State of pay

Salaries and conditions vary greatly by state; as budget conditions look set to get worse, some stakeholders call for more unified bargaining. 

When Jane-Marie Smith decided to become a nurse, she knew she wouldn’t be living a life of luxury travelling the world business class.

Still, she didn’t expect for her pay to increase only marginally and to work double shifts when she needed some extra money.

“I became a nurse because I love helping people,” Smith says. “No matter what their condition, I want to be there for them. In fact, when I first started, we were more active in the community, but now the system has become regulated and we are more confined within hospital walls.”

Back in 1999, data from the Australian Institute of Health and Welfare shows, an enrolled nurse’s starting salary ranged anywhere from $26,593 to $30,355 across Australia. In 2014, an enrolled nurse’s starting salary can be as low as $44,710 if you work in Victoria or as high as $57,550 if you work in Queensland. Across states, there is now a marked difference in pay categories in every level of nursing (see breakout).

The variation can be traced to each state union – its branch of the Australian Nursing and Midwifery Federation – negotiating on its own behalf, mainly through enterprise agreements.

“The Nurses Award 2010, together with the National Employment standards, set the minimum safety net for wages and conditions for most nurses across Australia,” ANMF federal secretary Lee Thomas says. “But since 1996, there’s been increasing use of industrial or enterprise agreements to replace awards.

“This growth in the use of enterprise agreements has reflected a move away from a centralised industrial relations system, to one that is decentralised, where agreements have progressively replaced awards as the principle vehicle for wage movements. This trend is of great concern to the ANMF and its members.”

There is perhaps no greater example of that than in Western Australia. During the 2013 state election campaign, nurses there went on strike and ran a comprehensive campaign that eventually led to the government awarding a pay rise over three years, increasing at 5 per cent from July 1, 2013, and then 4 per cent in 2014 and 5 per cent in 2015.

There was no loss of conditions and WA nurses became the highest paid in the country. For example, an RN and midwife at level 1.1 will receive a pay rise from $55,617 to $63,770 over the three years, whilst a senior registered nurse on level 1 will gain a salary increase from $90,653 to $103,943 over the same period.

It seems inevitable now that each state’s branch of the ANMF will launch its own campaign dependent on the specific conditions nurses face in each state and the state of the economy.

And now, following the announcement of the federal Budget, economic conditions are expected to be tighter throughout the health sector – in every state.

“Nurses and midwives are now under the real threat of working in a system where more and more Australians simply won’t be able to afford out-of-pocket fees to get the healthcare they require – whether it’s seeing a GP, visiting the hospital emergency department or getting a prescription filled,” Thomas says. “In addition, federal contributions to state health budgets have been significantly decreased and will mean every state will have millions of dollars removed from their health budgets.

The states are reeling at the Australian Government’s retreat from its election commitment to increase public hospital funding, deciding instead to index funding to a combination of growth in the consumer price index and population, starting from 2017–18.

The Australian Government also revealed $1.8 billion in funding cuts to hospitals worldwide after it ceased its funding guarantees made under the National Health Reform agreement in 2011.

Meanwhile, the Western Australian Government is set to lose $308 million over four years from its healthcare funding, and the four-hour emergency rule, so successfully introduced in 2009, is already under pressure and will face further strain.

“It's a bad time for the federal government to start defunding the programs that underpin the reforms, and for the state government to pull back on what it is investing,” says Dr Dave Mountain, Australian Medical Association WA emergency medicine spokesman.

Of course, the knock-on effects could well be jobs cuts, services reduced or eliminated, more pressure on staff and a growing population becoming even more frustrated awaiting medical treatment.

As conditions become more difficult, some nursing stakeholders want a more unified nationwide approach to industrial bargaining.

“Pay and conditions are all historical and all about the states,” Linda Shields, professor of nursing, tropical health, James Cook University, says. “I’m sure Sir Henry Parkes thought he was doing the right thing when he set up the Commonwealth of Australia, but we are seeing the downside of it with this as a good example. In a country of 23 million people and counting, it is just ludicrous that the whole state system remains, but it will not go away.

“Of course it is and always has been related to Australia’s vast size and its distances. But it does create a lot of anomalies, and different pay and conditions for a single occupational group is a good example of that. Of course it should all be the same. It would make life a lot easier.

“The best way is for everyone to join the unions and then work towards having one union for Australia. The collective bargaining would be much stronger than it is at present and might make some sort of shift. But of course, that would mean all the unions would have to become a singular entity as well.”

Some of the biggest potential casualties of the Australian Government’s cutbacks to healthcare will be those nurses in aged-care facilities. They are already paid less than most nurses in hospital departments and have to work in difficult conditions. As Australia’s population ages, those conditions won’t improve.

“Australia’s aged-care sector is suffering a shortage of 20,000 nurses, but there’s little hope of retaining or recruiting new ones if they continue to be underpaid,” Thomas says. “Aged-care nurses, on average, earn about $180 a week less than nurses working in public hospitals.

“If we can’t retain and attract new nursing and care staff in the aged-care sector through improved wages and working conditions, as was agreed to, the ANMF believes it’s going to be older Australians, primarily living in nursing homes, who will ultimately suffer through poorer care outcomes.”

The ANMF has announced the campaign, “Lies, Cuts and Broken Promises”, calling on members of the public to join nurses and midwives in fighting the proposed health budget cuts by asking Senators to reject the changes.

Last year, in the dying days of Parliament, the Abbott Government used its numbers to vote against the workforce supplement, which could’ve contributed to improved wages, training and working conditions for nurses and aged-care workers.

Jill White, dean of Sydney Nursing School at the University of Sydney, says nurses must start putting forward the economic argument in their defence.

“I think the question has to be, ‘What can nurses do to help themselves?’ ” White says. “Nurses constantly bemoan that they don’t have input to major healthcare decision-making but I believe they need to better understand politics and use political influence.

“We need to start getting back into the community and using community support and economic data to back our arguments.

“The healthier the society, the fewer people in emergency departments and in hospitals in general, the better it is for everybody. We need a better and bigger role in the community, working with local health districts to provide a better health service, like a return to many years before, and that will improve society’s health. Nurses have a big role to play and that shouldn’t be understated but we need to present our arguments in the right way, with a considered and measured approach.”

Which states pay the best?

The state you work in will influence your pay in Australia. There can be as much as a five-figure difference between states in starting pay.

For instance, a registered nurse/midwife can start off on an entry-level salary as low as $51,194 in Victoria, whereas their Queensland counterparts will be earning an extra $8000-plus a year on $59,977. And the maximum pay for an RN/midwife in that category will be as low as $67,766 in Victoria but as high as $77,620 in NSW.

The pay difference amongst nurse practitioners is even steeper. In QLD, the entry-level salary is $108,571, which is an $18,000 increase on nurses at that level in Victoria ($90,584). The maximum any nurse at that level can earn is $115,578, in Tasmania, whilst their Victorian counterparts can earn a maximum of $93,907.

In general, Queensland, Western Australia, Tasmania and New South Wales offer higher salaries, by a considerable margin, than their counterparts in South Australia and Tasmania. And it is clear that nurses in Victoria are the worst paid in Australia.