NOB State health cuts will cost lives

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State LNP Governments’ prioritising budget surpluses over quality health care is going to cost lives, says Jenny Haines.

NSW Health Minister Jillian Skinner along with the likely outcome of her budget cuts.

LIBERAL - NATIONAL Party Government’s in the NOB States (Newman in Queensland, O’Farrell in NSW and Baillieu in Victoria) are showing their true conservative economic credentials when in power.

There must be surplus budgets. This is dogma to these governments. To achieve that, savage cuts to health, education, welfare services and the public sector are being put in place. The people of the States must pay for the impact of the excesses of the global financial crisis on the States’ Budgets. Unemployment must rise, so that wealthy investors can be reassured by the State’s credit rating that it is a safe place to invest.

All of this is a foretaste of what is to come at Federal level, if and when the Liberal - National Party Coalition, led by Tony Abbott, win the next Federal Election. No one can say they weren’t warned!

As part of the implementation of this program of cuts in NSW, Gillian Skinner, Minister for Health, NSW, announced on the 13th September 2012 that $3 billion would be cut from health services in NSW over the next four years. This was just after Adrian Piccoli, Minister for Education, announced $1.6 billion cut in the States education services.

This amount includes $775 million from the imposition of a “labour expense cap” announced for every NSW government department in this year’s budget. A further $2.2 billion would be cut from NSW Health in “efficiency savings”. Gillian Skinner said that the money cut as part of the labour expenses cap would go back to Treasury as consolidated revenue, but she insisted at the time of the announcement that the $2.2 billion would be redirected to front line clinical services.

The NSW Opposition Leader, John Robertson, questioned whether the money would be redirected to frontline clinical services and warned the cuts could mean the loss of 3,600 jobs in the health sector. However, Mrs Skinner said it was "not necessarily jobs that will be cut". She said the savings could be found by cutting overtime, or not relying on locum doctors or agency nurses. The decisions would be made by local health district authorities but, she insisted, nurses would be exempt. What she does not explain is how the work could be done more efficiently without the use of agency staff, who fill the large number of vacancies for registered nurses and enrolled nurses on a shift by shift basis to ensure the delivery of a safe standard of care.

Then on September 24th 2012, Gillian Skinner re-announced that overtime payments for health workers and the use of contract workers and agency staff would be cut in order to save $89 million in this year’s budget. Mrs Skinner acknowledges that the 5.4 per cent increase in this year's health budget, to deliver $16.4 billion in recurrent spending, would not keep up with rising costs and patient demand. Hospitals will be expected to deliver an extra 50,000 emergency department visits, 30,000 overnight hospital stays and 2000 elective surgery procedures this year. Mrs Skinner said hospitals would just need to be “more efficient”. What this means, in effect, is that already overworked staff are now to be expected to work even harder and, come the time for the negotiation of the next wages round next July, they cannot ask for any more than a 2.5 per cent wage increase.

In all of this, Gillian Skinner is saying that she is protecting nurses’ jobs, but cutting overtime. But there is already a lot of overtime that is not paid now, as it is supposed to be taken as time in lieu — but the time off never actually eventuates. And there is a huge amount of overtime being worked due to the short staffing. So, cutting overtime is not going to fix any problems — it is just going to make them worse. Much worse.

The Unions, the NSW Nurses Association, the Health Services Union, and the medical unions are going to have to be a lot more active here if nurses and other health system staff are to be protected from exploitation.

NSW Health are offering redundancies in the Hunter New England Area. There are many experienced nurses who hope they will offer redundancies elsewhere, as they want to get out — and this is in a system that is in desperate need of experienced staff as mentors for the largely young, inexperienced workforce.

And in a sign of the madness of placing budgetary aims over safety in the delivery of health care — health system managers are now bringing in Assistants in Nursing in community mental health. These are untrained staff with, maybe, a Certificate 3 from TAFE, working on crisis teams with people who may need admission to mental health hospitals — this is just plain dangerous. These inexperienced staff will not know what they are looking at — and is bound to cost lives.

(Jenny Haines is former general secretary of the NSW Nurses Association.)

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