Issues of staffing for maternal and child health services was flagged in a 2018 parliamentary inquiry
The premier has blamed the pandemic for the lack of maternal and child health services but it can be revealed the nurse staffing issue was flagged two years before Covid.
Victoria
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The Andrews government was officially warned of worsening workforce shortages among midwives and the state’s maternal and child health nurse workforce at least two years before the Covid pandemic struck.
Despite Premier Daniel Andrews on Thursday blaming the pandemic for crippling nurse shortages in maternal and child health services, the Herald Sun can reveal the same issues were flagged during the 2018 parliamentary Inquiry Into Perinatal Services.
After hearing “constantly” of skills shortages and a lack of maternal child health nurses, the 2018 inquiry even recommended the Victorian government reimburse the costs for nurses undertaking additional training so more may take up roles to address shortages in the MCHS.
Thousands of new mothers across Melbourne’s west are now being left without vital checks for babies older than eight weeks due because council’s in the state’s fastest growing areas cannot attract enough qualified nurses to serve their communities.
Although Wyndham and Melton councils have blamed long-term workforce shortages and booming birth rates for the crisis, the Premier did not acknowledge particular pressures on Melbourne’s west and instead blamed Covid and the fact that nurses “are not immune from the virus”.
“They get sick too. And if they’re sick, they can’t they can’t go to work – that would be the wrong thing to do,” Mr Andrews said.
“So Covid, flu, winter, presents challenges across the whole health system.”
However, Victorian Parliament’s Maternal and Child Health Committee found in 2018 – two years before Covid struck – that “ the challenges and expectations of a changing community place an increased pressure on Victoria’s MCH Service and workforce”, including “staff attrition through retirement”.
“The Committee constantly heard of skills shortages and lack of MCH nurses and believes that the cost of training contributes towards these shortages,” the Inquiry Into Perinatal Services found.
Addressing the inquiry, Australian Nursing and Midwifery Federation Victorian secretary Lisa Fitzpatrick praised the additional qualifications required of Victoria’s MCHS workforce, but also warned of wider issues stemming from a growing birth rate and reduced midwifery workforce hours.
“When you have got Victoria with a growing birth rate and increasing demand and then the workforce reducing in hours, that is sort of heading for a collision,” Ms Fitzpatrick told the 2018 Inquiry Into Perinatal Services.
Mr Andrews on Thursday said he hoped services would resume in Melton and Wyndham in the near future.
“Well, I would hope it will (resume),” he said.
“I would hope that we’re able to, just with Covid catch up.
“But there are different impacts in different settings, some individual services in some parts of our state will be more impacted than others.
“That’s in some respects the kind of random nature of this.”
It is understood Wyndham and Melton have at least 20 MCHS vacancies they are unable to fill, despite having continued an extensive recruiting drive for several months.
The Herald Sun understands the ANMF was also actively working to help its members to undertake maternal and child health training to address workforce shortages in the years before the pandemic even struck.
A Wyndham City spokesman confirmed that long-term nurse workforce shortages were the main reason it had been forced to cut MCHS services, although Covid had exacerbated the issue further.
“A shortage of maternal child health nurses in Victoria together with Covid-19 related absences has impacted service delivery. In Wyndham priority service has been given to the youngest and most vulnerable,” the spokesman said.
“Wyndham currently has eight maternal child health nurse vacancies – positions remain vacant due to a state-wide shortage.
“In the past 12 months, 10 nurses have resigned from positions, largely due to staff gaining employment closer to their home. Ultimately, the shortage of nurses has meant individuals have more options available to them and can prioritise working closer to home for example.
“We have sought assistance from other Victorian councils to relieve pressure on staff whilst providing services to residents.
Melton Council’s community services manager Troy Scoble also confirmed there were long-term staffing issues.
“Our Maternal and Child Health Service remains under increased pressure. The City of Melton is experiencing a high birth rate, across the state there’s a low availability of fully qualified maternal and child health nurses, and the Covid-19 pandemic has also had an impact,” Mr Scoble said.
“The Maternal and Child Health Service is highly valued by council and the community, and we are eager to return it to its full capacity as soon as we have the nurses to do so.
“We have the equivalent of 14 full-time nurses and we need the equivalent of 12 more nurses.
One of the fastest growing areas of Australia, more than 140 babies a week are born on average to mothers from Melton and Wyndham.
But Melton City Council general manager of community services Troy Scoble said there was no option than scaling back its MCHS due to the lack of qualified nurses and workforce pressures that existed prior to Covid.
Melton alone has 11,400 families enrolled in its maternal and child health service – including 3800 due for a consultation in the next six months – though it is not yet known how many will receive appointments.
Under Victoria’s MCHS program council-employed nurse-midwives visit families when a child first goes home from hospital followed by routine checks at two weeks, four weeks, eight weeks, four months, eight months, one year, 18 months, two years and three-and-a-half years.
But after struggling to fill vacancies earlier this year Melton and Wyndham councils were forced to limit their MCHS to babies under four months.
This week families enrolled in the program were informed the situation had deteriorated further and appointments would be prioritised to only babies up to eight weeks or whose families had additional needs.
Melton now has only 14 MCHS nurses and has been unable to recruit staff to fill the 12 vacancies needed to service its community. Wyndham currently employs eight MCHS nurses, following the resignation of ten in the past year.
Australian Nursing and Midwifery Federation Victorian secretary Lisa Fitzpatrick said a number of local governments were having to prioritise MCHS visits, particularly in Melbourne’s west which has seen a birthrate increase 17 per cent higher than other parts of Victoria.
“Our maternal and child health nursing workforce is also experiencing unprecedented sick leave due to Covid and the flu,” Ms Fitzpartick said.
“Our members have advised this will be hopefully short-term and that those vulnerable families who require further visits, such as those at four months and beyond, are being prioritised for visits.”
However, The Australian College of Midwives has criticised Victoria’s regulations for only allowing registered nurses with midwifery qualifications and additional training to work in MCHS.
In a position paper released in April the ACM called for non-nurse midwives to also be able to undertake the additional training and work in the field and help thousands of desperate mothers being denied support.
Werribee GP Joe Garra said doctors in the Melbourne’s outer west were being inundated by mothers unable to see their maternal and child health nurses, even though they were not as well suited to the specialist tasks.
“We are definitely using our baby scales every day now, whereas they used to sit there for months without anyone using them,” Dr Garra said.
“We can do checks and say the baby looks healthy – but the mental health, the breastfeeding and all the other stuff that goes with having a baby … we’re not value adding as much as the child health nurses do.”
Plumpton mum Courtney Thorn said the maternal nursing service was “invaluable” when her son Ashton was born on 2019, however she has struggling to get any support after daughter Emersyn was born in June 2021.
“Her appointments were cancelled because of lockdowns and then the hospital code brown and now all of a sudden it’s the high birth rate,” Ms Thorn said.
“They were seeing four month olds and now they’re only seeing eight week olds, so it’s going backwards. It’s not improving.
“When my son was little, they checked on the mental health of the mum, they checked for family violence, and none of that has happened this time. My household fine, but are there people slipping through the cracks?”
A Department of Health spokeswoman said they were “working closely” with councils in the west to address the shortages.
“Victoria’s healthcare system, including MCHS, continue to face significant demand and workforce pressures due to the Covid-19 pandemic and influenza,” she said.
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Originally published as Issues of staffing for maternal and child health services was flagged in a 2018 parliamentary inquiry
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