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Second Reading: Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Bill 2015

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Sam Hibbins MP
Member for Prahran
17 September 2015

Mr HIBBINS (Prahran) — I rise to speak on the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Bill 2015. The Greens will be supporting this bill, and we will also be speaking in favour of this bill. I did not realise until I heard the contributions from the opposition that you could have a bet each way — that is, not oppose a bill but speak against it in the Legislative Assembly.

The Greens absolutely welcome this bill and strongly support nurse-to-patient and midwife-to-patient ratios. Certainly as a member whose electorate includes the Alfred hospital, and as someone whose family members are going to be proud users of the public system when I start my family in the new year, I support this bill. Ratios ensure proper care for patients and reasonable work conditions for one of our most respected and hardworking professions.

In the past, as elucidated in previous contributions, we have seen attempts to remove and downgrade nurse-to-patient and midwife-to-patient ratios during enterprise agreement negotiations but nurses and midwives have stood up. They have hit the streets, and they have fought for those rights — those rights for patients. Nurses and midwives have worked so hard to achieve these ratios, and such hard-won reforms should not be whittled away. They should not be subject to enterprise agreement negotiations; they should be non-negotiable. This bill will protect and legislate the safe patient ratios that currently exist in the nurses and midwives enterprise agreement. It will provide for compliance and reporting arrangements, and in circumstances where ratios are not met mechanisms for enforcement of those ratios in the Magistrates Court.

This bill will protect nurse-to-patient ratios now and into the future so they will be safe from the risk of being stripped away by future governments. Victoria will be the first state to have nurse-to-patient and midwife-to-patient ratios enshrined in legislation. These ratios will require major metropolitan hospitals to roster safe ratios of one nurse to four patients during the day shifts and one nurse to eight patients during night shifts.

Different ratios are in place for maternity units, regional hospitals, special care nurseries, aged-care facilities and emergency departments. These ratios serve to guarantee a minimum number of qualified nurses or midwives for each shift. They will ensure high-quality patient care and safety and prevent the substitution of nurses with unregistered health assistants. It is worth pointing out that the legislation also provides flexibility for health services to reconfigure nurse and midwife staffing and roster arrangements to enable the best utilisation of available nurses and midwives to ensure quality care.

This is important because, as studies have proven, the number, skill mix and practice environment of nurses and midwives directly affects the quality and safety of health services. Health services with a higher percentage of registered nurses and increased nursing hours per patient are shown to have lower patient mortality rates, reduced lengths of stay, improved quality of life for patients and less adverse events such as failures to resuscitate, pressure injuries and infections. Additionally, ratios contribute to organisational productivity, hospital efficiency and continuity of patient care through increasing staff satisfaction. Adequate ratios have shown to decrease attrition rates, reduce service variation and improve healthcare equity across all sectors. This is an investment we must make. It will protect the safety of both patients and the nursing profession.

The Greens have always believed that everyone has the right to timely, quality health care. This bill will save lives and improve patient outcomes. Victoria has a healthcare system that is in many ways the envy of the world, but our hospitals are under pressure. We urgently need to maintain our investment levels to keep up with demand and prioritise funding to underserviced areas. We need to take the politics out of healthcare funding by ensuring hospital investment is transparent and based on the areas of greatest need.

In previous parliaments we have called on the government to publish quarterly waiting and hospital performance data. We are glad to see that is occurring this year, and we welcome the government's ongoing efforts to increase transparency in hospital funding. However, in order to take the pressure off our hospitals and health services, we need to focus on preventive health. Preventable diseases such as diabetes, heart disease and respiratory illness are the leading causes of disability and death and create a huge burden on our health system. They are also a burden on people's lives and on economic productivity and social cohesion.

We know prevention is better than a cure, but government funding has not prioritised it. Only 1 per cent of the health budget is spent on promoting good health, and that is not enough. By keeping people healthy and better managing chronic disease, we can ease the pressure on our health system and our hospitals. We need to invest in keeping people healthy, promoting healthy communities and addressing chronic disease through restrictions on junk food advertising, immunisation and health screening. We need to make health and wellbeing an objective of our planning laws.

Antismoking measures have been the preventive health issue of our time, and the Greens have led the way through the introduction of private members bills to make outdoor dining and drinking areas smoke-free. It was good to see, as with many things, that the previous government adopted that policy before the election but unfortunately was unable to implement it. We certainly welcome the Labor government's commitment to implement smoke-free outdoor dining and drinking measures this year. We also need to make sure that we focus on other areas, including closing the gap in Indigenous health because we all know that Aboriginal and Torres Strait Islander Victorians have much higher rates of mental illness, family violence assaults and chronic preventable diseases such as diabetes and respiratory disease. We need to commit to closing that gap.

We need to be investing in our rural health services and repairing our community mental health services. We need to re-fund those mental health services that were cut by the previous government and reopen those drop-in centres like the Prahran Mission drop-in centre on Chapel Street and others that were forced to close under the previous government.

Federally the Greens, under our leader, Senator Richard Di Natale, have been leading the charge against the federal Abbott — now Turnbull — government's cuts to hospital and health services. Now that there has been a change of leader at the national level I call on the federal government to return in full the funding to our hospitals.

Dental care has been a major priority for the Greens. We saw in the previous government negotiations commenced for a denticare scheme, which makes dental care part of Medicare. We certainly want to see that program expanded to include all Australians so that going to the dentist is just like going to the doctor.

This bill is certainly a big step in the right direction. It secures the long-term quality of our health system, with a commitment to investment and patient outcomes, but there is more to do. In preventive health, in mental health and in dental health there is much more to do, but we certainly welcome this bill. The Greens commend the bill to the house.

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Sam Hibbins MP
Member for Prahran
17 September 2015




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