you’re with a private employer, the risk of losing your job is a major thing, so they put up with what’s been happening because they’re too frightened that they’re going to lose their positions.”

The report makes 12 recommendations, including greater regulatory mechanisms and policy frameworks around the delivery of public services, an independent body to oversee privatised assets to ensure accountability and a moratorium on privatisation, until these conditions are put in place.

The People’s Inquiry into Privatisation report will be officially launched this evening from 6pm at the State Library Victoria.

Download this media release: Health privatisation is damaging the nursing profession