The Australian Nursing Federation (ANF) abruptly ended a protracted industrial dispute with the Bracks Labor government in the state of Victoria on August 23 over the politically sensitive issue of staffing ratios in public hospitals.
The settlement, which was brokered with the assistance of Australian Council of Trade Unions (ACTU) secretary Greg Combet, not only enshrines staff shortages in hospitals across the State but also requires nurses to surrender hard-won conditions.
The deal was proclaimed “a great victory for nurses” by ANF state secretary Belinda Morieson and welcomed by Victorian Health Minister John Thwaithes as “satisfactory for all parties”. It came after the union agreed to suspend work bans on August 14. Thwaithes threatened to take Federal Court action against the nurses unless the bans, which were first imposed in July, were lifted.
While the dispute centred on demands that the government recruit an additional 700 nurses needed to implement a one-to-four nurse/patient ratio previously recommended by the Industrial Relations Commission, the deal only provides for 350 extra nursing positions.
The extra staff will cost about $21 million but most of this will be funded by the tradeoff in nurses’ work conditions. Under the deal the nurses will forgo some public holidays, saving $8 million, and allow the government to divert a further $5 million from a nurses’ “retention and recruitment” program. An additional $3 million will come from reductions in the number of staff hired from nursing agencies to cover shortages, a move that will increase the workload of permanent nurses.
While metropolitan and larger regional hospitals are to be staffed according to the prescribed ratio, smaller rural hospitals and some specialist services and evening shifts will have a nurse-to-patient ratio of one to five or one to six.
Rural hospitals already lost out in the last state budget allocation for patient management. While many went ahead and employed staff to meet the one-to-four ratio, they were subsequently informed that the positions would not be fully funded by the government. For example, Mount Alexander Hospital at Castlemaine recruited 22 nurses, but only 6.92 were funded. Maryborough Hospital recruited 24 with five funded, Warrnambool Hospital recruited 44 with 18 funded and Portland Hospital recruited 30 with only five funded.
The nurses’ dispute once again reveals that the chaotic conditions in the State’s health system are a result of systematic budget cuts by successive Liberal and Labor governments. Over the last decade these governments slashed the number of public hospitals from 158 to 92, pushing waiting lists to record levels. More than 42,000 people are currently waiting for elective surgery and in the March quarter alone, over 6,000 patients waited in emergency wards, often on trolleys, for more than 12 hours before admission to a hospital bed.
Budget restraints have also impacted on basic hospital hygiene and maintenance. In the past months three people have died from legionnaire’s disease, contracted while they were attending or admitted to two Melbourne hospitals for other complaints. Legionnaire’s disease is associated with the lack of maintenance and cleaning of central air-conditioning units.
Repairing the accumulated damage to the health system requires billions of dollars in investment—something the Labor government has made clear it has no intention of providing. Before the May state budget, the Victorian branch of the Australian Medical Association estimated that the minimum required to repair the public hospital system was $600 million per annum, including $360 million to update infrastructure and buildings. The Labor government’s budget outlay, however, was only $582 million over four years.New clashes with Labor government
The ANF settlement has given the Bracks Labor government a much-needed breathing space under conditions where it confronts a range of industrial disputes by health workers and other government employees.
Radiographers, physiotherapists, as well as cardiac technology, ultrasound and crisis intervention workers have placed a series of state-wide bans demanding improved working conditions, including a guaranteed four days leave per fortnight.
Over 4,500 disability workers caring for people with intellectual disabilities have also imposed bans in support of their demand for an immediate eight percent wage rise, better safety, reduced workloads and improved training and qualifications. The government has offered nine percent over three years.
Bans have also been imposed by 11,000 public sector workers in 23 government departments, including the Forensic Science Centre, Environment Protection Authority, Crown Land Management, State Revenue Office, Fisheries and Wildlife Department and the Victorian Curriculum and Assessment Authority. The public servants are demanding a six percent wage increase over 12 months.
These disputes follow statewide work bans by hospital cleaners, orderlies and support staff in March to demand a 12.5 percent wage claim over three years. The union accepted 9 percent. In June, government medical scientists imposed bans to demand an additional 296 jobs. The government agreed to fund only 100.
Despite union efforts to contain these disputes, conditions are emerging for further confrontation between public sector workers and the Labor government as it approaches the end of its second year in office.
Emboldened by the ANF’s closing down of the nurses’ dispute on August 23, State Premier Steve Bracks told ABC TV: “We’re not going to be soft... Like a lot of modern Labor governments across Australia we support the market, a transparent economy which is open to change.”
Referring to the record of the previous Kennett Liberal government, which initiated sweeping attacks on social welfare, public health and education and other social conditions, Bracks continued: “There were good initiatives by the Kennett government. It doesn’t worry me at all if we’re compared to Kennett.”
“We will pick up the threads of things that were done well in the last government. We’re doing better actually... We believe in working with the business community. We’re tight on fiscal policy.”