Health Minister Ryan Park has a plan to improve the workforce in NSW's healthcare sector. But will it work?
New South Wales Health Minister Ryan Park sometimes has trouble sleeping.
His insomnia is triggered by the challenge of being in charge of state parliament's most expensive industry, public health care.
"Without a doubt, workforce is the biggest challenge and it's what keeps me up at night," Mr Park said.
Two years ago a NSW parliamentary inquiry released damning findings into the state of health services in regional, rural and remote areas.
It repeatedly heard that while some hospitals were being upgraded or replaced, many sometimes did not have enough doctors and nurses to staff them.
NSW Health Minister Ryan Park has a plan to improve the workforce in the state's healthcare system. (ABC News: Marcus Stimson)
Mr Park has made it his mission to resurrect the NSW Health workforce.
"We're not going to be able to build our way out of this with new facilities and new services," he said.
"We have to focus on developing, retaining and attracting the workforce."
But staff turnover remains high.
'Teething issues' for first phase
Financial incentive programs have been launched to try to keep nurses in their jobs. (ABC)
NSW Health figures show in 2022-2023 the attrition rate was 13.1 per cent which is 5 per cent higher than in 2018-2019.
The state government has unveiled financial incentive programs to try to keep nurses in their jobs, or convince them to relocate to rural and remote communities.
"That's starting to bear fruit with significant numbers of people being attracted and retained to those areas," Mr Park said.
"We also know that it's about making sure we have a pipeline of new healthcare workers coming into our professions."
After years of campaigning, the Nurses and Midwives Association landed a deal in February 2024 for nurse-to-patient ratios.
The first phase of this policy will see one nurse to every three patients in hospital emergency departments.
Other wards will eventually follow with their own sets of ratios.
They were due to be introduced at Sydney's Liverpool Hospital's emergency department (ED) and Royal North Shore Hospital in March.
The minister said the delay was due to some "teething issues".
"There are some challenges around treatment spaces and how they're counted. For example, in a new facility versus an old facility and what we don't want to do is to distort that simply because of the nature of infrastructure that we're dealing with," he said.
Mr Park said the ratios are due to be introduced in rural and regional hospital EDs later this year or early 2025.
"This reform will take some time," he said.
"It's the largest reform that we've undertaken in terms of the way we staff our hospitals in the history of NSW."
No figure on how many staff needed
The minister could not put a figure on how many extra staff would need to be hired to meet the new ratios.
But he said the cancellation of state infrastructure projects had freed up money in the budget.
"The likelihood of us having to go back to the treasurer and asking for more is high," Mr Park said.
"We've made some tough decisions. We know that certain projects that haven't gone ahead, major transport projects, major underground roads, that we've made decisions on."
Nurses in NSW have held a number of protests over pay and conditions. (ABC News: Harriet Tatham )
The minister remains tight-lipped on whether nurses can look forward to more pay when their award expires in July 2024.
He said he would wait until he received the NSW Nurses and Midwives Association's request.
The state government is also looking at ways to curb the soaring cost of locum doctors and agency nurses.
These contract roles for hospital shifts see staff receive up to three times what they would be paid if they were full-time employees.
Health services have previously said they have no choice but to fork out what was being charged to ensure hospitals had coverage.
Condobolin Hospital in central western NSW. (ABC Central West: Joanna Woodburn )
Mr Park said NSW Health secretary Susan Pearce was leading a program which was examining whether a national price could be developed.
He said this could address the current "distortion" of fees being charged and stop local health districts trying to outbid each other to fill vacancies.
"What we're also doing is looking at what we can do in-house," he said.
"What we're looking at is the opportunities for NSW Health to play a role in the management and allocation of these locums.
"We haven't made a definitive decision, but we think it's an important area to look at."
'There's always going to be more we can do'
The state's paramedics have had a win since Labor came to power.
In December 2023, a 25 per cent wage increase was agreed between the state government and Health Services Union.
The minister hopes this extra money will ensure 500 extra paramedics, to be recruited for rural and regional NSW, will want to stay in their jobs.
The NSW branch of the Australian Paramedics' Association is pleased with the new cohort of staff, but is concerned the stations are not properly equipped.
"There's always going to be more we can do but I'll be blunt, my focus is making sure we get boots on the ground because what paramedics have been telling me is that if we're going to see improvements in our response times, we need to get more paramedics into the service," Mr Park said.
The 11 stations in line for an upgrade are Port Macquarie, South West Rocks, Lismore, Goulburn, Bathurst, Blayney, Lithgow, Mudgee, Parkes, Broken Hill and Ballina.
The minister has defended the rollout which does not include any remote locations.
"I understand that most communities want an upgraded health infrastructure, the demand is high, but in relation to the specific locations I let [NSW Ambulance Service] Commissioner Morgan make those decisions with his staff, in touch with the unions as well as staff on the ground," Mr Park said.