Clinical services becoming unsustainable

One of the big issues that is becoming clearer and of greater concern, especially as we start preparations for the next round of public sector enterprise bargaining, is the impact that unpaid work is having on the sustainability of key clinical services.

The intolerance of the broader community plus government (Federal and State) intentions to legislate against ‘wage theft’ has generated pressure on employers outside hospitality on employment practices that involve non-compliance with industrial agreements. In short, the noose is tightening around the widespread practice in the health sector of unpaid work, our version of wage theft that involves many millions of dollars of unpaid wages each year.

Members have told the Union, through the No Pay No Way survey, that the biggest contributors to workload increases were increases in demand for services, increases in patient numbers and the expansion of services offered. It is also worth highlighting that staff not being replaced when leave is taken or a vacancy arises is another significant contributing factor tor workload increases. The Union believes non-backfilling is under-reported given that for many workplaces the ‘new’ workplace culture is to work harder and longer when there aren’t sufficient staff available.

This is significantly damaging in the workplace and putting members directly in harm’s way. It also shows a dangerously cavalier attitude towards the health and well-being of members and the potential ramifications for patient care.

The Union’s concerns about the management of health services is further compounded by members indicating that staff on extended leave are not replaced, and where staff are replaced it took between 4 and 8 weeks. The failure of management is also highlighted with more than 85% of members indicating in the No Pay No Way survey that there is not sufficient staff to cover workloads when staff take annual leave or sick leave. And if unplanned absences occur, nearly 95% of members indicated that management required staff to pick up the work of the absent staff member as extra work.

There are further implications about the management of vital clinical services within our public health system. Members reported that their clinical service would not be sustainable if they stopped performing unpaid work. While 36% of respondents indicated that they were uncertain about whether their service would be unsustainable, it is of significant concern that the balance of respondents (+60%) indicate their service is unsustainable without unpaid work or unsure if their service would be sustainable. It further implicates the inability and ineffectiveness of direct supervisors and health services management and executives in ensuring that all clinical services are properly staffed.

This approach to management is creating highly stressed and unhealthy workplaces where more than 51% of members indicated they were refused leave because of understaffing. In creating unhealthy workplaces with onerous workload expectations, staff are being injured at work causing more unplanned absences and further compounding the level of understaffing and unpaid work undertaken.

One insidious consequence of understaffed and pressurised workplaces is the growing incidence of our members being threatened with disciplinary action because departments are underperforming in relation to quality and patient safety standards. A recent case saw a member issued with a warning (now withdrawn), as a result of a doctor’s complaint in relation to a delayed pathology test result, even though the delay clearly resulted from understaffing and unsustainable workloads.

The Union’s research clearly shows that unpaid work is structurally relied upon to keep vital clinical services functioning. The cuts to workforces are being compounded by ever increasing workloads. In order to ensure a world-class healthcare system, it is essential to ensure there is a professional workforce, not one made up of underqualified or inexperienced people, of sufficient size to meet the growing demand.

These are extremely important issues that we will be pursuing in the next round of bargaining; and we look forward to exploring these and other issues with members as we begin preparations for bargaining.

Paul Elliott

Share This Post On