What the Victorian election result means for nurses, midwives and carers

The re-election of the Andrews Government means work will accelerate on the ambitious agenda to recruit and retain nursing and midwifery workforce in Victoria. Many elements of the government’s workforce plan that are already underway, along with its election commitments, were initiated by ANMF members – predominately via resolutions passed at annual delegates conferences.

The government’s commitments to student nurses and midwives, nursing, midwifery, health, mental health, maternal and child health, and aged care will benefit our members’ working lives and the healthcare of all Victorians.

Many commitments, such as ratio improvements, apply only to public health services. ANMF will continue to use these initiatives, such as staffing levels, as benchmarks for improvements in the private acute sector during bargaining periods. We also expect private sector employers to recognise the critical importance of improving their recruitment and retention measures to stabilise and futureproof their workforces.

The government’s scholarship and refresher initiatives announced in August are already underway to educate the additional nurses and midwives we will need to staff improved and new ratios and almost 500 additional preceptor, clinical support and nurse educator roles to support students and early career nurses.

The financial assistance for undergraduate nursing and midwifery students will be an important incentive to reduce the attrition from these courses.

With public sector nurses and midwives enterprise bargaining due to start in late 2023, the re-election of the Andrews Government also means we can continue to improve wages and conditions rather than go to war to defend what we have in the current EBA. This is important for private acute members because we use the public sector EBA as the benchmark agreement for all negotiations.

ANMF will work with members and the Andrews Government to get all election commitments implemented. Read the Premier Andrews’ letter to ANMF members.

Here is a summary of those promises to nurses, midwives and carers:

Ratios

1. 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. Implementation in 2024-25.
2. A two-year trial of a registered nurse on every shift at each postnatal and antenatal ward at three maternity services. Implementation from 2023-25.
3. Level 1 hospital emergency department resuscitation bays will be 1:1 on the morning shift (currently 1:1 on afternoon and night duty). Implementation in 2024-25.
4. Formalise the ‘accepted practice’ of 1:1 ICU ratio for all shifts in level 1 and level 2 ICUs. Implementation in 2024-25.
5. Team leader (resource nurses) in addition to the prescribed ratios in levels 1 and 2 ICUs. Implementation in 2024-25.
6. Liaison nurse in addition to prescribed ratios in levels 1 and 2 ICUs. Implementation in 2024-25.
7. Night duty in charge in stand-alone high dependency units and coronary care units. Implementation in 2024-25.
   
   Plus:
8. Finalise the review of hospital classifications under the Safe Patient Care Act 2015 to ensure they reflect the changing needs of the local population by July 2023.
9. As part of the above review consideration to be given to the inclusion of Hospital in the Home services in the Safe Patient Care Act by July 2023.

Note: these commitments are in response to ANMF annual delegates conference resolutions. This is in addition to the two ratio amendments passed in 2019 and 2020 implemented between 2019 and 2023. Work is also underway on the ‘Rostering Project’ to identify barriers, such as childcare and nightshift preventing many nurses and midwives from working to their full capacity.

Workforce

1. A $5000 bonus (over two payments of $2500) to current nursing and midwifery undergraduate students, graduating in 2022, 2023 and 2024, who commit to working in the public health system for two years. This was a result of ANMF advocacy after meeting with our student members who have worked hand in hand with nurses and midwives throughout the pandemic. This is in addition to the following initiatives already underway:
2. The expansion of the nursing and midwifery undergraduate student employment program (RUSONs and RUSOMs), an ANMF initiative, which is strengthening students’ work experience beyond clinical placement and provided additional support above ratios (except during COVID surge periods).
3. Scholarships for thousands of nurses and midwives to complete postgraduate courses in priority clinical areas including intensive care, oncology and emergency.
4. Financial assistance of up to $16,500 for undergraduate students starting in 2023 and 2024 and commit to working in the public sector for two years after they graduate.
5. Development of employment and career pathways so nurse practitioners can work to their full capacity, plus 100 nurse practitioner scholarships. An audit of existing employed nurse practitioners.
6. 2000 scholarships for 2000 enrolled nurses working in the public sector to become registered nurses.
7. 1000 scholarships for re-entry education for nurses and midwives who were not practising in 2022.

Aged care

1. $170 million to redevelop three public aged care facilities in regional Victoria – in Cohuna, Numurkah and Maffra.
2. Fund an additional public sector 30 FTE to expand residential in-reach nursing teams to support public and private aged care and reduce avoidable hospital stays. Implementation in 2024–25.
3. With the review completed, amend the Drugs and Poisons Act so that only nurses (RN and EN – without notation) can administer medications in residential aged care facilities. Implementation in 2023.

Maternal and child health

1. Increase appointment times from 30 to 45 minutes so that maternal and child health nurses have enough time to respond to the needs of new parents and their children. This includes time to undertake recently introduced assessments such as early identification and referral for autism and family violence. Phased in from June 2023.
2. Programmatic review of Key Ages and Stages consultations with ANMF included in the review team. Fund the extension of the five key ages and stages consultations (2, 4, 5, 7 and 9 months) from 6.75 hours to 8 hours for each child.

Health

1. 20 new women’s health clinics at public hospitals, to provide comprehensive care for endometriosis, pelvic pain, polycystic ovary syndrome and perimenopause and menopause.
2. An inquiry and commitment to use the learnings from the new women’s health clinics to improve patient care.
3. A new statewide service and more sexual and reproductive health hubs across Victoria.
4. A new Aboriginal-led women’s health clinic.
5. A mobile women’s health clinic to visit remote areas of Victoria.
6. Double the number of endometriosis and associated condition surgeries.
7. Establish Australia’s first free public IVF service, including services in: Bendigo, Mildura, Shepparton, Geelong, Ballarat, Warrnambool, Epping, Sunshine and Heidelberg.
8. Free tampons and pads available in public locations across Victoria.
9. $45 million (includes $10 million from the Children’s Cancer Foundation) for research, safer therapies, clinical trials and education and training to fight childhood cancers.
10. $16 million for an extra 40 MICA paramedics. This is in addition to the recruitment of more than 700 paramedics in 2021 and additional Triple Zero call takers.

Workplace safety

1. As part of a review of the OHS regulations, consider ways to improve workplace health and safety for nurses and midwives including making healthcare a ‘regulated industry’. ANMF has been advocating for this change, which will provide protections equivalent to the construction industry. It will strengthen employers’ legal obligations to ensure the safety of healthcare workers and ANMF’s ability to intervene.

Reducing the red tape: a central ‘check’

1. Develop a central ‘check’ for Working with Children, Police Check and NDIS Check to reduce the time and financial cost on nurses, midwives and carers.

Bricks and mortar

1. $290 million to develop and expand Wonthaggi Hospital.
2. $850-$1050 million to deliver the new Queen Elizabeth II Hospital (rebuilding the Maroondah Hospital).
3. More than $1 billion to expand the Austin Hospital’s emergency department by 70 treatment spaces and increase Northern Hospital’s bed capacity by 100.
4. Up to $560 million to upgrade Monash Medical Centre with an expanded ICU, additional birthing suites.
5. $295 million to expand Dandenong Hospital’s emergency department and build a new ICU and outpatient clinic.
6. Up to $675 million to build a new 223-bed West Gippsland Hospital.
7. This is in addition to $15 billion for the new Footscray and Melton Hospitals, a new Albury-Wodonga Hospital and a new Royal Melbourne and Royal Women’s Hospital next to the new Arden Station.

One source of education

1. Establishment of a project team (including ANMF) to develop a central education portal that will reduce unnecessary duplication of required education across the state. Also develop and include important topics such as the care of the LGBTQIA+ Victorians, sentinel events, and care of autistic patients and clients.

Other initiatives benefiting ANMF members

1. Free kindergarten
2. Free TAFE places for skills and jobs in areas of need
3. 50 new government-owned and operated childcare centres in suburbs that need them most
4. Build 100 new schools and upgrade schools
5. Expand out-of-hours care for students at specialist schools, hire NDIS Navigators and train more therapy animals
6. Cap V/Line fares at metro prices
7. Bring back the SEC and build new, renewable energy and create 59,000 jobs including 6000 apprenticeships and traineeships
8. Offer the $250 Power Saving Bonus again in 2023