The struggle between Victorian nurses and the state government starkly illustrates the deep divide in Australian society between the super rich and the rest of us, writes Alex McAulay in Socialist Alternative.
On the side of the rich we have Baillieu’s Liberals continuing a decades old neoliberal offensive against public health, by attempting to rip $473 million from the nursing budget. On our side we have underpaid nurses taking illegal strike action in their fight for safe workloads and decent public health care.
Victorian Premier Ted Baillieu is the living stereotype of old money. Born in the ultra-posh Melbourne suburb of Toorak, he comes from a long line of industrialists, financiers and conservative politicians. He edged into office in 2010 on the back of disillusionment with the former Labor Government’s neglect of hospitals and other social services and infrastructure. Among Baillieu’s grander election promises was that he would open 800 new hospital beds in his first term.
In office Baillieu has discarded all pretence of progressive reforms and set about the task of ruling in the interests of his own class. Late last year the government announced that they would be slashing 3,600 jobs and $1.9 billion in funding across the public service. In public hospitals the Liberals are also attempting to open the door to slashing nurse numbers. During enterprise bargaining negotiations with the Australian Nurses Federation, they have demanded “nurse patient ratio flexibility” in return for a paltry pay rise. In Victorian public hospitals it is currently mandated that there be a ratio of least one nurse to every four patients in a ward. The Government is seeking the “flexibility” to include less qualified and cheaper health assistants as “nurses” in the one to four ratio.
Victorian nurses are already grossly underpaid for the work that they do, earning up to 18.5 percent less than their New South Wales counterparts. It is an outrage that a millionaire parasite like Baillieu should be putting such ultimatums to the people who perform some of the most vital and useful work in society.
It is not accidental that he has chosen to battle nurses over ratios. The question of ratios gets to the heart of what sort of public hospital system you want servicing the working class and poor. Nurses, and the overwhelming majority of Victorians, want a system where the wellbeing of staff and patients is the primary driver, one in which properly trained health workers have the time and energy to attend to each patient’s wellbeing properly. Ratios matter to nurse and patient health. The experience in Australia and internationally has been that lower nurse numbers lead to higher rates of needlestick and musculoskeletal injury among nurses, and higher rates of infection and other complications among patients.
The Baillieu Government and hospital administrators, however, are committed to a neoliberal model of health care, in which mandated ratios are regarded as an obstacle to achieving “productivity-related savings”. This market driven approach has dominated health policy in Australia and internationally since the end of the postwar boom in the 1970s. The promise was that opening public services up to the market would deliver better outcomes for “consumers”, and that reduced public spending would free up money for private investment, which would in turn drive economic growth and raise living standards. The reality was a massive redistribution of wealth from workers to bosses, and decades of crisis in public health.
During the 1980s the Victorian Labor Government sought to stimulate market competition in public hospitals by introducing ever stricter service targets and performance measures. This process was intensified during the 1990s under Liberal Premier Jeff Kennett, who closed many hospitals, privatised others, and drove thousands of nurses out of the sector. This period saw ballooning workloads for hospital staff, and a corresponding rise in infection rates.
Kennett was ousted on the back of popular outrage in 1999, and the new Labor government declared that privatisation was dead. But Labor failed to undo many of Kennett’s more disastrous experiments, and embarked on their own misadventures in Public Private Partnerships (PPPs). The absurdity of PPPs is evident in huge handouts given to the private consortiums contracted to build the new Womens’ and Childrens’ hospitals. The resulting buildings are ill-designed for future expansion, but will see Victoria give over $60 million each year until 2035 to these big business interests. If Baillieu was serious about finding efficiencies in the hospital system he could start by cancelling these corrupt deals, and turn this money over to funding the nurses’ pay claim and hiring thousands more to staff wards.
Nurses have been at the forefront of resistance to neoliberal attacks over the last thirty years, and won some important victories. In 1986 they won a 38-hour week after a historic state wide strike. In 1992 they engaged in rolling stoppages and wildcat strikes against Kennett’s privatisation agenda. They finally attained the mandated one to four nurse patient ratio in 2000 after striking against the Labor Government. In 2012 nurses are again engaging in industrial action to win better pay and defend mandated ratios. Today they risk massive fines and even potential jail time under Federal Labor’s Fair Work Act, which has retained many of the anti-strike provisions of Howard’s WorkChoices.
Across the world both Labor and Liberal style governments are using the global economic crisis as a pretext for slashing public services. Baillieu’s offensive against the nurses is but a taste of what is to come if Australia gets drawn further into this maelstrom.
In austerity-ravaged Greece nurse patient ratios have exploded to one to twenty. The appalling conditions have led to the spread of a new pneumonia-causing, drug resistant, superbug. Fed up health workers in the town of Kilkis have kicked out management, taken over their hospital, and called for the overthrow of Greece’s economic and political elite.
While the actions of Victorian nurses may be less dramatic, they also point to the simple fact that it is they, not Baillieu, who run the hospitals. Nurses, not Baillieu, have an interest in hospitals which provide quality care to the public, and nurses can grind the public hospital system to a halt if the government threatens their interests.