System under strain as mass psychiatrist resignations begin
The NSW mental health sector is under strain as the first of mass resignations come into effect. Unions say other doctors now need to consider what action they’ll take if other negotiations fail.
The dispute between public sector psychiatrists and the NSW government is at risk of expanding, with salaried doctors in other specialities being asked to consider “what actions they are willing to take” if their pay negotiations with the state fail.
The union representing doctors, ASMOF NSW, told members in an update that “considering the psychiatrists’ resignations, members must consider what they are willing to do to ensure that our demands are met. This needs to happen at a grassroots level, department by department, hospital by hospital.”
It comes as the state’s mental health sector starts to feel the strain after the first 55 resignations of public psychiatrists come into effect. The resignations are part of a protracted and bitter dispute over pay and conditions between public sector psychiatrists and the state government.
“Having 55 staff who were staff specialist psychiatrists not turning up to work to press their industrial case for a 25 per cent wage increase is going to have an impact, and we are managing that as best we can,” Mental Health Minister Rose Jackson said.
She declined to say if she thought the system was nearing breaking point but confirmed 28 public hospital beds had been removed from the system in recent weeks due to staffing issues.
At last count, 206 of the state’s estimated 295 public sector psychiatrists had indicated their intent to resign. While 55 have already come into effect, 26 have rescinded their resignations and 75 have deferred or delayed theirs. Meanwhile, 50 of those who tendered resignations have now transitioned into VMO contract roles – individual agreements between the state and a doctor.
Under a VMO a doctor is typically paid at a higher rate than if they were a salaried doctor. The state has also hired an additional 32 locums who are also typically paid at a higher rate.
The main concerns of psychiatrists relate to declining patient care, recruitment and retention. Public sector psychiatrists in NSW are asking for a 25 per cent pay increase to stop the mental health system bleeding permanent staff. Psychiatrists are paid less in NSW than their counterparts in Queensland and Victoria.
So far, the majority of resignations affect services in western Sydney. In an update to members, the NSW branch of the union representing doctors, the Australian Salaried Medical Officers Federation, said it had filed an urgent dispute with the Industrial Relations Commission after the Western Sydney Local Health District created a new unit at Blacktown Hospital, called C53, in response to the resignations. The union argues the unit was set up without consultation with it or other staff.
“Whilst the original purpose of the withdrawal unit was to admit patients with medical conditions solely related to addiction, ASMOF and its members were concerned that the C53 unit will admit patients with serious mental health conditions without any psychiatrist staffing,” the union told members. “During proceedings, the ministry conceded that ASMOF and its members have not been properly consulted as per the requirements of the Staff Specialists Award.”
NSW Health secretary Susan Pearce said staff were not being asked to act outside of their scope of expertise any more than usual.
“We are not asking managers and non-clinical staff to make decisions about mental health patients,” Ms Pearce said. “Our managers obviously have a role in helping to manage the system that they’re responsible for, and they do that every day, even outside of these circumstances.”
The government said it was working to relocate patients to other facilities, where needed. It has also urged members of the public to continue seeking out mental health support, although Ms Jackson conceded it was a “challenging” time, especially for the remaining psychiatrists.
“When you have this number of people participate in an industrial campaign to resign en masse, to press their 25 per cent wage claim, there will be impacts, and the impacts that we have seen are absolutely not desirable. We want people in the system, but considering the circumstances, care is being provided and we are delivering it as best we can.”
The pay dispute has been referred to the Industrial Relations Commission which is expected to hear the case in March. The government has again begged psychiatrists to delay any resignations pending the outcome.
“We do want to continue to work with staff specialist psychiatrists to resolve their really legitimate issues around staff retention and staff recruitment. We feel as though the industrial process is a fair, independent and transparent way to address that and ask them to work with us as the industrial relations considers this matter in front of a full bench in mid-March,” Ms Jackson said.
