The New South Wales (NSW) healthcare system is in crisis. The state’s public hospitals, starved of funding, staff and resources for decades by Labor and Liberal-National governments, have been pushed to breaking point by bipartisan “let it rip” COVID-19 policies.
Just 66 percent of patients who present to emergency departments (EDs) are treated on time, with more than 40 percent waiting more than four hours. 22 percent of patients arriving by ambulance waited more than half an hour to be transferred to the ED, while 10 percent were ramped for more than 56 minutes.
At the end of 2022, 100,000 people were on elective surgery waiting lists across the state, including more than 4,000 children.
Nurses, midwives, paramedics and other health workers have borne the brunt of this catastrophic situation, facing constant demands for overtime and double shifts, impossible workloads due to staffing shortages, as well as the ever-present threat of infection with COVID-19.
At the same time, health workers have been slugged with harsh real wage cuts. Like the rest of the state’s public sector, they are subject to a punitive 2.5 percent per annum wage increase cap. While this was temporarily increased to 3 percent by the Liberal-National government, it remains far short of the official inflation rate of 7.8 percent.
Whichever of the parliamentary parties takes office after the March 25 state election, the crisis confronting health workers and their patients will only deepen.
Labor and the Coalition have refused to implement minimum nurse-to-patient ratios, meaning staff will continue to be overwhelmed and unable to provide proper care to their patients. Both parties have vowed to keep nominal wage increases far below inflation, meaning health workers will fall further behind or be forced to leave the sector, worsening staff shortages.
The single most devastating factor affecting the public health system is the ongoing COVID-19 pandemic, which caused at least 20,000 excess deaths in 2022 alone, and is now the third-most common cause of death in Australia. But in the NSW election campaign, just as in last year’s federal election, the parliamentary parties have not uttered a word about the deadly virus.
This is because they are in complete agreement. Since taking office in May 2022, the federal Labor government has torn down almost all public health measures against the virus and attempted to cover over the devastating result by virtually eliminating testing and reporting. Almost 60 percent of all COVID-19 deaths in Australia have occurred in the ensuing 10 months.
The Health Workers Rank-and-File Committee (HWRFC) endorses Socialist Equality Party (SEP) candidates in the NSW state election because it is the only party offering workers an alternative to the ongoing slashing of wages and cuts to health, education and other social services. This is because the SEP opposes capitalism and rejects the subordination of every aspect of life to the profit dictates of big business.
Health workers have shown their determination to fight for decent wages, safe working conditions and a high-quality public hospital system. So far however, under the leadership of the union bureaucracy, they have been forced to undertake this struggle with their hands tied.
Last year, tens of thousands of nurses, midwives and other health workers took part in multiple mass strikes across NSW, demanding safe ratios and an end to the wage cap. The NSW Nurses and Midwives Association (NSWNMA) and other health unions, compelled to call these strikes to allow workers to let off steam, did everything in their power to undermine them.
Determined above all to prevent a broader struggle of health and other workers, under conditions where most of the state’s more than 400,000 public sector workers had voted to strike, along with train and bus drivers, the union apparatus ensured the disputes were kept isolated.
This is because the unions are not workers’ organisations at all. They are industrial enforcers of management and government demands, whose vast investment portfolios are tied to the stability and profits of big business, diametrically opposed to improving the wages and conditions of workers.
Any real industrial fight was blocked, as the union leaders attempted to channel workers’ struggles into, first, plaintive appeals to the Liberal-National government, and then, an extended election campaign for Labor.
The NSWNMA has been at the forefront of this betrayal. Even as Labor leader Chris Minns refused to support ratios, declared public sector wages must be tied to “productivity” and bragged on radio that he had “clashed with the nurses,” the NSWNMA bureaucracy has relentlessly backed his campaign.
But this is based on lies and obfuscation.
The NSWNMA falsely claims Labor is “committed to ratios.” In fact, Labor has promised unspecified “Safe Staffing Levels,” starting in Emergency Departments, and only “subsequently rolled out into other areas including ICUs, maternity wards, and Multi-Purpose Services.”
The truth is that, even if implemented, nurse-to-patient ratios alone would not resolve the staffing crisis. In other states where Labor is in office, including Victoria, Queensland and the Australian Capital Territory, ratios are legislated, yet nurses have faced the same shortages and excessive workload as in NSW.
Labor has also pledged 1,200 nurses and midwives recruited into the system over four years, a financial commitment of just $175 million, in addition to the Liberal-National state government’s additional recruits promised in the June 2022 budget. There is no indication of where the additional staff will come from or how they will be deployed.
Labor’s plan to “scrap the public sector wages cap” will not deliver real pay rises for nurses, midwives, or anyone else. Minns has made clear that Labor will not increase wages in line with inflation.
This policy is entirely in line with that of the federal Albanese Labor government, which has opposed “across-the-board” pay rises in line with inflation. The federal budget in October last year revealed that at least $2.4 billion will be cut from public hospital funding over the next four years and reinstated a 6.5 percent annual cap on federal hospital funding.
The SEP tells health workers the truth—in order to fight for decent wages, conditions and a high-quality public health system, they will need to take matters into their own hands. No such struggle can be advanced within the framework of Labor and the union bureaucracy.
This means workers need to build their own organisations of struggle, rank-and-file committees, in every hospital and workplace. Such committees, democratically controlled by workers themselves, are the only way to defeat union sell-out and isolation operations, unify their struggles across industries and build an industrial and political counteroffensive.
The SEP and HWRFC insist that health care is a basic social right. The establishment of free, high-quality health care is incompatible with the capitalist system, in which health policy is determined by the profit interests of the financial and corporate elite.
This underscores the fact that health workers confront broader issues related to how society is organised. One of these is COVID-19. Without a global fight to eliminate the virus, the crisis facing hospitals in NSW and everywhere will only deepen. Another is the escalating threat of world war. While governments say there is no money for wages or health funding, growing billions are being spent on machines of war.
This poses the urgent need for an alternative perspective—a fight to establish workers’ governments to implement socialist policies, including placing the banks and major corporations under public ownership and democratic workers’ control. This would allow billions of dollars to be redirected to the recruitment and training of new nurses, doctors and other healthcare workers, and the vast expansion of public health infrastructure, to meet the needs of the working class, not serve the profit interests of the wealthy elite.
The SEP and the HWRFC will provide workers with every political assistance in forming rank-and-file committees, publicising their activities and developing their initiatives. We urge health workers to contact us today and discuss this perspective.
Contact the Health Workers’ Rank-and-File Committee (HWRFC):
Contact the SEP:
Phone: (02) 8218 3222
Authorised by Cheryl Crisp for the Socialist Equality Party, Suite 906, 185 Elizabeth Street, Sydney, NSW, 2000.