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The Guardian 4 February, 2009

NSW hospitals hit quicksand

The old adage "Nero fiddles while Rome burns" does not come close to the NSW government’s response to the crisis in the state’s hospital system. Major newspapers latched onto the crisis during December 2008 and January 2009 and have used the issue as a brick-bat with which to beat an already dead state government with during those months.

However, the current state of affairs is a combination of a number of contributing factors, going back at least a decade:

  • natural decay untended, such as replacement of depleting human resources and redundant equipment,

  • accelerated decline due to the government policies of the Carr/Iemma Labor governments, such as the under-funding of hospitals and other health services, the failure to aggressively recruit and train new nurses and health professionals,

  • the adoption of the Howard govern­ment’s user-pays, private-is-best approach to healthcare.

    Now we have a blind-folded Nathan Rees wielding a sledge hammer at the health system like a piñata at a children’s birthday party.

    The severity of the situation can in no way have escaped Mr Rees and the ministers responsible, yet the government cannot even come forth with even a "confirm nor deny" statement.

    John Della Bosca, Minister for Health, has not issued a single press release on the issue. Browsing his website one can only find statements touting his attendance at "community forums". There are four of these press statements, identical in wording with only the names of the hospitals changed.

    "The forums will include an opening address from the Minister, a workshop, a workshop feedback session, and open group discussion. These consultations are the first step in a series of formal and informal meetings across the state which will involve the people who make our health system work and the people they care for. … It is important to get our response right so we can successfully implement improvements for communities now and into the future".

    Needless to say, a "community forum" in two weeks time will not feed hospital patients today, nor provide car accident victims with morphine tonight.

    The eyes, ears, hands and feet of the system

    The rapid degradation of nursing services in the state’s public hospital make in case in point of the extent of the problem.

    While the nurses are down at the local chemist buying hospital supplies such as boxes of rubber gloves, antiseptic hand-wash and paracetamol with money from their own pockets, they are at the same time worrying: What will my patients have to eat tomorrow? Will my ward be open? Will I have a job at all?

    The NSW government’s recent mini-budget left individual hospital budgets reeling, and plans were laid out to shed 500 nurses across the state. Yet the employment classified advertisements in newspapers reveal 1,100 positions in the state system already lie vacant. There will be a state-wide deficit of 12,000 by the end of next year as 20 percent of nurses currently in the workforce reach retirement age in the next 24 months.

    The solutions that have been put forward by the government over the last two months defy comprehension. In separate — and obviously without the slightest connection being made between them — policy decisions, the government has announced it will:

  • use registered nurses to fill the vacant positions of emergency department doctors,

  • sack university-trained registered nurses and replace them with TAFE-trained enrolled nurses and trainee enrolled nurses,

  • scrap the trainee enrolled nursing program being run at TAFE colleges,

  • fill as many positions as it can with untrained and unregulated nursing assistants.

    The only response from premier Rees on any of these issues was in a statement made by one of his aides: "He is too busy with other things."

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