Ask Shaye: Special edition – Rural Health Workforce Incentive
When it comes to your rights and entitlements at work, NSWNMA General Secretary Shaye Candish has the answers.
The lack of logic and public alarm is disturbing
Early August 2022, and we have COVID-19 and influenza cases reaching peak levels. Two and a half years of preparation, awareness and lived experience should have been enough to ensure readiness. But what has been delivered? Record numbers of COVID-19 cases, hospitalisations and, sadly, deaths. Influenza case numbers not seen for years. All-too-predictable levels of staff being absent – either unwell or in isolation, or simply crushed under the weight of work demands.
Our public health system lies near broken. Aged care facilities are being ravaged by outbreaks in numbers beyond even last year. We continue to break records, but all the wrong ones. And what is the response?
The usual political speak about a system being under pressure but coping. A fear to be honest and confront the reality of the situation – equal parts hubris and ignorance.
Have we learned nothing? Care cannot be delivered if nurses and midwives are not there, or staffing accountability on a shift-by-shift basis is not present. Regardless of the health or care setting, more nurses and midwives are needed. Governments of all persuasions and their bureaucracies need to admit we have reached rock bottom.
If we are open and honest about that fact, then maybe we can really start to rebuild.
Special edition – Rural Health Workforce Incentive
Where did this new scheme come from?
Leading up to the NSW Budget, the NSW Government announced it would commit $883 million over the next four years to attract and retain staff in rural and regional NSW. However, the release was big on headlines and light on detail.
Why now after all these years?
There is absolutely no doubt that the sustained pressure of Association members, and the damning findings of the Upper House Inquiry into health and hospital services in rural, regional and remote New South Wales, meant the NSW Government could no longer avoid this longstanding and endemic problem.
New Health policy
How will this scheme to be applied in the NSW Health Service?
The Ministry of Health recently released the Rural Health Workforce Incentive Scheme. This sets out the broad framework of the scheme, along with its key features.
Did the Association have any input to this new policy?
Whilst the Ministry of Health initially sought some feedback from public health unions on this initiative after the NSW Government’s announcement, unfortunately without further consultation or receiving answers to the many questions we posed, the Ministry released the policy directive.
Categorisation of the bush
Where will the incentive schemes be applied?
It will only apply to locations in NSW outside the metropolitan and regional city centres and their immediate surrounds. Rural and regional hospitals and services will be classified using the Commonwealth Department of Health’s Modified Monash Model, with the incentives potentially available to those identified as being MM3 to MM7. For example, Wagga Wagga would be classified as MM3, Mudgee MM4, Lockhart MM5, Nyngan MM6 and Bourke MM7.
Other locations may be deemed rural and remote by the Ministry of Health considering unique location attributes that present challenges to attraction and retention of the health workforce.
What roles will potentially be included in any incentive?
Firstly, it will only apply to roles undertaken by employees of the NSW Health Service, and excludes contractors, agency nurses, Visiting Medical Officers or contingent workforce who are not paid through the NSW Health payroll.
Secondly, to have the incentives applied (recruitment or retention) to a specific position or class of role, they will need to be identified as being hard to fill or a critical vacancy as defined under the policy directive.
What is the value of the incentives?
The value of the incentive that could be applied to a position or a class of role will be either $5,000 or $10,000, depending on the MM rating and whether the position is hard to fill and / or critical to service delivery. Additional benefits over and above this amount can be considered in certain circumstances.
What type of things could the incentives be used for?
Examples used in the policy directive (noting some are dependent on the MM rating applied) include: professional development; computer/internet reimbursement; additional personal leave; additional base salary; reimbursement of utilities; family travel assistance; transfer incentives (see below); study assistance; or a cash bonus.
What are the transfer incentives mentioned?
This includes a right to return to your substantive position (or like position) if only undertaking a fixed temporary secondment. However, it does also include consideration of a priority transfer to a preferred location nominated by the worker at the conclusion of the secondment. This would need to be agreed prior to commencing the incentivised engagement and have Ministry of Health approval.
Who decides the makeup of any incentive package?
A range of options may be used to tailor the recruitment or retention package that suits the individual ie it is not necessarily intended to be a one size fits all approach (as understood by the Association). You should have a say in how you would like the incentive used.
Leaving the scheme
Can I leave an incentivised placement early?
Certain constraints are applied if one was to leave an incentivised position prior to its term concluding, with repayment requirements possible. However, it may be possible to transfer to another incentivised role and maintain the incentives in place.
What happens next?
Members should check out the policy directive whilst the Association seeks to have the many unanswered questions clarified by the Ministry.