Almost 200 psychiatrists threaten to walk off the job in NSW amid mental health system collapse
Staff specialist psychatrists are threatening a mass walkout after the NSW government failed to offer them a single extra dollar in pay, despite a critically depleted workforce.
The NSW government has scrambled to reassure patients after scores of staff specialist psychiatrists handed in their resignations from public hospitals as part extraordinary bid by the doctors to rescue the public mental health system from its deep demise.
Public sector psychiatrists have banded together in a bid to address trends that are leaving hospitals with a critically depleted workforce and jeopardising their ability to provide patient care after a mutiny by the profession from the system.
They are seeking a special boost to staff pay in order to stem the mutiny of psychiatrists from the public system and to lift the low proportions of registrars who plan to work in public hosptials after completing their training. Years ago that figure used to 75 per cent, now only 20 per cent of registrars say they will stay in public sector psychiatry.
A dispute between the public sector psychiatry workforce and the government reached a flashpoint of high tension on Monday night when a group leading negotiations over pay and conditions was told that 150 staff specialists were prepared to immediately walk off the job as the mental health system in NSW teeters on the brink of collapse. A large number are now tendering resignations to take effect from 21st January next year in the biggest doctors’ uprising over system breakdown seen in many years in Australia.
NSW’s minister for mental health Rose Jackson issued a statement on Tuesday saying that NSW Health had offered psychiatrists in May this year via their union a 10.5 percent increase to remuneration over 3 years. This increase represents the offer to all staff specialist doctors in NSW and does not relate to the current special agreement being sought by psychiatrists, which is outside the normal enterprise bargaining process and which would replicate a deal offered to ED doctors in the past when their system was on the brink.
Ms Jackson said NSW Health had offered a suite of “trial productivity” measures to psychiatrists that would “enhance remuneration”.
“We recognise the pressures on psychiatry staff and have been clear in our committed to collaborate to resolve this,” Ms Jackson said.
“The NSW Government have also been actively engaging with (unions and Colleges) ... over the past seven months to address non-award issues affecting workplace satisfaction. Given the ongoing, robust conversations, news of the intended mass resignation of 150 Psychiatrists is a deeply disappointing outcome,” Ms Jackson said. “To be clear – the resignation is not effective immediately and the NSW Government is implementing strategies to safeguard service continuity. If you need help or mental support our hospitals and staff are here for you.”
Psychiatrists working in public hospitals in NSW are paid well below their counterparts in Victoria and Queensland, with staff morale in public hospitals in the nation’s largest state at an all-time low.
The doctors are despairing at the state of the broken system, with hospital psychiatric wards perpetually full, emergency departments overflowing, housing support for vulnerable patients non-existent and a frequently violent and stressful atmosphere existing in many mental health inpatient units across the state.
“We’re resigning in despearation at the system and how the quality of care that we are able give has declined,” said Dr Ian Korbel, a consultant forensic psychiatrist and chair of the Mental Health Staff Committee at Justice Health. “And we are taking this action in hope that we’ll be able to recreuit registrars and retain those who are currently in the system.”
Over the past 10 days, The Australian in a major series dubbed Cast Adrift has documented the scale of the crisis in the nation’s mental health systems as patients are cycled in and out of overloaded hospital wards where they receive ineffective care and staff bleed from the system amid a critical lack of resourcing. The nation is short about 10,000 necessary hospital beds, the workforce is less than half of what it should be to cater to need, and the severely mentally ill are frequently relegated to homelessness and incarceration.
The life expectancy of those suffering chronic severe mental health conditions is at least 17 years below that of the rest of the Australian population.
Doctors are facing routinely being forced to discharge patients before they are well, even though they are being ejected to insecure housing, in order to free up beds in the overloaded system. Many patients who are suicidal or with chronic eating disorders can’t get admission to hospital at all, with the bar now so high for admission that wards have become places often of violence and even horror.
Even private hospitals wards now cannot attract staff as many psychiatrists choose to work in the much less stressful and higher paid role of telehealth consulting.
The public sector psychiatry workforce is burned out and describes the nature of the job as daily “moral injury”. There is a critical retention crisis in the state. About a third of public position are unfilled in NSW because of a workforce exodus. The NSW government is paying enormous wage bills for locums to plug gaps.
Despite this, the government is refusing public sector psychiatrists a pay rise after a government efficiency review panel refused to sign off on a pay rise deal of at least 20 per cent. More than half of the state’s workforce of some 260 public hospital staff psychiatrists have said they are prepared to resign if they are not offered a fair deal.
An emergency meeting of the bulk of the public sector psychiatry workforce on Monday evening was held after staff were told by the NSW government they would be offered a yearly pay increase of zero per cent and any salary raises would need to be gained from “efficiency gains” and extra support, including redesigned workflows, extra clerical staff support and changes to evening shift rosters.
Very large pay rises recently were awarded to police officers and paramedics. The paramedics’ pay deal is costing NSW government coffers $500m; the pay deal that the psychiatrists were seeking was worth $24m.
The psychiatrists will present the NSW government with their position on Tuesday.