Sydney nurses take their concerns to the streets

By Erika Zimmer
22 November 1999

About two hundred striking nurses from Sydney's Westmead hospital took to the streets last Friday to campaign for public support against a proposed $6.5 million cutback to hospital funding. It was the first time that nurses at Westmead, the largest hospital in Sydney's western suburbs, had taken industrial action on their own, outside a statewide stoppage.

The nurses walked off the wards and held a two-hour rally in the local shopping mall to protest against plans for further bed closures and cuts to more than 300 surgical operations. The nurses handed passers-by leaflets explaining that in the last decade, 260 of Westmead's 1,000 beds, or over 25 percent, had been cut. The latest proposals, supervised by the state Labor Party government, would eliminate a further 41 beds and more than 300 operating theatre sessions and reduce the number of births at the hospital by 500 annually.

Strikers held placards saying, “Nurses care—executives and politicians apparently don't”. One nurse said the situation at Westmead made her “sick to the stomach. I can't remember the last time, it was so long ago, but we need desperate measures because the community is suffering.”

Nurses at the rally spoke to the World Socialist Web Site about their concerns. They said the public hospital system had been driven into crisis. Staff shortages were causing unprecedented levels of stress. Nurses rostered off sick were not being replaced, making it impossible to provide adequate patient care. Nurses felt compelled to cut short their sick leave, knowing the burden that they were placing on their colleagues. In addition, they were expected to do unpaid overtime.

Shortages of equipment added to worsening conditions. Nurses were also concerned that the stressful working conditions were causing newly graduated nurses to leave the profession in droves.

A few days before the nurses' rally, Westmead's head of medicine, Professor Richard Kefford, told the media that he was “being asked to breach my duty of care to my patients” when told to discharge cancer patients because of bed shortages in the emergency department. He spoke of one patient who had developed an overwhelming infection and another with intractable vomiting and dehydration.

For speaking out he was immediately condemned by NSW Health Minister Craig Knowles and Western Sydney Area Health Service chief executive Alan McCarroll. In a crude bid to set staff against doctors, McCarroll said Dr. Kefford's comments were a “slur on the professionalism of the medical and nursing staff of the emergency department”.

Throughout Sydney, funding shortfalls to public hospitals are straining the health system to the point of collapse. Patients have to be sicker in order to qualify for admission; face ever-longer admission queues and are discharged at a faster rate.

The rally at Westmead follows a similar one in September staged by nurses at the Royal Prince Alfred, another major Sydney teaching hospital, over the planned closure of at least six beds.

A day after the Westmead nurses struck, the Sydney Morning Herald reported that similar cuts were planned for public hospitals across the city:

* The Prince of Wales hospital, a major Sydney teaching hospital, faces a $7.19 million budget cut. It will have to sell off $17 million in assets in order to pay debts. There is no money available for upgrading, even though $12 million worth of upgrading is required.

* Funding cuts for the Nepean hospital in Sydney's far western suburbs are reported to be around $6 to $8 million.

* The New Children's hospital is set to perform 11,500 fewer surgical cases; waiting time for a tonsillectomy has gone up to one year; only 247 of an available 350 beds are in operation.

* Liverpool hospital, in Sydney's south-west, faces a cut to its operating sessions of up to 250 a year. This will blow out the waiting list to an estimated 9,000 by the end of the year. To cover the gaps, surgery hours are to be extended, sometimes until 3am.

* Bankstown/Lidcombe hospital, in the city's mid-west, faces a further 300 cutback in the number of operations performed. Three of its eight operating theatres are permanently closed. The hospital's waiting list for elective surgery was already 1,500 at the end of August and has lengthened since.

* The Royal North Shore hospital has a projected deficit of $8 million this year. The hospital needs close to $20 million to upgrade lifts, fire and safety equipment, but has only $2 million to cover this. No major capital expenditure has been undertaken in the last 20 years.

* Two other hospitals, St George in Sydney's south-west and Royal Prince Alfred in central Sydney, face similar bed closures and funding cuts.

Nonetheless, the Labor government's Health Department head Mick Reid ruled out giving hospitals any extra money, saying that the NSW health budget “was growing every year”. He demanded that “funds be used more efficiently” adding that “efficiencies only work if you reduce bed numbers”.

According to federal government figures, funding to public hospitals in NSW has increased by almost one-third in real terms since 1991. These figures are misleading, however. Over the past 15 years, spending nationally has declined in real terms from 1.07 per cent of Gross Domestic Product in 1984-5 to 0.90 per cent in 1998-99.

Moreover, since 1984 rising fees and falling living standards have caused private health insurance coverage to plummet from 65 percent of the population to 30 percent—placing more pressure on public hospitals. Now the federal government is siphoning $1.5 billion a year from public hospital budgets to subsidise the highly profitable private health funds.

The nurses' trade union, the NSW Nurses Association, has threatened to take state-wide strike action if funding concerns are not addressed, but has put this off for three weeks, promising the government no further industrial action during the intervening period.