People, jobs, health should be govt's priority: we need a shift of mindset. State Government—no matter what party is in office—needs to be committed to world-class public services, including health

Lamp, The, August, 2009 by Brett Holmes

It's clear we are going to face a battle over the next couple of years over the composition of the health system and the public service in general.

This will be a battle between managerialism--with its short-term expediency manifesting itself in cost cutting--and a more visionary approach that will be cost effective but will maintain a world-class health system and public service for NSW.

The signals coming from the NSW Government have not been promising with staff freezes and public sector wage cuts floated as solutions to budgetary problems.

At the coal face we also see worrying trends, with several Area Health Services offering voluntary redundancies to experienced nurses and a move to replace RNs with AiNs or other unregulated third level care workers.

This flies in the face of the Garling Inquiry's recommendations, which clearly acknowledged the key role of experienced nurses in the system and how hard they work.

Garling was adamant that experienced nurses are crucial in the workforce and need to be recognised and adequately remunerated. He also said nurses' skills could be more effectively used.

It is difficult to see how voluntary redundancies, which will increase workloads, reduce the skill level on wards and put more pressure on the nurses who remain, is consistent with Garling's recommendations. Experienced nurses, after all, have the most to gain by taking up voluntary redundancies.

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Similarly, replacing experienced nurses with third level workers is an ill conceived, short-term measure that will only exacerbate the problem.

Professor Mary Chiarella made the point in last month's Lamp that it would be a false economy to introduce extra support staff at the expense of RN numbers. Adverse events cost much more money than extra RNs. This a truism that is self evident to clinicians if not to deficit daleks in the NSW Treasury.

A state election in NSW is now less than two years away. No matter what party is in office, when they are faced with budgetary pressures, their kneejerk reaction is to make cuts to jobs and services. This is seen by government agencies and politicians as the only course of action.

So a challenge for nurses is beginning to crystallise. State politicians of all political persuasions need to be reminded that dramatic reductions in staffing across public sector agencies are always counterproductive.

There is an alternative to the tired and discredited economic rationalism that has dominated our politics for the past few decades. It requires a shift in mindset and involves putting people, jobs and the public good at the forefront of economic and social policy.

The economies that have best-weathered the global financial crisis are those that have invested in this way, including the Australian economy. At the Federal level, we have seen some evidence of this shift in thinking, including in the area of health.

This approach needs to filter down to the state level where it is ultimately implemented. We need to establish a public discourse where the State Government--no matter what party is in office--is committed to world-class public services, including in health.

The NSWNA intends to make a significant contribution to that discussion on behalf of NSW nurses.

BY BRETT HOLMES GENERAL SECRETARY