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The Hon Robert Brown MLC

Parliament of New South Wales

Legislative Council

Shooters and Fishers Party

MEDIA

RELEASE

Upper House United on Keeping

Registered Nurses

n

Nursing Homes

2 May 2016

NSW Shooters, Fishers and Farmers MLC Robert Brown hit back at the NSW Government's

response to the inquiry by General Purpose Standing Committee No 3 into

Registered Nurses n

New

South Wales Nursing Homes

The Minister for Health, Jillian Skinner, announced that the NSW Government won't be keeping the

30 year legislated requirement for nursing homes to have at least one registered nurse on staff at all

times. This was put into jeopardy by a 2013 Federal law change

to

the definition of a "nursing home"

in the ged Care ct 1997 Cwth)- the definition used in New South Wales legislation.

"This response by the Government fails the pub test," Mr Brown said.

"If you ask anybody in the community whether they believe that registered nurses should remain in

nursing homes the overwhelming response is 'yes'.

"It's surprising that in their response the NSW Government is deferring this fundamental issue to their

Federal counterparts on the eve or a Federal election.

"Since the

Nursing Homes ct 1988

New South Wales nursing homes have been required to have at

least one registered nurse on staff at all times, 24 hours a day. The only reason I can see for a

change is to increase profits for private operators, and that argument is just not good enough

"My understanding is that Opposition and Crossbench are united in favour

of

keeping registered

nurses in nursing homes. It's not often that you see The Greens, the Shooters Fishers and Farmers

Party, the Animal Justice Party, Labor and the Christian Democratic Party stand shoulder to shoulder

on a single issue.

Mr Brown said that registered nurses have a skill set

and

focus on the essentials of care framework

that's vital for health care settings, especially aged care.

"Registered nurses are required for their higher level of skills and focus on improving patient

outcomes, through the Government's own

Essentials of Care

framework.

"Without a registered nurse

on

duty

to

administer Schedule 8 medications, pain relief stronger than a

Panadol can't

be

given.

"A registered nurse has the clinical expertise to know when to and when not administer medications,

such as not giving blood pressure medications when somebody already has low blood pressure.

Parliament House Phone: 02 9230 3059 Fax: 02 9230 2613

Macquarie St SYDNEY NSW 2000

email: robert. brown@ parliament.nsw.gov.au

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''Their high level

of

training also allows them to respond to critical incidents to prevent unnecessary

hospital

admissions an

important attribute when 'trolley block' plagues many hospital emergency

departments.

Mr Brown added that he feared what impact this change could have.

I fear what this change to nursing home practices could mean for our elderly. This affects us all.

Nobody will be spared from the impact

of

this change whether it's our loved ones

or

even

ourselves, we all deserve quality nursing home care.

The Shooters, Fishers and Farmers Party will not stand idly by while older people are taken for

granted.

MEDIA CONTACT:

Robert Brown MLC

02) 9230 3059

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Key Points on Keeping Registered Nurses in Nursing Homes

One Regis tered Nurse on Staff At All Times

•  The requirement to keep at least one registered nurse on staff at all times is in s104 of thePublic Health Act 2010 (NSW). 

o  This requirement has existed since the Public Health Act 1991 (NSW) and earlier inthe Nursing Homes Act 1998 (NSW)

Why We Need Registered Nurses

o  Under the Poisons Act and TGA Act anybody needing pain relief greater than aparacetamol (i.e. codeine, oxycodone, opiate-based drugs, etc.) requires at least oneregistered nurse because the drugs are classed as Schedule 8 drugs (i.e. drugs ofaddiction).

  Medication scheduling, storage and administration in aged care has the samestandards as hospitals. There are whispers of these changing, but it bringsinto question why lesser standards should be allowed in aged care (these arein place to prevent medication errors, and to prevent theft of drugs.

o  Registered nurses also:  know when to and when not to administer drugs (e.g. withholding blood

pressure medications when a patient’s blood pressure is too low),  can admit patients back from hospi tal (a nursing home resident and

former doctor was evicted from hospital last year because there wasn’t aregistered nurse available over a weekend to readmit her   – apparently thepatient died a week or so later at St Vincent’s Hospital after leaving Prince ofWales and being refused at her nursing home due to inadequate staffing tocare for her), and

  can respond to critical incidents, preventing unnecessary hospitaladmissions  (reducing existing bed-block issues and taking the pressure off

the public health system).•  The Government’s idea is just to have employees with a minimum of

a first aid certificate on site, responding to an incident with the bareminimum of interventions (i.e. CPR if they arrest) and call anambulance.

 Arguments in Favour of Not Employing Regis tered Nurses

•  Pay rates are lower (NB hospital pay rates quoted here, but nursing homes often pay less,though ratios between roles is the same).

o  Base rate for a first year Registered Nurse in a public hospital is between$57,943.60 and $81,369.60 without penalty rates.

o  Base rate for an Enrolled Nurse is between $52,234.00 and $56,747.60 withoutpenalty rates.o  Base rate for an Ass is tant in Nurs ing is between $41,641.60 and $45,687.20

without penalty rates.

•  Assistants in Nursing are easier to employ, and there’s more of them looking for worko  Very little training is required for an AIN – at best a Certificate III course is required,

but unlike Registered Nurses and Enrolled Nurses, AINs are not registered and haveno professional standards governing minimum requirements.

  For the record, training for each level of nurse is as follows:•  Registered Nurse – 3 years, Bachelor Degree•  Enrolled Nurse – 1 year, TAFE Diploma•  Assistant in Nursing – 1 month Certificate III TAFE Course

http://www.legislation.nsw.gov.au/#/view/act/2010/127/part7/div4/sec104http://www.legislation.nsw.gov.au/#/view/act/2010/127/part7/div4/sec104http://www.legislation.nsw.gov.au/#/view/act/2010/127/part7/div4/sec104http://www.legislation.nsw.gov.au/#/view/act/2010/127/part7/div4/sec104http://www.legislation.nsw.gov.au/#/view/act/2010/127/part7/div4/sec104http://www.legislation.nsw.gov.au/#/view/act/1991/10/part1/sec3http://www.legislation.nsw.gov.au/#/view/act/1991/10/part1/sec3http://www.legislation.nsw.gov.au/#/view/act/1991/10/part1/sec3http://www.legislation.nsw.gov.au/#/view/act/1988/124/part3/sec39http://www.legislation.nsw.gov.au/#/view/act/1988/124/part3/sec39http://www.legislation.nsw.gov.au/#/view/act/1988/124/part3/sec39http://www.smh.com.au/nsw/elizabeth-rogers-the-elderly-patient-threatened-with-eviction-from-hospital-dies-20150821-gj4umk.htmlhttp://www.smh.com.au/nsw/elizabeth-rogers-the-elderly-patient-threatened-with-eviction-from-hospital-dies-20150821-gj4umk.htmlhttp://www.smh.com.au/nsw/elizabeth-rogers-the-elderly-patient-threatened-with-eviction-from-hospital-dies-20150821-gj4umk.htmlhttp://www.smh.com.au/nsw/elizabeth-rogers-the-elderly-patient-threatened-with-eviction-from-hospital-dies-20150821-gj4umk.htmlhttp://www.smh.com.au/nsw/elizabeth-rogers-the-elderly-patient-threatened-with-eviction-from-hospital-dies-20150821-gj4umk.htmlhttp://www.smh.com.au/nsw/elizabeth-rogers-the-elderly-patient-threatened-with-eviction-from-hospital-dies-20150821-gj4umk.htmlhttp://www.smh.com.au/nsw/elizabeth-rogers-the-elderly-patient-threatened-with-eviction-from-hospital-dies-20150821-gj4umk.htmlhttp://www.smh.com.au/nsw/urgent-measures-put-in-place-as-delays-cause-chaos-in-health-system-20150720-gig9sf.htmlhttp://www.smh.com.au/nsw/urgent-measures-put-in-place-as-delays-cause-chaos-in-health-system-20150720-gig9sf.htmlhttp://www.smh.com.au/nsw/urgent-measures-put-in-place-as-delays-cause-chaos-in-health-system-20150720-gig9sf.htmlhttp://www.nswnma.asn.au/wp-content/uploads/2013/07/Public-Health-System-Nurses-and-Midwives-State-Award-2015-Wage-Calculator-1-July-2015.pdfhttp://www.nswnma.asn.au/wp-content/uploads/2013/07/Public-Health-System-Nurses-and-Midwives-State-Award-2015-Wage-Calculator-1-July-2015.pdfhttp://www.nswnma.asn.au/wp-content/uploads/2013/07/Public-Health-System-Nurses-and-Midwives-State-Award-2015-Wage-Calculator-1-July-2015.pdfhttp://www.smh.com.au/nsw/urgent-measures-put-in-place-as-delays-cause-chaos-in-health-system-20150720-gig9sf.htmlhttp://www.smh.com.au/nsw/elizabeth-rogers-the-elderly-patient-threatened-with-eviction-from-hospital-dies-20150821-gj4umk.htmlhttp://www.smh.com.au/nsw/elizabeth-rogers-the-elderly-patient-threatened-with-eviction-from-hospital-dies-20150821-gj4umk.htmlhttp://www.smh.com.au/nsw/elizabeth-rogers-the-elderly-patient-threatened-with-eviction-from-hospital-dies-20150821-gj4umk.htmlhttp://www.legislation.nsw.gov.au/#/view/act/1988/124/part3/sec39http://www.legislation.nsw.gov.au/#/view/act/1991/10/part1/sec3http://www.legislation.nsw.gov.au/#/view/act/2010/127/part7/div4/sec104http://www.legislation.nsw.gov.au/#/view/act/2010/127/part7/div4/sec104

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  Most AINs are students studying to become RNs, so there’s a lot of peoplelooking for work. Many are also migrants, etc. from overseas working in theindustry as a stepping-stone to something else.

“ Nursing Home” Definition Changed Federally

•  The definition of a “nursing home” in the Act defaulted to the Aged Care Act 1997 (Cwth). 

•  The federal Aged care Act was changed in 2013, coming into force at the start of the2014/2015 financial year to streamline funding arrangements for residents and transitionsbetween low care and high care facilities.  One flow-on consequence was to change thedefinition of a ‘nursing home’. The term in the new  Aged Care (Living Longer Living Better) Act no longer used the word “nursing home” so s104 in the NSW Public Health Act becamenullified by default.

•  The three largest private nursing home providers floated on the ASX just soon after the lawchange and are recording high profits as a result.

•  NSW Health Minister Jillian Skinner  grandfathered the status quo provisions for keeping atleast 1 Registered Nurse on staff at all times to nursing homes that had been operating before1 July 2014, but it means that all other nursing homes that established after that datewere exempt from the standard. That’s why Uniting Care and other providers madesubmissions to the GPSC 3 inquiry saying it would affect their profits because many placesstarted building new nursing homes to take advantage of the loophole.

o  That regulation, the Public Health regulation 2012 (NSW) is due to be reviewed on 1September 2017.

http://www.legislation.nsw.gov.au/#/view/act/2010/127/part1/sec5http://www.legislation.nsw.gov.au/#/view/act/2010/127/part1/sec5http://www.legislation.nsw.gov.au/#/view/act/2010/127/part1/sec5https://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reformhttps://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reformhttps://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reformhttps://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reformhttps://www.legislation.gov.au/Details/C2016C00170/Html/Text#_Toc445198947https://www.legislation.gov.au/Details/C2016C00170/Html/Text#_Toc445198947https://www.legislation.gov.au/Details/C2016C00170/Html/Text#_Toc445198947https://www.legislation.gov.au/Details/C2016C00170/Html/Text#_Toc445198947http://www.crikey.com.au/2015/01/15/profits-rise-quality-called-into-question-in-aged-care-industry/http://www.crikey.com.au/2015/01/15/profits-rise-quality-called-into-question-in-aged-care-industry/http://www.crikey.com.au/2015/01/15/profits-rise-quality-called-into-question-in-aged-care-industry/http://www.legislation.nsw.gov.au/regulations/2014-566.pdfhttp://www.legislation.nsw.gov.au/regulations/2014-566.pdfhttp://www.legislation.nsw.gov.au/regulations/2014-566.pdfhttp://www.legislation.nsw.gov.au/regulations/2014-566.pdfhttp://www.legislation.nsw.gov.au/regulations/2014-566.pdfhttps://www.parliament.nsw.gov.au/committees/inquiries/Pages/inquiry-submission-details.aspx?pk=%2041040https://www.parliament.nsw.gov.au/committees/inquiries/Pages/inquiry-submission-details.aspx?pk=%2041040https://www.parliament.nsw.gov.au/committees/inquiries/Pages/inquiry-submission-details.aspx?pk=%2041040http://www.legislation.nsw.gov.au/regulations/2012-311.pdfhttp://www.legislation.nsw.gov.au/regulations/2012-311.pdfhttp://www.legislation.nsw.gov.au/regulations/2012-311.pdfhttp://www.legislation.nsw.gov.au/regulations/2012-311.pdfhttps://www.parliament.nsw.gov.au/committees/inquiries/Pages/inquiry-submission-details.aspx?pk=%2041040http://www.legislation.nsw.gov.au/regulations/2014-566.pdfhttp://www.legislation.nsw.gov.au/regulations/2014-566.pdfhttp://www.legislation.nsw.gov.au/regulations/2014-566.pdfhttp://www.crikey.com.au/2015/01/15/profits-rise-quality-called-into-question-in-aged-care-industry/http://www.crikey.com.au/2015/01/15/profits-rise-quality-called-into-question-in-aged-care-industry/https://www.legislation.gov.au/Details/C2016C00170/Html/Text#_Toc445198947https://www.legislation.gov.au/Details/C2016C00170/Html/Text#_Toc445198947https://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reformhttps://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reformhttp://www.legislation.nsw.gov.au/#/view/act/2010/127/part1/sec5