Since 2023, the Victorian State Government has been undertaking a review of the Health Services Regulations, which cover private hospitals and day procedure centres.
These Regulations essentially set minimum requirements in private hospitals and day procedure centres for everything from staffing levels and skill and experience mix to nursing and midwifery career structure, clinical governance requirements, reporting and quality and safety.
As part of this review, ANMF last year made a submission recommending, among other things, that the Regulations establish minimum nurse-to-patient and midwife-to-patient ratios in general and specialty areas, and that these be identical to or align closely with the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015.
In other words, we are recommending that government implement ratios in the private sector, and that these ratios are comparable to those in the public sector. Many of our private acute sector members contributed to our submission by completing an extremely lengthy survey.
Disappointingly, that first regulatory impact statement of proposed amendments to come out of this review has effectively ignored our recommendations, or delayed decision-making on key matters – including ratios and other staffing requirements such as career structure improvements, better support of graduate nurses and midwives, initiatives to better prevent and manage staff fatigue.
It also omits any mention of regulation of emerging areas of clinical practice (including cosmetic surgery and mobile anaesthesia). Disappointingly we understand that private acute employers are lobbying the government for the status quo relating to staffing within the Regulations.
The existing Regulations are grossly inadequate regarding staffing requirements, cosmetic surgery and Health Service Definitions, and accordingly do not adequately provide for the safety and quality of care of patients or align with the accepted standards of the professions of nursing and midwifery and the broader health care sector.
The regulatory impact statement does mention that these elements will be considered further at some point but nurses and midwives, and their patients, consumers and women, require a firm commitment in relation to dates for implementation.
In pursuit of such a commitment, the Branch has written to the government seeking an urgent progression to the next stage of the review.