Registered Nurses in Aged Care Facilities

I make a contribution to debate on the Public Health Amendment (Registered Nurses in Nursing Homes) Bill 2016. Since I was elected, I have spoken on numerous occasions on this issue in this place. It was one of the first matters I spoke about. I am pleased to do so on behalf of the Labor Opposition and my community. Friday 12 May is International Nurses Day and it is fitting that today we are debating this bill. This bill is about the minimum standards of care afforded to our elderly citizens in aged care facilities or nursing homes. 

For the benefit of members in this place, I remind the House of the key recommendations of the upper House inquiry. Recommendation 7 states:

That the New South Wales Government retain the requirement in section 104 (1) (a) of the Public Health Act 2010 for registered nurses to be on duty in nursing homes at all times and to amend the definition of "nursing home" under the Act.

For nearly 30 years, in the interest of patient safety, a regulation has been in place to ensure adequate coverage of nursing homes by registered nurses. However, the Minister has chosen to put the interests of business and profit ahead of patients and their families. In spite of the Government's own parliamentary inquiry recommending retention of registered nurses at all times, the Minister chose to ignore that recommendation. A change to the definition of "nursing home" is needed in order to harmonise legislation in this State with Commonwealth legislation in this area.

Sadly, the Government has been completely inactive and unresponsive to the calls from aged care residents, activists and the nursing profession for legislative action in this space. It is now time to put this right. The commercial interests of for-profit aged care providers cannot be placed above safety and care simply because a reduction in nursing standards will reduce their wages costs.

Hardworking, dedicated nurses deserve the security and assurance that only the Minister can provide with the legislative change proposed by this bill. Moreover, the residents and patients of aged care facilities and nursing homes deserve that protection and assurance too. Having a registered nurse on duty at all times reduces the likelihood of an unwell elderly resident ending up in the emergency department of the local hospital. I am told this again and again. This causes unnecessary trauma for the patient as well as placing further strain on our already overburdened emergency departments. It forces residents to be admitted unnecessarily, further adding to bed block in our emergency departments and hospital wards.

Registered nurses are aged care specialists. They provide supervision and training to junior and lesser qualified staff. I hear from enrolled nurses and assistants in nursing, who do a remarkable job and are part of the team that ensures quality care to nursing home residents, that they are also concerned about the professional implications of current requirements. Without registered nurses rostered on at all times they will be forced to take on duties for which they are not qualified nor trained to do. There are many duties and procedures which only registered nurses are able to perform in the nursing home environment. Without registered nurses 24/7, who will undertake these specialised procedures?

It is not just aged care nurses who are concerned about the downgrading of nursing care standards. I have heard from doctors, various medical associations and others who are opposed to the reduction in nursing care. It is absolutely imperative that this Government finally acts on the recommendations of its own upper House inquiry and supports this legislation. We have a responsibility to ensure the needs of residents and patients are not lost in the race towards profitability, as we know what will happen if private operators are not compelled by legislation to provide the highest level of care through the rostering of permanent, around-the-clock registered nurses.

In calling for action from the Government I place on the record my gratitude and deepest respect to the activists here today, such as Jocelyn Hoffman, Shirley Ross-Shuley, Annette Peters, Louise Stammers, Peter Buckney, and Peter Lammiman. These Blue Mountains nursing warriors are incredible. They do tough, physical work and they have medical and professional expertise that is among the very best in the industry. In their spare time, they fight, through their union, for better conditions at work for their patients and colleagues.

The NSW Liberals enjoy union bashing and undermining the good work of collective action. The next time they decide to attack unions and workers, they should remember the faces of the people seated in the public gallery watching this debate. I say to them, comrades, you are the faces and voices of modern trade unionism. We will not let the Liberal and National parties get away with attacking you in this place or in the media. You should never be made to feel guilty about standing up for yourselves and the people in your care. I congratulate our nurses and I congratulate Brett Holmes, Rita Martin and Jon Farry, each of whom has been doing excellent advocacy work at the Nurses and Midwives Association [NMA]. But they are being stonewalled by this Government at every turn.

For some years, the NMA and other stakeholders have met regularly to explore the issue around the future of registered nurses and aged care nursing homes in relation to changes to the Public Health Act. This meeting was known as the Aged Care Steering Committee and in 2016 put forward a report that contained a number of recommendations regarding the future role of registered nurses. The NMA and its members have attempted to gain access to the final report of the Aged Care Steering Committee; however, their efforts have been blocked at every turn by this Government. The Minister for Health has cited Cabinet in confidence. I ask if the Minister for Health takes seriously the concerns of nursing home residents and their families as well as those of the staff intimately responsible for their care. Why the secrecy and the obstruction?

The Government should stop playing games on this issue. Let us support registered nurses in our aged care facilities 24/7 for the sake of safety and quality of care for our teams of healthcare workers. It is the right thing to do. Let us do it today. As the President of the Country Women's Association stated in the op-ed published by The Land today, "We're not reaching a crisis in aged care, we're in the middle of it." It is high time the Berejiklian Government accepted this reality and began to do something about it today.

[Download PDF]