Stretched to breaking point by Covid, NSW’s public healthcare system is struggling to return to acceptable levels of staffing and efficiency. Labor is promising to remove the Coalition’s public services wages cap, while the Coalition promises to pour billions into attracting new healthcare workers. In the latest in his series on NSW election platforms. Callum Foote reports on health as voters go to the polls.
NSW’s public health system is experiencing a healthcare worker exodus, with 12.6% of public nursing staff leaving in 2021-22 compared to 7% annually over the previous three years.
Australian College of Emergency Medicine President Dr Clare Skinner has cautioned against inaction to address the growing shortage of medical professionals, “Without intervention, workforce issues self-perpetuate: skilled health care workers leave because of unsustainable working conditions, then working conditions get worse because of further staff shortages – so more skilled staff leave or reduce their working hours. But this can be fixed – if we work together”.
For its part, the Coalition is committed to spending $4.5 billion to add 10,000 workers over four years, including $883 million to direct nurses, doctors and other health professionals to rural and regional areas.
Labor offers nurse to patient ratios
Labor is to offer university fee subsidies of up to $12,000 a person for students who commit to the public system for five years in a $76 million promise. Both commitments, more so on Labor’s side, have been criticised as doing very little to address the retention issue for public health nurses.
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However, nurses are calling for better pay and better conditions. Specifically a commitment to a minimum nurse-to-patient ratio.
Labor will introduce mandatory minimum staffing levels for nurses and midwives in public hospitals, starting with emergency departments, and recruit an additional 500 paramedics to regional and rural communities.
NSW Nurses and Midwife Association general secretary, Shaye Candish says that “NSW is the second worst paid state in Australia because of this policy, making it near impossible to attract and retain staff in such a tight labour market”.
Labor leader Chris Minns has agreed to scrap the current public wages cap which offers a 3 per cent increase in 2022-23 and up to 3.5 per cent in 2023-24, far below the rate of inflation.
Minns will not commit to a specific pay rise for nurses but is instead promising public sector wages for nurses will increase through negotiation.
Elective surgery backlog
More than 17,000 patients needing elective surgery waited longer than was recommended between October and December 2022 according to a Bureau of Health report released earlier this month – 33% of these cases required semi-urgent procedures.
The government has made no additional commitments to reducing the elective-surgery backlog in the public sector, while Labor has promised a surgical care taskforce to tackle the state’s near-100,000-person waitlist for elective surgeries.
Capital spending
Who voters preference on Saturday may depend on where they live. Perrottet said the Coalition would spend $1.2bn to build 20 new hospitals across the state, including $260m to upgrade Concord Hospital if re-elected in March.
Additionally, the government announced a $1.3 billion hospital for East Hills, in southwest Sydney, which the government holds by a 0.1%, margin.
Labor’s commitments are modest in comparison with the government promises. Minns promised that Labor would reinvest extra savings into health and education by slashing the state’s $1.6bn budget on third-party workers.
Labor will also commit $700 million to install an additional 300 beds at Rouse Hill Hospital in Sydney’s Northwest.
Vaping and child healthcare
No matter who forms the next NSW government, it looks to be a win for the vaping industry which will be able to exit the shadow of the black market with commitments to legalisation from all major parties.
The NSW government have not made any commitment regarding vaping, with the federal National party set to support legalised vaping.
Many public health expert groups including the Australian Medical Association, Cancer Council, the Public Health Association of Australia (PHAA), and the Australian Council on Smoking and Health (ACOSH) support banning the free sale of vaping products.
NSW Labor offers only a modest commitment to vaping, mainly regarding vaping detection in schools. NSW Labor leader Chris Minns will host an expert roundtable within a year of taking office, support a health and safety campaign and consider installing vaping detection technology in schools.
NSW Greens have also adopted a proposal to legalise vaping, according to a letter sent to Associate Professor Kate McBride, Public Health Association of Australia NSW Branch President.
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“The Greens position makes a serious error in adopting a proposal to legalise vaping, which risks normalising vaping and its industry. The Greens’ statement includes useful commitment to education campaigns and retailer penalties, but these would be overwhelmed by the adverse impact of their main policy” says McBride.
The government have made no specific commitments towards combating childhood obesity, despite over 1 in 5 children in NSW suffering from obesity.
Shadow Health Minister Ryan Park, in typical Labor fashion, has promised to review the arrangements that are in place in relation to food advertising, with a view to achieving better health outcomes for NSW.”
While the Greens have made commitments to remove all unhealthy food advertising targeted at children on state property and promote a healthy eating campaign. The Greens have stated that they “believe in banning junk food ads.”
Preventative healthcare
Neither the government or the Opposition have made commitments on preventive health.
Shadow Health Minister Ryan Park’s letter to PHAA positively discusses issues of prevention and health spending and concludes: “I am committed to ensuring a Minns Labor Government does preventative health better.”
Labor has made a commitment to suicide prevention. Productivity Commission data shows NSW has the lowest spend per capita for mental health in 2020-21 – a gap set to widen with recent commitments from Queensland and Victoria to bolster the sector.
Dr Angelo Virgona, Chair of the NSW Branch of Royal Australian and New Zealand College of Psychiatrists said that “New South Wales is languishing. The mental health workers across the state describe a system that’s too complex, too hard to access, fragmented and weighed down with inequality.”
Dr Virgona has called for any new government to invest more into mental health preventative care ““We don’t need another commission or inquiry. They’ve been done. The issues are known, as are many of the fixes. Other states are showing it can be done. It’s NSW’s turn.”
Both Labor and the Greens are supporting a ban on manufactured stone, working with which can lead to Silicosia, a long-term lung disease caused by inhaling unsafe levels of silica dust.
“The explosion of silicosis cases in our workforce is a tragedy, and is made all the more tragic by how preventable it was. A failure of safety standards and regulation has left workers exposed to dangerous workplace conditions, with inadequate monitoring and support,” Abigail , Greens NSW MP and spokesperson for Fair Trading and Better Regulation said.
The Greens are also committed to publicly funded dental care and a reproductive health package.
Both parties, if elected, will continue to lobby the federal government to increase payments to GPs amid declining bulk billing rates with Perrottet, alongside Victorian premier Dan Andrews promising to build 25 urgent care clinics as a way of taking pressure off GP services earlier this year.
Callum Foote was a reporter for Michael West Media for four years.