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Nurses across New South Wales are preparing to take industrial action for the third time this year on September 1, fighting for better staff to patient ratios as hospitals across the state struggle with long wait times and frustrated patients.
By Harry Mulholland
Every quarter the Bureau of Health Information (BHI) releases a report that tracks public hospital and ambulance service performance in New South Wales, and their latest report released in June shows evidence that patients have been left waiting in emergency departments and are leaving hospital before being treated.
In their Q1 2022 report from January to March this year, the BHI reported over 700,000 people presented to emergency departments around NSW which is down 2.8 per cent from their pre-pandemic levels, however these levels rose to 5.9 per cent higher than 2019 figures at the end of the quarter.
Hospital admissions were also down for Q1 2022 with 161,319 patients being admitted to hospital in this period, which is a 15.6 per cent reduction compared to 2019, however Q1 2022 recorded the highest patient walkouts since 2010 with 55,305 patients leaving hospital either before completing treatment or leaving without treatment.
For waiting times, just over a quarter of patients who were treated and admitted to hospital spent less than four hours waiting in emergency, while one in 10 patients spent longer than 18 hours in emergency.
BHI Chief Executive, Diane Watson, said patients generally had longer waits for emergency department and ambulance services during the quarter, which was marked by high Omicron COVID-19 case numbers and changes to the state’s management of the pandemic.
“January to March saw the suspension and subsequent resumption of some non-urgent elective surgery and the relaxing of public health restrictions.
“As the health system adapted, it continued to experience fluctuations in hospital and ambulance activity and performance,” Watson said.
Q1 2022 also saw the BHI record 326,544 ambulance responses, up 6.1 per cent compared to pre-pandemic levels, with 9,360 of these responses being priority 1A callouts.
Watson said the demand for ambulance responses continued the steady upward trend seen over the past five years with patients waiting for longer periods of time for paramedics to arrive.
“In January to March 2022, patients tended to wait longer for treatment in EDs and those arriving by ambulance waited longer for their care to be transferred to ED staff.
“There was a notable drop in patients who were admitted to hospital after being treated in the ED, down 15.6 per cent from 2019 to 161,319.
“These patients also spent longer in the ED before being admitted.
“Just a quarter of patients in ED who required admission to hospital were admitted within four hours, and one in 10 spent longer than 18 hours and 29 minutes in the ED, up from 13 hours and 29 minutes in 2019,” Watson said.
NSW Shadow Minister for Health, Ryan Park, said at a media event at Gosford Hospital on August 29 that Labor was working on a plan with healthcare workers across the state to improve these statistics.
“The situation we have in our hospitals is a result of 12 years of understaffing, under resourcing and under investing in our hospital systems.
“We now have a situation where 55,000 people right across NSW actually leave our emergency departments before they get treatment because wait times are too long, and that’s not fair on our frontline workers, and not fair on our hard-working health care staff or our clinicians.
“What we want to see is an investment in that human capital, additional resources and additional staff and Labor is going right across NSW to the major metropolitan areas and to the remote towns and trying to engage with our frontline healthcare workers about what is the best model forward.
“We’re in negotiations literally as we speak with the nurses and midwives as well as the Health Services Union because we want to make sure we have a package of policies around enhancing staff before the election.
“Shiny new buildings are great, but they don’t deliver healthcare.
“Frontline healthcare workers, nurses, allied health staff and clinicians are responsible for delivering that healthcare that growing communities like this on the Central Coast need and deserve.
“It’s not a case of the health care workers not digging in and doing their bit, what we need to see is an investment in staff prior to COVID, because what COVID has done is exacerbated the situation in our hospitals, and made it even more difficult for staff, and more challenging for patients.
“What I’ve committed to doing is making sure that as we develop our policies, they’re done in a way where I’m engaging with frontline staff because I want to make sure what we announce works, and what we announce can be delivered, and most importantly that’ll make a difference to our hospitals.
“I think people are a bit over politicians cutting ribbons on shiny new buildings and when they go there they’re not getting the access to health services.
“I’m determined to flip that on its head,” Park said.
Park said that he could not reveal what Labor was planning at the moment, but more information would be coming after the Parliamentary Budget Office opens on September 1.
“We don’t have a parliamentary budget office that opens until September 1, so we can’t even have an opportunity to have policies properly costed, but we are doing everything possible every single week.
“The shadow treasurer and I are meeting with the nurses and midwives every single week and meeting with the Health Services Union about how we can enhance paramedics, how we can improve allied healthcare staff and how we can improve nursing and maternity staff, I’ve got the message very clear.
“I’m not sitting on my hands, I’m working hard with the shadow treasurer but we also, at the same time, are wanting to engage with our local members to make sure that we’re hearing those experiences on the ground and we’re developing policies that work here on places like the Central Coast,” Park said.
Park also spoke of how he supported expanding the capabilities of pharmacists in our healthcare system, saying he is already in talks with the Pharmacy Guild to see how this can be implemented for better healthcare outcomes.
“I support pharmacists being able to do a lot more than what they currently do.
“I’ve spent a lot of time in rural and regional NSW and I can assure you they have, like many healthcare staff do, a very trusted relationship with their community.
“What we want to make sure is they don’t become an add on, but they become a support and a supplement for healthcare services out there.
“We want to make sure that healthcare can be delivered as quickly and as efficiently as possible, and if that means enhancing their scope, then I’m certainly prepared to listen and work with them.
“We’re already in discussions with the Pharmacy Guild on these things that have to be worked through, but it’s certainly something that came through loud and clear in the regional rural health query that certainly people felt their pharmacists had a unique relationship, a trusted relationship, and they wanted them to be able to do their maximum that that they should be doing,” Park said.
Park also said that more people were turning up to emergency departments instead of GPs, blaming the Federal Government for causing GP shortages in areas like the Central Coast.
“I’ve already met with Federal Minister Butler and his staff, and we’ll be having ongoing discussions around this exact issue because whether people understand it or not, the reality is often people end up in our emergency departments because they can’t access primary care in their community.
“We need to make sure that there is adequate GP access in every community across NSW, and certainly the Federal Government is committed to urgent care centres to make sure that they do try and take a little bit of pressure off our emergency departments.
“But this is something that we must cooperatively work with, it doesn’t matter who is in power in Canberra.
“People don’t care about that, what they want to see is a State and Federal Government working together to deliver the best possible healthcare they can for our community,” Park concluded.
Member for Gosford, Leisl Tesch said Gosford Hospital was ranked the worst hospital in New South Wales for emergency department wait times, and the community was suffering because of this.
“These delays have been around for a quite a while, and it’s just getting more exacerbated.
“The waits at ED are increasing and Gosford is now the worst in the state, so we’re looking at what solutions we can come up with, but really shining a light on the government’s failure to invest in our health.
“Our staff are exhausted, but waiting times are blown out and it’s not okay.
“We’ve got possible preventable deaths.
“We’ve got people who are waiting seven, eight and nine hours in ED.
“We’ve got 100 people in a day, and people are just going home over and over again because the wait times are just too long.
“We need to be investing in our staff… this is a long-term failure of this government, which is tragic, so it’s now we’ve got to be looking at what they’re doing in Victoria.
“They’re sending nursing staff to uni for free… we’ve got to be looking at better solutions and Labor is looking at alternative solutions to improve this crisis in the March election next year.
“Dominic Perrottet promised nursing staff and they’ve just failed to deliver, so we’ve got to look at the best possible solutions to deliver the best care for the community here on the Coast.
“That’s why I’ve got Ryan up here today talking to our community, talking to health staff, talking to HSU and vital staff in our community to really see what pressure in on here.
“We’re really looking at how there is a crisis in staffing at Gosford Hospital.
“The percentage of emergency department patients who waited over four hours for treatment in March was 54 per cent at Gosford, 48 per cent at Wyong and 46 per cent in Belmont, so they are the worst in the state at this point and time.
“Our ambulance wait time is nearly up to 64 minutes… between January and March, the number of priority one patients where an ambulance did not arrive within 15 minutes was up nearly 60 per cent in the Gosford area.
“It’s not a crisis that belongs here on the Central Coast, this is a crisis that is across New South Wales and its hitting ambulances, and hitting our hospital’s EDs,” Tesch said.
Central Coast resident, Martine Peters, says she spent six hours in the emergency department at Gosford Hospital.
“I was pregnant and having some blood tests and I received a phone call in the middle of the night. It was like midnight from my GP saying that my blood tests came back and I potentially had leukemia and I needed to present to emergency immediately.
“I came into emergency at about 1am really scared and still not well from early pregnancy and I presented to triage.
“When I got there I said I’m six weeks pregnant and my doctor said my results would be available for them to look at them straight away.
“The triage nurse said to me we’re backed up with patients because of the long weekend and said it was going to be a fairly huge wait.
“It was a Tuesday, and there were only about three people in the waiting room, so I asked him how long did he think the wait might be, and he had this very blank look on his face and looked at his watch and he said to expect the see the sun.
“I went out and found a spot away from a bunch of people coughing around me.
“I slept on my mum’s lap… I had to lie down on the cold seats for six hours.
“Eventually I saw a doctor and I had to have my blood tests reworked and then it came up with the same results.
“And then I was put into a positive pressure room for the risk that I might catch something because I was so immunocompromised.
“What’s the point? I’ve already been lying in emergency with people coughing all around me.
“From there I was admitted to hematology, this was Wednesday afternoon. I had a bone marrow biopsy on Wednesday evening.
“Thursday morning I had a diagnosis of acute myeloid leukemia and very tragically on Friday I had to make a decision about losing our baby.
“I really felt like that nurse was deflated.
“I wasn’t angry with him at all, I just know the difference between the treatment that I’ve been getting in hematology compared to emergency is huge.
“The staff that take care of me at hematology are a lot more supported.
“I know they’ve got a lot more staffing and I honestly believe that downstairs they are overworked, and underpaid, and they didn’t look like there was a lot of stuff on at the time.
“I’m not putting that nurse down at all, he just seems really deflated to me.
“I’m fully aware and I fully understand that my experience in emergency is one of many.
“I fully understand what they’re going through and I know it’s probably hard for everyone else to put their experience aside, but I think seeing first-hand how well I’m taken care of in hematology, I can see the differences,” Peters said.
Parliamentary Secretary for the Central Coast, Adam Crouch said the region’s dedicated health staff continue to provide high quality and safe care despite a challenging year.
“I want to start by thanking each and every one of them for their incredible efforts.
“The substantial number of COVID-19 cases in our community not only presented serious challenges with respect to complex presentations and admissions to our hospitals but are also due to significant staff unavailability as staff contracted or were exposed to the virus, whether in the community or at work.
“To ensure safe and timely care for patients, the Local Health District put in place several strategies to allow them to admit patients and transfer them out of the emergency department more quickly during peak periods.
“The district is also actively recruiting additional doctors and nurses to the area.
“Between mid 2012 and mid 2022, the Central Coast Local Health District increased its workforce by an additional 1,178 full time equivalent staff, an increase of 26.7 per cent including 269 more doctors, 469 more nurses and midwives, and 117 more allied health staff.
“I welcome the Premier and Minister for Regional Health announcement on Friday that communities in regional and rural New South Wales will benefit from a significant expansion of programs to increase the number of junior doctors and nurse practitioners in regional New South Wales will be doubled to 200 over four years.
“The New South Wales Government also announced a major regional health workforce scheme as part of this year’s budget.
“$883M will be spent over the next four years to attract and retain staff in rural and regional New South Wales by transforming the way health clinicians are incentivised in our regions.
“More than 3,800 full-time equivalent staff will be recruited to hospitals and health services across regional New South Wales over the next four years with most to be recruited in the first two years,” Crouch said.
Nurses across New South Wales will be striking on September 1 for 24 hours, demanding better staff to patient ratios and a pay increase.
The New South Wales Nurses and Midwives’ Association General Secretary, Shaye Candish, said in an interview with The Guardian that this is a direct response to the government’s inaction.
“Nurses have put their own health and lives on the line for the community.
“All they want to do is provide safe patient care and their inability to do that is actually making their job impossible,” Candish said.
The union is pushing for a staff to patient ratio of 1:4, and they are demanding for a 7 percent pay rise to keep up with the cost of living.
“This health system will look fundamentally different if we don’t see the government making real and genuine investment in nurses and midwives workforces,” Candish said.
WHAT YOU CAN DO
The community can do many things to support nursing staff including supporting their strikes and understanding their working conditions.
Unions New South Wales currently has an online petition circulating the internet addressed to the New South Wales Premier, Dominic Perrottet asking for pay rises, more secure jobs, better working conditions and stopping privatisation.
The Australian College of Nursing also has a guide on how the community can support nurses including being kind to them, showing compassion, trusting them and being a role model to the rest of the community.
Another way the community can support nurses is by getting in touch with their local MP and sharing stories of long wait times in emergency departments to help push for change.
