‘If the IRC comes to the determination that a 25% wage increase is fair and reasonable, we'll pay it,’ says NSW minster for mental health Rose Jackson.
NSW Health is offering locum contracts to any staff specialist psychiatrists choosing to resign during the ongoing industrial disputes – 43 and counting.
Last Saturday health minister Ryan Park said “we can’t afford wage increases akin to around $90,000 or 25% for some of the highest paid health care workers in our profession”.
But, speaking at a press conference today, NSW minister for mental health Rose Jackon said the government would pay the 25% pay rise if ordered to by the Industrial Relations Commission of NSW, implying that the money could be made available.
“If the IRC comes to the determination that a 25% wage increase is fair and reasonable, we’ll pay it,” said Ms Jackson.
“I’m assuming that the IRC’s outcome will be fair and reasonable … [the government] will abide by their decision.”
Today Ms Jackson also said, “as of today there are 43 psychiatrists who have engaged in the mass resignation tactic, and we do anticipate that number to rise over coming days”.
“The good news is that we’ve engaged 23 locums to fill those roles and that there are another eight in the system being processed right now.
“As a consequence of that, we’re not seeing the significant disruption of mental health services at the local level.
“The message to the community remains: care is available.”
According to the minister, all resigning psychiatrists were, and would continue to be, offered locum opportunities, but she was unable to indicate how many had accepted the offer.
A total of 25 psychiatrists have chosen to rescind their resignations and 99 have pushed back their date of resignation, with the remaining allegedly on the fence.
Ms Jackson was unable to outline the cost of the 31 locums currently in the pipeline “because it’s still early days”.
An analysis by HSD earlier this week found that locums in NSW are paid an average daily rate of $3000. That would mean an annual cost for those 31 locums of around $33.9 million.
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“There are also costs to agreeing to a 25% wage increase over one year for one group of medical specialists, when we know other medical specialists and other public servants have got their eye very clearly on that,” said Ms Jackson.
“That’s why those discussions have led to an outcome where we’re working through the Industrial Relations Commission.”
Arbitration through the IRC was a “real and meaningful path forward” which was independent from the government, unshackled from the wages cap and had clear priorities to maintain recruitment and retention, she added.
Ms Jackson insisted that there had been no ward closures, but a statewide reduction of eight beds had occurred due to the “amalgamation” of some wards.
NSW Health deputy secretary Matthew Daly said some services were being “reconfigured to ensure they have appropriate clinical supervision and adequate clinical governance”.
This included the closure of 14 rehabilitation beds at the Prince of Wales site to open six additional acute beds – a net loss of eight beds.
Metropolitan Sydney, Hunter and Illawarra remain the areas most likely to see resignations.
Ms Jackon said that no justice or forensic mental health psychiatrists had resigned as of today, although some had indicated that they would be tendering their resignations over the coming weeks.
She added that resources would be prioritised to the highest risk situations and patients.
“I should say it’s not just forensic psychiatrists who manage those patients.
“We are talking about a very, very small number of people, and I do want to be careful not to stigmatise people with mental illness. Almost all of them are not dangerous.”
NSW Health has been in discussion with the Commonwealth Department of Health and Aged Care on a system redesign as this situation “is not something that is unique to NSW”, added Ms Jackson.
While they have not directly touched on lifting the 10-year moratorium on overseas-trained doctors to increase the supply of psychiatrists, as called for by the Australian Private Hospitals Association, there have been ongoing discussion around the new expedited pathway, said Ms Jackson.
“There is an opportunity to look at how we can deliver better, holistic mental health care, wrapping services around people through psychosocial supports, whether it’s through social workers, whether it’s through peer workers, whether it’s through clinical psychologists, whether it’s through general practitioners, and that is something that the government is exploring as well.”
In response to concern from the nurses union over additional workload, NSW chief psychiatrist Dr Murray Wright said, “it’s nurses themselves who have talked to me over many years about the fact that some of the training and skills that they have don’t get used”.
“I think we need to understand that we’ve got a range of highly skilled nurses working in our system, and there are opportunities for nurses with ambition to improve on those skills.
“We are not asking anyone to operate outside their scope of practice.”
Dr Wright said many groups, including nurses, psychologists, occupational therapists and social workers, were working “well below their scope of practice”.
“We are very keen to do a redesign which looks at simultaneously reducing some of [workload, burnout, onerous responsibility] concerns and some of the burdens that exist for psychiatrists and improving the opportunities for highly trained clinicians in other disciplines to operate at the top of their scope of practice.”