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Andrews Government promises more ratio improvements if elected

Andrews Government promises more ratio improvements if elected

Health Minister Mary-Anne Thomas (left) and Premier Daniel Andrews announcing the new ratio commitments, 9 November 2022. Photo: Penny Stephens

The ANMF (Vic Branch) has welcomed the Andrews Government’s commitment to a third round of improvements to legislated minimum nursing and midwifery staffing levels in public hospitals.

The commitment, announced by Premier Andrews and Health Minister Mary-Anne Thomas on Wednesday 9 November, will see an increase in the number of nurses required to work in Victorian public hospital intensive care units, high dependency units, coronary care units and emergency departments under a re-elected Andrews Government.

Postnatal wards will also see an increase in the number of midwives looking after new mothers and their babies. The postnatal night-shift ratio will improve from one midwife to six mothers to one midwife to four mothers – to match the ratios on morning and afternoon shifts – on Level 4, 5 and 6 services under the Safer Care Victoria Maternity Capability Framework.

In addition to improved ratios, a re-elected Andrews Government will also trial rostering a registered nurse on every postnatal ward shift, commencing in 2024 for two years. If successful, the new nursing position will be rolled out across Victoria, with the aim also of exposing more nurses to midwifery so that they will take up midwifery studies.

Committing, and delivering

In making the announcement, Premier Andrews said ‘we made commitments in 2014 and again in 2018 to not only strengthen nurse- and midwife-to-patient ratios, but to put nurse- and midwife-to-patient ratios beyond doubt. But there’s always more that has to be done; we know that ratios can be further improved.’

Elaborating, the premier said ‘We’re going to legislate team leader positions and liaison nurses in our intensive care units. We’re going to have extra night duty staff in high dependency units and coronary care units. We’re going to change the night maternity ratio from one to six to one to four. We’re going to have an extra 30 residential aged care in-reach nurses. And we’re going to trial a neonatal support nurse, an additional position, in our maternity wards, so that those little bubs that are sick and their mums can get additional attention and support and care.’

Going into more detail, Health Minister Mary-Anne Thomas said ‘this package will deliver another 457 very experienced nurses and midwives into our system, including 184 nurses in those ICU team leader and nurse patient liaison positions. We are also recruiting an additional 141 midwives to improve night-shift ratios from one to six to one to four in level 4, 5 and 6 maternity units. We are also enshrining into legislation the existing practice of one-to-one nurse to patient staffing ratios in ICU.’

This particular commitment will correct the Safe Patient Care Act’s omission of the ‘accepted practice’ of the 1:1 ICU ratio that has sometimes resulted in inconsistent staffing.

A win for ANMF members

Responding to the announcement, Branch Secretary Lisa Fitzpatrick said ‘these improved ratio initiatives reflect resolutions passed by ANMF (Vic Branch) Job Reps at our Annual Delegates Conferences over recent years – it’s what nurses and midwives at the bedside have asked for. ANMF uses those resolutions to lobby the Andrews Government for improvements to staffing levels and other asks by our members.

‘By announcing these improved ratio commitments, the Andrews Government has demonstrated once again it is really listening to nurses and midwives to recover from the pandemic and improve the system for all Victorians. Some of our members who moved those resolutions at the Delegates Conference were able to be present today and hear firsthand Premier Andrews commit to implementing their resolutions, which they have put forward on behalf of their colleagues.

‘Just talking about increasing or recruiting nurses and midwives can be meaningless if there are no rules about rostering and minimum staffing levels, as we have seen in private and not-for-profit residential aged care.

‘I cannot overstate how improving the staffing levels is one of our most effective recruitment and retention tools because it reduces the nurses’ and midwives’ workloads and improves patient care,’ Ms Fitzpatrick said. ‘Less ambitious people will ask where will they come from? Our experience of nursing and midwifery recruitment is that when you improve workloads, then nurses and midwives who have decided to take a break come back and those nurses and midwives who reduced their hours to cope with the pressure start to increase their shifts.’


A re-elected Andrews Government has committed to legislate further ratio improvements:

  • postnatal night shift ratios will be 1:4 (currently 1:6) in Level 4, 5 and 6 services under the Safer Care Victoria Maternity Capability Framework
  • level 1 hospital emergency department resuscitation bays will be 1:1 on the morning shift (currently 1:3)
  • formalise the ‘accepted practice’ 1:1 ICU ratio for all shifts in level 1 and level 2 ICUs
  • team leader (resource nurses) in addition to the prescribed ratios in level 1 and level 2 ICUs
  • liaison nurse in addition to prescribed ratios in level 1 and level 2 ICUs
  • night duty in charge in stand alone high dependency units and coronary care units

A re-elected Andrews Government will also trial a registered nurse in a neonatal support role per ward above the postnatal ratio on all shifts in three pilot health services. Read the Andrews Government ratio election commitments.

Extra support for current nursing and midwifery students

In addition to the above ratio improvements, Premier Andrews also announced an expansion of the support being offered to nursing and midwifery students.

Following the August announcement of a $270 million workforce training and recruitment plan that includes funding the studies of all new domestic students enrolling to study a nursing or midwifery undergraduate degree in Victoria in 2023 and 2024, the Premier announced a further initiative to pay a $5,000 bonus to any graduating nurses and midwives in 2022, 2023 and 2024 if they commit to the public hospital system for two years.

‘If you’re thinking about studying nursing, then your degree will be free,’ Premier Andrews said. ‘If you are graduating, and you come to the public hospital system, under Labor you’ll receive a $5,000 sign on bonus.’

The bonus initiative addresses some of the concerns from current students that they were not included in the August announcement. ‘This is something that our existing students asked us to achieve for them,’ said Ms Fitzpatrick. ‘The announcement today for our existing students that are going to be graduating in 2022, 2023 and 2024 is a really positive commitment to help those new graduates work their way through transition to being registered nurses and registered midwives and perhaps pay off some of their HECS debt.’

Pre-polling opens on Monday 14 November and election day is Saturday 26 November 2022. Find the polling booths in your electorate via