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Pay rates fuel union action

Different work conditions between states is behind a push for an industry-wide agreement. Linda Belardi reports.

Almost half of surveyed practice nurses say they are looking to resign in the next six months.

The Australian Practice Nurse Association’s survey of more than 1000 primary healthcare nurses found 46 per cent were looking for a new position or would do so within the next six months Belinda Caldwell, CEO of APNA, said that while practice nurses reported high satisfaction with their professional roles, there was clear discontent with salary and conditions.

“There remains a strong correlation between salary and conditions and the intention to leave,” she said.
While not reflecting actual attrition, the potential cost to practices of a rapid exodus of nurses would present a serious workforce challenge to the sector. However, of those intending to leave, 71 per cent indicated they wanted to remain in primary healthcare.

Nurses in the ACT and Northern Territory are among the highest paid, earning $33.02 and $36.50 an hour respectively, while those in Queensland were the lowest paid, earning $29.48 an hour. The average annual salary for nurses working in primary health care is $60,000. While 99 per cent are female, men in nursing are ahead when it comes to pay, earning $1.16 more per hour than their female counterparts.

The difference in pay between nurses very dissatisfied with their current salary arrangements and those very satisfied is $6.10 per hour. While nurses have received wage rises in recent years, the percentage increase has flattened out in the last two years and is currently below the RBA inflation rate of 3.5 per cent. (See table below).

The survey’s release coincides with the launch of the Australian Nursing Federation’s industrial campaign for an industry-wide agreement for practice nurses. In December, the union lodged a low-wage bargaining claim with Fair Work Australia to establish a new minimum standard for nurses in primary care.

Caldwell said few nurses in general practice were part of an enterprise bargaining agreement that negotiated entitlements over and above the award. While not part of the industrial action, the professional peak body said it was concerned that nurses in general practice were disadvantaged in terms of effectively negotiating good wages and conditions.

“We have long advocated that nurses in general practice are disadvantaged in obtaining good pay and conditions by the fact that general practices are very diverse and nurses are fairly isolated,” she said. However, a degree of autonomy and diversity of roles also presented professional opportunities for nurses, she said.

APNA has commissioned the annual national salary and conditions surveys since 2004 to benchmark employment conditions and to support its lobbying efforts. One area of continuing concern is the steady decline in professional development opportunities for practice nurses and inadequate levels of government funding.

Since the consolidation of nursing scholarships into a single government scheme, the number of scholarships offered to practice nurses has diminished substantially, she said.

In 2011, 28 per cent of primary healthcare nurses did not receive practice support for professional development and had to cover the full costs of their course fees.

“A GP workforce shortage, increases in chronic disease prevalence and an ageing population demonstrate the growing value of the practice nurse workforce to the nation’s health system. Practice nurses are the fastest growing specialty and it is in the interests of the Commonwealth government to ensure they are well supported,” said Caldwell.

Of the 1130 primary healthcare nurses who responded to the survey, 77 per cent were from general practice and a further 17 per cent worked in divisions of general practice.

The survey also found that 43 per cent of primary healthcare nurses have never asked for a pay rise, and of those who asked, 35 per cent were successful.

General practices won’t be worse off under funding changes

Meanwhile, Caldwell welcomed the introduction of the government’s new funding program for practice nurses, which came into effect on January 1.

She said the Practice Nurse Incentive Program (PNIP) would create new opportunities to expand the scope of nursing services and shifted the focus away from restrictive, task-based funding.

APNA anticipates growth in the employment of nurses in urban practices because a large number of practices will now become eligible for government subsidies for the first time.

Under the new regime, six Medicare practice nurse item numbers will be scrapped and replaced with block funding payments to general practices.

Caldwell said she estimated a very small percentage of general practices would be financially impacted under the scheme and grandfathering payments meant no one would be worse off in the short term.

The Department of Health and Ageing declined to publicly release the government’s detailed modelling of the changes. However, a spokeswoman for the department said the vast majority of practices would benefit financially. “Medicare is administering the program and assessing applications. If a practice is assessed as being financially disadvantaged by the introduction of the PNIP, grandparenting or top-up payments will be made to the practice for the first three years of the program (January 1, 2012 to December 31, 2014) to address this disadvantage. Practices will have until June 30, 2012 to apply for grandparenting and top-up payments,” she said.

Caldwell said this arrangement provided practices with an important safety net and would give the government and practices time to assess the fallout of the scheme and redesign their business plans accordingly. APNA will also be monitoring the impact of the scheme on quality of patient care and the role and employment of practice nurses.

Number crunch: 2011 salary and conditions survey
18 per cent of primary healthcare nurses did not receive a higher rate of pay for overtime.
33 per cent of nurses were never offered a pay rise and 43 per cent have never asked for one
72 per cent of nurses had suggested to their GP they wanted to extend their clinical practice and duties but only 55 per cent had their duties extended in the last year
45 per cent said they were employed above the award wage
19 per cent of nurses indicated that their position description did not accurately reflect their duties

A summary of results from the 2011 salary and conditions survey is available on the APNA website: www.apna.asn.au

Percentage increase in the mean hourly rate of a registered nurse working in primary healthcare over the life of the annual APNA benchmarking survey.

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