Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2020

Mr KENNEDY (Hawthorn) (15:02): It is always good when you can get up and speak about bills that you have had some sort of involvement in, and at the end of January I had a few days in hospital—bit of elective surgery—just preparing me for the rigours of 2020. That was a good experience. I was so impressed—I had not been in a hospital for a long time. Seeing all the modern developments, the enthusiasm of the nurses, the highly professional approaches and so on was most impressive—well, so I thought. I do have to record, though, and this is as good a place as any, that one night I was seeking to sleep and I thought, ‘Oh, this will be a simple matter of calling the nurse for a simple sleeping tablet of some kind or other’—which I have not had for years and years. I called the nurse and I said to her, ‘Look I can’t sleep. Could I have a tablet to help me?’, and she turned to me—a nice smile—and said, ‘Just close your eyes’. I thought, ‘Oh, okay’. So I did that, and I went off to sleep. So it shows you it is not all modern medicine there, just a bit of practical awareness and so on.

I am proud to speak on the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2020, which enshrines in legislation the Andrews Labor government’s commitment, not only to Victorians having access to high-quality and safe health care, but to ensuring improved standards of care. The bill achieves this end by varying and improving the operation of nurse-to-patient and midwife-to-patient ratios. As eloquently noted in the second-reading speech, the bill will deliver on our commitment to ensure safe and high-quality nursing care in our publicly funded health facilities and maternal and child health services. The bill does this, first, by recognising and improving proper minimum staffing arrangements and thereby increasing nursing and midwifery workforce numbers in Victoria’s public hospitals, and, second, by ensuring our maternal and child health nurses are optimally trained to deliver the best child, maternal and family centre practice for the community.

It is important that the background to and the need for the amendments set out in the bill is remembered. The Liberals’ callous industrial policy when last in office—that is, their endeavour to lessen the nursing and midwives staffing minima in our public hospitals and clinics—should not be forgotten. Their policies were not only misconceived and unfair but threatened to destroy the harmonious relationship which had developed within the public health system under the previous Labor government. The Liberal method adopted of endlessly delaying the negotiations for a new public health sector agreement for nurses and midwives and other ancillary staff set the sector back in time and in goodwill. Particularly obnoxious was the Liberals’ determination to reduce health standards by linking reductions to the independently established minimum staffing levels and ratios for nurses and midwives with bargaining for the appropriate wage and conditions outcome to apply in our public hospitals and clinics.

The Labor government’s determination was and remains to remove nurses’ and midwives’ working conditions and minimum staffing standards from the bargaining table, assuring patient care and improved health outcomes through staffing ratios being enshrined in legislation. The present bill continues the reforms commenced by the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015, amended and improved by this Parliament in March 2019 and now to be further strengthened following extensive consultation with stakeholders.

It is important to note the major benefits accruing within the bill result from consideration of some 80 written submissions received from wideranging industry associations, employer and employee representatives and other interested parties, particularly including executive directors of nursing and midwifery at regional and small rural hospitals and clinics. Reflecting stakeholder and community consultation through the Nurse/Midwife to Patient Ratio Improvements Taskforce, the bill delivers sound conclusions following a genuinely consultative approach. The task force was established in 2016 to provide expert advice to the Minister for Health on improvements to ratios and to identify recommendations across a range of clinical areas and settings. The task force recommendations and information provided through such expert collaboration will continue to inform ongoing analysis and monitoring by the Department of Health and Human Services.

The bill has as a principal objective the proper application of research-based staffing minima and ratios for application within the public health sector. There can now be no doubt, having regard for the Australian and relevant overseas research findings, that there exists a correlation between nurse staffing levels and improved nursing-sensitive patient outcomes. Essentially these establish a nexus, which should not surprise, between adequate nursing levels and improved health outcomes generally. The English research examining higher nurse staffing levels reflects a reduction in adverse medical outcomes and a significant diminution in the risk of mortality.

The bill achieves these objectives by the removal or improvement of the rounding methodology which has applied to staffing ratios to ensure consistency across shifts and settings in determining workload under the safe patient care act. Also beneficial will be alterations in staffing numbers achieved in several ways.

Particularly noteworthy is the provision of an in-charge nurse or midwife across a range of settings, predominantly on night shift—I did refer to that night shift at the beginning of my speech—which will reduce clinical risk, improve patient safety and better ensure patient and staff wellbeing. The in-charge nurse or midwife frees nurses and midwives from administrative duties in favour of direct care to patients. This innovation is intended to address the overnight workload seen as an area of high nursing demand and risk.

The second major advance in the bill involves the introduction of the supernumerary after-hours coordinator, which will benefit our small and regional hospitals by addressing the problem of increasing complexity in nursing coordination across the range of services in regional health services such as Alexandra District Health, the Mansfield District Hospital and the Terang and Mortlake Health Service. The after-hours coordinator in hospitals with one or two wards which operate birthing suites and/or emergency departments with more than 2500 annual presentations will facilitate effective nursing and midwife duty.

The bill also includes the reclassification of Warrnambool Base Hospital from level 3 to level 2 from 1 July 2022—a big year 2022—recognising the district growth of Warrnambool and thereby meeting the anticipated present and future demand consistent with the service plan and feasibility study undertaken in 2019.

Fundamental too are the amendments to the Child, Wellbeing and Safety Act 2015 which ensure that the operator of a maternal and child health care centre or a statewide telephone service providing maternal child health advice must in engaging a nurse to provide such service ensure that the nurse possesses the prescribed specialist qualification or its equivalent under the regulations.

How appropriate is it that in the International Year of the Nurse and Midwife and also marking the 200th anniversary of Florence Nightingale’s birth such magnificent advances in support of our nurses and midwives is to be made. I join with my colleagues to acknowledge the outstanding professionalism and dedication to their work of Victoria’s nurses and midwives, which in the time of COVID-19 has highlighted their selflessness, compassion and care. I commend the bill to the house.