Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2018

Second Reading Debate
05 February 2019

Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2018

It gives me great pleasure to speak today on the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2018. As has been previously outlined by the lead speaker for the opposition, the member for Lowan, we are really here today because the bill that was left to the last minute in the last Parliament made a glaring omission where the government clearly did not understand what is meant by a midwife and what the capability of a midwife is versus that of a nurse.

I stand here in this Parliament with some 30 years experience in the nursing sector working right across many of the wards, from medical wards to surgical wards to coronary care wards to the emergency department and high-dependency wards. I never did midwifery other than during my hospital-based training, and it would be optimal for me here to give a shout-out to the Warrnambool Base Hospital where I completed my training as one of the last nurses through that system down in south-west Victoria. I am very proud of my training and the profession that I spent so many years in.

We have got some pretty good hospitals across south-west Victoria, from the Portland health service to Warrnambool Base Hospital and even St John’s, which is not relevant today because this is a bill that affects the public sector. But it is very relevant to our part of the world, because sharing the load is how the public and private sectors work so necessarily together, creating the systems that we have to make sure we meet our health needs.

Leaving midwives off and not understanding their capability, I think this really does give us an understanding of just how much relevance the government attributes to the hardworking community that they purport to represent. In Warrnambool for example, the nurses were very excited because they have been working hard since 2001 trying to get the hospital changed from a category 3 to a category 2. For many years they have been disadvantaged while the discussion was going on, saying that they wanted to increase the nurse-to-patient ratio. Warrnambool make the statement that they have put up with ratios that do not help them for a long time. As a cardiac nurse I could look after five patients in Warrnambool with acute myocardial infarction, for example, but I would be looking after only four of those very same patients in Melbourne at the Royal Melbourne Hospital, yet they have the same clinical condition. The fact that the hospital cannot be upgraded to a category 2 from a category 3 is a real disappointment because prior to the election that we have just had the minister was quite vocal in saying that they were going to make the Warrnambool Base Hospital increase to category 2 so we could get the nurse-to-patient ratios that others have had for so long.

Minister Hennessy said in a letter to the midwives and nurses that Warrnambool would be under this new regime, but that appears to be not the case. There is no listing of that and it looks like it might not be until after 2022 that that promise that was given to the Warrnambool Base Hospital even looks like coming to fruition. My advice from the department is that it might even require more legislation for that to occur. What a missed opportunity by this government, to introduce the bill now with the glaring omission that it is fixing to make sure midwives are categorised for the capability that they definitely have to be able to look after an infant in a special care nursery yet missing out on using this opportunity to take the Warrnambool nurses on the same journey. The government is again leaving them hung out to dry despite the promise from the election that we have just had in November 2018.

But omissions in legislation are something we are seeing a fair bit of, along with unintended consequences by this incompetent government we have now got for another four years. Just look at the port legislation that came in over two years ago: a glaring omission was the terminal charges that were left off the legislation, so currently we have got a 1000 per cent increase in charges for terminal movements that is costing the consumer hundreds and hundreds of dollars. It is also being passed back to the producers, like your dairy farmers, who are struggling, and your grain farmers, who are going through drought at the moment. In some cases it equates to over $4000 for a dairy farmer and $4 a ton for grain, which is disadvantaging the farmers.

I think what we need is some legislation or some regulation to come in to make sure that this glaring omission in relation to the ports, which was missed, is fixed. We had the former minister for ports, the member for Narre Warren North, in his role in October call for an expedited inquiry, and yet we are now in February and where is that inquiry? We have not seen even one word. I call on the current Minister for Ports and Freight to actually do something about this situation urgently, because the farmers are suffering and our community is struggling with the cost of living. Everything that comes through the port in containers—servicing Kmart, servicing Woolworths, servicing Bunnings, which are all big customers, along with everything that families actually buy—will be affected by this omission in the legislation.

As I said, there is a history of omissions. In clause 10 of the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2018, which inserts new section 27, we see that midwives are now included. What we also need to think about is how country hospitals, for example, are going to manage this new ratio. If we do have hospitals whose ability to provide more nurses to patients is increased, we have got a real capability crisis, and workforce capability is something this government really needs to focus on.

During my work in the inquiry into perinatal services last year something I highlighted over and over was how it is all very well to say we need change, but unless you can actually facilitate that change by developing the workforce, then you are just leaving the situation high and dry. We need to make sure that the government looks at workforce capability and makes sure that we train the midwives and encourage the midwives to come to the region. It is not just midwives; it is doctors, it is anaesthetists, it is all sorts of specialties that we require to make sure we address and meet the health needs of the community that we have today right across Victoria.

We do not want to see the government focusing only on Melbourne. We want to make sure that we are focusing right to the far reaches of the region, because governing Victoria is the responsibility of government. It is not about governing for Melbourne. We have all seen many examples—even this week with the Port Fairy Hospital and the Heywood hospital coming to my attention over the issue of centralised banking. The government has come up with this plan—a fair call to get better efficiencies—but they have not understood that the banks that the hospitals are banking with are community banks. The government has completely disregarded the fact that the community bank, Bendigo Bank, in Port Fairy just gave $50 000 to the urgent care centre in Port Fairy. It is foolish, because the government is going to have to make up that shortfall anyway if community funds are taken away. Those in government really need to spend a bit of time out in the country listening to the people who can make wiser decisions based on the community that they live in.

Back to the nurses in Warrnambool, who in 2001 were crying out to be moved from hospital category 3 to category 2 so they could get better patient care ratios. This is a hospital that is needing to be upgraded. The nurses already put up with enormous challenges in their emergency department. In today’s world, where we have technologies that mean we need equipment around us to do our roles when we are in crisis situations in emergency departments, the emergency department at Warrnambool is well and truly past its use-by date. But the nurses do an extraordinary job in extreme circumstances, as do the operating theatre nurses.

I trained in 1985 or 1986, I think it was, when I was doing my theatre stint, and the theatres that they are operating in today are actually exactly the same as they were then. So clearly when you are doing much more surgery like we are doing today—hips, knees and all sorts of surgery that we could not do back then—the throughput through those theatres has increased exponentially, and we need to upgrade the hospital to meet that need. This government talks about nurse-patient ratios. That is great, but it leaves off Warrnambool, and it is just ignoring Warrnambool Base Hospital. I hope the nurses there have a think about how they have been promised so much—promised that they would be included in the nurse-patient ratio—and here we are in front of the Parliament today with this legislation going through and completely missing that opportunity, and there is no mention of upgrading Warrnambool Base Hospital.

I have already written to Minister Mikakos and said, ‘Come up to Warrnambool. Come and have a look at the hospital. I’ll take you through A and E, I’ll take you through the operating theatres and introduce you to the surgeons, the specialists and the nurses’. We have got incredible capability up our way. Special mention to my oncologist, John Hounsell, who is a great man who helps me in my work here in the Parliament. I am happy to call him to ask him questions about things I do not understand. Noel Bayley, one of our physicians, is another man who has helped me understand different perspectives on the challenges of legislation regarding medical things that I might not understand.