The secretary of the Queensland Nurses Union, Beth Mohle, gives her thoughts on how to avoid shortages predicted in the Health Workforce 2025 report
There is no doubt there is a lot affecting nursing and midwifery right now at a state and local level and from industrial, professional and political perspectives.
The change of government in Queensland in March provides us with a challenging context. The incoming LNP government appointed a Commission of Audit headed by former federal treasurer Peter Costello.
Its interim report attempts to paint a bleak picture of the state's finances.
We do not have the time to discuss the agenda at play here, but in summary the Queensland Nurses' Union (QNU) does not accept the basic premise of the commission that the finances are in such a mess that dire action is needed.
We reject the catastrophising. Yes, we have had recent challenges that have affected state finances: the global financial crisis, floods and cyclones and the unacceptable cost of the Queensland Health (QH) payroll disaster. But surely the role of government is to protect the community in such disasters, just as its role is to provide essential services such as health and education?
Since 2005 we have had record funding allocated to QH in the wake of the Bundaberg Hospital Commission of Inquiry. This was needed because successive governments had under-invested in public health delivery for decades. Bundaberg was merely the "canary in the coal mine".
The result was thousands of extra clinical and non-clinical staff, including a 41 per cent increase in nursing and midwifery numbers since 2005. Nursing and midwifery planned for and can justify this increase through the application of the agreed workload management tool (the Business Planning Framework) which when applied properly matches supply with demand.
But within six months of the change of government the growth is being reversed. There are to be 2754 jobs cut across QH. Despite the promise to deliver "more nurses, less red tape" prior to the election, nurses and midwives ("frontline staff") are being affected.
It should be noted that a higher number of 4140 redundancies have been funded for QH in the state budget papers, with QH being by far the agency most affected by the 14,000 public sector job cuts. In Townsville Hospital and Health Service (HHS), 45 nursing positions are to be cut. In Mackay HHS they are doing away with the whole of the chronic diseases nursing team, affecting six nurses.
Hundreds of nurses are likely to be affected by the plans by QH to "get out of the business of aged care" with the proposed closures of Eventide and Moreton Bay Nursing Care Unit in Brisbane and Farr Home in Kingaroy.
These are just a few examples - the cuts are coming in daily. Aged and primary and preventative healthcare services are particularly at risk. In effect, anything the state government thinks the federal government should be funding they are getting out of - and doing so brutally and quickly.
I never thought I would see the day when nurses and midwives wouldn't have job security. Our members are fearful about what the future will hold for them. We have started a dual campaign focusing both on our members' job security, workloads and career structures and also on the cuts to publicly provided health services to the community of Queensland. "Hands off our jobs" and "Hands off our public health services" are the two themes. This is not just about nurses' personal interest, it is about services for their community. We take our advocacy role very seriously and will be campaigning strongly in our community to reverse these cuts. This will be a long-term campaign.
While fighting to protect jobs and services in Queensland we also have an eye to the future by maintaining our focus on new graduate nurse and midwife employment. The tragedy unfolding before our very eyes is that at this point in time less than 10 per cent of the 2765 applications received by QH for graduate positions have received offers of positions.
Yet by 2015 it is estimated that through QH facility expansions alone (if these still go ahead) an additional 6000 registered nurses will be required. A new model of graduate recruitment is required to address this unacceptable failure in public policy and planning. We have been focusing on this and other workforce planning issues for some time, with the launch of our "Nurses. For you. For life" campaign in 2008.
We will maintain an eye to the future with our campaign to shame government, state and federal, into doing something about this unacceptable wastage of our graduates. We do this in the context of fighting to maintain our existing member's jobs and the provision of high-quality nursing and midwifery services to our community.
As part of this we must reframe how nurses and midwives are viewed - not as merely a dollar bottom-line cost, but as an investment in the health and wellbeing of our community, day in day out.
The community gets it. The overwhelming positive response we have received from our current "Australia's nurses and midwives. You couldn't be in better hands" campaign is testament to this. Our focus must be on communicating our values, worth and contribution, on telling our stories. If we don't who will?
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