South Australia’s health system in need of acute care


15 October 2021

Article from October 2021 INPractice

Calling on our political leaders to commit to a better health care system

The chronic issues facing the South Australian health system have never been so dire and in such urgent need of redress as they are right now. 

ANMF (SA Branch), with the strength of more than 22,000 members, is keen to influence policy responses of all political parties on issues relevant to nurses, midwives and personal care workers and in the interests of healthy public policy. 

As a consequence, we have documented the ANMF (SA Branch) Policy Position Statement for the forthcoming South Australian Parliamentary election in 2022. ANMF (SA Branch) is not affiliated with any political party. We guard our independence jealously.

“It is important that all serious candidates address the future funding and capacity of our state health system. Never before have we seen such alarming levels of ‘ramping’ and overcrowding, to the point where our health system is failing even our children,’’ ANMF (SA Branch) CEO/Secretary Adj Associate Professor Elizabeth Dabars AM wrote to state parliamentary candidates.

“In one night alone at the Women’s and Children’s Hospital we had 60 children either waiting to be treated or waiting in the emergency department for a ward bed. At the time of writing the WCH’s emergency department was running at 2½ times capacity (250 per cent). 

“All hospitals continually run far beyond their designated capacity, resulting in delayed and missed care. Whilst emergency departments and ambulance ramping feature in the media reporting we know, as do you, that emergency capacity is only one part of the hospital capacity crisis. 

“Patients attending the EDs need ongoing places in which to receive the care needed, whether that be hospital beds, operating theatres, mental health community support, aged care or disability services. All of these are in undersupply or difficult if not impossible to access. 

“We have a situation where Voluntary Separation Packages are being offered to nurses at a time when there are simply not enough nurses to fill shifts - again resulting in delayed and missed care - and highly fatigued, over-stressed nurses working double and extra shifts, a clear danger to patients in their care. 

“Every day we hear reports of scores of patients waiting in emergency departments for a ward bed and people waiting perilously long times for an ambulance responder. 

“The health system as it currently stands is woefully under-resourced and understaffed and in urgent need of investment. If the COVID-19 pandemic has taught us anything it is that the public health sector is the frontline shield in the fight to protect the community. Just last year the Premier ruled out privatising SA Pathology, saying it had “stepped up to the plate during the coronavirus pandemic and provided South Australians with a world-class COVID-19 testing service that has reduced the spread of the virus and saved lives’’.

“The ANMF (SA Branch) has long campaigned against privatisation of our public health services in many forms. The privatisation experience in Australia (at least seven failed hospital ventures including Modbury) shows public investment is the most efficient and cost-effective way to deliver health care. Research also shows that investment in public services and infrastructure boosts an economy. 

“A strong, robust health care system is the bedrock and most crucial and fundamentally basic component of any society. The incoming government has an absolute responsibility to its citizens to ensure we have the best health care system possible, and not just for patients. We also need a system that values its medical staff, not one that subjects them to the stress, fatigue and violence we currently see on a daily basis.

“Right now the nursing and midwifery professions are on the cusp of implosion. Ensuring a strong and sustainable workforce capacity is critical in light of the significant workforce changes anticipated in the coming years. It is expected that 50% of nurses and midwives will leave the workforce in the next 10 years, with a peak in retirements in 2025. Many of these staff are leaders and specialists in their fields which will put enormous stress on SA Health given the significant loss of skills and knowledge. 

“Health Workforce Australia has projected a shortfall of approximately 85,000 nurses/ midwives by 2025, and 123,000 nurses/ midwives by 2030 We desperately need a health system that retains and attracts nurses, midwives and care workers, otherwise the consequences for society could be catastrophic. 

“We know there are solutions to the many issues confronting health in this state. We have offered those solutions in the past and will continue to offer them to whichever party forms government. 
These solutions include:
 • Resourcing and providing appropriate publicly employed staffing levels that ensure a quality public health system that meets
   the needs of our community.

 • Public hospitals to run at 90% capacity through the provision of additional acute and subacute beds to enable better flow from the
   emergency department, with the ability to flex up.

 • Implementing measures that improve the flow of patients through hospital care such as nurse led discharge.

 • Support specialised mental health care funding which is commensurate with the requirements of individuals, groups
   and communities. 

 • Measures that will increase the availability of nurses and midwives to meet the communities needs including:
    o  The development of appropriate graduate support, including increasing the number of graduate placements in rural hospitals. 
    o  The cessation of Voluntary Separation Packages that lead to a loss of nursing or midwifery positions. 
    o  The casual employment of nurses, midwives and assistants in nursing to only be used for temporary employment situations or
         in exceptional circumstances. 
    o  Initiation of a workforce planning committee in partnership with the ANMF (SA Branch) to identify and monitor skills shortages
       and implement necessary supports and programs. 

• No further privatisation or outsourcing of public health services.

• Protecting nurses and midwives from injury in the workplace including in areas such as: 
   o  Workplace bullying and harassment 
   o  Fatigue and burnout 
   o  Violence and challenging behaviours. 

The ANMF believes it is important for the wide areas of policy addressed in this position statement to be addressed in the parties’ responses to the South Australian community and, in particular, in their positions put to nurses, midwives and personal care assistants. 

We have outlined what we want to see happen in a range of health and social policy areas, including action on COVID vaccinations, Aboriginal and Torres Strait Islander health, workforce and industrial relations and measures to improve the capacity of the entire health system to meet the needs of the community.

The major political parties’ responses to the issues, and the ideas we advance for policy, will be published to our members in the lead-up to the state election. We will also publish these responses on our website for the benefit of the wider community.

Click here to read the October 2021 Edition of INPractice