West Australian nurses issue challenge to government's health cuts

In the midst of the campaign for a state election on February 10, registered nurses in Western Australia have challenged the right-wing Court government's protracted running down of the public health system.

After months of critical funding shortages, emergency department shutdowns and lengthening surgery waiting lists, nurses launched industrial action to close beds at Perth's major public hospitals in order to establish safe nurse-to-patient ratios and fight for decent wages and conditions.

Nurses refused to service 147 beds at Royal Perth, Sir Charles Gairdner and Fremantle hospitals, highlighting the deepening crisis in the health system, which has seen cash-starved and understaffed hospitals repeatedly forced to turn away patients.

The nurses, members of the Australian Nursing Federation (ANF), are demanding increased staffing levels, a 16 percent pay rise over two years, limitations on the use of casual and private agency nurses, improved long service and study leave and better career structures.

The ANF based its industrial action, initiated on Monday, on a federal Industrial Relations Commission (IRC) decision handed down in Victoria last year that nursing staff could not safely look after more than four patients per shift. The WA nurses shut down the hospital beds as part of the fight for this ratio.

After just two days, however, the union leadership lifted the bed closures, following an IRC recommendation that nurses halt their industrial action and hold further discussions with the Health Department. This was despite the Court government offering a pay rise of only 13.5 percent over three years. Earlier in the day, Premier Richard Court threatened to make nurses personally liable if patients were unable to be admitted to hospital.

While the ANF officials have called off the industrial action, it could erupt again. Keenly aware of the depth of anger among their members, the union has rejected the government offer and threatened to resume the bans if nurses' demands are not met.

Like Court, the mass media has tried to turn public opinion against the workers, blaming them for the cancellation of elective surgery cases and the turning away of all but life-threatening cases from emergency departments. According to the West Australian: “Cancer and open heart surgery were among 165 operations cancelled yesterday after nurses closed beds in Perth's major hospitals.”

In fact, the nurses took action precisely to combat the dangerous deterioration of the health system. Government funding cuts and nursing shortages have forced five public hospitals—Fremantle, Royal Perth, Sir Charles Gairdner, Bentley and Osborne Park—to impose ambulance by-passes and postpone elective surgery in recent months.

Statistics published in the media show that 3,000 people statewide are now waiting longer than they should be for non-urgent and semi-urgent elective surgery. Last month, the general surgery waiting lists increased by 280 to 10,083. Stories abound of patients waiting up to 12 hours for treatment and even going without food.

The conditions are so appalling that nurses have been quitting the system to seek better pay and conditions working for private agencies. Some 21,000 nurses are registered with the WA Nurses Board, but the ANF estimates only 15,000 are working in the public hospital system.

Dissatisfaction and anger have been mounting for some time. In a union survey of 2,300 nurses throughout the state last year, 99 percent said they were unhappy with the level of government funding and 90 percent said nurse-staffing levels were inadequate.

But the Court government has decided to inflict further budget cuts. In the face of a shortfall in funding for community services, the Metropolitan Health Service has been instructed to slash $5.6 million from public hospital budgets to pay for new services that the government announced last year, including speech and language clinics for children and suburban public health units.

Representing doctors, the Australian Medical Association condemned the announcement, stating that hospitals could not afford to hand back money halfway through the financial year. “The system is at its limits and it is really distressing for people trying to do the right thing and deliver services without blowing their budgets,” state AMA president Simon Towler said.

In addition, another major problem has emerged—a dire shortage of nursing home and hostel beds, which are funded by the federal government. Many sick and elderly patients are stuck in public hospital beds awaiting placement to homes or hostels. According to a leaked report last year from the Metropolitan Health Service, there are 306 fewer nursing home beds available in Perth compared with a year earlier.

Statewide there is a shortage of more than 700 nursing home and hostel beds. A Department of Health and Aged Care report revealed that over two years, the average waiting time for nursing home beds has almost doubled—from 31 days in 1997-98 to 47 days in 1998-99 and 55 days in 1999-2000.

Despite opinion polls showing that the Court government faces defeat on February 10, the business-owned media has warned it not to make concessions to the nurses. An editorial in the West Australian this week insisted: “If the Government caved in to union pressure in the midst of an election campaign to rid itself of a troublesome issue, it would be seen by many of its supporters to be putting political expediency ahead of proper decision making.”

Across the board, the media owners have told both the government and the Labor Party opposition that no rash election spending promises will be tolerated. Whichever party wins the election, their brief is to further reduce state debt, maintain the financial markets' AAA credit rating and extend corporate tax and investment incentives.

Court has offered a miniscule health funding increase of $40 million, to be financed from the sale of the public gas utility, Alinta Gas. This amount—some 0.2 percent of the state health budget—will do nothing to overcome the present crisis.

Yet, when the Labor Party released its health policy statement it pledged even less. An extra $36.5 million was offered for child and community health, palliative care, public health campaigns and regional health services. Nothing was promised to tackle the nursing shortages and poor pay and working conditions in the state's major hospitals.