SPEAKING ON A BILL | SAFE PATIENT CARE (NURSE TO PATIENT AND MIDWIFE TO PATIENT RATIOS) AMENDMENT BILL 2018

Mr Melhem (Western Metropolitan): I also rise to speak on the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2018. I will start by apologising to our nurses and midwives that we were not able to pass this legislation back in August last year, even though this side of the house and the Greens were willing to extend the sitting past midnight so that we could pass the legislation. Unfortunately—

Mr Finn interjected.

Mr Melhem: Mr Finn, you are telling me you have started believing in union rules. That is a new revelation. Unfortunately we were not able to do that. The reason I am saying this is just to reflect. I will never forget that night and looking behind me to see the expressions of the midwives and nurses in the gallery who were basically breaking down in tears because they could not see justice done when we were not able—we were so close—to get debate on this bill finalised so we could pass it. We were not able to do that then, but now I am pleased that this bill has been brought to this house as one of the first bills to be debated. We actually made some minor changes to the original bill, which was put together in August last year. I am pleased that the opposition are supporting the legislation which they were not last time. Hopefully the bill will be passed this week so we can actually deliver some long-awaited justice or recognition for the midwifery staff and nurses, because they are currently treated to some degree as second-class citizens. Nurses do enjoy the ratio which was first introduced through an enterprise agreement negotiated by the Australian Nursing & Midwifery Federation and the hospitals back in 2000. I just want to pay tribute to all the officials and delegates and members of the ANMF who drove a hard bargain and campaigned over a number of years to achieve the ratio. Mr Atkinson talked of his reservations about why we should or should not have ratios. I accept some of his concerns, but I think it is important to point out the reasons why we need ratios. As I said, I accept where Mr Atkinson is coming from. You want to allow management flexibility to run their operations, but the problem—and this is why the ANMF started campaigning about putting nurse-to-patient ratios into operation—involves three factors. The first factor is budget cuts. I am not going to talk about Labor or Liberal. I am going to use the word ‘government’, so I am not going to even colour it in that way. There is always an argument about health budgets in relation to where a minister can impose certain cuts, or where there is not enough money to go around hospitals, in order to be efficient and get by they will start looking at cuts. Where would you impose cuts? Nurses would be probably the easiest target. The number of nurses you need to look after patients, rather than how many doctors, is probably the first one to cut. Let me say this: if a patient goes into hospital, they tend to spend most of the time in hospital seeing and interacting with nurses. You are lucky if you see a doctor once a day or once every few days. I unfortunately had to experience that in November last year when I had an issue with my pancreas. I waited two days to see the doctor, the specialist. I paid my private health insurance and went to a private hospital. I screamed my head off. I said, ‘Am I going to see a doctor or not?’, but I was taken care of by the nurses. They were always there. I think that is very important. Let us not lose sight of the fact that our nurses and midwives are the cornerstone of our health system. Talking about midwives and nurses, when our children, Christopher and Caitlin, were born, who was there beside my wife? It was the midwife. The doctor was a good bloke. He did a great job, but he was going backwards and forwards because Collingwood and Carlton were playing at the MCG when Christopher was about to be born. The doctor was going backwards and forwards but the midwives were there throughout that period, so I think it is very important that we have that ratio. The second point is the safety of the nurses. I think it is very important that we do not burden them with too much responsibility and too many patients to look after. I think their safety is very, very important but so is the safety of patients, because if you have got a nurse looking after 10 patients or 15 patients versus a nurse looking after three patients or four patients, the level of services is going to be different. Obviously a better service will be provided when there are less patients to look after. For these three reasons, it is very important for us to make sure that a ratio is in place. I go back to the enterprise bargaining agreement that was done by the ANMF in 2000 and the good work by the Fair Work Commission at the time to facilitate an agreement between the ANMF and the government. From memory, I think the commissioner at the time was Wayne Blair. He spent days and days and days and weeks basically facilitating an agreement. When I see him from time to time—in fact he is retired now—he tells me that one of the highlights of his working life at the Fair Work Commission was getting an agreement between the ANMF and the government in relation to nurse-to-patient ratios, and I want to commend him for the work he did and the ANMF. For these reasons I think it is very important that this legislation passes. This bill is on top of the commitment that the Andrews Labor government has put into health over the last four years. We are looking forward to continuing that investment over the next four years. We made a commitment to the nurses and midwives that we would enshrine ratios in legislation. We did that in 2015, but there was another side—the midwives were accidentally left out. I understand that some hospitals were actually implementing the ratio but some others were not. This bill will ensure consistency across the board and make sure that different standards are not being applied at different hospitals. This builds on the commitment the Andrews Labor government gave midwives—nurses as well—to make sure that that happens and that we deliver on those commitments. There have been some discussions today in relation to the record investment that the government is putting into health in Victoria. I want to join Mr Atkinson in acknowledging the good work that the former Minister for Health, Jill Hennessy, did in that space over the past four years. We could not have found a better minister to hand over the baton to to continue the good work of the last four years. We now have a minister in Ms Mikakos who will take on that very important portfolio. I know she is a very driven individual who will continue to deliver record investment in health. She will be one of our great advocates within cabinet, within the whole of government and also between ourselves and the federal government, because let us not forget that our health system is 50-50 funded and there is a lot of dependence on investments from the federal government. We all know about the unfortunate cut we experienced in 2014 when Tony Abbott was Prime Minister and Joe Hockey was the federal Treasurer. We experienced a massive cut to health and we have not really recovered from that period. Talking about my electorate, there is the investment in Sunshine Hospital and the building of the new children’s hospital at Sunshine; I am looking forward to the opening of the hospital later this year. There is a $29 million investment in the emergency department to provide first-class service for our patients. On top of that, there are the investments made the year before that, including $85 million for the Werribee hospital. I think that is a great investment. Then there was the announcement made by the Premier last year. We heard from the minister this afternoon in question time about the $1.5 billion investment in Footscray Hospital. That is going to be a state-of-the-art hospital in Footscray. That work will commence in the next few weeks, and I think that is very welcome news. That is in addition to the 10 community hospitals that will be built throughout the state. I note two of them—one in Point Cook in my electorate and one in Sunbury. I think that is another good indication of how this government is fair dinkum about investing in health and making sure we can take some pressure off the main hospitals and deliver health services to the people in the places they need them—close to home. There is also the investment in ambulance services. We heard from the minister today about how response times have improved and how the whole service has been revamped over the last few years. Going back to nurses, I think one of the great achievements was introducing Nurse on Call so that when you dial 000 you can be put onto a nurse and there can be an analysis made about how urgent your case might be. In some cases you will not need an ambulance, so then the ambulance is able to respond to more urgent cases. That in my view has improved the level of response time in the ambulance services. There has been good work done by the ambulance services and by Minister Hennessy to make sure we continue to improve our health service delivery to Victorians. I think it is very important that with this bill we finally implement a long overdue process, which has been subject to a lot of discussions with the various industry stakeholders, including the Australian Nursing & Midwifery Federation. As I said earlier, I believe we have rectified the wrong that occurred in August last year. I will finish up with these comments: I will always have at the back of my mind a memory of those nurses and midwives sitting in the gallery behind me, tears in their eyes—

Mr Finn: Wondering why the government hadn’t brought it on two days earlier.

Mr Melhem: Mr Finn, you are the last person who should be lecturing us about these sorts of matters. Let us not forget—

Members interjecting.

Mr Melhem: Let us not forget Good Friday. Let us not forget that. At least now we are doing the right thing and we are—

Mr Finn: Sitting through the night, sitting all day. Disgraceful.

Ms Patten: I thought you went home.

Mr Finn: I did.

Mr Melhem: Yes, well, you could have stayed an extra hour and we could have passed that bill back in August last year. I am pleased that this bill is before this house as one of the first pieces of legislation, because we are delivering on our commitment to make sure we are doing the right thing by our nurses and midwives. I commend the bill to the house.