Melina BATH (Eastern Victoria) (15:44): I have been listening intently to the debate, and it is quite a wideranging debate. There is some fact in there, and we have heard some folly and some falsities from those opposite just now –
David Davis interjected.
Melina BATH: and, as Mr Davis just said, some hyperbole into the bargain. We do not want to play politics with health care or the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2025. I was listening to my colleague and our lead speaker, Ms Crozier, who is certainly well informed in this space, being a nurse herself, but also being very much available, interested and with a finger on the pulse of our health system, as much as you can be from opposition. She does a very fine job of it, and I thank her for the work, on behalf of the Liberals and Nationals, on the scrutiny of government and being an ear and being accessible to those in the health system that need to ventilate their concerns about the government and what it is doing and what it is not doing in our healthcare system.
Indeed this bill seeks to improve patient care and safety, and that should be the primary focus, concern and motivation of all healthcare legislation coming through this place. We have heard this before, but I just want to put it on record: it makes changes to existing ratio requirements for level 1 and level 2 hospitals; level 1 and level 2 ICUs are to be at a one-to-one ratio; in level 1 hospitals and level 2 ICUs new requirements are introduced to have team leaders or ICU liaison nurses and a nurse in charge of the unit; it looks to have a one-to-one nurse-to-patient ratio for each resuscitation cubicle in an emergency department on the morning shift, which is currently at one to three, and also a one-to-four ratio for midwives in postnatal and antenatal wards on night shift – currently that is that at one to six; and also, finally, it requires in-charge nurses on night shift in standalone high-dependency units and coronary care units. I am just putting on record some of the main provisions in the bill. We have also heard the government is going to commit a tad over $100 million into implementing these increasing staffing levels, but it has certainly not been able, in discussions and questions by the Liberals and Nationals, to give any detail of this allocation in the budget papers.
We do know that our health system is under enormous strain; you do not have to be sitting on a mountain and contemplating this to see it. Day to day in our electorate offices we have constituents who come in and lament the lack of services or, particularly in rural Victoria, the waitlist to access services or sometimes, very unfortunately, the lack of good service in a system under pressure. No-one likes talking about that, and I am not going to stay and dwell on it too much. But clearly there are system pressures in regional Victoria, there are staffing allocations that are frequently a challenge to meet and there are hospitals where services are being trimmed and cut. We have seen certainly that hospitals have been challenged in relation to meeting the current and existing ratios as they stand in regional Victoria.
The Liberals and Nationals will not be opposing this bill. We support its intent to improve safety and achieve better health outcomes for patients but also of course take some of that stress and strain off our nursing fraternity and enable them to do their jobs with more focus, more capacity and more time allocated to each individual patient. Clearly in this case that is critical care that needs that urgent attention and monitoring around the clock. As Ms Crozier has spoken about, it is certainly concerning how the government is going to fill these rosters with the requirement for new nursing staff across Victoria. Indeed some of that will potentially come from backfilling with casuals. What are the cost implications on our hospitals in relation to covering those costs for the casual work pool?
I was having a little read while listening to debate on this of the report Nursing Supply and Demand Study 2023–25. This is right across our nation, not just in Victoria. There are examples and illustrations around how our nursing supply is not actually keeping up with demand. Our population is growing. Our need for community health care – and not only community but hospital and intensive care – is growing. We are an ageing population of course and all of us humans and our body parts require specialised nursing, and it seems to me from this report that we are not keeping up.
Indeed the report did say, and I concur, in relation to female staff that it is overwhelmingly a female-based workforce, the nursing workforce, of 88 per cent across the nation – I am sure that is quite similarly reflected in Victoria – and 12 per cent males. And if I can put a comment out on this one, it is that my own son happens to be a nurse, and not only is he a nurse, he is a nurse in intensive care. He has worked in emergency departments, he has a masters degree and he has worked in paediatric intensive care units, and of course PICU is a very significant and specialised area of paediatric intensive care. He has been on the floor in those units, where he is looking after either one very delicate and prem baby – and paediatrics can mean up to 18 years old – but also up to teenagers with head injuries from accidents and the like. They really do watch every breath that that patient takes, and I just want to pay homage to and thank our nursing fraternity for having those skills, that patience, that commitment and that love of those people or children who are in their care for that time. And I am sure they take it home too. I am sure they worry about their patients as well, and I am sure even though they feel regularly burnt out they make it their utmost concern and care to make it to the next shift where and when they can. And without giving any further confidences away, I am also very much aware of when both doctors and nurses are trying to fill staffing allocations for wards and can be in a long and draining and quite intensive position themselves, because there is a time factor and a need factor to fill those rosters.
One of the things that we also note is the importance of our sectors and, in relation to our training, both our universities, for registered nurses and bachelor degrees, but also our diploma courses, for our enrolled nurses with the work that they do to backfill some of those more intensive roles in our healthcare system. And again, some of my colleagues – I note Dr Heath – certainly raised it about the workforce in regional Victoria.
It is interesting when you read in the papers that post COVID many of our agencies – and by that I mean government departments – have decided and the government is saying, that you can work from home. I often reflect on the fact that nurses cannot work from home, they have to be on the floor. Doctors cannot work from home. Victoria Police cannot work from home no matter how tired they are; they often backfill and come in even though they are overworked and exhausted. And also of course there are our teachers – although they were forced to work from home during COVID. But their normal habitat is certainly in front of a class of noisy and demanding children with varying degrees of understanding. So those are our really frontline services – ICU, EDs and the like – for our nurses.
What I just want to finish off with is: we do need to have a focus. This government must have a focus to keep up with that demand. I get concerned that our sectors, both our universities in regional Victoria and our TAFEs, also need staff to provide that workforce education ongoingly, and I know that there are examples where that is not always the case; they struggle. So it is a whole-of-system requirement. And this government is very good at spruiking their credentials, but we see the pressure points certainly in regional Victoria. And if we look at some of these hospitals, we are talking about level 1 hospitals in Victoria and level 2. Many of our regions actually of course feed into those level 1 hospitals, and there are 14 of them on my count. And in relation to our level 2 hospitals we know Latrobe Regional Hospital is in that category, and again, it has a wide catchment in Gippsland. It always brings me no joy to talk about some of those pressures that it is under. It is all very well and good to build new buildings, but to staff them, to furnish them and to have the funds to be able to continue to pay for them and to pay for those staff are ongoing challenges.
Indeed it will not be a shock to people from my electorate to understand some of the concerns that people have had in relation to Latrobe Regional Hospital and the fentanyl issues that I am sure they are working on, but the government needs to give full focus and full support – and the same with Safer Care Victoria. It has to pay that full eye, mind and resolve to improve patient outcomes into the future.
Finally, I want to make some comments in relation to what are called local health service networks. We in the regions know, and Ms Crozier certainly knows, that that is code for hospital mergers. We have heard in regional Victoria and in my electorate the discussion around the Bayside mergers. That seems to me to be code for concern that, if you have got a major hospital in the Alfred, the government is going to supply it with far more funds and direction, the lion’s share of that funding, if there is, we will say, a merger, a Bayside merger – and it looks like there will be – as opposed to those smaller hospitals at Leongatha and the like. It will just end up being the case that local hands on the boards are removed, and we are going to see a stripping away of local jobs and a stripping away of the ability to prioritise the unique needs of those regional communities. I think this is quite a heavy-handed approach. Of course it is always seems to be done by this government without that detailed conversation and consultation. Many of the boards are probably required or requested to have a positive slant on it, and I can understand that, but at the end of the day the Nationals and the Liberals are concerned about that service delivery.
We do not oppose this bill. I am pleased that Ms Crozier will investigate or interrogate her concerns on behalf of the Nationals and the Liberals, but this bill certainly can pass through this house.
