The NSW public health system is in deep crisis, with more than half the public mental health workforce set to resign on January 21.
The Australian Salaried Medical Officers Federation NSW (ASMOF), the public doctors’ union, has been urging NSW Labor Premier Chris Minns to take urgent action to avert the impending disaster.
However, Minns and heath minister Rose Jackson have repeatedly said the state cannot afford the sums being asked and re-offered a 10.5% wage rise over three years — which the ASMOF rejected last April.
Labor asked the NSW Fair Work Commission to adjudicate on January 21, and promised to accept the decision.
The ASMOF is asking for a 25% pay rise over three years, less than their counterparts in most other states. (The NSW government gave 17,000 police officers a 39% pay rise at the end of last year.)
ASMOF NSW acting executive director Ian Lisser said on January 14 that the Minns government has known for at least 16 months that “there are at least 140 vacancies in the psychiatry workforce”.
He said psychiatrists have “fiercely advocated for safe staffing levels and better patient care” but that they are “now being blamed for the same crisis that they have sounded the alarm on”.
Minns’ failure to retain and recruit staff puts the welfare of patients at risk, ASMOF said, adding that there will be “significant flow-on effects impacting the entire public health system”.
“This is an impending disaster for NSW and our entire health system,” Lisser said. “The crisis will see even more beds and clinics close.”
“Everyone needs to care about this,” ASMOF said. “Within a week of the mass resignation of psychiatrists, the NSW health system will go off a cliff.”
Lisser said “distressed patients presenting to NSW emergency departments requiring treatment from could be left in the ED for up to five days. They deserve better.”
Despite knowing the risks, Lisser said Minns is doing everything to avoid fixing the problem. He is blaming psychiatrists and putting “contingency plans” in place which would put patient care at “significant risk”.
Lisser said the union is concerned that the treatment burden “will fall on trainee doctors, nurses or paramedics”.
“We do not want to see our already overworked health staff being forced to take on even more work, and work beyond their scope of knowledge and training.”
The ASMOF is calling on Labor to fill the 140 vacant psychiatrist positions “by providing the remuneration and conditions necessary to attract and retain the doctors our mental health system requires”.
The minimum base salary for a NSW psychiatrist is $186,241. Depending on seniority that figure can rise to $251,618.
However, many psychiatrists do not work full-time: from 443 positions, only 290 are full time.
According to the ASMOF, the equivalent salary in Western Australia is 51.66% higher, 44.6% in the Northern Territory, 38.98% higher in South Australia, 28.44% in Queensland, 25.51% in Tasmania and 2% higher in Victoria.
However, in Victoria, as most psychiatrists do not work full-time, they are paid an hourly rate — which amounts to 31% more than NSW.
Dr Pramudie Gunaratne, a Sydney-based public system psychiatrist, said in the January 13 Sydney Morning Herald that as much as the politicians wanted the public to see the crisis as a “pay dispute”, the reality was about a broken system breaking doctors.
“Even when people are accepted into care, the system is so under-resourced that clinicians cannot provide the standard of care that they are trained to give,” Gunaratne said. “This is why I needed to leave a broken system, before it broke me.
“The truth is that there is no shortage of work in psychiatry. If these psychiatrists were simply interested in increasing their income, there are myriad options available to them.
“These doctors could easily step into the private sector, take a locum position in their own hospital or move interstate.
“Instead, public psychiatrists choose this work so they can care for some of the most marginalised people in our society …”
She said the psychiatrists are “resigning in despair” as “they can no longer provide the care their patients need”.