Around 50 midwives and nurses held a demonstration outside Sydney’s Royal Prince Alfred Hospital (RPA) on Tuesday, to protest cuts to staffing in the hospital’s birthing centre. The inner-west facility is one of the major public hospitals in the city.
Staff were told on the afternoon of Friday, June 27 that, beginning Tuesday, just six midwives would be rostered on each shift in the birth unit, down from the current eight on the day and night shifts and ten on the afternoon shift.
In addition, five midwives would be cut from RPA’s midwifery group practice (MGP). MGP allows women and families having a baby to be cared for by a known midwife throughout their pregnancy, during labour and birth, and postnatally. This practice enables higher rates of natural births and positive experiences for mothers.
In total, the changes would amount to the slashing of 20 full-time equivalent roles in the birthing and delivery unit. So chronic is the understaffing already, that the New South Wales Nurses and Midwives’ Association (NSWNMA) said no individual midwives would lose their jobs—the cuts could be accomplished simply by not filling vacant positions and reducing the number of casual staff currently engaged to cover the shortage.
According to the Guardian, facing sharp opposition from staff and the broader community, RPA management agreed late Thursday to “pause” the cuts, “while discussions continued between management and staff.” This is not a reprieve, but an indication that the union bureaucracy is working closely with management to determine where to cut costs, in order to fit within the state Labor government’s austerity budget.
Introducing the budget on June 24, Treasurer Daniel Mookhey boasted in parliament that the Labor government had done much more than its Liberal-National predecessor to cut spending. “Expense growth is now projected to average just 2.4 percent a year—down from 6.2 percent under the previous government,” he told parliament.
A nurse who has worked at RPA for 10 years told World Socialist Web Site reporters, “There have been multiple consultations with staff directly involved—the intrapartum midwives, the antenatal midwives and others. We voiced our concern about patient safety, about the compromise to healthcare quality and about the already stretched workforce, but we have not been heard.
“There should not be cost-cutting in a unit which deals with such complex cases. We believe it’s a cost-cutting move and there’s no transparency. It would be good if [management] would explain to us, help us understand why these decisions have been made. We should also be provided with a report on what is happening in hospitals overall, be given the bigger picture.”
Other nurses said the cuts would mean midwives couldn’t look after the number of people the unit is set up for. RPA has nine birthing rooms, and with only six midwives on each shift they would not be able to provide proper care for women in labour, or assess women who come into the unit unplanned. They raised that birthing rooms may need to be closed as a result.
One local healthcare nurse who attended the rally commented: “Overall, it’s across health, across the districts. It’s psychiatrists, it’s nurses, midwives, radiologists, radiographers—we just want to be here for the community.”
Gary, a patient, said: “I am a local and we had four children back in the 1980s and early 1990s at RPA, where the services were magnificent, and you can see the difference now. I know from my children—we have 9 grandchildren—and I’ve seen the services they’ve been provided with. They have been forced to go into private healthcare because of the neglect of the public system.
“I’ve seen the hard work that nurses do in trying to provide what is needed, and the extended hours on low pay. The public pays taxes and we need these services.”
Referring to Northern Beaches Hospital, he said, “We’ve seen what happens when public hospitals are sold by the government to the private sector. Deaths of children happen.”
Jane, who came to support the protest, said: “My daughter had a baby here three months ago, she received the most magnificent care from the midwives and it’s appalling that they are trying to cut the hours, when already they were so strapped for time delivering patient care. They take so many shifts and staff away and the system is going to collapse and there will be deaths. Babies will die if they don’t have the attention, and the mothers will suffer as well.
“The healthcare system in Australia is declining. Running facilities into the ground is not a good idea. The government should [handle] the running of the hospitals and not sell them off to the corporates. That’s the end of healthcare as we know it.”
Public hospital maternity units around the country have been under pressure over the past period as private hospital maternity care has been reduced considerably. While birthing numbers have declined overall, figures for births in private hospitals are declining faster than those in the public system. Private health insurance cover for maternity care is only available in premium care packages and cost-of-living pressures are impacting the choices being made by young families.
The Australian Broadcasting Corporation has reported 14 private birthing units closing over the past 10 years. This includes the shuttering of maternity services at Darwin Private Hospital and Hobart Private Hospital this year, by private hospital group Healthscope, just before the company went into liquidation. Other closures were in Cairns Private, in Far North Queensland, along with three other Queensland hospitals, two in the Sydney region, two in Western Australia and two in Victoria.
Tuesday’s rally, organised by the NSWNMA, was a 15-minute “own time” protest, deliberately kept small and isolated by the union, which did not advertise the demonstration to its broader membership outside of RPA, let alone other sections of health workers.
In doing so, the NSWNMA was seeking to cover over the fact that the cuts at RPA are part of a broader onslaught against public health, being carried out by the state Labor government. The union bureaucracy is, above all, hostile to a unified struggle linking nurses and midwives with doctors and other health workers looking for a way to fight the deepening cuts to jobs, wages and conditions throughout the sector.
On June 23, Neonatal Intensive Care Unit (NICU) midwives and nurses protested at Westmead Hospital, a major public hospital in the west of Sydney. Nurses at the hospital were protesting lack of staff, overcrowding and incidents where sick babies requiring 1:1 or 1:2 nursing care were being “double-” or “triple-parked” in an area that was originally used as a storeroom.
The same week, also at Westmead, an entire group of interventional radiologists resigned, citing inadequate pay and antiquated and dysfunctional equipment.
In April, approximately 5,000 public hospital doctors took strike action for the first time since 1998, demanding increased pay and relief from understaffing and an under-resourced health system.
None of these issues were raised by the union speakers at the RPA protest. While NSWNMA president O’Bray Smith told the assembly, “We will continue. If we have to go out and walk out the door, we will, because we are not gonna rest,” the union’s track record exposes this as nothing more than empty bluster.
Over the past two years, nurses have repeatedly displayed a willingness to fight real-wage cutting pay “offers” from the Labor government, only to be shepherded into the anti-worker Industrial Relations Commission (IRC) by the union, which is enforcing a nine-month strike ban.
The role of the NSWNMA and other health unions underscores that to fight for their jobs, wages and conditions, health workers need a new perspective. There is no way forward within the union framework of appeals to management, governments or the pro-business industrial courts.
Rank-and-file committees, democratically run by workers themselves, politically and organisationally independent from any union bureaucracy, must be built in hospitals and other health facilities. Through these committees, midwives and other health workers can fight for demands based on their actual needs, not what governments and union officials say is affordable or possible.
Health workers’ struggle for decent pay and conditions is inseparable from the fight against the privatisation of the health system, and for the establishment of high-quality public healthcare as a basic social right, freely accessible to all. This requires a political struggle by the working class against Labor and the capitalist system itself, under which everything is subordinated to big-business profits.
What must be fought for is a political alternative, socialism, under which society’s vast resources can be utilised to serve human needs, not fulfil the profit demands of the wealthy elite.
Please contact the Health Workers Rank-and-File Committee (HWRFC) to discuss this further:
Email: sephw.aus@gmail.com
Twitter: @HealthRandF_Aus
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