1st of April, 2025, 2:55pm
Parliament of Victoria | Legislative Council
David ETTERSHANK (Western Metropolitan):
Legalise Cannabis Victoria welcomes the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2025, which, as the title suggests, introduces further improvements to nurse-to-patient ratios in hospitals, plus improves staffing ratios for midwives in postnatal and antenatal wards. Specifically, the bill introduces one-to-one nurse-to-patient ratios in intensive care units so that a nurse will be assigned to every occupied bed in the ICU, and it also introduces an ICU team leader/liaison nurse position. Secondly, the improved staffing ratios on morning shift in resuscitation cubicles in emergency departments are captured, bringing them in line with the afternoon and night shift provisions. It introduces a one-to-four midwife-to-patient ratio in postnatal and antenatal wards for night shifts, and it also introduces an in-charge nurse for standalone high-dependency units and coronary care units during night shifts. The reforms have the backings of the Australian Nursing and Midwifery Federation (ANMF), and these improved ratios are a credit to the union and its members and are the product of a very long, long process of advocacy and negotiation by the union and its members. The reforms will support the safety, health and wellbeing of Victoria’s nurses and midwives, which of course in turn will lead to better outcomes for the patients who are in their care.
I do note, as have a number of speakers, that we recently received correspondence from the Australian College of Critical Care Nurses, who the ANMF have worked closely with on these ratios since I believe 2021. The ACCCN are requesting an additional assistance, coordination, contingency, education, supervision and support nursing position for intensive care units to be included in the bill, as well as additional ICU liaison nurse positions. Their concerns, however, do seem to focus on the nomenclature of these ACCESS nursing roles. We have discussed this with the ANMF, and their understanding is that the bill provides for both liaison nurses and team leaders. These team leaders are basically the ACCESS nursing positions according to the ACCCN’s workforce standards definition. Given the extensive mapping undertaken by the ANMF in relation to this bill, they are confident that these roles are clearly delineated and that the ratios are appropriate and satisfactory.
I will just make two other points at this stage. One is that of course we need to remember that these ratios are minimums. They are not a cap; they are not designed to contain. They are operational minimum safety nets that should apply in the setting. So concerns about who is covered and not should I think perhaps be seen in that context. Secondly, I would just like to take umbrage with where I think Mrs Hermans was going in terms of a fear, or a perceived fear, that these changes might see nurses standing around. I do not know how much time Mrs Hermans has spent in an ICU at night or a CCU, but I can tell you that they are not standing around; they are not waiting for things to happen. These are positions that require skill, energy and dedication. These are high-pressure jobs, and it concerns me that there might be this implied suggestion or smear that these ratios represent an excuse for nurses to stand around. I just want to object most profusely to that imputation from Mrs Hermans.
These ratios were an election commitment by the Andrews government in 2022. While it is gratifying to see the government honour that pledge to our dedicated and hardworking nurses and midwives, it does bring to mind another group of equally dedicated and hardworking health professionals who are still waiting for the election commitments made to them to be honoured.
Back in 2018 the Labor government committed to enshrining mental health staffing profiles in bed-based services as per the 2016 mental health nurses enterprise agreement. Anyone paying attention to the public mental health enterprise bargaining agreement negotiations would know that this commitment has subsequently been, to put it politely, shelved by the government. The mental health sector is generally treated as a poor relation to the health sector, and its workers are not afforded the same entitlements and protections as other health workers – and I use the word ‘protections’ intentionally. These health workers are the very backbone of the mental health system, but they are subject to unworkable conditions, dangerous understaffing and increasing levels of occupational violence and aggression in the course of their work. A core reason is the lack of any staffing ratios for workers. It is no wonder that the mental health sector cannot retain its highly qualified and dedicated staff.
For too long government has relied on the goodwill of its mental health workforce to prop up the system. We simply cannot sacrifice the wellbeing of our mental health workers, particularly at a time when our suicide rate is double the road toll, we are in the midst of a youth mental health crisis and there is ever growing anxiety due to cost-of-living pressures. We simply must start to invest in our mental health workforce at this critical time. We call on the government to introduce staffing profiles for mental health workers in all bed-based units and community teams. That said, we commend the bill to the chamber.
[Bill passed without division]
