Report to 2018 Annual Conference by NSW Nurses and Midwives' Association

REPORT TO

ANNUAL CONFERENCE

CONTENTS

Report to 2018 Annual Conference Coral Levett, President

ANNUAL CONFERENCE

ROSEHILL GARDENS 25-27 JULY 2018

A Year in Review

Report to 2018 Annual Conference

Brett Holmes, General Secretary

Judith Kiejda, Assistant General Secretary

Key Direction 5

Key Direction 1

Ensure our people and resources are aligned with our Vision

Grow our capacity to influence

Key Direction 3 Promote a world class, well-funded, integrated health system

Conclusion

Annexure

Index

70 Key Direction 4 Key Direction 2 Be innovative in our advocacy and bargaining

Promote the Association as a significant and professional advocate for the health system and our members

Summary of Financial Information

for the year ended 31 december 2017

REPORT TO 2018 ANNUAL CONFERENCE

4 4

Report to 2018 Annual Conference CORAL LEVETT, PRESIDENT A warm welcome to everybody attending our 73rd Annual Conference. In addition to all the registered delegates here today, we also have some special invited guests from Global Nurses United (GNU), their leadership group and of course our valued life members. I also welcome a new group of member leaders here as observers to conference. At this conference, our elected delegates come together to engage in debate on issues important to our union, and to the union movement more generally. To achieve this, we will celebrate our achievements from the previous year and as a group decide our direction for the future. I am confident you will all enjoy your time with us and we look forward to your participation in both the formal and social program. This President’s report provides a brief summary of the activities of the Association’s Executive and Council for the past year. The General Secretary’s report will provide a more detailed account of the full range of activities of the Association.

NSWNMA COUNCIL AND EXECUTIVE Our 23 democratically elected nurses and midwives including the General Secretary, the Assistant General Secretary and eight executive members are vested with the responsibility of managing the affairs of the Association according to our Rules. Since last year’s conference, we have had two new Councillors join our ranks – Natalie Ellis and Julie Goss. Natalie and Julie filled casual vacancies left after Lee Taylor moved from Council into an employed role with the Association, and Tania Gleeson left to focus on her career as a cardiac nurse. I would like to acknowledge Lee’s short time on Council, and also Tania’s much longer contribution over many years.

Leading and managing this organisation continues to be an extremely challenging but important responsibility, and I acknowledge the continued strong leadership and the commitment of Brett Holmes and Judith Kiejda, now in their 16th year as our leaders, with the support of a very capable and experienced senior leadership team. The NSWNMA continues to be at the forefront of the union movement in NSW with a healthy growing membership. I consider it a privilege to be on the Council of the Association and to be a part of such a progressive, dynamic and inspirational team. Over the last 12 months, the Executive and Council have been involved with many NSWNMA and ANMF NSW Branch core activities, including: ■■

Driving our new Award claim for improved and extended nurse-to-patient ratios, that will include a 1:4 ratio across the state, the counting of babies in post-natal maternity services, 1:3 ratios in emergency departments and children’s wards, improved ratios in mental health units, rehabilitation units and the community;

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Authorising around $60,000 worth of donations and community engagement sponsorships to various charities and community groups on your behalf;

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Continuing to be at the forefront of policy and procedure review for both the NSWNMA and the ANMF NSW.

EDITH CAVELL TRUST Edith Cavell scholarships are awarded to enable current and future nurses and midwives to embark on undergraduate or postgraduate studies. An amount of $80,000 was allocated this year. Congratulations go to the 25 members, including student members, who were successful with their scholarship applications for the 2018 academic year.

PROFESSIONAL ISSUES COMMITTEE

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Campaigning for ratios in aged care; Campaigning to Change the Rules, so that working people in Australia have access to job security, fair pay rises and fair working conditions; Campaigning for Tax Justice and Fair Trade; Campaigning to Keep NSW in a Healthy State, and opposing the privatisation of our public hospitals; Campaigning to Save Medicare;

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Campaigning to keep the NSW government’s Hands Off Public Disability Services;

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Campaigning to save penalty rates and the meaning of our weekends;

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Campaigning to save Paid Parental Leave;

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Active involvement as committee representatives in The Lamp Editorial, the Professional Issues Committee (PIC), numerous Log of Claims Committees and Working Parties, and the Edith Cavell Trust;

The Professional Issues Committee (PIC) has been focused on the review and development of policies, guidelines and position statements for presentation to Annual Conference for endorsement, and has also provided valuable input into the numerous professional issues that present themselves. The PIC also oversees a number of specialist nursing and midwifery interest groups doing some great work. Thank you to all the members of the PIC for their ongoing contribution, including regular attendance at our meetings.

AUSTRALIAN NURSING AND MIDWIFERY FEDERATION (ANMF) NSWNMA and the ANMF NSW Branch now operate in tandem so as to meet new industrial requirements in both state and federal arenas. This relationship is continuously being consolidated and we now believe the interests of our members are protected in the different jurisdictions and accommodated for in our internal policies and procedures. The ANMF NSW Branch forms a sizable component of the national ANMF collective of around 270,000 members, with NSW being the second largest membership state in the country. In addition to the regular interactions at Federal Executive level by the state and territory ANMF branches and Federal Office, every two years

REPORT TO 2018 ANNUAL CONFERENCE

delegate representatives from the states and territories meet to progress issues of common interest. The National Biennial Delegates’ Conference was held last October in Hobart, Tasmania, and NSW delegates played an important role on your behalf. A number of resolutions passed at last year’s Association Annual Conference were taken to the Biennial Conference for debate. I am pleased to report that all were endorsed by the delegates, and later by the ANMF Federal Executive. Of great significance, two Australian states (Victoria and Queensland) were able to report on their success in achieving legally mandated ratios written into their state laws. Aged care and the need for improvements also featured heavily at the conference. Federally, the ANMF has transitioned to new leadership, with Annie Butler appointed to fill the casual vacancy of Federal Secretary following the resignation of Lee Thomas which took effect on 14 June 2018. Lori-Anne Sharp was appointed as the new Assistant Federal Secretary. Sally-Anne Jones remains the Federal President with James Floyd, the Tasmanian ANMF President appointed as the Federal Vice President following Lori-Anne Sharp’s resignation.

CONCLUSION I am very honoured to stand before you as President of this fantastic union of nurses and midwives. It is a privilege to work with such a dedicated team of Councillors and Association support staff. This union’s ongoing success and growth can be attributed to the extraordinary efforts by many people, both within the organisation and in our broader membership. The hard work carried out day to day by our delegates, branch officials and activists is extraordinary and I thank each and every one of you for your personal contribution. Our teams within the Association play a vital part in keeping this union relevant, successful and influential. As proud union members we will continue to have our voices heard by those that need to hear them. We will continue to advocate for our professions and our communities. To do this, it is imperative that we do not rest on our laurels when it comes to membership growth. It is encouraging to see so many new delegates here today. I am confident you will be able to pursue your passions and achieve great things through this great union family.

NSWNMA COUNCIL – MEETING ATTENDANCE Meetings held from September 2017 to July 2018 = 10 Alldrick, Annette 8

Makepeace, Edward 8

Brazil, Sue 8

McCall, Liz 9

Cashman, Michelle 10

McKenna, Lucille ** 6

Clark, Gary 9

Noort, Richard 10

Ellis, Natalie * 8

Rodgers, Kerry 8

Goss, Julie * 7

Scott, Lorna 8

Hibbert, Peg 10

Smith, Debra 9

Holmes, Brett 9

Smith, O’Bray *** 7

Hopper, Lyn 8

Straub, Michelle 9

Kiejda, Judith 8

White, Sue 8

Lang, Debbie 8

Wilson, Gil 9

Levett, Coral 9 * from 21 November 2017 ** leave of absence May and June 2018 *** leave of absence April and May 2018

I congratulate Brett and Judith once again on their extraordinary and incredible leadership. They have stayed strong in an industrial environment often working against them. Their passion for this union and their stewardship is unique in so many ways. Let us all continue to work together to achieve a better deal for the nurses and midwives of NSW and the people we care for. I wish you all an enjoyable and productive 73rd Annual Conference. Coral Levett President

A Year in Review BRETT HOLMES, GENERAL SECRETARY

There has never been a more important time to support each other and work together collectively as a united union.

We must work together as a collective to change the rules by standing up for patients, the elderly and those who need care.

Our hospitals are experiencing unprecedented growth, aged care is in crisis and disability services are struggling under the sluggish rollout of NDIS.

In 2018, NSW nurses and midwives are calling for Ratios both at state and federal levels for public hospitals and aged care respectively. Private hospital nurses are increasingly demanding ratios as well in their enterprise bargaining campaigns.

NSW nurses and midwives work with the best interests of their patients, residents or clients top of mind. For years, presentations to our hospitals have been rising rapidly and complex care needs increasing. Yet, it is clear the current rules around staffing in both public and private health are broken. Diminished industrial rights have put wage caps at 2.5 per cent and power has been stripped away from the independent umpire, leaving little choice around how we advocate for safe patient care. The terms, ‘reasonable workloads’ or ‘adequate staffing’ have been taken advantage of by employers. For too long our health facilities across NSW have been propped up by the goodwill of hardworking nurses and midwives. Funding of nursing or midwifery staff is not meeting the demand in the sector and it is not safe. The voices of nurses and midwives must be heard.

We need a transparent ratios policy that cannot be rorted by governments or employers.

CHANGE THE RULES Nurses and midwives face challenges at work that are having an increasing impact on their day to day lives. Inequality is at a 70 year high and underemployment a reality for many who cannot find full-time work. Workers are fighting unfair workplace laws and wage stagnation, while big business continues to take an ever increasing proportion of productive wealth and to avoid paying their fair share of tax. We are at a point where employers have too much power. We must be strong and stick together as a movement if we are going to win on these issues.

REPORT TO 2018 ANNUAL CONFERENCE

The Association is consolidating and building on the strong relationships we have with other unions and the community to stand together and fight for what is right. To improve and extend ratios, confront the crisis in aged care and fight against unfair workplace laws, we need to first acknowledge that the current system is broken. Significant changes are needed if we are to protect the rights of workers that we fought so hard to establish. For more secure jobs and better pay, I urge you all to become an active member in the Change the Rules movement.

PUBLIC HEALTH SECTOR CAMPAIGN FOR RATIOS In early June, the NSW Government responded to our claim for the NSW public health system Award. Not only was our renewed request for nurse-topatient ratios ignored, any increase in pay beyond the 2.5 per cent wage cap was rejected. Nurses and midwives were again faced with the hard decision of accepting the pay offer as legislated by the Governmentâ&#x20AC;&#x2122;s wages policy with no movement to address our claims. There was one exception in that our members call for the provision of four week rosters was heard by the Minister and included in the new Award effective in October 2018. The Association Council after being briefed on the discussions that had been held with the Ministry of Health Officials, the Minister and Association

SURVEY RESULTS 7 IN 10

officers, endorsed a recommendation to vote yes to accept the pay offer and to continue the campaign for ratios outside the industrial framework that has been so limited by the NSW Industrial Legislation and Government wages policy since 2011. Branches voted 160 in favour and 19 against the pay increase and 172 Branches voted to commit to local campaigning for the extension and implementation of ratios in line with our claims. Eight Branches voted no to local campaigning efforts. We are working with Branches across the Public Health System to highlight the failures of the current system and breaches of the Award. If we are stuck with the current system until there is a change of government then we must enforce its application. Outside the workplace we will continue to campaign for a ratios system that

Not only is understaffing affecting patients, it is also driving people away from the nursing and midwifery professions. We need to keep the campaign going to make sure all state politicians back the claim and support ratios in all NSW public hospitals. In a survey we conducted of 2,500 members working in the public sector across NSW:

said they had seriously thought about leaving the profession, with almost all citing workloads and inadequate staffing levels as the cause.

PATIENT SAFETY

was a major concern for

73%

OVER 90%

believe ratios would improve patient safety and workloads.

delivers the right numbers of nurses and midwives on every shift and without a geographical divide on nursing care.

Missing hours

The staffing system as it currently stands is not working. Over a period of 12 months, the Association collected data in NSW hospitals and uncovered around 40,000 hours of missed clinical nursing care as a result of a manipulation of the Award to save costs. Seven years after the implementation of the first phase of ratios, the Ministry of Health has now had to reinforce to Chief Executives that the Award is the law and they ae required to apply it. Year on year, presentations to our public hospitals rise and nurses and midwives are being forced to take on that increased workload. It has become untenable. This is the year for nurseto-patient ratios across all wards and units in all NSW public hospitals delivered on a shift by shift basis. We know ratios save lives. The NSW Government can no longer continue to ignore the link between nurse staffing levels and improved patient outcomes. Research has shown that every additional patient per nurse can increase the likelihood of an inpatient dying by seven per cent1.

Midwifery shortages

The Association also collected data around midwifery shortages, which were listed in our submission to the inquiry into Support for new parents and babies in NSW late last year.

Updated figures obtained by the media in June, found similar shortages, with shocking figures at Blacktown Hospital, indicating permanent midwifery vacancies at almost 25%. After an extensive campaign at Wollongong Hospital earlier in the year, figures have improved but there is still a very long way to go to consistently improve staffing in maternity. We are in continuing talks with the NSW Health Minister around this issue.

RATIOS FOR AGED CARE On International Nurses Day, we launched our campaign to fight for legislated ratios in aged care. The national campaign endeavours to enforce guaranteed staff ratios and mandated nursing and care hours for each resident in residential aged care. Ratios will help deliver a sustainable staffing methodology that considers both staffing levels and skills mix for residential aged care across the country. The urgent problem that needs to be addressed is not funding, but the declining quality of care from chronic understaffing. There is no point in increasing funding without adequate measures to ensure that money is tied to care. The aged care industry is in a staffing crisis. We have seen a 13% reduction in trained nursing staff working full-time in aged care facilities between 2003 and 2016. This has a direct impact on the care delivered. The most recent Government workforce taskforce has identified that the Aged Care industry operates on a 25 percent vacancy rate.

1 Aiken, L.H. et al. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study

REPORT TO 2018 ANNUAL CONFERENCE

Chronic understaffing has seen a 400% increase in preventable deaths of elderly Australians in aged care over the last 13 years, with hundreds dying from falls, choking and suicide. The Federal Government, Opposition and all other Federal politicians must stop ignoring the staffing crisis in aged care. They must stop conducting reviews, inquiries and reports and start fixing the problem by making ratios in aged care law. The upcoming Federal election is our chance to get the government to take action. Without a mandatory minimum staffing level in aged care, employers can simply choose not to employ enough staff or cut nursing and care hours. Just one week after the ANMF released a report – prepared by the Tax Justice Network, titled Tax avoidance by for-profit aged care companies: profit shifting on public funds, a Senate inquiry into the financial and tax practices of Australia’s for-profit aged care providers was announced. Aged care residents receive one and a half hours less care than they should, every day. Yet there are no rules to ensure the $2.17 billion in government subsidies given to these for-profit providers is spent directly on their care. The Report, proves we need ratios in aged care – not just more funding. These providers have the financial capacity to employ more nurses and carers but are placing their profits and shareholders before safe care for their residents by using available loopholes to avoid paying their fair share of tax.

Our campaign to make ratios law will put a spotlight on this unfair practice and make sure companies – that receive millions of dollars via Australian Government subsidies – be required by law to meet higher standards of transparency in financial reporting. We will also examine the so called not-for-profit sector of aged care as well, to follow the money trail and find out what financial methods they use to manage the billions of commonwealth subsidies they receive.

NORTHERN BEACHES It has been a gruelling process to obtain basic information from the Ministry of Health and Healthscope around the transition of staff from Manly and Mona Vale Hospitals. A lack of consultation with staff and the Association during the EOI process led to staff being matched to very different positions with no explanation or logic around why those decisions were made. It was only after a threat to strike at the end of April that Association members got more information around the transition arrangements, staffing numbers and profiles and redeployment options should they choose to remain in public health. We keep being reassured that public patients will not be affected in these public private partnerships (PPPs) but the secrecy surrounding the agreement between the NSW Government and Healthscope right up until the final hours is extremely concerning.

There are just over two months to go until the new Northern Beaches Hospital opens its doors. The Association and its members will be monitoring the transition process closely to ensure that the NSW Government’s promises to the community and staff are delivered. Everything our members are experiencing justifies vigorous opposition to privatisation of public health.

As a result of our joint anti-privatisation campaign, unions partnered with the McKell Institute to produce a report which looks at the key drivers of the increased need and demand for public healthcare in NSW. Keep NSW in a Healthy State: Investing for a healthy future, emphasises the economic sense of public health but also the common sense argument to invest in a healthier future for the people of NSW.

KEEP NSW IN A HEALTHY STATE

The key findings suggest that in order to keep pace with national and global trends, NSW needs to commit to an annual health budget of $45 billion by 2030. For many of our members, this investment could be the difference between life and death for their patients. It would mean a robust public health system that ensures adequate numbers of nurses and midwives to look after the growing health needs of the NSW population.

Some time ago we learned the NSW government’s short-term ‘fix’ for our hospital funding crisis was to privatise. The public-private-partnership model planned for the Northern Beaches took five more hospitals into the fold in 2016: Maitland, Wyong, Goulburn, Shellharbour/Port Kembla and Bowral hospitals. When it was announced that these five hospitals were to be privatised, we fought back along with Unions NSW, the HSU and ASMOF. For over 13 months, nurses and midwives, health workers, community members, public health advocates, and even politicians, campaigned tirelessly. In the end, thankfully, all the hard work paid off. We stopped the privatisation of all five hospitals. Things might have been a lot different had we not succeeded. Since the NSW Coalition has been in office, a record number of privatisations have been pushed through. The rise in revenue from handing public services over to the private sector, resulted in budget surpluses worth more than $8 billion over the next four years. Amidst all this, funding for staffing in NSW hospitals is still not sustainable.

FINANCE The NSWNMA remains in a sound financial position, with the benefit of continuing membership growth to 30 June and careful financial management. The Audited Accounts for the year ended 31 December 2017 are summarised at the end of the report and a full set is supplied to delegates and available to members. Delegates may recall from reports to Committee of Delegates in previous years that, because of the Howard government’s WorkChoices legislation, the Association was required to restructure in 2016/2017. Amongst other matters, the legislation moved our members in the Private Hospital and

Aged Care sectors from the New South Wales to the federal industrial system. As part of that process, state based unions such as the Association were granted “transitional registration’ (recognition) under the federal laws and became known as a TRA (Transitionally Registered Association). A significant part of that TRA status was that state registered union employees could receive a federal Right of Entry permit (RoE), without which a union official could not visit a Private Hospital or Aged Care facility to speak with and represent members. As the TRA status was due to expire from 1 January 2016, it was necessary for any employee requiring a RoE to become an employee of the Association’s counterpart federal union i.e. the ANMF. Thus, commencing 1 October 2016, Association employees requiring a RoE were transferred to the ANMF NSW Branch, and any new employee requiring a RoE was employed by the Branch. In simple terms, the ANMF NSW Branch provides organising and industrial services to members on behalf of the Association, whilst the Association provides office space and equipment to the ANMF NSW Branch. 2017 is the first full year of this arrangement and this is reflected in the Association’s accounts, particularly with respect to: ■■

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Income: Service Fee ANMF NSW Branch, much greater than in 2016 as the Branch pays the Association for office accommodation and equipment; Expenditure: Employee benefits, significantly less for the Association than in 2016; and Expenditure: Service Fees – ANMF, significantly greater for the Association than in 2016, predominantly due to the transfer of staff to the ANMF NSW Branch and the additional organising/industrial staff that have been appointed in that period.

The 2017 result is a total comprehensive income attributable to members of $4,018,741 ($4,114,383 at 31 December 2016). Our Net Assets, as at 31 December 2017, were $46,083,103 ($41,808,948 at 31 December 2016). In the unaudited five months to 31 May 2018, we currently have a surplus of $8,398 which is less

REPORT TO 2018 ANNUAL CONFERENCE

KEY GROWTH

for the period 30/6/2017 – 30/6/2018

An increase in the Public Health System for the year – up by 1,355 members (3.23%) A decrease in Residential Aged Care for the year – down by 32 members (-0.32%) An increase in Private Hospitals for the year – up by 451 members (7.83%) A decrease in Justice Health for the year – down by 5 members (-0.71%) A decrease in ADHC and Public Service down by 197 members (-23.88%) Other sectors have increased by 185 members (5.43%) The number of PRD members has decreased by 569 during the year from 6,429 to 5,860 (-8.85%).

than budget by $32,869. Net assets as at 31 May 2018 total $46,091,505. As delegates would be aware, the Association has embarked on two major projects to update our capacity and ability to meet member requirements: development of new offices and a new membership system. The financial management of these two projects will be critical to the future success of the Association.

NSWNMA RULES CHANGES The significant rule changes endorsed by the 2017 Annual Conference have been registered by the NSW Industrial Commission. Along with complementary changes to the ANMF Rules (registered by the Fair Work Commission), these changes to allow elections for offices in the NSW Branch to be deemed to be elections for the corresponding offices in the Association. As part of the registration process, both the NSW Industrial Registrar and the Fair Work Commission identified some minor inconsistencies within the rules and those changes were forwarded to branches and have subsequently been endorsed by Council. Further changes will be presented to the 2019 Annual Conference: these will be to delete redundant rules and consequently renumber rules as a result of those deletions.

Report to 2018 Annual Conference JUDITH KIEJDA, ASSISTANT GENERAL SECRETARY We have a big campaigning year ahead with our fight for ratios in both public hospitals and aged care facilities. As encouragement to continue, it is important to recognise our campaign wins from last year. I want to thank everyone who had anything to do with the successful win against the government in overturning the decision to privatise five regional hospitals – Wyong, Shellharbour/Port Kembla, Bowral, Goulburn and Maitland. The result was more than amazing and I still have to pinch myself that we won five out of five. Most people thought we were ambitious at best and mad at worst but by standing together with those communities and other health unions, we did it. It is an important victory because in these difficult times where it looks like everything is against us we can still win if we stand together! We need to keep up that fight to make sure the government commits to ensuring those hospitals are enhanced to what they need to be in a timely manner – and we can do that too!

ORGANISING We have been working particularly hard in the Member Organising Team (MO) to apply all our learnings from the structures and education

invested in the union in the last 18 months. Political Scientist Hahrie Han told us at annual conference last year that if we truly wish to grow our capacity on the ground, we need to enhance our branch structures in all sectors to include workplace member leaders. Our messages need to go broader and encourage members to get involved. This is particularly important now as the public sector has become extremely hostile under the Berejiklian government. We have experienced incredible push-back from traditionally accessible workplaces, forcing us to use our Right of Entry to discuss matters with our members. There has been a real change in the environment in which to organise the public sector and we are challenging our usual modes of operation in looking at ways to better communicate with our membership. In my 24 years at the Association, I have never seen it this tough and I wish to congratulate all Association staff and members who have stood their ground and ensured that our democracy stays intact. I know it is not easy. This government has our union in its sights with the new electoral funding laws. This leaves us no choice but to organise in a very different way. Members have rights that they need to be aware of and enforce – this is much easier done when you stand

REPORT TO 2018 ANNUAL CONFERENCE

together. We have no rights under the wages law to advocate for extra staff; workers compensation has been so ravaged that it leaves truly vulnerable injured workers hung out to dry; current public hospital management act as though there is no Award governing our rights; and the independent umpire – the Industrial Relations Commission – has very limited means by which to assist us. The laws are broken, they need to be fixed – and in some cases rewritten – and this is our moment in time to stand together in the fight to return this country to the fair and egalitarian country it used to be. Our job is to advocate for those in our care and therefore we should seize this moment and get involved in the ratios campaigns in both public health and aged care. If you want to be the member leader on your ward or unit – talk to your Organiser – and we will give you the necessary information to allow you to do that. We need every member of every ward to know what this union is currently doing to improve their working lives. So put your hand up to help us win these incredibly important campaigns – you cannot afford to leave it to someone else.

ENFORCEMENT As difficult as it has been for Organising staff to work in this hostile environment, so it has been for our enforcement team – the Member Industrial Services Team (MIST). They spend their time enforcing members’ rights according to the workplace Awards or Agreements. Those legally binding documents do hold our members in good stead when put to the test.

In trying to find out why a number of our especially large branches were experiencing staffing issues and management refused to provide us with documents, we then exercised our Right of Entry, which obliges them under the Award to hand over documents. It then became completely obvious why they were so reluctant. We discovered around 40,000 hours of nursing care had been withheld from patients due to a reduction in staffing. There was an explicit intention to rort the nursing hours arrangement which has led to our current claim for mandated minimum ratios on a shift by shift basis. This has been great work done by MIST Officers and given it had to be done as per the Industrial Relations Act 1996 and not on our traditional methods of working together, I applaud those officers who managed to get the data that matched with what we were being told by members. This again stresses the need for all nurses and midwives to be members of this union – sign up your colleagues so we can all stand together to fight for better workplace rights and a better society.

SYDNEY ALLIANCE The Association has been a partner of this civil society organisation for more than 10 years and has decided to withdraw this year. We will still support their aims and their campaigns where they benefit our members, however we will no longer be a formal partner.

GLOBAL NURSING UNITED (GNU) The annual GNU meeting was held in Quebec City in Canada in November last year and is growing each year. The meeting was productive and

eye-opening at the same time because every country is experiencing the same thing – privatisation of public services and immense attacks on our public services, particularly health. Violence at work is a major issue for all partners as we work to try and find workable solutions. In 2018, the meeting was held here in Sydney on the Monday and Tuesday prior to Annual Conference, so attendees could experience our conference. Since our last meeting, the nurses from Quebec have been successful in securing mandated staffing. Input from the Association informed their claim and it is that sort of international work done collaboratively that builds the case for minimum mandated ratios around the world.

PUBLIC SERVICES INTERNATIONAL (PSI) The PSI Congress that is held every five years was held last October. Again, the major issues for health workers (the majority of whom are nurses and midwives) were the widespread attempts to privatise public health services, the fight for minimum mandated staffing, finding ways to ensure safety at the workplace and the need for appropriately funded health systems that guarantee access to quality health for all global citizens.

The work the Australian PSI affiliates have undertaken on anti-privatisation, tax and trade issues has been a real example to other sub regions in the Asia Pacific and has really equipped unions to fight for fair tax and trade. We have worked with PSI globally to look at tax avoidance, especially in the aged care sector. The report just released into the for-profit sector in aged care has informed our campaign strategy for ratios in aged care and led to a Senate Inquiry. Our affiliation to PSI has placed the Association in a space where we can truly argue for reform from a place that really does speak to politicians. At the recent World Congress I was elected to the Executive Board of PSI and the World women’s Committee. I was humbled to accept. This allows your union to have a voice at the peak level of this Global Union Federation and I take that responsibility very seriously.

AUSTRALIAN COUNCIL OF TRADE UNIONS (ACTU) As a Vice President of the ACTU, I have the privilege of representing our members at that peak level. It is fair to say that the profile of the ACTU has lifted under the leadership of Sally McManus. As you would be aware, the ACTU is running a campaign in the lead up to the federal election around changing the rules. So many are broken. The shift is now so far in the employers’ favour that new rules need to be written. Things like industrial laws, workers compensation, work health and safety need to change so there is balance again between employer and employee. Workers’ capital and superannuation needs to be shored up so they are not undermined. We need tax reform that guarantees our public services and fair trade agreements, not free trade agreements because they impact on peoples’ health.

UNIONS NSW As President of Unions NSW I again have the privilege of representing our membership at the state level. The peak body is committed to working with all the affiliates to ensure that despite the politically hostile environment, workers in NSW are able to enforce their rights.

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There are many who say our union should not get into party politics, however it is the politicians in the government of the day who make the decisions and consequently the laws that govern the way we work and live. If those laws do not work in our best interest then we need to do something about that. We stand together and we say enough is enough and we work to get a government that aligns with our values and supports our issues. Politicians are elected by us to govern in the best interests of everyone and they need to be held to account.

THE LAMP The Lamp continues to be our main means of communication with each member and our research tells us it enjoys a high level of readership. A lot of work goes into putting this magazine together and I wish to thank all those members who every month allow us to publish their stories and photos for the benefit of other members. We are fully aware that in some circumstances members may hesitate due to fear of intimidation or reprisal, however I urge you to keep standing up for your patients and our workplace rights.

CONCLUSION I want to conclude by again thanking each and every member, branch official and member leader for the tireless efforts you put in to making our workplaces operate in a way that is fair. It is not easy and we know you certainly have plenty of other things you could be doing, however our union is the membership and we must increase that membership if we are to grow our capacity to influence â&#x20AC;&#x201C; be it politicians, employers, our communities or even our colleagues. Without your contribution we cannot do the work we do. Delegates, we have two major campaigns running that must be won. We do not have a choice in this â&#x20AC;&#x201C; it is time and I urge you to commit to doing whatever you can to make sure we bring it home. Ratios in the public sector and ratios in aged care. I also want to thank the Association staff for their commitment and diligence to the membership and our organisation. It has been extremely testing in recent times and you have risen to the challenge. Finally your General Secretary, Brett Holmes has led us through another turbulent year but a year of wins. His generous leadership has been on display again this year and for that we thank him. Judith Kiejda Assistant General Secretary

KEY DIRECTION 1

Grow our capacity to influence In order to win better outcomes for our members, the Association* must grow our influence. Influence comes when Association members and member leaders have the ability to use their collective power to enforce rights and achieve new outcomes in their workplaces, their sector and within the health system. We define the health system as inclusive of everywhere our members work.

STRATEGIES

1.1 Grow power and influence by increasing the number of Association members 1.2 Identify new member leaders who can build their workplace influence 1.3 Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence 1.4 Grow the number of Association members actively engaged across the health, disability and aged care systems 1.5 Ensure a focus on retaining as many members as possible * Association should be read to mean the New South Wales Nurses

and Midwivesâ&#x20AC;&#x2122; Association and the Australian Nursing and Midwifery Federation New South Wales Branch.

REPORT TO 2018 ANNUAL CONFERENCE

2018 Sydney May Day

ACTU

Change the Rules campaign

Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 The national campaign of the ACTU, Change the Rules, is gearing up for a federal election either later this year or early next year. Working people and members of unions in marginal seats around the country are being asked to consider the issues that are important to them. ACTU Secretary, Sally McManus, officially launched the campaign in March at the National Press Club. Her address outlined the solutions needed to change laws at work because they no longer guarantee and protect workers’ rights. The Change the Rules campaign to date has featured local community and workplace campaigning, as well as a nationwide media campaign that will continue until the election. ACTION May Day this year signalled an important milestone in the ACTU’s Change the Rules campaign. Thousands took to the streets nationally on May Day with growing cries about inequality, fuelling the momentum to change the rules so that working people have secure jobs and better pay.

Change the Rules campaign launches have occurred all over the state in key marginal electorates with the aim of encouraging union members to vote according to the issues that matter to them. Nurses and midwives in particular

have a role to play in this campaign as healthcare and aged care sectors are not immune to needing change. The rules need to change around aged care providers dodging corporate tax so that funding can go to staffing and decent wages. Legislation for aged care also needs to stipulate ratios and skill mix. The current enterprise bargaining system which our private hospital and aged care members operate under, needs to be overhauled for a stronger industry bargaining system for workers. OUTCOME ■■ We need to change the rules to give all working people the basic rights they need to improve their living standards. ■■

Delegates and members are all strongly encouraged to sign up to the campaign on www.changetherules.org.au and start spreading the word.

NSW HEALTH SERVICE Non-compliance with NHPPD requirements

The Association has undertaken ‘right of entry’ (‘ROE’) actions in a range of hospitals due to suspicions that Nursing Hours Per Patient Day (NHPPD) requirements, were not being adhered to under clause 53 of the Public Health System Nurses’ and Midwives’ (State) Award (‘Award’). Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4 Key Direction 2: Strategy 2.3. Strategy 2.7

142 eight-hour shifts not filled at Hornsby

ACTION The ROE actions initiated by the Association provided, compelling evidence of widespread non-compliance with basic NHPPD requirements under the Award. Local policies were also identified during this process that unfairly impeded the rights of NUMs or applied constraints at odds with the Award. These ROE actions revealed a staffing system broken. The table (page 20) summarises the hospitals so far subject to ROE action. OUTCOME ■■ The Association filed an initial dispute in the IRC of NSW in relation to the Belmont Hospital outcomes in 2017. These resulted in the Commission making 17 supportive recommendations. These have become the template that the Association has sought to apply subsequently to other hospitals/ LHDs, either voluntarily or via the assistance of the IRC of NSW. ■■

Some of the recommendations made by the Commission included: ■■

■■

HNELHD shall comply with the provisions of Clause 53(iv) Section I (b) of the Award which allows Nurse Unit Managers to determine the backfilling of absences. HNELHD shall agree and accept that the Nurse Unit Managers can make an assessment to determine whether vacant shifts should be filled or not. Where a position is to be filled, the default position requires that the position be fully backfilled rather than partially backfilled (for example an absence which creates an 8.5 hour vacancy should, as a default, be filled with an 8.5 hour replacement).

AGED CARE SECTOR Safe Staffing Campaigns

Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5

ALBANESE AGED CARE GROUP – MEREDITH HOUSE AGED CARE FACILITY

Importantly, HNELHD shall inform Nurse Unit Managers, Nurse Managers and Hospital Management that the 5.0 NHPPD is the minimum number of hours possible in NHPPD wards and that there may be occasions where patient need will require additional staffing.

Management attempted to introduce a roster restructure without any prior consultation. The restructure would have reduced every shift at the facility by 30 minutes and would have forced many part-time workers to work an extra shift in order to reach their contracted hours.

NHPPD data shall be measured on a weekly rather than monthly basis in accordance with the Award provisions.

ACTION Members decided to fight the change to maintain safe workloads and a dignified work-life balance.

REPORT TO 2018 ANNUAL CONFERENCE

LEVEL OF COMPLIANCE DURING PERIOD OF DATA ACCESS*

COMMENTS/OUTCOMES

Armidale

Non-compliant

Resolved identified breaches. Watching brief.

Belmont

Non-compliant

Widespread non-compliance during January to August 2017. IRC proceedings, resulting in the Belmont Recommendations.

Cessnock

Compliant

Watching brief.

Hornsby

Non-compliant (3,232 nursing hours below the required minimum on NHPPD wards.)

Widespread non-compliance. IRC proceedings, resulting in mirroring of the Belmont Recommendations.

Inverell

Generally compliant

Watching brief.

John Hunter

Non-compliant (6,695 nursing hours below the required minimum on NHPPD wards over a seven month period in 2017.)

Widespread non-compliance. IRC proceedings following industrial action by members. Belmont recommendations generally applied within LHD.

Kurri Kurri

Generally compliant

Watching brief.

Lismore

Non-compliant (2,378 nursing hours below the required minimum on NHPPD wards.)

Widespread non-compliance. Dispute processes to be initiated.

Macquarie

Non-compliant (3,456 nursing hours below the required minimum on NHPPD wards.)

Widespread non-compliance. Dispute processes initiated.

Maitland

Non-compliant (965 nursing hours below the required minimum on NHPPD wards over an 8 month period in 2017. This included not meeting minimum resuscitation nurse requirements in ED.)

Resolved identified breaches. Watching brief.

Manly

Non-compliant (900 nursing hours below the required minimum on NHPPD wards.)

Widespread non-compliance. Dispute processes initiated.

Manning

Generally compliant

Watching brief.

Mona Vale

Non-compliant (6,101 nursing hours below the required minimum on NHPPD wards.)

Widespread non-compliance. Dispute processes initiated.

Nepean

Non-compliant (6,143 nursing hours below the required minimum on NHPPD wards.)

Widespread non-compliance. IRC proceedings, resulting in mirroring of the Hornsby Recommendations.

Royal North Shore

Non-compliant (2,220 nursing hours below the required minimum on NHPPD wards.)

Widespread non-compliance. Dispute processes initiated.

Ryde

Non-compliant (796 nursing hours below the required minimum on NHPPD wards.)

Widespread non-compliance. Dispute processes initiated.

Tamworth

Generally compliant

Watching brief.

Westmead

Non-compliant (5,147 nursing hours below the required Widespread non-compliance. Dispute processes minimum on NHPPD wards over a five month period in 2017.) initiated. TOTAL: 38,033 nursing hours below the required minimum on NHPPD wards**

* The period that data was sought varied dependent on timing and circumstances at the particular facility, resulting in data being captured for periods of 6-15 months. Figures provided reflect the full 2017 calendar year unless otherwise stated. Only the more significant shortfalls are identified for the purposes of this report. ** This total figure does not reflect continuing breaches of NHPPD requirements which occurred into 2018 at a number of the above sites until the Associationâ&#x20AC;&#x2122;s compliance action occurred. If 2018 data were included, the shortfall balloons to over 40,000 nursing hours in total below the required minimum on NHPPD wards.

When management informed members that the change was inevitable, the members commenced organising a rally to highlight safety issues across the aged care sector. A plan was developed with members to ensure that management would be aware of the reason for the rally well in advance to pressure them into reconsidering the restructure. OUTCOME ■■ When management learned of the rally it withdrew all plans for the restructure. Guarantees have been given to staff that the status quo will continue into the foreseeable future. ■■

Three new member leaders have been identified.

■■

Members formed a new Association Branch.

BUPA CARE SERVICES – CLEMTON PARK Members began organising to address concerns for a lack of staff on night duty which would see one AiN working alone on one floor of the facility with a variety of complex residents in their care. ACTION Member leaders met with management to express their concerns. These calls were initially rebuffed by management leading members to push for an all-staff meeting to discuss staffing concerns during night duty. Management agreed to arrange such a forum and members from across the facility spoke about the safety concerns they had for their residents. OUTCOME ■■ Management acknowledged that there was a problem and introduced an extra RN shift each night of the week to provide residents with safer care.

COLUMBIA AGED CARE – STRATHDALE AGED CARE FACILITY Members began organising to win staffing improvements when a rise in resident acuity resulted in the facility becoming dangerously understaffed. ACTION Members collected data to demonstrate the complex acuity profiles of residents at their facility. This data was submitted to management with a resolution demanding that action be taken to restore resident safety by providing staffing levels that better matched the acuity profile of their facility.

OUTCOME Management responded to the resolution by introducing an extra AiN shift as a float nurse on each morning shift.

■■

HUNTER VALLEY CARE – BETHEL AGED CARE FACILITY AND AMAROO AGED CARE In June 2017 management introduced a roster restructure across all Hunter Valley Care facilities to align rosters with their flagship facility Waterview Aged Care, resulting in a two-hour period each afternoon staffed by one RN and two AiNs. To best manage the workload, management directed nursing staff to commence putting residents, without their consent, in their beds in the early evening as a means of managing the workload. The restructure also resulted in a number of safety issues for staff as they lacked the resources to care for aggressive residents in their care. ACTION The Bethel Aged Care branch collected a petition with the signatures of 45 nursing staff calling on the owners to consult with nursing staff on the WHS issues that the restructure had generated. The owners responded by calling a staff meeting chaired by their Human Resources team to discuss the petition. This meeting was attended by 35 nurses who each gave an account of the dangers of working in the facility and the lack of dignity experienced by the residents in their care. Moreover, each nurse advised HR that they were prepared to speak to the media about their concerns. Members at Amaroo Aged Care passed resolutions, voiced concerns at staff consultation meetings, and encouraged families to escalate their concerns to management when they received complaints about the lack of care. OUTCOME

BETHEL AGED CARE ■■

A working group from the branch was invited to meet with HR to design a new roster structure that would better meet the needs of the facility and the nurses. The roster includes an additional nurse on afternoon shift seven days a week and new shift times that better match workloads and provide for greater work-life balance.

■■

A new duress system has been installed at the facility.

REPORT TO 2018 ANNUAL CONFERENCE

■■

A new Facility Manager has been brought in to develop a more open dialogue with nursing staff into the future.

AMAROO AGED CARE ■■

Management acknowledged that the change had created an unreasonable workload and that the quality of their service delivery had declined since the change was introduced.

■■

An additional four-hour AiN shift was introduced on each afternoon shift to provide further nursing coverage at the facility.

MORAN HEALTH GROUP – MORAN SYLVANIA The branch began organising when members raised concerns about night duty staffing levels on the first floor of the facility: staffing was one AiN who would have to manage a number of complex residents. Attempts to bring these concerns to the attention of local management were repeatedly ignored. Branch meetings further revealed an unsafe workload for the RNs working afternoon shifts. ACTION Branch members resolved to escalate their concerns to the company’s senior management and organised a meeting with the senior executive team. At this meeting members recounted their experiences of working on the first floor during night duty and the ensuing safety and resident dignity issues. Moreover, members advised management that they were prepared to participate in a public awareness campaign if nothing was done to resolve the matter. On the same day the executive team attended a special meeting of RNs where unsafe workloads were discussed. OUTCOME ■■ Management agreed that staffing levels were not providing adequate care to residents on the facility’s first floor. Management introduced an additional AiN shift each week night allocated to the first floor, as well as to work as a float when needed elsewhere in the facility. The branch is continuing to campaign to have this position permanently allocated to the first floor. ■■

An extra RN shift was added to the roster working afternoon shifts Monday to Friday to alleviate the RNs workload and restore safety to the facility.

ALBURY WODONGA HEALTH Nolan House - Staffing HDU unit

Nolan House is a 24-bed Acute Mental Health Unit situated on the Albury Health Campus and is under the dual jurisdiction of NSW Health and Health Victoria. The facility has three HDU beds and one seclusion room with 34 FTE multidisciplinary staff, and at the time, 26 of these were Association members. New member leaders identified that a change in practice in the HDU would compromise the safety of staff and in July 2017 members voted unanimously to close the HDU until all works identified to ensure safe patient care had been completed. On 4 December 2017, management attempted to open the HDU. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 ACTION At the time of the proposed bed closure, 20 members supported their peers who were on duty and insisted on speaking with the Chief Executive. Management was forced to negotiate with the members and after a considerable struggle they reached a satisfactory agreement. Albury Hospital and Nolan House branches subsequently met and moved several resolutions supporting their colleagues, increasing the pressure on Albury Wodonga Health (AWH). AWH has maintained a consistent theme through the course of these complex negotiations and insisted that the CCTV would no longer be used in the patients’ bedrooms in the HDU. The members disagreed with this proposal and sought a compromise. OUTCOME ■■ The branch members negotiated the reopening of the HDU after eight months of closure. ■■

AWH agreed to staff the HDU and the general ward separately, significantly improving care for patients in the general ward.

■■

CCTV would remain for six months and used on a case-by-case basis in the HDU.

■■

Orientation sessions of the new unit and education regarding policies and procedures are being provided by AWH management.

■■

WHS issues are being addressed and members have insisted on having input into all workplace inspections.

■■

As not all WHS issues were resolved, the unit remained closed over the Christmas period despite significant pressure from management.

SURVEY RESULTS

■■

Recruitment of staff is occurring including the addition of a new position of one FTE CNE for six months.

Over 500 Allity employees responded to the survey

■■

Membership density of 81% has risen to 93%.

93% + 96% + 98%

ALLITY AGED CARE

rejected Allity’s low pay offer

New Enterprise Agreement

Allity refused members’ requests to bargain for much of 2017. In late 2017, the company directly offered nurses a 1.8% pay increase, which was voted down by members. This was followed up with an inadequate pay offer of 2% (with no back-pay), then increased to 2.2% with back pay to March 2018 (the pay increase was due in October 2017). In mid-May, Allity increased their pay offer to 2.35% for four years, with back pay to January 2017. They also included some improvements to the workload clause in the Agreement. Allity management unilaterally put the Enterprise Agreement out to a vote of all staff in late May 2018, without the agreement of the Branch and its members. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4 Key Direction 2: Strategy 2.2, Strategy 2.5 ACTION Throughout much of 2017 and 2018, Allity members have been actively campaigning in their workplaces to secure an improved Enterprise Agreement. Campaign activities have included: ■■

A successful majority support petition – over 50% of the workforce signed;

■■

A successful “no” vote to Allity’s 1.8% variation in October 2017;

■■

Passing resolutions at eleven facilities calling on Allity to improve their offer and bargain fairly; and,

■■

Over 150 “messages to Allity” collected and presented to the company in March 2018.

Allity incrementally increased their offer over the course of the first part of 2018. Over 500 employees responded to the survey of which: ■■

93% rejected Allity’s low pay offer;

said the backpay should go all the way to October

said the workload clause was not strong enough to stop them working short.

60% “NO” VOTE was returned on 29 May 2018

■■

96% said the back-pay should go all the way to October; and,

■■

98% said the workload clause was not strong enough to stop them working short.

Allity then decided to put an Agreement to a vote of employees in late May 2018 which included a pay increase of 2.35% with back pay to January. Member leaders were strongly united behind recommending a “no” vote, and a significant organising effort was undertaken to ensure a successful “no” vote. Despite enormous pressure from management encouraging a “yes” vote, members remained united and a 60% “no” vote was returned on 29 May 2018. Members at Allity stood strongly against management intimidatory tactics and were well led by local member leaders who provided support and encouragement throughout the vote. OUTCOME ■■ Member leaders have undertaken significant roles throughout the facilities, organising meetings to pass resolutions and collect messages. New member leaders were identified and mentored in this task, achieving excellent results.

REPORT TO 2018 ANNUAL CONFERENCE

■■

Two new Branches have formed.

■■

Member leaders obtained 500 survey responses through one-on-one conversations.

■■

Staff voted 60% against the second substandard offer from the company on 29 May; the Association has called on Allity to recommence negotiations.

■■

Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 Key Direction 2: Strategy 2.1, Strategy 2.2 ACTION ■■ Extensive 1:1 conversations with nurses to:

Density has grown by over 30% since the campaign began.

BUPA CARE SERVICES

■■

Ensure extensive consultation with members on Bupa’s improved offer of pay and conditions;

■■

Agitate and build power;

■■

Recruit members; and,

■■

Identify new member leaders.

■■

Use of targeted 1:1 phone conversations with nurses for mapping, recruitment, and potential member leader identification.

■■

Use of Facebook, SMS and emails to reach members.

■■

Member feedback on Bupa’s offer has shaped our responses to Bupa during bargaining.

The focus of negotiations has been staffing and the low wages Bupa pays to nurses.

■■

Linking organising work for bargaining at Bupa with the National Aged Care campaign.

The re-commencement of bargaining coincided with a significant increase in Association organising activity in Bupa facilities. Association officers conducted extensive 1:1 conversations with members and potential members in Bupa facilities around NSW, visiting all 30 facilities on multiple occasions.

OUTCOME ■■ Ongoing membership growth due to recruitment of members.

Enterprise Agreement Bargaining

Long-running negotiations with Bupa Care Services for an enterprise agreement re-commenced in January 2018. Negotiations stalled in mid2017 when Bupa provided an administrative pay increase to employees on 1 July 2017 of 2.1%.

Following a period of intensive workplace visits, members feedback and Facebook activity, Bupa improved its offer of pay and conditions, including a Staffing and Workloads clause and a Family and Domestic Violence Leave Clause. Association officers are simultaneously talking to nurses at Bupa about the National Aged Care Campaign. Members at Bupa have raised serious concerns about staffing issues, which is both a bargaining claim and the focus of the ratios campaign.

■■

New member leaders have been identified.

■■

Bargaining is continuing.

HEALTHE CARE AUSTRALIA Enterprise Agreement

Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 ACTION Enterprise bargaining concluded in September 2017 resulting in significant wins in a four-year agreement covering 25 Healthe Care facilities.

Agreements covering the private hospitals and day procedure clinics received 90.97% approval. OUTCOME ■■ The campaign achieved an increase of 10% net growth in membership. Branch and delegate activity contributed to growing the union’s power and influence in the workplace. Industrial activity escalated in this period utilising good faith bargaining provisions of the Act to support bargaining activities. ■■

■■

Throughout the bargaining campaign, members and the Association were engaged in coordinated member meetings and media activities including Facebook and paid newspaper advertisements to agitate our claims for: ■■

safe staffing ratios;

■■

a staffing framework to establish better rostering practices;

■■

support for clinical leadership;

■■

improved work/life balance; and,

■■

better pay to recognise the work of nurses and midwives.

Coordinated member pressure through active Branches and member leaders contributed to wins across staffing and pay conditions which achieved outcomes in Key Direction 1.1 and 1.2.

HEALTHSCOPE PRIVATE HOSPITALS Member Growth and Development

The Healthscope Enterprise Agreement expires on 10 February 2020. This period is being used to build momentum for growth and leader development to maximise our success at the next round of negotiations. Their biggest hospital – Northern Beaches – is due to open in October 2018. This hospital has been the subject of much dispute covered elsewhere in this Report and will be an important organising priority at a time when there is much uncertainty around the workforce split between public and private. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 Key Direction 2: Strategy 2.1, Strategy 2.6

ACTION

EMPOWERING MEMBERS AND ENSURING EMPLOYER COMPLIANCE ‘Know your Rights’ flyers continue to be effective about; Christmas Shutdown, Overtime; Public Holidays payments; On Call and Recall; and, Rostering and Breaks. Work Health and Safety legislation has been utilised to undertake workplace inspections at Norwest Private Hospital and The Sydney Clinic, with Norwest electing Health and Safety Representatives (HSRs). Members have utilised the Nursing Practice Decision Framework to address skill mix issues. Employer compliance with workplace change, restructuring and redundancy has been enforced, including: improved skill mix, no split shifts and stopping shorter shifts. Also, there has been compliance with 19 days or less rosters occurring via utilisation of 10-hour shifts. Access to time off in lieu (TOIL) continues to be extended and secured at various hospitals.

EDUCATION AND BRANCH DEVELOPMENT Member leaders from Newcastle Private and Nepean Private hospitals attended the Hahrie Han leader development workshops prior to Annual Conference in 2017. Workplace visits occurred to promote understanding and discussion of branch development, industry superannuation entitlements and issues, shut down and annual leave, and the 2016 AHPRA registration standards and Nursing Practice Decisions Framework. Association officers addressed new graduates at the Newcastle Private hospital orientation, with Prince of Wales Private and Hunter Valley Private hospitals in service days also to be addressed. The Healthscope nurses and midwives Facebook site provides an easy platform to increase Association reach and visibility to non-members for the purposes of participation and membership. Dialogue with one of the superannuation organisations is occurring to develop industry superannuation posts for a Facebook series.

REPORT TO 2018 ANNUAL CONFERENCE

OUTCOME ■■ All branch biennial general meetings have been successfully concluded with The Sydney Clinic forming a branch. ■■

Net increased membership continues.

■■

Annual pay rises continue to ensure Healthscope nurses and midwives are further ahead of the public sector and many major private hospitals. The 2019 pay rise of 3.25% will accelerate this trend.

■■

Consolidated membership and leadership power and increased employer compliance with the enterprise agreement is occurring.

JUSTICE HEALTH AND FORENSIC MENTAL HEALTH NETWORK Forensic Hospital - Security Issues

Following a series of serious assaults on nurses in 2017, the branch escalated the issues concerning lack of security or interventions to address the situation. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 ACTION Forensic Hospital management rejected members’ notification that management must initiate security. The Association became involved and a range of actions were undertaken, including: ■■

Notification and action from WorkSafe NSW;

■■

Notification to the Ministry and discussion with the relevant Minister;

■■

Members attending meetings with management, and SafeWork NSW strongly highlighting the risks;

■■

Intervention of HSRs to insist on risk assessments on the care of violent patients; and,

■■

Association participation at the Mental Health Tribunal.

OUTCOME ■■ Although the goal of having security officers employed in the Forensic Hospital has been achieved there has been a lack of consultation on their introduction. ■■

The actions of the branch brought significant focus on the practices and behaviours of the management and WHS teams.

■■

A senior SafeWork NSW officer continues to be involved and participates in WHS meetings, with many changes having taken place within executive management and the WHS unit.

Forensic Hospital - Breach of agreed staffing numbers

Management at the Forensic Hospital introduced a policy that staff working overtime must finish at either 03:30 or 05:30 hours to ensure they were available to start their rostered shift at 13:30 hours. This resulted in significant depletion of staff numbers from 05:30 to 07:30 hours. Key Direction 1: Strategy 1.1, Strategy 1.2 ACTION However, JH&FMH management refused to reverse the directive which resulted in a dispute and a subsequent Right of Entry process. Documents revealed that over a three-month period, staffing fell below agreed minimum standards on 86 occasions. OUTCOME ■■ Forensic Hospital management was then forced to rescind the directive and revert to the provisions outlined within the award, allowing staff to finish at 07:30 hours and proceed to a 10-hour break.

MARRIAGE EQUALITY Campaigning for a YES vote

The marriage equality campaign presented an opportunity for the Association to advocate for a change to benefit the health of the LGBTIQ community and stand up for members being discriminated against on the basis of their sexual orientation. Previous Association survey results indicated this was an issue that the majority of members supported, especially younger members. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4 Key Direction 3: Strategy 3.1, Strategy 3.2, Strategy 3.4, Strategy 3.5 Key Direction 4: Strategy 4.1, Strategy 4.2, Strategy 4.3, Strategy 4.4

likes, 1,248 shares and only four negative reactions. The post was also featured on Buzzfeed as one of the most successful posts in the campaign for marriage equality. ■■

On 15 November 2017 the plebiscite results were announced, with 61% in favour.

MARDI GRAS 2018 40 years of evolution

The 2018 Sydney Gay and Lesbian Mardi Gras parade provided an opportunity for the Association to continue its support for LGBTIQ members and further position itself as a progressive organisation. ACTION The Association launched a campaign to support a YES vote for marriage equality after a resolution was passed at the 2016 annual conference to participate in the Australians for Equality National Campaign for Marriage Equality. The campaign consisted of social media – including video and meme production, direct emails to members, flyers, member training at the Association for activists/leaders run by an Association Organiser, a day of action across supportive health facilities in NSW, ‘Nurses & Midwives for Equality’ branded campaign materials and involvement in supporter events. To assist in dealing with any negative feedback, the Association also produced key messages and statements of support to reinforce our position. OUTCOME ■■ The Association received overwhelming support from members. ■■

Students became more inclined to sign up as Associate Members on hearing we supported the issue.

■■

Over 520 members pledged their support to actively assist with the campaign.

■■

Around 15 branches participated in the day of action, which also resulted in two local newspaper articles and one local TV news clip.

■■

The Facebook page, Nurses and Midwives for Equality attracted 560 followers throughout the campaign.

■■

The most popular Association Facebook post achieved a reach of 212,956, with over 4,000

After a successful year in 2017, the Association applied to march again at this year’s parade. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4 Key Direction 3: Strategy 3.1, Strategy 3.2, Strategy 3.4, Strategy 3.5 Key Direction 4: Strategy 4.1, Strategy 4.3, Strategy 4.4 ACTION Following on from a successful YES vote around marriage equality and that it was the parade’s 40th anniversary, there was extremely high demand from Association membership to participate. We also participated in Fair Day this year. OUTCOME ■■ The Association received over 100 requests from members to join our float at the 2018 parade. ■■

Our float was featured on the SBS broadcast with a special mention from hosts acknowledging the hard work of nurses and midwives.

REPORT TO 2018 ANNUAL CONFERENCE

■■

Participants were from a range of health facilities across the state, from inner Sydney to Newcastle, Coffs Harbour and Tamworth.

■■

Multiple letters of thanks were received from members following the event.

MURRUMBIDGEE LOCAL HEALTH DISTRICT

development of the members, branches and member leaders, to grow our power and influence. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 Key Direction 2: Strategy 2.1, Strategy 2.2 ACTION

CLAIM DEVELOPMENT AND ENDORSEMENT PHASE

Wagga Wagga Rural Referral Hospital

In November 2017, the Association’s Ramsay Enterprise Agreement campaign commenced with Enterprise Agreement claim endorsement meetings. The bargaining team focused on growth and development of the members, branches and workplace leaders. Education of members on their rights continues as well as work on getting the right staffing claims together for different specialties.

Key Direction 1: Strategy 1.4, Strategy 1.5 Key Direction 2: Strategy 2.1

Surveys and focus groups were undertaken in early 2017 by ReachUp Consulting, followed by a member survey to further identify and develop claims for the new Enterprise Agreement, whilst identifying new leaders and engaging members.

A member who was employed and working as a midwife and held both nursing and midwifery registration had her application for Continuing Education Allowance (CEA) rejected by the Murrumbidgee Local Health District on the grounds of advice they had allegedly received from the Ministry of Health.

ACTION An audit of issues received by the Association revealed that a number of members across the State were affected by this approach. A strategic plan was formulated to apply pressure on the LHDs in these matters. A number of representations were made to the Murrumbidgee LHD as to the CEA provisions within the Public Health System Nurses and Midwives’ (State) Award and the Continuing Education Allowance policy directive PD2012_002, including the intent of the provision. OUTCOME ■■ The Association received formal notification from the Murrumbidgee LHD that the Ministry of Health had revised its advice and nurses who held dual registrations were eligible for the CEA. ■■

Ministry of Health Continuing Education Allowance policy directive was updated as a result (PD2018_008).

RAMSAY HEALTH CARE Member Growth and Development

The Association’s Ramsay Enterprise Agreement for Safe Staffing negotiations are continuing despite a March 2018 expiry date and a July pay increase due. This campaign includes the first comprehensively researched staffing claims for private hospitals with a focus on growth and

The results were significant with 1,397 responses. When asked if they can provide the quality care their patients need – 1,000 nurses and midwives said ‘NO they can’t.’ 90% of respondents said improved staffing is their top priority. In addition, to develop and endorse appropriate staffing ratio claims for Ramsay members, specialty working groups were set up through 2017 similar to preparation for the Public Health System ratios claims. Members were actively involved in these groups to determine the right claims.

ENDORSEMENT MEETINGS – STANDING TOGETHER FOR SAFE STAFFING The Association conducted workplace meetings at many of Ramsay’s 33 Hospitals to discuss the draft claims and gain further feedback. Member leaders Ramsay members on the enterprise agreement negotiating team.

were developed through these meetings to build upon the 1:1 relational work by Association organisers. Facebook was a useful tool to promote the meetings with pictures posted of those attending. Members passed resolutions supporting claims and seeking the support of their Directors of Clinical Services.

SURVEY RESULTS 1,397 Ramsay employees responded to the survey of which:

At some hospitals, MyTime remains a top issue where members’ entitlements have been overridden by management; a letter was provided to management requesting that this cease.

PRIORITISING FOR GROWTH The Association’s Ramsay negotiating team reviewed priority sites, focused on leader development and set targets for leaders and contacts across all Ramsay hospitals in NSW with a view to the Association’s Strategic Plan. OUTCOME ■■ Increased Association visibility and presence. ■■

Membership growth.

■■

Developed and empowered leaders.

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Increased social media engagement and awareness.

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Increased awareness of rights to enforce and question the Enterprise Agreement.

■■

Engagement in the new Enterprise Agreement campaign and a “buzz” around ratio.

Enterprise Agreement Negotiations ACTION Early on during the negotiations, Ramsay agreed to pay eight members to be part of the Association’s ‘negotiating team’. These bargaining representatives have been invaluable in negotiations sharing their experiences with senior management at the table with increasing confidence and making them listen as well as being an integral part of campaign planning. These leaders represent the majority of nursing specialties and come from Lake Macquarie Private, Westmead Private, Kareena Private, Wollongong Private, St George Private, North Shore Private, Tamara Private and Castlecrag Private hospitals. Negotiations have been long and difficult due to a comprehensive list of claims. At the time of publication, Ramsay have refused members safe staffing claims with the exception of “Like for Like” replacement and a process for NUMs where patients needs cannot be met. Key outstanding claims are:

1000

said they can’t provide the quality care their patients need

90%

said improved staffing is their top priority.

■■

In charge without a patient load;

■■

ACORN Standards; and,

■■

Face-to-face training for mental health nurses.

Safe staffing remains members’ number one issue; the staffing claims are accompanied by an extensive list of conditions claims. Organising activity continues to put pressure on the employer around targeted issues. OUTCOME ■■ Increased Association visibility and presence. ■■

Develop and empower leaders.

■■

Improved wages and conditions.

■■

Steps towards staffing arrangements.

■■

Wins on securing ADOs for recently employed new graduates and other nurses.

■■

Forcing an employer memo to managers to stop overriding MyTime entitlements.

Local Hospital Activities KAREENA HOSPITAL: WORKLOAD ISSUES ACTION In September, the Kareena Private hospital Branch met to discuss their workload concerns, particularly in Theatres and the Botany Bay Ward, and collected data as evidence to support their workload concerns. Midwives have also raised workload issues providing opportunities for new leaders to be identified. OUTCOME ■■ Increased Association visibility and presence.

REPORT TO 2018 ANNUAL CONFERENCE

■■

Membership growth.

■■

The Association conducted a WHS inspection of the Botany Bay ward.

■■

On-Call roster for the Matson Maternity ward.

ST GEORGE PRIVATE: RECOVERY WORKLOADS ACTION In March, St George Private Hospital Branch members and leaders met with the Director of Clinical Services and the hospital’s Chief Executive Officer about ongoing workload issues in the Recovery area. Numerous incidents had highlighted serious concerns about the staffing and layout of the Recovery unit. A number of meetings were held with Recovery nurses and a survey was undertaken of Theatre and Recovery Nurses. An analysis of the Recovery area and compliance with the ACORN standards uncovered that Ramsay Health see ACORN as a set of guidelines, rather than a set of mandatory standards that are required to be met. OUTCOME ■■ Increased Association visibility and presence. ■■

Membership growth.

■■

Identification, development and empowerment of member leaders.

STRATHFIELD PRIVATE HOSPITAL AND BARINGA PRIVATE HOSPITAL ACTION Both the Strathfield Private and Baringa Private branches are new and have been supporting all Enterprise Agreement activities. The Strathfield Private hospital Branch has been campaigning to ensure their new colleagues obtain ADOs like their fellow colleagues in North Shore Private and St George Private hospitals. There have been several resolutions sent to the new Chief Executive Officer and Director of Clinical Services, but are still awaiting a result. They have held several meetings to discuss the issue with a very good turn out and increased their membership since forming the branch. The Baringa Private hospital Branch at Coffs Harbour sent a resolution to their Director of Clinical Services, as members were being pushed into having days off and going home early.

Management agreed they have been reading the clause incorrectly and will not be sending or cancelling staff unless by mutual agreement. Members also achieved success with an issue where management requested staff to take excess leave. Upon investigation, excess leave did not apply to many of our members, subsequently management had to retract the letters. The Baringa Private hospital Branch recently held their first branch meeting where they had 23 members attend, not including the branch officials. Four non-members joined after the meeting. OUTCOME Increased Association visibility and presence.

■■ ■■

Membership growth with identified targets to achieve the aims of Key Direction 1.1.

■■

Increased confidence and solidarity throughout the membership through local campaign wins.

■■

Increased enforcement and education the Enterprise Agreement.

WESTMEAD AND ST GEORGE HOSPITALS: QUALIFICATIONS ALLOWANCE CAMPAIGN ACTION Organisers have been working with members collectively to enforce payment of the qualification allowance under the Enterprise Agreement. Midwives at both Westmead Private and St George Private hospitals have been applying for the allowances – 75% of members at Westmead Private and 50% at St George Private have now been successful. The Association continues to support and fight for those members not yet paid their allowances. This will be a useful win to spread across Maternity and other specialties where Ramsay have ignored the payment. The matter was filed in the Fair Work Commission. After conciliation failed to resolve the dispute an arbitration was listed for June 2018. Meanwhile during negotiations Ramsay are arguing to reduce the ability for nurses and midwives to receive the qualifications allowances making them discretionary. As this report is published the matter awaits the FWC hearing. OUTCOME ■■ Increased Association visibility and presence. ■■

Membership growth with identified targets to achieve aims of Key Direction 1.1.

■■

Identifying, developing and empowering leaders.

■■

Increased enforcement and education around the Enterprise Agreement.

Workplace Health and Safety Inspections These inspections are a powerful leverage tool making the most of the authority under WHS legislation using the Association’s expertise often unmatched by the employer.

NORTHSIDE CLINIC ST LEONARDS: WHS INSPECTIONS Ramsay have closed their 88 bed mental health facility, Northside Clinic Greenwich, and relocated operations to a brand new 122 bed facility, Northside Clinic St Leonards, which commenced operations in February 2018. Prior to its opening, members raised safety concerns regarding an unsatisfactory consultation process, manual handling hazards with new bed heights (kneeling to make beds) and systems of work issues including a proposed new medication administration system, security and duress arrangements, safe staffing and skill mix and emergency procedures. ACTION The Association commenced a WHS investigation with site inspections occurring at the Greenwich facility on 5 February and at the new St Leonards facility on 8 February 2018. OUTCOME ■■ WHS inspections have occurred at the old and new facility – allowing the Association to gain valuable information into potential WHS issues for members with relocation to the new facility. ■■

■■

A WHS report was developed from the investigation with recommendations for Ramsay to address WHS concerns. A valuable advocacy experience for members from which to link to the formation of a branch and WHS workplace structures.

A WHS report will be developed from the investigation with recommendations for Ramsay to address WHS concerns. OUTCOME ■■ The local hospital campaigns provided an opportunity for branch and member leader development. ■■

Increased Association presence (face-to-face and through various communication channels).

■■

Strong overall membership growth.

■■

Increased confidence and solidarity throughout the membership through local and companywide campaign wins.

RECRUITMENT Associate Recruitment and 2018 New Graduate Recruitment Strategy Key Direction 1: Strategy 1.1

ACTION Activities have been undertaken to recruit associate members, increase awareness of the Association, engage with and recruit as many nursing and midwifery students as possible, at universities, TAFE and other education facilities across NSW. Additionally, early career nurses and midwives were recruited to the Association at orientations and other events across NSW.

1300 + 215 = Join face-to-face

Join online

1515

new Associate members

The Association currently have

OVER 6000 Associate members

KAREENA PRIVATE HOSPITAL: WHS INSPECTIONS ACTION During May, WHS inspections have been conducted at Kareena Private Hospital allowing valuable information to be gained into potential WHS issues for members and to identify risks.

1207 + 144 + 21 + 306 = 1678

Join Upgrade face-to-face to RN/RM

Join at events

Join online

new graduates

REPORT TO 2018 ANNUAL CONFERENCE

Nurses from St Vincent’s Hospital voiced their anger at the closure of almost half the hospital’s beds, without consultation, a week out from the Christmas holiday period.

OUTCOME ■■ At the end of May 2018, 1,300 new Associate members were joined face-to-face, while a further 215 joined online. Total joined = 1,515. ■■

■■

The Association currently has just over 6,000 Associate members with the plan to increase this to 8,000 by the end of the study year. At the end of May 2018, 1,207 new graduates joined at face-to-face orientations. 144 upgraded membership to RN/RM, 21 others also joined at new graduate events. A further 306 new graduates joined online. Total joined = 1,678 in this recruitment phase.

ACTION Attended by approximately 150 community and branch members, a lunch time community awareness rally was held in Green Park, a rally that also attracted favourable media coverage. OUTCOME The community awareness action allowed members to express their disappointment in some of the decisions of their employer.

■■

Although the bed closures went ahead, undertakings were made that members could not be forced to take leave at short notice without agreement.

■■

Members were to be supported by educators, and members were not to be on call on days off as per the agreement.

■■

These actions increased the number of engaged members and most of the branch positions have been filled. Members were able to re-establish the reasonable workloads committee, hold the rally at three days’ notice and have seen between 70 and 150 members at branch meetings.

■■

St Vincent’s Hospital has the employer consulting with members in a more meaningful way.

ST VINCENT’S HEALTH AUSTRALIA Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5

St Vincent’s Hospital, Darlinghurst – Christmas bed closures

In November 2017, St Vincent’s Hospital management was forced to admit that it intended to close beds during the Christmas period. The primary reason was St Vincent’s Health Australia’s (SVHA) dire financial situation as a result of increased activity that was not met by the NSW Health predictive funding model. Approximately 50% of the bed base was to be closed for a six-week period and members were expected to take holidays and/or be redeployed to other clinical areas.

St Vincent’s Hospital, Darlinghurst Nurses performing non-nursing duties and EOI for VR

On 23 February 2018, St Vincent’s Hospital advised its intention to implement a practice that nurses provide a meal service in the Emergency Department

and PECC, along with the expectation to also provide additional domestic duties to clean up afterwards.

department and seeking that future confidential information be sent in a more appropriate way and without disclosing other recipients.

This followed the hospital-wide EOI for Voluntary Redundancies and bed closures over the Christmas period because of budget constraints.

THE WHIDDON GROUP

Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5

Enterprise Agreement Bargaining

ACTION A branch resolution on 25 February 2018 invoked Clause 44 Domestic Duties of their agreement, which was ignored by hospital management until the Association sent correspondence to members outlining their industrial rights within the clause. The response from management was to notify a dispute, claiming the Association’s advice to members represented unprotected action.

The Whiddon Group Agreement 2017 was lodged with the Fair Work Commission on 11 October 2017 and approved in April 2018. Member involvement and activity resulted in improved conditions and countered Whiddon’s attempts to cut existing entitlements. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 Key Direction 2: Strategy 2.1, Strategy 2.2

Association officers met on 16 March 2018 with hospital management and outlined the Association position; it was agreed that the branch would investigate the possibility of an alternative solution. In addition, the Association notified SVAH of a dispute for breaching Clause 44. A meeting with management on 23 March 2018 reached agreement that the hospital’s direction to PECC nurses may breach Clause 44 and the concerns about cleaning were noted.

ACTION Member activity and involvement was critical in negotiations to improve employment conditions in the Agreement and in countering Whiddon’s attempts to cut conditions.

OUTCOME ■■ Management agreed the PECC and MAU units recommence meal services and that nurses would not be required to provide this service.

Members fought to retain already grandfathered rostered days off and payment for interrupted meal breaks, including by completing an additional survey of missed breaks, providing evidence to support our successful claim to retain these conditions. This action also prompted management to conduct a roster review at all sites with written promise to provide outcomes to the Association.

■■

ED nurses will offer sandwiches at the clinical discretion of the nurse and will not be expected to provide a set meal time service or clean up afterwards.

■■

In relation to the EOI for Voluntary Redundancies, two NUM3 positions were offered and accepted a voluntary redundancy, with these positions to be affected by restructures with the new Psychiatric assessment service being established; and, a NUM positon in the Cardiac Catheter Lab, which due to a change of service, was to be deleted and combined with the Day Surgery Unit.

■■

However, a breach of employee confidentiality occurred during the EOI process, when a group email was sent to a significant number of staff, including nurses, by HR advising them of their unsuccessful application. The branch responded with a resolution, accepting the apology of the HR

A high member participation rate in the initial claim development survey was achieved by multichannel communications, including Facebook, email, SMS and Organiser tea-room visits.

In addition to the 2% per annum pay increases, a significant percentage of existing RNs at Whiddon have received an additional 2% pay increase in the first year of the Agreement (meaning they receive a 4% pay increase in the first year) due to the amended RN pay structure, once they progress to the new Grade 6 – Senior RN level. The final stages of negotiations were rushed by Whiddon, in order to meet Whiddon’s own deadline. The Association was not provided with the final version of the Agreement before it was given to employees for the access period, and we were not advised the Agreement was going to the access period earlier than expected. This meant that the

REPORT TO 2018 ANNUAL CONFERENCE

Branch Secretary Jackie Holmes (left) at a rally attended by over 100 Blacktown nurses and midwives.

final Agreement was put out to the vote containing an error and not complying with the better off overall test (BOOT) for casual AiNs. Potential BOOT issues were brought to the attention of the Fair Work Commission and the Commission required a number of undertakings from Whiddon addressing these issues prior to approving the Agreement. OUTCOME ■■ Membership increase of 15%. ■■

New branches formed at the Kelso and Easton Park facilities.

■■

New member leaders identified.

■■

Increased pay rates and improved employment conditions.

■■

Existing conditions and penalty rates protected in the Agreement.

■■

A new Gender Identification clause to support employees with issues related to gender identification including gender transition and non-binary gender identification.

■■

Changes to conditions: ■■

Use of performance reviews in the RN pay progression process. This was not explicitly agreed to by the Association. Although protections for members, including a detailed appeal process, were negotiated into the EA, we remain concerned about this approach.

■■

New Senior RN role: RNs classified as Grade 6 – thereafter, who have worked for Whiddon for 18 months or more, may apply to be classified as Grade 6 - Senior RN. This is an additional 2% pay rise but is conditional on maintaining a proficient (or higher) performance rating.

WESTERN SYDNEY LOCAL HEALTH DISTRICT Blacktown Hospital - Unreasonable Workloads

Blacktown Hospital members struggled through winter and spring 2017 with wards surging above bed numbers; poor skill mix; high overtime rates; like-forlike replacement not met by classification, nor hours; several NHPPD ward spot checks not met; specialling within numbers, and high levels of sick leave. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 ACTION From July 2017 branch officials and Nursing Unit Managers (NUMs) were engaged through education (1:1 conversations, reasonable workload training, NUM education meetings, Association education for branch officials and potential member leaders) to empower members to work collectively. Member leaders/engaged members were educated on the Ratios claim and then actively involved in member education on all units. OUTCOME ■■ Union engagement increased with over 100 members attending a lunch time rally on 14 September 2017 to highlight their unreasonable workloads. ■■

Membership and member engagement increased and seven member leaders identified.

■■

Momentum continues to build with the knowledge of what ratios will mean for each ward.

■■

Over 100 members attended the launch of the Blacktown Ratios Campaign on 4 May 2018.

More than 200 angry nurses rallied in protest against the decision to close Westmead ward despite bed shortage.

Member leaders attended the May Day Rally on 6 May 2018 and the launch of the National Aged Care Campaign on 12 May 2018.

UNION SUMMER PROGRAM

■■

Member leaders visited local State ALP MP Stephen Bali on 21 May 2018 and gained support for extended ratios in NSW.

■■

Members continue to wear their ratios badges at work, engaging in conversations with patients and community members.

Union Summer is an annual three week internship held in conjunction with Unions NSW. Successful applicants who are nursing or midwifery students are placed with the Association for three weeks to gain a better understanding of how their union works.

■■

Westmead Hospital - Closure of 29-Bed Surgical Ward

On 25 October 2017, members reported the closure of Ward B3a, a 29-bed surgical specialty ward (Head and Neck, Vascular, Plastic and ENT surgeries) from 1 November 2017. Over 40 nursing staff were relocated to other areas throughout the hospital and 29 beds were closed. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.5 ACTION The branch wrote to management condemning the closure of the ward. A lunch time rally was held on 1 November 2017, attended by over 100 nurses. The branch also wrote to the Health Minister, Brad Hazzard, requesting that he intervene in the current situation and fund Westmead Hospital appropriately. OUTCOME ■■ Management stood by their decision to close the ward, maintaining that the decision was made as part of the hospital’s routine bed management activities to move to its summer bed platform after the busy winter period.

2018 Program

Key Direction 1: Strategy 1.1 ACTION Five nursing students undertook the program from 29 January to 16 February 2018. During this time the students had a chance to gain greater insight into the role and function of the Association. OUTCOME ■■ They took part in many activities including assisting with new graduate recruitment and associate recruitment at university “O Weeks”. ■■

They accompanied some Association organisers on workplace visits.

■■

They observed hearings in the NSW Coroners’ Court and sessions in the NSW Parliament.

■■

One new graduate has taken up a position on her Branch and another is keen to obtain a role on her Branch in the near future.

UNITING AGED CARE 2017 Enterprise Agreement

Negotiations for a new Enterprise Agreement for Uniting Aged Care members have been concluded with a positive staff vote.

REPORT TO 2018 ANNUAL CONFERENCE

Key Direction 1: Strategy 1.3 Key Direction 2: Strategy 2.2, Strategy 2.5 ACTION The Enterprise Agreement endorsed by employees contains: ■■

improved staffing arrangements;

■■

a clause that allows existing staff in AiN classifications to remain in the AiN stream, including on promotion, is significant given Uniting has a large majority Care Service Employee (CSE) workforce;

■■

2.4% per annum pay and allowance increases for the majority of covered employees; and,

■■

2.4% pay increase from 1 July 2017 for former Blue Care employees whose wages are then frozen until the “main” Uniting rates catch up. Former Blue Care employees also have a number of their conditions “grand-parented” or bought out.

The Association’s negotiating team included two members employed by Uniting. The Association decided not to make a recommendation to members on how to vote, yes or no, largely because of the concerning final offer for former Blue Care members. OUTCOME ■■ Improved staffing arrangements for safe patient care in the aged care sector. ■■

Maintenance of existing branch structures and continued member leader activity facilitated by the ability of members in AiN classifications to remain in that classification.

■■

Continued development of member leaders’ skills, knowledge and confidence.

Union Summer Program participants

nurses have a limited function within the structure and are no longer being recruited. It should be noted that other not-for-profit employers are also moving into this model of care, although some (including Mercy Health & Aged Care Group) are embedding RNs in the household unit, retaining ENs for their skill and knowledge, and maintaining the AiN classification. Key Direction 1: Strategy 1.2, Strategy 1.3 ACTION The Association holds information meetings with members on site to provide advice on potential workloads matters with the new model of care. Shift patterns will change, with no loss of contracted hours. No positions will be lost, and interviews have been conducted by the employer to make individual accommodations. Uniting has established a statewide Staff Consultative Committee with the unions who have coverage, and members are able to attend the meetings via video conference. OUTCOME ■■ The Association has successfully argued that the gauges of success of this model should include more clinical measures, and the Association will be assessing areas of concern including unplanned hospital visits. ■■

The Association is reviewing the Safe Medication Practice Process to ensure that members only work within their scope of practice, and that the new model and its associated duties do not expose members to unsafe practice.

■■

While member recruitment is attempted at each visit, it is restricted by the model itself because of the low numbers of RNs at each site, along with Uniting’s decision to limit employment of ENs and only recruit CSEs in the unqualified direct carer classification.

■■

A new network based on qualified staff, and not relying solely on the branch officials, is to be established in order to monitor the progress of the model.

Uniting - State-wide introduction of ‘Household Model’

In early 2017, Uniting commenced implementation of the Household Model, with a view to transitioning 50% of their NSW and ACT facilities. The model creates households around groups of residents, to be more responsive to their needs, in a home-style setting. The household is headed by a ‘Homemaker’ who may be a nurse or a CSE while the RN sits outside the household as part of the clinical support team. The remaining members of the household team are AiNs/ CSEs who will perform generic functions in the direct care of the residents in their household. Enrolled

KEY DIRECTION 2

Be innovative in our advocacy and bargaining New challenges and environments require new thinking and continuous improvement of professional and industrial advocacy and bargaining. The Association will directly represent and organise members and their workplaces, as well as engage with the community and other key stakeholders, to achieve advancement in professional and industrial outcomes.

STRATEGIES

2.1 Review and implement improved Association approaches and processes for collective bargaining and enforcement of rights 2.2 Ensure that advocacy and bargaining aligns with our growing capacity to influence 2.3 Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance 2.4 Actively use political and community lobbying campaigns to assist with advocacy and bargaining outcomes 2.5 Campaign to extend enforceable staffing arrangements for safe patient care into other sectors 2.6 Review Association approaches and processes for linking professional advocacy to organising and growth 2.7 Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups.

REPORT TO 2018 ANNUAL CONFERENCE

PUBLIC HEALTH SYSTEM 2018 Public Health System Award claim and Ratios It’s A Matter of Life or Death Campaign

A 2018 Award claim was developed, endorsed and served on the Ministry of Health. A pay offer has been accepted by Branches, with the ongoing ratios campaign to continue. Key Direction 2: Strategy 2.1, Strategy 2.5 ACTION

CLAIM PREPARATION, LOG OF CLAIMS COMMITTEE AND ENDORSEMENT There were two ‘working groups’ of expert member clinicians established to review and develop ratios/staffing claims in adult inpatient mental health and the postnatal area. The outcome of this research and proposed claim was presented to a Log of Claims Committee (the Committee) for consideration, alongside a number of other proposed Award claims. The Committee consisted of the President Coral Levett; elected Delegates Clare Bolton, Michelle Callard, Jeffrey Furolo, Remana Harris, Liz McCall, Eleanor Romney; Councillors Michelle Cashman, and Michelle Straub; and senior NSWNMA Officials. The Committee considered all resolutions relating to the Public Health System Nurses’ and Midwives’ (State) Award since the previous Award claim and was presented with extensive assessments on the

legality, practicality and achievability of these potential claims. A small number of proposed claims were not supported by the Committee, with the affected initiating Branches being advised. After thorough consideration, a final list of claims was recommended to Branches in March 2018 by both the Committee and also the NSWNMA Council. The proposed Award claim, including improved and expanded ratios claim, was unanimously endorsed by those branches that voted, and subsequently served on the Ministry of Health. Ratios-related claims ■■

Ratios applied on a shift by shift and based on the actual number of patients in each shift.

■■

In charge of shift in addition to minimum ratios and without a patient load.

■■

Additional Nurses/Midwives allocated to patients who are assessed as ‘Specials’ and will be in addition to ratios or rostered staffing minimums.

■■

AiNs and AiMs in addition to minimum ratios and only where clinically appropriate.

■■

The same ratio for all adult inpatient medical/ surgical wards across the state.

■■

Introduce ratios in paediatric and neonatal intensive care units.

■■

Introduce ratios in EDs, EMUs and MAUs.

■■

Introduce ratios in intensive and critical care units.

■■

Introduce a ratios-equivalent system in community and community mental health.

■■

Extend ratios to more mental health units, and improve ratios in specialised mental health hospitals.

■■

Introduce Clinical Supervision for Inpatient Mental Health and Community Mental Health.

■■

charge’ and increase the minimum notice for displaying rosters from 2 to 4 weeks. ■■

Days off must be consecutive except by agreement.

■■

Remaining NHPPD wards converted to equivalent ratios.

Increase special paid leave from 5 to 20 days in Clause 11 Leave for Matters Arising from Family Violence.

■■

Introduce ratios for short stay wards – High Volume and Day Only.

Extend secondary carers leave for Parental Leave from 1 week to 2 weeks.

■■

Enrolled Nurses who meet the criteria will be classified as Special Grade by personal grading, instead of by employer appointment.

■■

NSWNMA and NaMO to work cooperatively over the term of the next Award to review the appropriate remuneration for NUMs/MUMs.

■■

Vary Clause 53 Staffing Arrangements (ii) Principles to include there must be a staffing review in consultation with the NSWNMA when a ward/unit/service is created, reconfigured or has changes proposed to the model of care.

■■

Introduce ratios for Drug and Alcohol units – Inpatient and Outpatient.

■■

Introduce guaranteed staffing arrangements for outpatient clinics.

■■

Up to date ACORN standards to apply in Perioperative services.

■■

Improved claim for maternity services, including post-natal – babies counted as patients in postnatal when determining maternity services, additional staffing principles.

■■

1.4 FTE CNE/CME for every 30 nursing staff across all shifts seven days a week.

Pay and conditions claims ■■

4% increase in wages and salary related allowances per year (next increase due July 2018)

■■

Pay superannuation to nurses and midwives on paid parental leave.

■■

Rosters to ensure training in paid time, paid handover with appropriate skill mix and early career nurses/novice practitioners not ‘in

AWARD DISCUSSIONS AND PAY OFFER Discussions were held with the Ministry of Health from 9 April to 25 June 2018 to advocate for members’ claims. The sole issue that eventually formed the offer to members was a pay increase. The Government continues to flatly refuse to improve ratios or any other existing Award conditions, other than a last minute offer to accept our claim for 4 week’s roster notice, received after the Branch voting had occurred on 27 June.

REPORT TO 2018 ANNUAL CONFERENCE

OUTCOME ■■ A pay offer of 2.5% for the year from July 2018 was received, with Branches voting to accept the pay increase offer. ■■

■■

The new Award was made on 30 June 2018 to incorporate the 2.5% pay increase and increase to salary-related allowances. Clause 8 “Rosters” was also varied to increase the minimum notice for displaying rosters from 2 to 4 weeks commencing from 1 October 2018. The General Secretary thanks the Log of Claims Committee members for their commitment to the membership, and willingness to provide clear direction and reach recommendations in a consensus manner.

Ratios campaign: It’s a matter of Life or Death

The Association commenced the 2018/2019 Public Health System Ratios Campaign in anticipation of the current Award expiring on 30 June 2018, with the aim of improving and extending ratios across NSW facilities. Branches across the state voted to endorse the 2018 pay and conditions claim for Ratios. Local actions to launch the campaign were undertaken in April and May along with a paid media campaign to raise awareness with the community more broadly. Many members have been involved in a range of public and workplace activities that demonstrated the current system of staffing in NSW hospitals is not working. Broad media coverage of the campaign has been positive and supportive. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 ACTION Branches across the state voted on the offer for the Public Health System award claim on 27 June 2018. In a show of solidarity and strength, an overwhelming number of branches endorsed a resolution which also contained a commitment to stand up for patients because ratios are a matter of life or death.

RESOLUTION 1: PAY RISE OFFER 161

RESOLUTION 1: PAY RISE OFFER The NSWNMA Branch resolves to stand together and act to show the State Govern ment that safer patient care can only be delivered through better, guaranteed nurse to patient ratios. There aren’t enough nurses and midwives, and it’s risking patient safety and our professional registration.

Yes

19 No

A proper, guaranteed ratios system needs a clear shift-by-shift calculation, specials additional to the numbers, babies counted as patients in maternity services, and ratios in all specialties and all hospitals no matter their size or location. We accept the 2.5% pay increas e offer for July 2018 but we condem n the Government’s 7 year refusal to negotiate genuine Award improvements , and we resolve to continue standing up for patients, because ratios are a matter of life or death.

RESOLUTION 2: OUR BRANCH ACTIONS 172

RESOLUTION 1: PAY RISE OFFER

YesThe

NSWNMA Branch resolves to stand together and act to show the State Government that safer patient care can only be delivered through better, guaranteed nurse to patient ratios. There aren’t enough nurses and midwives, and it’s risking patient safety and our professional registration.

We accept the 2.5% pay increase offer for July 2018 but we condemn the Government’s 7 year refusal to negotiate genuine Award improvements, and we resolve to continue standing up for patients, because ratios are a matter of life or death.

RESOLUTION 2: OUR BRANCH ACTIONS The NSWNMA Branch will join our colleagues statewide to step up our fight for safer staffing. We will: 1. Run local activities to raise community and politicians’ awareness about how better ratios can stop the understaffing and risks to patient safety, and 2. Safeguard our professional registration and patient care obligations by determining on each shift whether our employer has provided enough nurses with the right skills 3. Highlight the inadequacies of the current Award staffing system and the flagrant disregard of legal obligations by local health districts.

OUTCOME The final result showed 172 Branches in favour of campaigning for better, more transparent ratios. While a majority voted in favour of the 2.5% pay increase in the Award, 19 Branches have expressed their absolute anger towards the Government by rejecting the offer. The Association acknowledges those Branches and their anger at the NSW Government’s refusal to guarantee better patient care and their failure to recognise the hard work nurses and midwives do in understaffed wards and units. Branches have resolved to raise community and politicians’ awareness about how better ratios can stop the understaffing and risks to patient safety.

RESOLUTION OUR BRANCH

The NSWNMA Branch w statewide to step up We will:

1. Run local activiti politicians’ aware ratios can stop th to patient safety,

2. Safeguard our pro patient care oblig on each shift whe provided enough

3. Highlight the inad Award staffing sys disregard of legal health districts.

AGED AND COMMUNITY SERVICES AUSTRALIA (ACSA) ACSA Template Enterprise Agreement 2017 The Aged and Community Services Australia (ACSA) Template Enterprise Agreement is negotiated to cover employers from the not-forprofit aged care sector who belong to ACSA.

The use of a template agreement allows the Association to deliver pay increases and improvements to conditions to members across a significant percentage of the aged care sector.

OUTCOME ■■ Increases to pay and most allowances of 2.4% per annum in 2017, 2018 and 2019. ■■

Improvements to conditions including: ■■

New family and domestic violence clause including access to paid leave;

■■

Paid partner leave increased to two weeks;

■■

Casual loading to be paid on weekends for AiNs and ENs; and,

■■

An improved disputes resolution procedure clause will allow the Association to be a party to a dispute, to raise and escalate disputes on behalf of members.

Key Direction 2: Strategy 2.1, Strategy 2.3 ACTION The Association negotiated the ACSA template enterprise agreement with ACSA and the HSU, with a log of claims developed through member consultation via a survey and phone conference meetings. Negotiations took place over a period of three and a half months, concluding in September 2017. Once the parties reached agreement on the template, the template was rolled out to employers, and voted on by employees. A total of 89 employers used the 2014 ACSA template agreement. To date, 90 employers have adopted the 2017 ACSA template agreement, covering 201 facilities and 13,991 beds. Some employers agreed to further improvements to the template which have been negotiated between the Association, HSU and the individual employer.

IMPROVEMENTS 2.4%

increases to pay and most allowances per annum in 2017, 2018 and 2019.

LEADING AGED CARE SERVICES LASA Template Enterprise Agreement 2017 Leading Aged Care Services (LASA) Template Enterprise Agreement is negotiated to cover employers in the aged care sector who belong to LASA. The use of a template agreement allows the Association to deliver pay increases and improvements to conditions to members across a significant percentage of the aged care sector. Key Direction 2: Strategy 2.1, Strategy 2.2 ACTION In March 2015, the Association approached LASA to re-negotiate the previous LASA template agreement. Claims were developed through member

ACSA Template Enterprise Agreement 2017

NEW FAMILY PAID & DOMESTIC PARTNER VIOLENCE LEAVE 2 weeks increase LEAVE

CASUAL LOADING WEEKENDS PAY for AiNs and ENs

IMPROVED DISPUTES RESOLUTION PROCEDURE

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consultation via a survey and phone conference meetings. In June 2015, LASA ceased negotiations and gave employees a 1.3% wage increase by administrative increase, effective 1 July 2015. Negotiations between LASA, HSU and the Association recommenced in May 2017. Negotiations with over 31 employers (covering 80 facilities and 6,229 beds) have now concluded. This has resulted in the adoption of 43 template agreements to date. These agreements have now been approved by the Fair Work Commission. OUTCOME ■■ Pay increases of 3% in 2017; 2% in 2018; and, 2% in 2019. ■■

Most allowances will increase by the same quantum as the pay increases.

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A number of improvements including: ■■

Family and Domestic Violence Leave (accessed through Personal carers leave);

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Inclusion of Home Care classifications;

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Cashing out of ADOs;

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Change of roster by mutual agreement within 7 days (allows members to swap shifts); and,

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Casual employees to have the same overtime rights as permanent employees.

IMPROVEMENTS 3%

pay increases in 2017 + 2% in 2018 + 2% in 2019

AGED CARE – NOT FOR PROFIT Management of Branches and Member Leaders ACTION The not-for-profit (NFP) sector employs minimal qualified nurses and where most of the unqualified staff were once AiNs, the current recruitment practice is to employ generic classifications which are not Association coverage. This has led to a necessity to review branch structures, including that branch officials must be mainly classifications of RN and EN, and AiNs for those employers who have retained that classification. As branch membership also shrinks there is a need to develop new networks for activism in facilities and across employer groups. Key Direction 2: Strategy 2.1 OUTCOME ■■ Branch biennial general meetings were attended at the majority of the 32 NFP branches and only two did not re-form. ■■

Branch official positions were filled by RNs and ENs (and AiNs who were employed in that category) with a view to using their professional status to form an activist network.

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The planning process for new networks has commenced.

LASA Template Enterprise Agreement 2017

FAMILY & HOME CASHING ROSTER DOMESTIC CARE OUT OF CHANGE classifications by mutual VIOLENCE inclusion ADOs agreement within 7 day LEAVE

OVERTIME RIGHTS

Casual employees to have the same rights as permanent employees

FAMILY AND COMMUNITY SERVICES

LEGAL MATTERS

Forced transition of FACS staff to the NGO sector

Legal Representation before Statutory Bodies

Issues continue to arise with the rollout of the NDIS and the decision of the NSW Government to vacate the disability field entirely, which has resulted in FACS nurses being progressively transferred without their consent to various NGO providers. Key Direction 2: Strategy 2.7 Key Direction 1: Strategy 1.2, Strategy 1.5 Key Direction 3: Strategy 3.2 ACTION The Association has participated in a variety of forums and consultations on this transition, and have continually raised concerns with the utilisation of powers under the National Disability Insurance Scheme (NSW Enabling) Act 2013 which permits the unilateral transfer of FACS staff to NGO employment – without the necessity of obtaining the consent of the individual worker. OUTCOME ■■ The Association (with the participation of members/Branch officials) have undertaken: individual representations of members; invoked disputes where necessary; undertaken representations with FACS, the Ministry of Health, NSW IR (Treasury), and the Minister for Disability Services; and also initiated and pursued proceedings before the IRC of NSW to ventilate concerns like recognition of previous public sector service if returning to the government sector. ■■

As a result of these representations, a Determination is to be issued by the Ministry of Health to permit recognition of previous public sector (FACS) service for long service leave purposes if they obtain permanent employment in the NSW Health Service within 12 months of being forcibly transferred to the NGO sector.

Key Direction 2: Strategy 2.7

ACTION The past 12 months have seen a 26% increase in the number of member issues. Legal advice, representation and advocacy was sought and provided to members in a range of matters including complaints brought by the Health Care Complaints Commission before the NSW Civil and Administrative Tribunal (NCAT), the Nursing and Midwifery Council of NSW and the Coroner’s Court. OUTCOME ■■ Since the report to Annual Conference in 2017, there have been 1,015 issues referred to Association Legal Officers. ■■

Australian Health Practitioner Regulation Agency (AHPRA) – 154 matters/enquiries;

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Health Care Complaints Commission (HCCC)/ Nursing and Midwifery Council (NMC) – 263 matters/enquiries;

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Coronial Inquests – 195 matters/enquiries; and,

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General legal issues (civil, criminal, other) – 403 matters/enquiries AHPRA

26%

General legal issues

increase in the number of member issues in the past 12 months

HCCC/ NMC Coronial Inquests

Emerging Legal and Professional Issues Key Direction 2: Strategy 2.7

ACTION Association Legal Officers represent members where they are the subject of a notification or complaint to the HCCC or NMC. The HCCC and NMC consider notifications against nurses and midwives where they relate to their health, performance and/or conduct. Serious matters often result in the prosecution of a

REPORT TO 2018 ANNUAL CONFERENCE

nurse or midwife by the HCCC before NCAT and this can result in the suspension or cancellation of their registration. Less serious matters can result in the imposition of conditions on registration. OUTCOME ■■ While complaints about nurses and midwives are varied, a significant number of complaints made to HCCC and NMC revolve around common themes and issues. In the past year, the most prevalent types of issues include: ■■

Failure to appropriately document clinical care;

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Failure to recognise and escalate care of deteriorating patients;

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Acting outside of or failing to understand scope of practice (i.e. use of alternate therapies in nursing);

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Inappropriate use of Facebook and social media;

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Medication administration errors;

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Failure to carry out clinical observation levels at required frequency;

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Elder abuse;

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Unauthorised access to patient electronic medical records;

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Inappropriate relationships with patients and professional boundary breaches; and,

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Misuse of prescription medications, alcohol and illicit drugs.

NORTHERN NSW LOCAL HEALTH DISTRICT Tallowwood Mental Health facility – staffing dispute

OUTCOME ■■ The IRC of NSW found in favour of the Association. ■■

NNSWLHD has filed an appeal in the matter.

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The actual hearing of the main matter (relating to the staffing) is further delayed.

NSW GOVERNMENT Relocation of the IRC of NSW to Parramatta

In late January 2018 the NSW Government decided to relocate the Industrial Relations Commission of New South Wales from the central business district of Sydney to Parramatta. The decision was made without any consultation with the employees working at the Commission, the Public Service Association (PSA) or other users of the Commission including unions and employer representatives. Key Direction 2: Strategy 2.7 Key Direction 3: Strategy 3.4 ACTION The PSA notified a dispute regarding the lack of consultation and all public sector unions, including the Association, intervened. The Association has argued that the relocation would impose an additional barrier to accessing the IRC of NSW particularly for our rural and regional members who often fly to Sydney for proceedings. The NSW Government subsequently agreed to engage in consultation. OUTCOME ■■ Despite opposition, the NSW Government announced on 20 April 2018 that it had signed a lease to move the IRC of NSW to Parramatta.

“The IRC relocation to Parramatta will be a huge boost for the area that will help grow the local economy, create new jobs and reduce congestion in the Sydney CBD,” Treasurer Dominic Perrottet said in a released statement.

A long standing dispute over the attempt by NNSWLHD to reduce staffing in the acute mental health/close observation unit continues. Key Direction 2: Strategy 2.7 Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4 ACTION NNSWLHD objected on jurisdictional grounds to the orders the Association is seeking to separate the Acute and Close Observation Units for the purposes of assessing staffing under clause 53 of the Award. A hearing in the IRC of NSW occurred in February 2018.

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The above is an insult to Western Sydney if suggesting this move will have a “huge” (or any discernible) impact upon their economy.

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This decision will inconvenience members attending proceedings from intrastate, be an impediment to accessing justice, and will have resourcing issues for the Association and a great number of unions (and employers), which perhaps is the desired, unstated effect.

KEY DIRECTION 3

Promote a world class, well-funded, integrated health system Increasingly, health is becoming a defining political issue in our country and budget decisions impact on the delivery of care. The Association will be an effective advocate for delivery of quality outcomes of care in an everchanging health system and influence policy and decision-makers to invest in prevention and universality.

STRATEGIES

3.1 Consult with Association members on their vision of an integrated health system 3.2 Identify the features of a world class, wellfunded, integrated health system 3.3 Develop an education program for Association members and member leaders 3.4 Develop initiatives, affiliations and partnerships on issues that affect Association members 3.5 Advocate and influence decision makers on key issues that affect Association members and the delivery of care

REPORT TO 2018 ANNUAL CONFERENCE

STAFF RATIOS IN AGED CARE: MAKE THEM LAW NOW

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Nurses have the attention of decision makers

Our national aged care campaign launched on International Nurses Day, May 12th, and it garnered media attention and the attention of decision makers. The ANMF Queensland branch’s action of auditing aged care facilities drew the ire of Federal Minister for Aged Care, Ken Wyatt, who blamed the nurses for the poor level of care rather than understaffing issues. Key Direction 3: Strategy 3.2 ACTION Significant to the campaign, in the week leading up to the federal budget, the ANMF launched the report: Tax Avoidance by For-Profit Aged Care Companies: Profit Shifting on Public Funds, (the Report) prepared by the Tax Justice Network. The report highlights the current lack of accountability for the use of taxpayers’ funds in the for-profit aged care sector.

The chronic staffing crisis in Australia’s aged care system has led to dangerous workloads for nurses and carers resulting, too often, in missed care for vulnerable nursing home residents, yet the report finds that the big for-profit providers clearly have the financial capacity to improve staffing to ensure safer and more effective care. OUTCOME ■■ The launch of the tax report garnered international media attention both here and in Europe. ■■

On 10 May, the Federal Government’s Senate Economics Reference Committee announced an Inquiry into the financial and tax practices of Australia’s for-profit aged care providers.

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It came a week after the release of the report in Australia, Tax avoidance by for-profit aged care companies: profit shifting on public funds.

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There is growing support amongst Labor and Greens federal MPs to support staffing ratios in aged care.

The Report makes two key recommendations: ■■

Any company that receives Commonwealth funds over $10 million in any year must file complete audited annual financial statements with the Australian Securities and Investments Commission (ASIC) in full compliance with all Australian Accounting Standards and not be eligible for Reduced Disclosure Requirements.

Public and private companies must fully disclose all transactions between trusts or similar parties that are part of stapled structures or similar corporate structures where most or all income is earned from a related party and where operating income is substantially reduced by lease and/or finance payments to related parties with beneficial tax treatment.

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Senator Derryn Hinch who introduced the Aged Care Amendment (Ratio of Skilled Staff to Care Recipients) Bill 2017 to Federal Parliament last year, continues to be a vocal proponent of our campaign.

Clockwise from top: aged care campaign launched on International Nurses Day in Sydney (top left) and Tweed Heads (top right); (from left to right) NSW State Labor MPs, Trish Doyle (Blue Mountains) and Julia Finn (Granville), and Federal Labor MP for Parramatta, Julie Owens, pledged their support for our campaign.

KEEP NSW IN A HEALTHY STATE CAMPAIGN Health Unions campaign results in win to keep hospitals public

After more than 12 months of intense campaigning, late last year it was announced that all five regional hospitals would remain public; Goulburn, Bowral, Wyong, Shellharbour/Port Kembla and Maitland. In a decisive win for health unions, the last of the public hospitals slated for privatisation, Maitland, will be kept public. Key Direction 3: Strategy 3.2, Strategy 3.4, Strategy 3.5 ACTION After more than a year of intense campaigning which involved the Association, HSU, ASMOF and Unions NSW, health advocates and the local community which included actions, such as: ■■

Local rallies that drew thousands of people;

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Collecting thousands of petition signatures which resulted in parliamentary debates;

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Community forums;

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Local events like handing out information at market stalls and train stations;

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Lobbying the government and local members of the State including delegations to meet the health minister;

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Regular peak tactical stunts by all the health unions, which kept the issue relevant in the local media;

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Community forums where the local community were able to question local decision makers; and,

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An active social media presence which engaged the broader community.

OUTCOME ■■ Last year Health Unions and Unions NSW decided to commission the McKell Institute to research the key factors that impact on public health funding. The report, Investing for A Heathy Future, which was launched at State Parliament House on 2 May, follows on from our anti-privatisation campaign win. ■■

The report builds on the sentiment of members and the community at large which is: The NSW Government should invest more in public health, not less and certainly not gift public hospitals to the private sector.

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The report emphasises the economic sense of public health but also the common sense argument to invest in a healthier future for the people of NSW. The key findings suggest that in order to keep pace with national and global trends, NSW needs to commit to an annual health budget of $45 billion by 2030. For many of our members, this investment could mean the difference between life and death for their patients. It would mean our world class universal health system, supported by a robust public health system ensures adequate numbers of nurses and midwives to look after the growing health needs of the NSW population.

REPORT TO 2018 ANNUAL CONFERENCE

COMMUNITY HEALTH Community Health Campaign

With a dedicated campaign coordinator for community health and community mental health, a number of issues were identified for closer exploration: workloads; the threat of privatisation of services; the threat of the removal of the Commonwealth Home Support Program (CHSP) funding (formerly HACC), and increasing public awareness of community health and community mental health.

OUTCOME ■■ The results of the survey are being compiled, along with academic research, into a professional issues paper which will be completed in the second half of this year. ■■

In the meantime, stories are being gathered from community health nurses and community health services consumers about their experiences and why community health and community mental health services should remain a public service.

Key Direction 3: Strategy 3.1, Strategy 3.2

ILLAWARRA SHOALHAVEN LOCAL HEALTH DISTRICT

ACTION The first stage of this campaign was to conduct a survey to gauge how members feel working in community health and community mental health. With over 420 responses, three main concerns were identified:

Wollongong Maternity Services Campaign

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Workloads and staffing – insufficient staff and not backfilled when on leave;

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Poor communication and consultation from management; and,

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Over 90% of respondents agreed that privatisation of their service would not improve it.

SURVEY RESULTS 3 main concerns were identified from over 420 responses:

WORKLOADS & STAFFING insufficient staff and not backfilled when on leave

POOR COMMUNICATION & CONSULTATION from management

PRIVATISATION

Over 90% agreed that privatisation of their service would not improve it.

Members at Wollongong Maternity Services raised issues with the branch regarding staff shortages of approximately 19 FTE. This vacancy issue has been known for over two years by hospital management, with little effort made by the hospital executive and the LHD to actively recruit to these vacancies. As of 15 May 2018, the service has vacancies of at least 13 FTE, not including long service and maternity leave vacancies. Key Direction 3: Strategy 3.4, Strategy 3.5

ACTION In September 2017, a delegation of members met with the Health Minister, Brad Hazzard, who indicated to members that it was likely a budget issue that was leading to these positions not being recruited to, but he would require more information. The branch subsequently endorsed a campaign strategy to focus on politicians in the area and specific Ministers while also aiming to form affiliations and partnerships with community consumer groups. The campaign launch, held on 24 October 2017, was attended by approximately 70 midwives and community members along with consumer group Better Births. It received favourable media coverage at a local level and had the support of the State ALP MP for Wollongong. OUTCOME ■■ Since the media attention and pressure from members, the Wollongong Hospital commenced advertising interstate and outside of eRecruit. Management has also stated that they have accelerated the recruitment process.

Association endorses. It is essential that such a framework is consistently applied and any approach adopted is proportionate to the issue(s) involved. OUTCOME The Association with other public health unions initially met with the Ministry.

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Wollongong Maternity Services campaign launch

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Support has been gained from local MPs.

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After-hours support staff, such as cleaners, have been implemented.

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The members and the Association have not received any further information from the Health Minister or the ISLHD on the maternity services and staffing issue.

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The branch members are still meeting with MPs and recognise that this is a state-wide problem.

MINISTRY OF HEALTH Managing Complaints and Concerns about Clinicians Policy Directive

The Ministry of Health approached public health unions to consult on a proposed new Managing Complaints and Concerns about Clinicians Policy Directive, along with some ancillary changes to related policies and information sheets. The approach being adopted by the Ministry will result in any new policy directive superseding both the current policy (PD2006_007) and the associated Guidelines (GL2006_002). Key Direction 3: Strategy 3.4, Strategy 3.5 ACTION The reasoning for these changes, apart from developing a more robust and consistent approach across NSW Health organisations, is that such processes should be reserved for the more serious issues requiring a formal approach, as opposed to those that should be dealt with at a local level between a staff member and their supervisor/ manager. This is a general approach that the

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The Association subsequently provided to the Ministry some initial thoughts and feedback on the drafts provided and approach to be adopted.

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These were complemented by detailed written feedback and representations from the Association.

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A further two meetings have been held with the Ministry on the proposed changes.

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A revamped policy directive is anticipated shortly.

Occupational screening and vaccination Policy Directive (amended)

The Ministry of Health approached public health unions with an amended draft policy directive ‘Occupational Assessment Screening and Vaccination Against Specified Infectious Diseases’. Key Direction 3: Strategy 3.4, Strategy 3.5 ACTION The key changes originally proposed included a recategorisation of positions to include a Category A High Risk position for workers employed in high risk clinical areas which would require mandatory annual influenza vaccination. It also included termination of employment (where reassignment to a non-high risk clinical area is not feasible). The Association with other public health unions met with the Ministry. The Association provided immediate feedback and subsequently further detailed comment on a revised draft. The Association was successful in having the draft amended to squarely deal with an identified ambiguity in the original so that it is now clearly understood that NSW Health staff who have a medical contraindication to vaccination, etc will be risk managed, and will not be subject of any action to terminate their employment. A handful of other aspects were also subject to feedback by the Association. OUTCOME ■■ The revamped policy directive (PD2018_009) was subsequently released on 5 March 2018.

REPORT TO 2018 ANNUAL CONFERENCE

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Since then the Association has also ensured, arising from a dispute in the Justice Health and Forensic Mental Health Network, that those staff aged 65 years and over received the same treatment under the policy directive as all other workers (i.e. vaccination in work time and for free).

NORTHERN SYDNEY LOCAL HEALTH DISTRICT – MINISTRY OF HEALTH Northern Beaches Hospital transition process

The NSW Government has contracted Healthscope to build and operate a new Northern Beaches Hospital located at Frenchs Forest. This new hospital would be in lieu of public health services currently provided at Manly and Mona Vale Hospitals, with Manly Hospital closing entirely, and residual services remaining at Mona Vale Hospital. Key Direction 3: Strategy 3.4, Strategy 3.5 Key Direction 1: Strategy 1.2, Strategy 1.5 Key Direction 2: Strategy 2.7 ACTION The Association and its members have participated in a variety of forums and consultative mechanisms on this transition. Members have continually raised concerns with the information available and the delay in commencing any transition process till earlier this year. These processes should have commenced as requested in the later part of 2017. The Association has provided constant feedback, suggestions and representations regarding the process and timing of the EOI process and the need for greater certainty as early as possible.

Dissatisfaction remains in three broad areas, being: (i) transition arrangements and protections if returning to the public health system; (ii) greater clarity and transparency regarding staff numbers and profiles at the new hospital; and, (iii) re-deployment options if remaining in the public health system. OUTCOME ■■ The Association has undertaken: individual representations of members (especially during the EOI process); invoked disputes where necessary; and, undertaken representations with the NSLHD, Ministry of Health, Minister for Health, and Premier of NSW. ■■

Members at both Manly and Mona Vale Hospitals have participated in various community campaigning activities.

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A threat of strike action by members in May of this year provided some movement with decision makers.

NSW AGED CARE ROUNDTABLE 10 Questions to Ask

Key Direction 3: Strategy 3.1, Strategy 3.2, Strategy 3.3, Strategy 3.4, Strategy 3.5 ACTION The Association has continued to work with 16 external organisations as part of the NSW Aged Care Roundtable. 2017 saw a consolidation of the work undertaken to develop a series of consumer facing leaflets aimed at people seeking residential aged care entitled “10 Questions to Ask”. Each leaflet used expertise from an organisation either

represented within the Roundtable, or a supporter of the work of the Roundtable. The series will be completed during 2018 with a final leaflet focusing on allied health services. The leaflets contain an underlying safe staffing message in support of the National Aged Care Campaign. In addition, the Roundtable continues to collectively campaign for safe staffing in aged care. They are particularly aligned to the need to retain registered nurses, and a director of nursing in those aged care facilities funded to provide high complex healthcare. OUTCOME ■■ 12 leaflets have been developed covering staffing, mental health, dementia, palliative care, Aboriginal and Torres Strait Islander needs, culturally and linguistically diverse needs, LGBTI needs, GP services, contracts and fees, lifestyle, rural and remote and oral and dental care. ■■

A 10 Questions website has been launched www.10questions.org.au.

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Leaflets are being translated into popular community languages. A Turkish version is complete, and a Hindi version nearing completion.

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Leaflets have been promoted in all NSW Libraries, on the ABC television program ‘The Checkout’, on consumer specific Department of Health webpages and by individual organisations.

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A Queensland Aged Care Roundtable has been established by the QNMU.

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The leaflets have been promoted at community forums, national conferences and by NSW Aged Care roundtable members and supporting organisations.

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Co-signed letters from various Roundtable members have been sent to the federal Minister for Aged Care, Ken Wyatt, on the issue of skills mix in aged care.

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The Roundtable has engaged with the Chair of the Aged Care Workforce Taskforce and produced a set of principles for safe staffing which were forwarded to the Taskforce committee.

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The 10 Questions series was promoted via ePoster presentation at the International Dementia Conference held in Sydney on 7 and 8 June 2018.

NSW PARLIAMENT Government Sector Employment Amendment (Transfers to NonGovernment Sector) Regulation 2016

Disallowance motion to be debated in the NSW Parliament. Key Direction 3: Strategy 3.4 ACTION In 2016, the then Baird NSW Government (without any prior warning or consideration to consult) had the Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation 2016 (‘Regulation’) gazetted. The Regulation further eroded the rights of government sector workers whose role may be subject to privatisation. Unions NSW and affiliates have agitated with cross bench members of the NSW Legislative Council to support a disallowance motion on the Regulation (i.e. have it set aside) tabled by the ALP Opposition in June 2016. OUTCOME ■■ Following numerous adjournments, this motion remains to be debated. ■■

Whilst members subject to possible transition to the new Northern Beaches Hospital have been exempt from the reach of the Regulation, it remains on the books. In the future if a staff member does not apply for or accept employment with a private Hospital Operator and cannot subsequently be redeployed within NSW Health, they will not be entitled to a redundancy or severance payment from NSW Health.

REPORT TO 2018 ANNUAL CONFERENCE

NSWNMA EDUCATION Education Program 2017-2018

seminars

Key Direction 3: Strategy 3.3

ACTION The Association’s Education Calendar has been expanded in 2018 and following a review of the 2018 calendar from January to July, there have been 55 seminars conducted with all regional and rural Local Health Districts and metropolitan areas covered. OUTCOME ■■ There were 26 seminars held in the period July to December 2017. This has been an increase of 50% of courses being offered with the following new courses for 2018: ■■

Dementia management training;

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How to be an effective preceptor/mentor;

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Professional documentation;

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Wound Care series;

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Professional obligations and the Decision Making Framework;

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Cultural competence in healthcare;

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Bullying: Let’s put an end to it;

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Self-care forum;

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In charge team leader skills; and,

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Skill set for new managers and senior nurses and midwives.

seminars

July – December 2017

January – July 2018

and nurses with experience and expertise were engaged to ensure that contemporary nursing issues and best practice were presented. ■■

Facilities continue to request education on site, mainly to address professional issues. Subjects such as: medication safety, medication documentation, professional obligations and the Decision Making Framework, legal and ethical issues and workplace culture are topics that have been provided.

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A trial of an online evaluation was piloted early in the year with some success but will be revisited when the Association’s new membership system is fully implemented.

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Marketing and promotion of education continues to be a challenge and new ideas are being explored.

NSWNMA PROFESSIONAL MATTERS

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The Enrolled Nurses Forum, Medicinal Cannabis and Aged Care Nurses’ Forum were all held in regional areas.

Professional Issues Committee and Reference Groups

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Collaboration with key organisations, such as, Partners in Culturally Appropriate Care (PICAC) and Arthritis NSW & ACT has provided additional education for members. Some external educators

ACTION The Professional Issues Committee (PIC) consists of Association Professional Officers, members and Councillors from all areas of the health sector and

Top: Medicinal Cannabis Forum at Coffs Harbour. Right: paticipants at the Enrolled Nurses Forum earlier this year.

meets bi-monthly through the year with a number of issues discussed by the group and the policy review schedule completed. OUTCOME ■■ The PIC provides invaluable advice to Association Professional Officers on a wide range of professional issues. The committee also annually reviews the Association’s policies, position statements and guidelines that are due for discussion and endorsement at the Annual Conference. ■■

The PIC has also provided comment on the ANMF policies due for review in the period. The number of policies requiring review continues to increase.

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PIC allows numerous professional issues to be discussed including national registration, aged care, midwifery, mental health, environmental health and a variety of educational topics.

AGED CARE REFERENCE GROUP ACTION The Aged Care Reference Group continues to meet bi-monthly. This group is gaining momentum and membership. Members of the group have a range of diverse backgrounds and represent registered nurses, enrolled nurses and assistants in nursing. Membership includes educators, managers and workers employed in the public, private and not for profit aged care sector. The reference group provides a source of expertise to inform the Association of contemporary matters affecting members. In particular, the Association benefits from the insights of the rural and remote members who attend. OUTCOME ■■ Members of the reference group have supported the National Aged Care Campaign and some have lobbied local MPs. ■■

Members have been used to provide expertise in responding to several aged care Inquires that have been undertaken during 2017-2018.

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Members’ expertise is also used to inform the development of aged care specific professional issues papers.

Environmental Health Forum earlier this year.

CLIMATE CHANGE REFERENCE GROUP ACTION The Climate Change Action Reference Group (CCARG) met regularly throughout the 20172018 year. Active members of this group are a complementary mix of environmental activists who attend Rallies, and members who are interested in political lobbying to support the Climate and Health Alliance (CAHA) in promoting the Framework for the National Strategy for Climate, Health & Wellbeing of People in Australia. Others are involved with colleagues in the new Inter-disciplinary Planetary Health Forums, in attempts to further develop environmental sustainability within NSW Health. OUTCOME ■■ Two environmental health seminars were held on 15 September 2017 at the Prince of Wales Private Hospital and on 6 April 2018 at the Association. ■■

The Global Green & Healthy Hospitals (GGHH) Network is slowly advancing within NSW, with the Association becoming a member of the NSW Health Sustainability Network. This is a new group which is endeavouring to promote environmental sustainability within NSW Health and link up other groups like Health Share. There is also a focus being placed on Local Health Districts to provide environmental sustainability outcomes.

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The Association was informed by the GGHH Network that it had received a Silver Climate Leadership Award as it had participated in the 2020 Health Care Climate Challenge has been congratulated and showcased as a global leader in the movement towards climate-smart health care.

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The Association provides on-going support to CAHA’s Campaign which has continued from 2016 – 2018, in order to promote The Framework for the National Strategy for Climate, Health & Well-being of People in Australia.

REPORT TO 2018 ANNUAL CONFERENCE

DRUG AND ALCOHOL REFERENCE GROUP ACTION The Drug and Alcohol Reference Group met bimonthly throughout the 2017-2018 year.

Health workers who were all arrested on the Adani blockade with supporters outside the Clermont police station.

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On two occasions the CCARG have had appointments, with NSW MPs, Dr Mehreen Faruqi (Legislative Council) The Greens, in November 2017; and, with the Hon Penny Sharpe (Legislative Council) ALP, Shadow Minister for the Office of Environmental Heritage and Tourism on 23 May 2018. These visits were very successful and the Framework was endorsed by these politicians. The Association has received a grant from the Climate Action Network Australia (CANA) for $9,000 which will enable a Professional Officer to undertake the research. The research is about: ‘Supporting the Upper Hunter Valley Community in the Energy Transition to the Closure of Liddell Coal-fired Power Station in 2022’. The project commenced in March this year and is mostly running to time and will finish by the end of July 2018.

COMMUNITY NURSING AND MIDWIFERY REFERENCE GROUP ACTION The Community Nursing and Midwifery Reference Group (CNMRG) meets bi-monthly. OUTCOME ■■ The CNMRG has provided a forum for members to discuss and debate professional issues relevant to community nursing and midwifery. ■■

This is a newly formed group and the main concerns and issues raised is around the funding for community services and the push for services to be moved to NGOs.

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This group is also an ongoing platform for our members to provide information and support to the current Association campaigns.

OUTCOME ■■ Input from the reference group was sought on the Legislative Assembly Health and Community Services’ ‘Inquiry into the provision of drug rehabilitation services in regional, rural and remote NSW’; the Association’s ‘Draft Harm Reduction Position Statement’; and, The Horton report for ‘Review of licence conditions for 14 Newcastle CBD venues’.

EDUCATION REFERENCE GROUP ACTION The Education Reference Group has held regular meetings throughout 2017-2018. OUTCOME ■■ The reference group provided a forum for members to discuss and debate professional issues relevant to education in nursing and midwifery. ■■

Survey development for a Professional Issues paper is being finalised by the group.

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There has been much discussion on nurse and midwifery educators to be recognised as a specialty/discipline of their own. These discussions will continue and recommendations made once final agreement is reached.

MENTAL HEALTH REFERENCE GROUP ACTION The Mental Health Reference Group met bimonthly throughout 2017-2018. OUTCOME ■■ Correspondence was sent to The Hon Tanya Davies MP, NSW Minister for Mental Health, regarding the ‘Seclusion Restraint and Observation in NSW Mental Health Facilities Inquiry Recommendations’. This resulted in the Association being invited to discuss issues with the Chief of Staff to Minister Davies and then being invited to provide feedback to the NSW Ministry of Health on the Implementation Plan. ■■

Discussions were held on the NSW Ministry of Health recently distributed Policy Directive ‘Engagement and Observation in Mental Health

Inpatient Units’ Policy Directive PD2017_025. There is a responsibility for staff to “engage with people during purposeful observation”, but this requires more time and has created significant workload issues for staff. ■■

The Hon Pru Goward MP, when acting NSW Minister for Health, wrote to the Association and reinforced that AiNs should not be employed in MICUs.

■■

Feedback on the Ministry of Health’s Draft Family Focused Recovery Framework 20192022 was provided by members.

MIDWIFERY REFERENCE GROUP ACTION The Midwifery Reference Group met in 2017-2018.

NSWNMA RECONCILIATION ACTION PLAN Key Direction 3: Strategy 3.4 ACTION The Association has liaised closely with Reconciliation Australia to develop the Association’s Reconciliation Action Plan (RAP). Our RAP details the framework of initiatives that our organisation has committed to implement in support of the national reconciliation movement. OUTCOME ■■ The Association has committed to developing a RAP as we recognise our responsibilities as leaders in both the union movement and the health sector to consciously build better relationships with Aboriginal and Torres Strait Islander peoples:

OUTCOME ■■ Input from the reference group assisted in providing valuable feedback to the Association on models of care, education, the midwifery forum and provided a forum to discuss professional issues relevant to midwifery.

Professional Issues Papers Key Direction 3: Strategy 3.3

ACTION A series of professional issues papers and occasional reports are being written following member engagement. These provide an alternative medium from which to highlight, or seek further understanding of contemporary issues that affect members. These documents are aimed at policy makers, external organisations and also to be used as a resource for members of the Association. OUTCOME ■■ As a top area of concern for aged care members, a paper was written examining the management of medications in NSW residential aged care facilities. This paper was used as a supporting document in several aged care Inquires. ■■

An occasional report of the value of mindfulness practice was produced to coincide with the new requirement to undertake selfcare in s71b of the NMBA Codes of Conduct for Nurses and Midwives.

■■

to improve our understanding and response to the health needs of Aboriginal and Torres Strait Islander members of the community and to promote health equality;

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to better represent our Aboriginal and Torres Strait Islander members; and,

■■

to further the cause of social justice for all Aboriginal and Torres Strait Islander peoples by identifying and providing opportunities to build capacity and realise potential.

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The Association has had our Reflect RAP endorsed by Reconciliation Australia and this is available for members to view on the Association website.

■■

The plan will result in greater focus on matters related to Reconciliation.

NSWNMA SCHOLARSHIPS Key Direction 3: Strategy 3.4

Bob Fenwick Mentoring Grants Program ACTION The Bob Fenwick Mentoring Grants Program Round 6 was successfully completed with the Ceremony held at the Rydges Sydney Central Hotel on 19 October 2017. OUTCOME ■■ In attendance were Mrs Jan Fenwick and Ms Kate Fenwick with Warren Shaw, Acting Principal Policy Officer of Clinical Services

REPORT TO 2018 ANNUAL CONFERENCE

OUTCOME ■■ Seven scholarships were awarded to members working in and committed to aged care.

Participants at Bob Fenwick Mentoring Grants Program

■■

Scholarships were awarded to assist these nurses to attend a range of courses, both short courses and others leading to formal qualifications specific to aged care.

■■

Further OPWC Aged Care Scholarships will be announced later in 2018.

SUBMISSIONS AND INQUIRIES Business Unit, NSW Ministry of Health providing the opening address. ■■

The 2018 Round 7 Program is well under way with a full complement of mentees.

Edith Cavell Trust ACTION The Edith Cavell Trust Scholarship provides scholarship funding for studies being undertaken in the following academic year and is open for application between 1 May and 31 July annually. OUTCOME ■■ 145 applications were received in 2017 for studies being undertaken in the 2018 academic year; 26 applications received favourable consideration.

Key Direction 3: Strategy 3.5

Affordable Housing ACTION The Association has made several submissions that relate to Affordable Housing in 2017-2018. Including the City of Parramatta’s Draft Affordable Housing Policy and the Amendment to State Environmental Planning Policy No. 70 Affordable Housing (Revised Schemes). OUTCOME ■■ In each of the submissions the Association strongly supported the increased supply of affordable rental housing and the inclusion of moderate income earners in eligibility criteria for affordable housing.

Lions Nurses’ Foundation ACTION The Lions Nurses’ Foundation Scholarship also provides scholarship funding for studies being undertaken in the following academic year and is open for application between 1 August and 31 October annually. OUTCOME ■■ 124 applications were received in 2017 for studies being undertaken in the 2018 academic year; 14 applications received favourable consideration.

Older Peoples Welfare Council ACTION The Older Peoples Welfare Council provided further funding in 2018 to continue the Older Persons Welfare Scholarship. This provides funding for members working in aged care to attend training specific to their role.

Nurses attended the ‘Everybody’s Home’ campaign launch at Canberra’s National Press Club to show support for affordable housing.

Aged Care submissions and Inquiries ACTION Several aged care specific federal Inquires have either continued, or commenced during the period 2017-2018. Many were prompted by the events at the Oakden facility in South Australia. Others as part of the Living Longer, Living Better aged care reforms.

OUTCOME ■■ The Association has made submissions, or responded to the following consultations: ■■

■■

Inquiry into the effectiveness of the Aged Care Quality Assessment and accreditation framework for protecting residents from abuse and poor practices, and ensuring proper clinical and medical care standards are maintained and practised (plus supplementary Submission);

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Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia;

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Aged Care Workforce Taskforce Consultation; and,

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Draft Aged Care Standards.

The Association gave evidence at the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia in Canberra on 11 May 2018.

Inquiry into the Management of Health Care Delivery in NSW ACTION Evidence to the Legislative Assembly Inquiry into the Management of Health Care Delivery in NSW was provided. OUTCOME ■■ A submission to the Inquiry was made in July 2017, with an invitation following to provide further evidence at the Legislative Assembly public hearing on 30 October 2017. The Association’s survey report, conducted by the Association with mental health members that focused on seclusion and restraint in NSW mental health facilities, was tabled.

Inquiry into Parklea Correctional Centre and other operational issues ACTION A submission was made into the privatisation of Parklea Prison. OUTCOME ■■ The submission to the inquiry raised concerns regarding risks of how staffing impacts on safety, workplace design of rapid build, private prisons in NSW and associated benchmarking.

Ministry of Health – Mental Health ACTION Feedback to the Ministry of Health regarding the NSW Strategic Framework for Mental Health 2018-2022 and the NSW Health Mental Health Workforce Plan 2018-2022 was provided. Feedback was also provided for the Draft Family Focused Recovery Framework 2019-2022. OUTCOME ■■ In relation to the Strategic Framework and Workforce Plan, the Association’s main emphasis was on the provision of appropriate staffing levels and skill mix. ■■

With regard to the Draft Family Recovery Framework, one recommendation was the adoption of ‘Nurse to Patient Ratios’ to help build a sustainable “skilled, capable, informed and well-resourced workforce” as outlined in the framework. A ‘Peer Worker Position Description and Implementation Package’ needs to be developed by NSW Health similar to the ‘Assistants in Nursing working in the acute care environment health service implementation package’ to ensure a clear understanding of the peer worker role expectations and its limitations.

Provision of Drug Rehabilitation Services in Regional, Rural and Remote NSW ACTION A submission to the NSW Legislative Council Inquiry into the Provision of Drug Rehabilitation Services in Regional, Rural and Remote NSW was made. OUTCOME ■■ The recommendations made were: ■■

The need for more drug and alcohol treatment beds across NSW was highlighted.

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NGOs operating in this sector should be under close scrutiny from the NSW Ministry of Health.

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The Association is of the opinion that any review of service provision must include a workforce strategy.

REPORT TO 2018 ANNUAL CONFERENCE

Review of Seclusion, Restraint and Observation of Patients with Mental Illness in NSW Health Facilities

■■

Comment was provided towards improvements in the Act, Regulation and Codes of Practice.

ACTION The Association provided a submission for the Review of Seclusion, Restraint and Observation of Patients with Mental Illness in NSW Health Facilities.

WORK HEALTH AND SAFETY

OUTCOME ■■ The Association is supportive of the review into the practice of seclusion, restraint and observations and believes that seclusion episodes can be reduced if the right resources are put into place, but hold’s the opinion that seclusion must remain as a last resort for the safe management of a small number of clients.

ACTION Association officers have been actively working with external stakeholders to support the needs of nurses and midwives.

■■

The submission was also provided to the NSW Legislative Assembly, ‘Inquiry into the Management of Health Care Delivery in NSW’ (July 2017).

Key Direction 3: Strategy 3.4

External Stakeholders

OUTCOME ■■ The Association has been represented and contributed to SafeWork NSW Work Health and Safety (WHS) Roadmap and the associated Musculoskeletal and Hazardous Chemical strategies. ■■

Representation and consultation with NSW Health in policy development and collaboration with NSW Health WHS and Manual Handling forums.

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Development of Australian Standards for Vendor Credentialing, Security and Waste Management in Healthcare.

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Collaboration with ACTU and Unions NSW in WHS issues.

Voluntary Assisted Dying Bill ACTION A submission was made to the NSW Parliamentary Working Group on Assisted Dying on the Voluntary Assisted Dying Bill 2017 (NSW). OUTCOME ■■ The Association supported the draft Bill on the basis of the position statement on Assisted Dying endorsed at the 2017 Annual Conference. ■■

Suggestions were made as to how the Bill could provide more specific protections for nurses involved with requests for assistance in dying.

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Prior to the introduction of the Bill in the Legislative Council, the Association wrote to all NSW members of parliament to explain why the Association supported the Bill.

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Unfortunately the Bill did not pass the Legislative Council, with 19 votes for and 20 votes against.

Work Health and Safety model laws ACTION A submission was made to the review of the model WHS laws. OUTCOME ■■ The review examined how the model WHS laws are operating in practice, whether they are achieving the objects stated in the model Work Health and Safety Act 2011 (‘the Act’) and if they have resulted in unintended consequences.

Representation of members ACTION Members have been represented and supported directly on WHS issues through follow up of issues and indirectly with collaborative interventions utilising the power of Union support through the ACTU, Unions NSW and the ANMF. OUTCOME ■■ Workplace violence continues to be a priority issue of concern for nurses and midwives. Areas of concern are predominantly from mental health, community and Forensic Services. Serious incidents have occurred across NSW where Association support has been provided. ■■

Workplace design and consultation is another key area of concern for members, as has exposure to infectious and hazardous substances. Advice and recommendations have been made to redevelopment teams, management and members to assist in these identified areas of risk.

■■

Manual handling issues are another area of concern, predominantly around the management of patients with bariatric needs.

KEY DIRECTION 4

Promote the Association as a significant and professional advocate for the health system and our members The Association must be a viable organisation in the public arena and vocal advocates of health and industrial relations. Our reputation must be protected and our Values actively promoted as a way of enhancing the professional advancement and standing of our members in their workplaces. We will continue to strive to be an organisation relevant to all nurses and midwives, build relationships with key stakeholders and be an influential voice in the communities where our members work and live, as well as nationally and internationally.

STRATEGIES

4.1 Build and develop partnerships with key community, academic and political organisations to promote issues that define our Vision and Key Directions 4.2 Develop risk management strategies to uphold the Associationâ&#x20AC;&#x2122;s reputation 4.3 Advance and promote nursing and midwifery as professions creatively and through multiple platforms 4.4 Ensure our Vision and Values are reflected in all our communications and actions

REPORT TO 2018 ANNUAL CONFERENCE

NSW Nurses and Midwives’ Association

PROFESSIONAL ISSUES | 1

Who will keep me safe? Elder Abuse in Residential Aged Care

CONFERENCES AND TRADE EXHIBITIONS

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Key Direction 4: Strategy 4.1

An ePoster presentation was made focusing on the 10 Questions leaflets as an opportunity to further promote the dementia leaflet given the theme of consumer empowerment.

Conferences, Seminars and Forums ACTION During the year Association Professional officers have either attended and/or presented at a range of conferences, seminars and forums.

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AUSTRALIAN ASSOCIATION OF GERONTOLOGY CONFERENCE, Perth – 8 to 10 November 2017

The conference was used as an opportunity to promote the work of the NSW Aged Care Roundtable. The Association gave a presentation on the 10 Questions leaflet with a representative from the NSW Faculty of the Royal Australian College of General Practitioners. A poster presentation was also provided. Leaflets sparked particular interest from members and workers from within the Aboriginal and Torres Strait Islander communities. ■■

AUSTRALIAN COLLEGE OF MIDWIVES 2017 NATIONAL CONFERENCE, Adelaide – 30 October to 2 November 2017

The conference provided an opportunity to hear about current midwifery research projects and to hear about professional issues facing midwives across Australia.

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CALDWAYS CONFERENCE, Parramatta – 29 & 30 May 2018

The CALDWays conference provided an opportunity to further engage on issues affecting members from culturally and linguistically diverse backgrounds. Professor John Pollaers also gave an update in relation to the future direction of the aged care workforce taskforce.

INTERNATIONAL ELDER ABUSE CONFERENCE, Sydney – 19 & 20 February 2018

A presentation was given on the professional issues papers “Who will Keep me Safe?” and “The State of Medications in NSW Residential Aged Care Facilities”. This was an opportunity to highlight the daily dilemmas faced by aged care workers across the state.

OUTCOME ■■

INTERNATIONAL DEMENTIA CONFERENCE, Sydney – 7 & 8 June 2018

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17TH ANNUAL NATIONAL NURSE EDUCATION CONFERENCE, Melbourne – 1 to 5 May 2018

The important message throughout the conference was the need to provide student nurses and midwives with the resources to problem solve and critically think. Current methods of assessment and processes were challenged as not meeting the desired outcomes for our nurses and midwives as they are still struggling to transition.

Promotion through trade exhibitions ACTION Association Professional officers attend numerous conferences throughout the year in a trade capacity and provide an effective means of having the Association being out in the public arena and showing our support for the various organisations who hold these conferences. This also provides excellent networking opportunities as well as learning and education for the Professional Officers attending which they bring back with to the workplace.

OUTCOME ■■ Trade displays that were attended 2017-2018 were: ■■

Drug and Alcohol Nurses Annual Conference in Sydney, 11 August 2017.

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Australian College of Midwives Annual Conference in Tamworth, 18 and 19 August 2017.

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HNELHD Nursing and Midwifery Conference in Newcastle, 14 and 15 September 2017.

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Enrolled Nurse Professional Association Annual Conference in Sydney, 21 and 22 September 2017.

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Diabetes NSW and ACT update day in Rosehill, 7 October 2017.

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Professional Association of Nurses in Developmental Disability (PANDDA) annual conference in Parramatta, 10 and 11 October 2017. A satchel insert of the “10 Questions for Aboriginal and Torres Strait Islanders to ask when seeking residential aged care” leaflet was provided to the CATSINaM Annual Conference on the Gold Coast, 10 to 12 October 2017.

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NUMs Society Annual Conference in Brighton le Sands, 20 October 2017.

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Australian College of Mental Health Nurses Greater Western Sydney Branch Annual Conference in Parramatta, 6 April 2018.

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Babies in the Vines Seminar hosted by John Hunter Children’s Hospital in the Hunter Valley, 6 April 2018. A satchel insert of the “10 Questions to ask about Rural and Remote Residential Aged Care” leaflet was provided to the Rural and Remote Scientific Symposium in Canberra, 11 and 12 April 2018.

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University of Wollongong Annual Nursing Careers Expo on 17 May 2018.

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UTS Annual Nursing and Midwifery Fair on 24 May 2018.

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University of Newcastle Open Days, Newcastle and Ourimbah campuses, 6 and 8 June 2018.

KEY PARTNERSHIPS Key Direction 4: Strategy 4.1

City West Housing ACTION The Association facilitated information sessions with City West Housing at St Vincent’s Hospital, Royal Prince Alfred Hospital and Sydney/Sydney Eye Hospital in December 2017. OUTCOME ■■ City West Housing is an affordable housing provider for people currently living or working in the City of Sydney Local Government Area. ■■

The information sessions provided an opportunity for members to hear about affordable housing opportunities in the City of Sydney Local Government Area. 38 members attended the sessions.

■■

Interested members, who met eligibility criteria, were able to express an interest and be placed on the waiting list for affordable housing.

Department of Health Agency Liaison ACTION Association officers attend quarterly Department of Health Agency Liaison meetings, NSW Ageing Alliance meetings and Australian Aged Care Quality Agency Liaison meetings. OUTCOME ■■ Quarterly meetings are used to engage external organisations in issues that are important to Association members and be updated on government policy affecting aged care members.

NSW Council of Social Services ACTION In February 2018, the Association became a member of NSW Council of Social Services (NCOSS). OUTCOME ■■ Currently, NCOSS is considering regional NSW consultations in regard to choosing a specific project for the electoral platform. At present it appears the topic chosen through regional consultations by some members of the group, including the Association, will be: ‘Investment in community mental health services, including more peer workers and support for youth.’

REPORT TO 2018 ANNUAL CONFERENCE

” I BELIEVE

THE LACK OF STAFF AMOUNTS TO ABUSE. THE CARE SIMPLY CANNOT BE DELIVERED.

”

Margaret, Widow

Authorised by B.Holmes, General Secretary, NSW Nurses and Midwives’ Association, 50 O’Dea Avenue Waterloo NSW 2017

Quality Aged Care Action Group ACTION The Association has continued to provide secretariat support to the Quality Aged Care Action Group Incorporated (QACAG). Membership was affected by restructuring of the annual fees during 2017. This prompted a review of the strategic direction of the group which has resulted in further promotion of QACAG and growing membership. Membership now stands at 62, including two new organisational memberships. QACAG has remained active in responding to consultations and recognition of the group as a key source of consumer advocacy is widening. QACAG has aligned with the National Aged Care Campaign. QACAG meetings have continued throughout 201718 at bi-monthly intervals. OUTCOME ■■ QACAG made submissions to: ■■

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Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia;

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Aged Care Workforce Taskforce Consultation;

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Severe Dementia Care Units; and,

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Draft Aged Care Standards.

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QACAG gave evidence at the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia in Sydney on 5 March 2018.

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The QACAG President has become the consumer face of the National Aged Care Campaign featuring on the television campaign advertisement.

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A Newsletter has been sent to all members to maintain engagement for those unable to attend meetings and to maintain contact between meetings. This received an excellent response from members. Newsletters will be distributed quarterly from now on.

KEY DIRECTION 5

Ensure our people and resources are aligned with our Vision The Association is committed to valuing and developing our staff and managing our resources to enable it to achieve its Vision and Key Directions. Resources are managed in the best interests of Association members who have placed their trust in good governance of their union.

STRATEGIES

5.1 Further build a workplace culture embedded in the Values of the union 5.2 Organisational governance systems are continually developed and evaluated 5.3 Define roles and relationships within and between Association teams in line with the Vision and Key Directions 5.4 Implement a workforce development plan that focuses on the education and training required to deliver the Vision 5.5 Develop a systematic review of planning and resources against the Vision and Key Directions across all teams within the Association

REPORT TO 2018 ANNUAL CONFERENCE

CORE VALUES

NSWNMA EMPLOYEE SCHOLARSHIP

Key Direction 5: Strategy 5.1 The Core Values of the NSWNMA are Integrity, Courage, Innovation and Advocacy. The NSWNMA recognises that a healthy workplace culture promotes and models these shared values.

The NSWNMA is committed to excellence in the professional development of its employees. The annual Employee Scholarship provides an opportunity for employees to further their academic studies and in turn support union principles and our Strategic Plan.

Recruitment processes

Key Direction 5: Strategy 5.4

ACTION Incorporate our Core Values into the NSWNMA external recruitment processes.

ACTION In addition to optional and mandatory training courses that are provided, the NSWNMA also invites all employees to apply for an annual Scholarship Award, which has the aim of encouraging their professional development in the areas of: union organising and recruitment; Industrial Relations; recognised nursing qualifications; general and specialised administrative roles; management skills and; attendance at a recognised conference or seminar.

OUTCOME ■■ Interview questions for positions advertised externally now ask the candidate to provide an example of how they have demonstrated one of our Core Values in a previous position.

Values Workshops ACTION Values workshops have been developed and will be implemented for all staff. During these workshops staff will reflect on our four Core Values as they relate to our day-to-day work as an individual staff member, a team and an organisation. OUTCOME ■■ Workshop outline has been developed and workshops will be scheduled for late 2018.

Working for Unions ACTION To ensure that all staff understand the importance and history of unionism, Working for Unions training has been developed for NSWNMA staff. Whilst the intended audience will be those staff who have not come from a union background, it will be available to all staff. This training will also form part of a new employee’s on-boarding process. OUTCOME ■■ Training outline has been developed and initial training session to be scheduled.

OUTCOME ■■ The Scholarship Committee (made up of Council and external representatives) awarded four scholarships to NSWNMA employees for the calendar year 2018 to assist with tertiary studies relevant to their positions at the NSWNMA.

MENTAL HEALTH ACTION PLAN The NSWNMA and ANMF NSW Branch Mental Health Action Plan 2018 – 2020 outlines the strategies and actions that will be undertaken over the next two years to reduce the stigma associated with mental illness by increasing awareness, encouraging health and well-being in the workplace through identified programs, and reducing risk to mental health in the workplace. Key Direction 5: Strategy 5.4 ACTION The Mental Health Action Plan Committee was convened in November 2017 following an Expression of Interest process that was open to all staff. The Committee had responsibility for identifying and developing mental health actions that would form the basis of the plan.

OUTCOME ■■ On 26 June 2018 the NSWNMA and ANMF NSW Branch Mental Health Action Plan 2018 – 2020 was launched at an all Staff Meeting.

STAFF ENGAGEMENT SURVEY The ability for the NSWNMA to successfully grow and improve requires us to effectively work together and maximise the talents of staff. We value the ideas and experience of all our staff. This annual survey is an important mechanism to capture feedback and find out what is working well and the areas we can improve. On Friday 8 June 2018 an organisation wide staff engagement survey was launched. As this is our second year, we will have access to comparative data. The survey was conducted in order to get a better understanding of what we are doing well, what we could do better and what changes need to occur to ensure the successful implementation of our Strategic Plan. Key Direction 5: Strategy 5.5

ACTION The survey was managed by an external provider, Insync Surveys, with all responses strictly anonymous. The survey was broken up into two sections with the first focusing on staff engagement. This section will be repeated annually to measure the effectiveness of initiatives that arise from the survey results. The second section was specific to the Strategic Plan and was designed to help us manage the change required for its implementation. OUTCOME ■■ Survey data will be analysed and responses shared with staff in August 2018.

NSWNMA OFFICES In recognition of the growing office accommodation, meeting and training space requirements, the Association has entered into a ‘Put and Call’ option to purchase 9,000 square metres of office space in Mascot, which is subject to development approval.

REPORT TO 2018 ANNUAL CONFERENCE

Conclusion

We should always celebrate wins and 2018 is marked by a very remarkable win with five out of five regional public hospitals being saved from privatisation as detailed earlier in the report. Congratulations to all those who made a contribution to that win. We need to continue that winning feeling across all of our membership where we are campaigning for Ratios to be legislated in Aged Care, true shift by shift ratios expanded and improved in our Public Health System with Ratios being a life or death outcome. We must also continue the campaign for ratios in Private Hospitals where Private Health corporations are prepared to use every legal threat and the rules of the Fair Work Act to prevent the union from exposing the shortfalls in their staffing. On June 27 2018 the majority of our Public Health Sector Branches voted to accept a 2.5% pay increase and continue the campaign for ratios in the public arena rather than facing the dead end of the NSW Industrial Relations Commission who have had the powers to arbitrate such claims removed. I acknowledge the commitment and determination shown by the 19 Branches which voted to reject the pay offer contrary to the advice of the Council. I want to reassure those Branches that we are determined to pursue the ratios claims for as long as it takes but I was not prepared to recommend that members be denied any pay increase while we do that.

The March 2019 State election will be critical in determining the outcome of our Ratios Itâ&#x20AC;&#x2122;s a matter of Life or Death campaign. We need a political commitment from the Government of the day to achieve the outcomes necessary to deliver a Public Health System properly staffed with Nurses and Midwives to deliver safe patient care on every shift at all hospitals and in community health. The current Liberal National Government does not share our vision. The State Government has legislated to limit our capacity to engage in political discourse necessary to express the views and aspirations of our members. A cap on Third Party Campaign expenditure of $500,000 in the period October to March has left us and other unions no choice but to go back to the High Court to try and preserve your rights to campaign publicly in the six months before an election. The outcome of the Federal Election due in 2019 will be a major determinate of the outcome for two very important campaigns. The National Aged Care Campaign to legislate ratios in aged care also needs a new Government to commit to fix the crisis in aged care. The current Federal Liberal National Party Government has not acknowledged that aged care is in crisis and has given no commitment to deliver the nursing and care hours necessary to deliver what residents in our aged care system need.

The second major campaign dependent on the federal election outcome is the Change the Rules Campaign being led by the ACTU. A win for this campaign is going to be critical if we are to see a real chance for workers to get fairness at work and a better industrial relations system where workers can bargain with employers with some chance of getting better wages and conditions. The bargaining and campaigning for new enterprise agreements in Private and Aged Care employers is a continual cycle often frustrated by the limits and restrictions of the Fair Work Act which reinforces the need to Change The Rules.

ACKNOWLEDGEMENTS I acknowledge our President Coral Levett who has served on Council since December 2000, Vice President 2002 to 2003 and as President since February 2003. During that time Coral also served as the Federal President of the ANMF from 2003 to 2015, to say that Coral has made a massive contribution to the Association and the Federation is a gross understatement. Thousands of unpaid hours providing sage advice, inspirational leadership and meticulous presiding over a thousand meetings at her branch, at the Association and at the Federation. I thank Coral for her ongoing guidance and leadership. I thank all of the Councillors for their contribution and the sacrifices they make to offer their time and energy to the proper functioning of the Association and in their roles on Branch Council of the ANMF. Our Councillors show great leadership foresight and diligence in their roles to support the work of the Association, its officers and staff and take the hard decisions needed for this union to be continuously focused on our delivery of services and support for our members. Judith Kiejda has my deepest gratitude for her ongoing joint leadership of this union. Judith is providing leadership in our union as well as being the President of Unions NSW, a Junior Vice President of the ACTU as well as her Women’s Titular for Oceania and Oceania Representative on the Executive Board and the Women’s Committee in Public Services International (PSI), a mark of the respect for Judith’s capacity and passion for not only our union but the union movement at state, national and international levels.

Our executive office team of Maggie Potts, Alyce Gillespie, Miriam Galea, Kerry Halliday and Chantel Miller continue to make very essential contributions to the running of the union. Judith and I cannot do our job without their dedicated assistance. The Senior Leaders Group continue guiding us towards our strategic goals with their leadership as Co-Chairs of our Key Direction Leadership Teams as well as managing and leading their teams in the day to day management of their portfolios. Their leadership of their teams is what delivers outcomes for members and I thank each and every one of them for their efforts and support. Many of them are now supported and assisted by Leads or Coordinators taking on the role of supervising and leading the sub-teams. I join with Judith in recognising and thanking the staff of the Association and the ANMF NSW Branch for their energy and enthusiasm in their work organising and supporting our members in a very challenging and difficult environment where we are pursuing our Strategic Plan goals but also responding to the challenges faced by our membership. Running three major campaigns and as much of business as usual as we can is no mean feat but we do it with a great deal of commitment to our members. There is a very significant contribution to the running of the union undertaken by staff behind the scenes without whom we could not get the job done and when numbers are called for, they don the scrubs and take to the streets to represent our members who cannot leave the bedside. I hope that delegates here will join with me in recognising all of the staffs’ efforts. Finally, I want to thank all of our Branch Officials for their efforts throughout the last twelve months. I welcome our new Workplace member leaders who are being developed and supported to build on the power of our branches and workplaces and supporting the branch officials. Our unions the NSWNMA and ANMF NSW Branch would not be anywhere as effective without your volunteer efforts to make the working and personal lives of our members and their communities better. I thank the members for continuing to put their trust in us all, we do not take that for granted and will maintain our efforts to act in their best interests. Brett Holmes General Secretary

NEW SOUTH WALES NURSES AND MIDWIVES’ ASSOCIATION

Summary of Financial Information for the Year Ended 31 December 2017 The financial statements of the New South Wales Nurses and Midwives’ Association have been audited in accordance with the provisions of the Industrial Relations Act 1991, and the following summary is provided for members in accordance with Section 517(2) of the Act, as applied by section 282(3) of the Industrial Relations Act, 1996. A copy of the Financial Statements, including the independent Audit Report, will be supplied free of charge to members upon request. Certificates required to be given under the Act by the Accounting Officer and the Committee of Management have been completed in accordance with the provisions of the Act and contain no qualifications.

SUMMARY STATEMENT OF PROFIT OR LOSS OR OTHER COMPREHENSIVE INCOME FOR THE YEAR ENDED 31 DECEMBER 2017 Membership revenue NursePower fund subscriptions Reversal of Impairment Provision – Land and Buildings Other income Total income Less total expenditure Result for the year Net fair value movements for available-for-sale financial assets Remeasurement of retirement benefit obligations Total comprehensive income attributable to members

2017 ($)

2016 ($)

35,731,324 3,970,143 2,926,638 42,628,105 (38,609,364) 4,018,741

34,004,364 3,778,262 2,083,769 1,831,210 41,697,605 (37,583,222) 4,114,383

115,878

255,414 4,274,155

249,884 4,480,145

46,083,103

41,808,948

20,079,128 32,220,678 52,299,806 6,119,678 97,025 6,216,703 46,083,103

22,252,998 31,407,006 53,660,004 11,123,840 727,216 11,851,056 41,808,948

SUMMARY BALANCE SHEET AS AT 31 DECEMBER 2017 Total equity Represented by: Current assets Non-current assets Total assets Current liabilities Non-current liabilities Total liabilities Net assets

INFORMATION TO BE PROVIDED TO MEMBERS OR REGISTRAR

In accordance with the requirements of the Industrial Relations Act, 1991 [NSW] the attention of members is drawn to the provisions of Sub-Sections (1) and (2) of Section 512 which read as follows: (1) A member of an organisation, or the Industrial Registrar, may apply to the organisation for specified information prescribed by the regulations in relation to the organisation. (2) An organisation must, on the making of such an application, make the specified information available to the member or the Industrial Registrar in the manner, and within the time, prescribed by the regulations.

REPORT OF THE INDEPENDENT AUDITOR ON THE SUMMARY FINANCIAL STATEMENTS TO THE MEMBERS OF THE NEW SOUTH WALES NURSES AND MIDWIVES’ ASSOCIATION OPINION The summary financial statements, which comprise the summary balance sheet as at 31 December 2017 and the summary statement of profit or loss and other comprehensive income for the year then ended are derived from the audited financial report of New South Wales Nurses and Midwives’ Association for the year ended 31 December 2017. In our opinion, the accompanying summary financial statements are a fair summary of the audited financial report.

SUMMARY FINANCIAL STATEMENTS

The summary financial statements do not contain all the disclosures required by Section 510 of the Industrial Relations Act 1991 (NSW) or Australian Accounting Standards. Reading the summary financial statements and the auditor’s report thereon, therefore, is not a substitute for reading the audited financial report and the auditor’s report thereon.

THE AUDITED FINANCIAL REPORT AND OUR REPORT THEREON

We expressed an unmodified audit opinion on the audited financial report in our report dated 10 April 2018. Our Independent Auditor’s Report to the members on the Financial Report did not contain any particulars of any deficiency, failure or shortcoming as referred to in the Industrial Relations Act 1991 [NSW], as applied by Section 282(3) of the Industrial Relations Act, 1996.

COMMITTEE OF MANAGEMENT’S RESPONSIBILITY FOR THE SUMMARY FINANCIAL STATEMENTS

The Committee of Management is responsible for the preparation of the summary financial statements.

AUDITOR’S RESPONSIBILITY

Our responsibility is to express an opinion on whether the summary financial statements are a fair summary of the audited financial report based on our procedures, which were conducted in accordance with Auditing Standard ASA 810 Engagements to Report on Summary Financial Statements.

Daley and Co Chartered Accountants

Stephen Milgate Partner 10 April 2018, Wollongong Liability limited by a Scheme approved under Professional Standards Legislation

A copy of the Financial Report, including the Independent Audit Report, may be found on the Members page of the website www.nswnma.asn.au or can be obtained upon written application to: Brett Holmes, General Secretary, NSW Nurses and Midwives’ Association, 50 O’Dea Avenue, Waterloo 2017.

Annexure

NEW AGREEMENTS FINALISED BY NSWNMA Over the past year the Association has finalised 172 new Agreements with 151 employers, covering 9,000 members across 462 sites. Name of Employer and no. of sites

Sector Name of Employer and no. of sites

Carrington Centennial Care Ltd • 1 AFO Karitane • 1 AFO Little Company of Mary Healthcare Ltd • 2 AFO Royal Society for the Welfare of Mothers & Babies • 4 AFO St Vincent's Health Australia (x3) • 6 AFO/PH Abel Tasman Village Association Ltd • 1 AC Albanese Aged Care Group (x2) • 2 AC Anglican Care - Diocese of Newcastle • 14 AC Anglican Community Services • 34 AC Apex Software Pty Ltd • 2 AC Arcare Pty Ltd • 1 AC Arete Pty Ltd (x2) • 2 AC Ark Health Care Pty Ltd • 6 AC Armenian Rest Home Association • 1 AC Ashfield Baptist Homes Ltd • 1 AC Ashford Ageing Care Facility Inc • 1 AC Australian Croatian Cardinal Stepinac Assoc. Ltd • 1 AC Australian Nursing Home Foundation Ltd • 4 AC Autumn Lodge Village Inc • 2 AC Banksia Villages Ltd • 1 AC Bankstown City Aged Care Ltd • 4 AC Barraba & District Retirement Homes Assoc. Inc • 1 AC Berrigan and District Aged Care Assoc. Ltd • 1 AC Bethshan Ministries Ltd • 2 AC Booroongen Djugun Aboriginal Corporation • 1 AC Buckland Convalescent Hospital • 1 AC Bushland Health Group Ltd • 3 AC Castellorizian Aged Care Services Ltd • 1 AC Cedar Place Aged Care Facility Ltd • 1 AC Central Coast Local Health District • 1 AC Charingfield Ltd • 1 AC Christadelphian Homes Ltd • 7 AC Christian Brethren Community Services • 3 AC Christophorus House Retirement Village • 1 AC Clarence Village Ltd • 1 AC Coffs Harbour Legacy Welfare Fund • 1 AC Columbia Holdings Pty Ltd • 4 AC Cooinda Coonabarabran Ltd • 1 AC Cowra Retirement Village Ltd • 1 AC Cranbrook Care Group • 5 AC Crookwell/Taralga Aged Care Ltd • 2 AC Cypress View Lodge Ltd • 1 AC Deniliquin Nursing Home Foundation Ltd • 1 AC Doherty & Associates Pty Ltd (x2) • 2 AC Dougherty Apartments Retirement Housing Project • 1 AC Dubbo RSL Aged Care Association • 2 AC East West Health Care Pty Ltd (x3) • 3 AC Fairlea Aged Care (x2) • 3 AC Fairview Care Ltd • 1 AC Farad Nominees Pty Ltd (x2) • 2 AC Feros Care Ltd • 3 AC

Sector Name of Employer and no. of sites

Finley Regional Care Ltd • 2 Garden Village Port Macquarie • 1 Great Lakes Aged & Invalid Care Assoc. Ltd • 1 Gulgong Hostel Association Inc • 1 Gundagai and District Hostel Accommodation Inc • 1 Hakea Holdings Pty Ltd • 1 Halenvy Pty Ltd • 2 Hall & Prior • 12 Harbison Memorial Retirement Village • 2 Haven Community Ltd (The) • 1 Hay Senior Citizens Association • 1 Homewood Care Pty Ltd • 1 Hunter New England Local Health District • 3 Illawarra Diggers Aged & Community Care Ltd • 1 Inasmuch Community Ltd • 1 Indochinese Aged Care Ltd • 1 Juliana Village Association Ltd • 1 Kanandah Retirement Ltd • 1 Koonambil Aged Care Ltd • 1 KOPWA Ltd • 1 Korlim Pty Ltd • 1 Kurrajong & District Hospital Society Inc • 1 Lee Hostel Committee Inc • 1 Linburn Nursing Home Pty Ltd • 1 Lithgow Aged Care Ltd • 1 Live Better • 1 Lockhart and District Aged Care Assoc. Inc • 1 Lutheran Aged Care Albury • 3 Mackellar Care Services Ltd • 2 Maitland Benevolent Society • 1 Maroba Ltd • 2 McLean Care Ltd (x2) • 2 Merton Living Ltd • 1 Montana Nursing Home Pty Ltd • 1 Moss Care Group (x2) • 2 Multicultural Aged Care Illawarra Ltd • 1 Murrurundi Retirement Home Ltd • 1 Nambucca Valley Care Ltd • 3 Nazareth Care • 1 Nepean Blue Mountains Local Health District • 1 North Sydney Retirement Trust • 2 Our Lady of Consolation Aged Care Services Ltd • 1 Palms Aged Living Management Services Pty Ltd • 1 Pathways Aged Care Pty Ltd • 5 Pioneer House Living Ltd • 1 Plateau View Aged Care Pty Ltd (x2) • 2 Port Stephens Veterans & Citizens Aged Care Ltd • 2 Presbyterian Aged Care NSW and ACT • 9 Quirindi Retirement Homes Ltd • 1 Residential Gardens for Spanish Speaking Frail Aged Ltd • 1

Sector

Roseneath Aged Care Centre Pty Ltd • 1 AC RSL LifeCare Ltd (x2) • 31 AC S'Antonio de Padova Protettore di Poggioreale Syd N/H • 1 AC Sapphire Coast Community Aged Care Ltd • 3 AC Seventh-day Adventist Aged Care (North NSW) Ltd • 2 AC Sir Joseph Banks Aged Care Facility Pty Ltd • 1 AC Sir William Hudson Memorial Centre • 1 AC Sisters of Our Lady of China (x4) • 4 AC Southern Cross Care (NSW & ACT) Ltd • 31 AC St Andrews Village Ballina Ltd • 1 AC St Catherines Aged Care Services Ltd • 2 AC St Elizabeth Home Ltd • 1 AC St Ezekiel Moreno Ltd • 1 AC St Hedwig Village • 1 AC St Joseph's Aged Care Facility for Religious Ltd • 1 AC St Luke's Care Ltd • 1 AC Stroud Community Lodge Inc • 1 AC TBG Senior Living Services Pty Ltd • 1 AC Tenterfield Care Centre Ltd • 2 AC The Pioneers Lodge Ltd • 1 AC The Whiddon Group • 19 AC The Willows Private Nursing Home Pty Ltd • 1 AC Thomas Holt Memorial Village • 3 AC Thompson Health Care Pty Ltd • 12 AC Timbrebongie House Inc • 1 AC Tinonee Gardens The Multicultural Village Ltd • 1 AC Tocumwal Lions Community Hostel Ltd • 1 AC Touriandi Inc • 1 AC Trustees of the Roman Catholic Church Diocese of Lismore • 11 AC Trustees of the Maronite Sisters of the Holy Family • 2 AC Uralba (Carcoar) Inc • 1 AC Waratah Respite Centre (Mid North Coast) Inc • 1 AC Warrigal Care • 9 AC Western NSW Local Health District • 1 AC Woolgoolga and District Retirement Village Ltd • 1 AC Woy Woy Community Aged Care Ltd • 2 AC Yass Valley Aged Care Ltd • 1 AC The Salvation Army (NSW) Property Trust (x2) • 19 AC/O Maari Ma Health Aboriginal Corporation • 1 MC & GP Western Health Alliance Ltd (x3) • 6 MC & GPS/PSSS/O Coal Services Pty Ltd • 5 0 International SOS (Australasia) Pty Ltd • 11 0 Medibank Health Solutions (x2) • 2 0 Norfolk Island Legislative Assembly • 1 0 Adventist HealthCare Ltd • 3 PH Chris O’Brien Lifehouse • 1 PH St John of God Health Services • 1 PH Healthe Care Australia Pty Ltd (x2) • 16 PH/PSDPC Nurses on Wheels Inc • 1 PSSS AC Silver Chain New South Wales • 1 PSSS

AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC AC

AFO: Affiliated Health Organisation • PH: Private Hospitals • AC: Aged Care • MC: Medical Centres • GP: GP Services • O: Other PSSS: Private Sector Specialist Services • PSDPC: Private Sector Day Procedure Centres

Index CONTENTS 3

Recruitment 31

REPORT TO 2018 ANNUAL CONFERENCE 4 NSWNMA Council and Executive 4 Edith Cavell Trust 5 Professional Issues Committee 5 Australian Nursing and Midwifery Federation (ANMF) 5 Conclusion 6

A YEAR IN REVIEW 7 Change the Rules 7 Public Health Sector campaign for Ratios 8 Missing hours Midwifery shortages

9 9

Ratios for aged care 9 Northern Beaches 10 Keep NSW in a Healthy State 11 Finance 11 Key growth 12 NSWNMA Rules Changes 12 REPORT TO 2018 ANNUAL CONFERENCE 13 Organising 13 Enforcement 14 Sydney Alliance 14 Global Nursing United (GNU) 14 Public Services International (PSI) 15 Australian Council of Trade Unions (ACTU) 15 Unions NSW 15 The Lamp 16 Conclusion 16 KEY DIRECTION 1: GROW OUR CAPACITY TO INFLUENCE 17 ACTU 18 Change the Rules campaign

NSW Health Service Non-compliance with NHPPD requirements

Aged Care Sector Safe Staffing Campaigns

Albury Wodonga Health Nolan House - Staffing HDU unit

Allity Aged Care New Enterprise Agreement

Bupa Care Services Enterprise Agreement Bargaining

Healthe Care Australia Enterprise Agreement

18 18

19 19

22 22

23 23

24 24

Healthscope Private Hospitals

Member Growth and Development

Justice Health & Forensic Mental Health Network 26 Forensic Hospital - Security Issues Forensic Hospital - Breach of agreed staffing numbers

Marriage Equality Campaigning for a YES vote

Mardi Gras 2018 40 years of evolution

Murrumbidgee Local Health District Wagga Wagga Rural Referral Hospital

Ramsay Health Care Member Growth and Development Enterprise Agreement Negotiations Local Hospital Activities Workplace Health & Safety Inspections

26 26

27 27

28 28

28 28 29 29 31

Associate Recruitment and 2018 New Graduate Recruitment Strategy

St Vincent’s Health Australia St Vincent’s Hospital, Darlinghurst – Christmas bed closures St Vincent’s Hospital, Darlinghurst - Nurses performing non-nursing duties & EOI for VR

The Whiddon Group Enterprise Agreement Bargaining

Western Sydney Local Health District

10 Questions to Ask

32 32 32

33 33

Blacktown Hospital - Unreasonable Workloads 34 Westmead Hospital - Closure of 29-Bed Surgical Ward 35

Union Summer Program 2018 Program

Uniting Aged Care 2017 Enterprise Agreement Uniting - State-wide introduction of ‘Household Model’

KEY DIRECTION 2: BE INNOVATIVE IN OUR ADVOCACY AND BARGAINING Public Health System

35 35

35 35 36

37 38

2018 Public Health System Award claim and Ratios It’s A Matter of Life or Death Campaign 38 Ratios campaign: It’s a matter of Life or Death 40

Aged and Community Services Australia (ACSA) ACSA Template Enterprise Agreement 2017

Leading Aged Care Services LASA Template Enterprise Agreement 2017

Aged Care – Not for Profit

41 41

Management of Branches and Member Leaders 42

Family and Community Services Forced transition of FACS staff to the NGO sector

Legal Matters

43 43

Legal Representation before Statutory Bodies 43 Emerging Legal and Professional Issues 43

Northern NSW Local Health District Tallowwood Mental Health facility – staffing dispute

NSW Government Relocation of the IRC of NSW to Parramatta

KEY DIRECTION 3: PROMOTE A WORLD CLASS, WELL-FUNDED, INTEGRATED HEALTH SYSTEM Staff Ratios in Aged Care: Make them law now

44 44

45 46

Nurses have the attention of decision makers 46

Keep NSW In a Healthy State Campaign 47 Health Unions campaign results in win to keep hospitals public

Community Health Community Health Campaign

48 48

Illawarra Shoalhaven Local Health District 48 Wollongong Maternity Services Campaign

Ministry of Health Managing Complaints and Concerns about Clinicians Policy Directive Occupational screening and vaccination Policy Directive (amended)

NSW Aged Care Roundtable

49 49

NSW Parliament Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation 2016

NSWNMA Education Education Program 2017-2018

NSWNMA Professional Matters Professional Issues Committee & Reference Groups Professional Issues Papers

50 50

51 51

52 52

52 52 55

NSWNMA Reconciliation Action Plan NSWNMA Scholarships

55 55

Bob Fenwick Mentoring Grants Program Edith Cavell Trust Lions Nurses’ Foundation Older Peoples Welfare Council

55 56 56 56

Submissions and Inquiries

Affordable Housing 56 Aged Care submissions and Inquiries 56 Inquiry into the Management of Health Care Delivery in NSW 57 Inquiry into Parklea Correctional Centre and other operational issues 57 Ministry of Health – Mental Health 57 Provision of Drug Rehabilitation Services in Regional, Rural and Remote NSW 57 Review of Seclusion, Restraint and Observation of Patients with Mental Illness in NSW Health Facilities 58 Voluntary Assisted Dying Bill 58 Work Health and Safety model laws 58

Work Health and Safety External Stakeholders Representation of members

58 58 58

KEY DIRECTION 4: PROMOTE THE ASSOCIATION AS A SIGNIFICANT AND PROFESSIONAL ADVOCATE FOR THE HEALTH SYSTEM AND OUR MEMBERS 59 Conferences and Trade Exhibitions 60 Conferences, Seminars & Forums Promotion through trade exhibitions

Key Partnerships City West Housing Department of Health Agency Liaison NSW Council of Social Services Quality Aged Care Action Group

60 60

61 61 61 61 62

KEY DIRECTION 5: ENSURE OUR PEOPLE AND RESOURCES ARE ALIGNED WITH OUR VISION 63 Core Values 64 Recruitment processes Values Workshops Working for Unions

NSWNMA Employee Scholarship Mental Health Action Plan Staff Engagement Survey NSWNMA offices

64 64 64

64 64 65 65

CONCLUSION 66 Acknowledgements 67

Northern Sydney Local Health District – Ministry of Health 50

SUMMARY OF FINANCIAL INFORMATION FOR THE YEAR ENDED 31 DECEMBER 2017 68

Northern Beaches Hospital transition process 50

ANNEXURE 69

REPORT TO

ANNUAL CONFERENCE

MORE INFORMATION: NSW NURSES AND MIDWIVES’ ASSOCIATION WWW.NSWNMA.ASN.AU 50 O’Dea Avenue, Waterloo NSW 2017 P 8595 1234 (METRO) 1300 367 962 (NON-METRO) F 9662 1414 E gensec@nswnma.asn.au Authorised by B.Holmes, General Secretary, NSWNMA