Babies included in midwife-to-patient ratios in upcoming ACT Budget

Nurse and midwife-to-patient ratios are being expanded across the Territory’s hospitals as part of the upcoming budget.

Phase Two of the ratios will also make Canberra the second jurisdiction in Australia to consider babies as part of minimum staffing levels for maternity services.

More than $86 million will be allocated in the 2024-25 ACT Budget to fund the 137 full-time equivalent nurse and midwife positions, forming part of the upcoming enterprise bargaining agreement (EBA) between the government and health unions.

Delivery of phase two was expected to take about 18 months.

Health Minister Rachel Stephen-Smith said delivery would be staged given the workforce shortages across the country.

“For example, we know that there is a national shortage of midwives. So we’ve come to an agreement with the ANMF [Australian Nursing and Midwives Federation] about what those timeframes are where we will be able to be held to account for meeting those ratios across the system,” she said.

“But we’re also committed to doing that as soon as possible.”

Hospital-based ratios were a 2020 Labor election commitment, with phase one delivered in the current EBA.

The first phase of nurse-to-patient ratios was delivered across general medical and general surgical medical wards, acute aged care and mental health through $50 million from the 2021-22 Budget.

Phase two ratios will be implemented across Canberra’s public hospitals and Clare Holland House within maternity services (including postnatal wards), the neonatal intensive care unit and special care nurseries, critical care (including ICU and emergency departments), perioperative areas, subacute mental health units, cancer services, rehabilitation units and palliative care services.

North Canberra Hospital nursing and midwifery executive director said including babies as patients in the ratio meant they’d be able to deliver more “women-centred” care.

“[It] will give our midwives the time they need to support for our mothers and our babies in that transformational period that birthing a baby is,” she said.

The ratio model includes both minimum staffing levels on each ward and additional team leaders or support nurses and midwives.

Ms Stephen-Smith confirmed the funding would help start delivering an ACT Labor 2024 health election commitment.

“This funding is the first of those 800 [healthcare workers] that we will be funding through this budget to meet our Phase Two ratios commitment,” she said.

“Implementing ratios guarantees there will be more staff on the ward to provide care and ensures an increased skill mix on each shift. Staff feel safer with more team members on the ward and, importantly, are able to spend more time focusing on individual patients.”

The Canberra Liberals have rubbished the announcement, accusing ACT Labor of “playing catch-up” for the election year.

Shadow Health Minister Leanne Castley accused the government of “chronic underfunding” of public health services and not doing enough to address poor workplace culture and the staff separation rate.

“You cannot trust anything this government promises leading up to an election, especially in healthcare and when it comes to adequately staffing and improving service delivery,” she said.

“Let’s not forget announcements made at previous elections that have not been met, including the new hospital expansion over a decade ago, along with 60,000 elective surgeries that will not be delivered.

“Over three years ago this Minister promised to fix hospital wait times within nine months but the ACT continues to lag behind the rest of the country with some of the longest wait times.”

This money comes on top of more than $21 million allocated in the mid-year budget review to support other elements of the proposed EBA.

This includes a $2000 education and development boost, an annual $750 professional development allowance, an increase in pay, and a review of rostering in nursing and midwifery.

ANMF members are yet to vote on the proposed agreement.

The 2024-25 ACT Budget will be released on 25 June.