Wednesday, 19 February 2025

Bills

Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2025

Statement of compatibility

Mary-Anne THOMAS (Macedon – Leader of the House, Minister for Health, Minister for Ambulance Services) (10:38): In accordance with the Charter of Human Rights and Responsibilities Act 2006, I table a statement of compatibility in relation to the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2025:

Opening paragraphs

In accordance with section 28 of the Charter of Human Rights and Responsibilities Act 2006, (the Charter), I make this Statement of Compatibility with respect to the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2025.

In my opinion, the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2025, as introduced to the Legislative Assembly, is compatible with human rights as set out in the Charter. I base my opinion on the reasons outlined in this statement.

Overview

The purpose of the Bill is to amend the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios Act 2015 (the Act) to introduce new and modify existing nurse to patient ratios and midwife to patient ratios that the operators of certain publicly funded health facilities must comply.

Human Rights Issues

Human rights protected by the Charter that are relevant to the Bill

The Bill promotes the following human rights protected by the Charter:

• The right to life (section 9 of the Charter); and

• The right to protection of families and children (section 17 of the Charter).

Right to life (section 9 of the Charter)

Section 9 of the Charter provides that every person has the right to life and has the right not to be arbitrarily deprived of life.

Clause 7 introduces a new nurse to occupied bed ratio for intensive care units in certain hospitals and also introduces requirements for team leaders and intensive care unit liaison nurses in those units. The introduction of these requirements will ensure the delivery of high-quality care in intensive care units.

Clauses 6 will improve nurse to patient ratios that apply to emergency departments by requiring one nurse for each resuscitation bed on the morning shift. Clauses 8 and 9 improve nurse to patient ratios that apply to the night shift in coronary care units and high dependency units of relevant hospitals. Clauses 11 to 13 improve nurse to patient and midwife to patient ratios that apply to the night shift in antenatal and postnatal wards of prescribed hospitals. The improvement to the ratios in these areas of specialty will ensure safe and quality patient care and as a result, will promote the right to life of the patients receiving care in these speciality settings.

The protection of families and children (section 17 of the Charter)

Section 17(1) of the Charter recognises that the families are the fundamental group unit of society and that families are entitled to be protected by society and the State.

Section 17(2) of the Charter provides that every child has the right, without discrimination, to protection as is in their best interests, in recognition of a child’s special vulnerability because of their age.

Clauses 11 to 13 of the Bill improve nurse and midwife to patient care in antenatal and postnatal wards of prescribed hospitals. These improved ratios will ensure that babies, mothers and pregnant women receive a high quality of care by improving opportunities for dedicated patient care and as a result will promote the protection of families and children.

Other potential rights invoked

The right to equality (section 8 of the Charter)

Section 8(3) of the Charter provides that every person is equal before the law and is entitled to equal protection of the law without discrimination and the right to equal and effective protection against discrimination. The new and modified nurse and midwife to patient ratios in clauses 6 to 13 will distinguish between patients in different hospital settings. This may invoke the protected attributes of ‘disability’ and ‘pregnancy’ under the Equal Opportunity Act 2010 and therefore engage the right to equality and non-discrimination.

However, distinguishing the level of care owed to a patient based on their setting in a hospital is reasonable and justified because patients with different illnesses and conditions require varying levels of care depending upon their clinical acuity and the associated treatment necessary to appropriately manage their illness or condition.

For the reasons outlined it is my view that the Bill is compatible with the Charter.

Mary-Anne Thomas MP

Minister for Health

Second reading

Mary-Anne THOMAS (Macedon – Leader of the House, Minister for Health, Minister for Ambulance Services) (10:38): I move:

That this bill be now read a second time.

I ask that my second-reading speech be incorporated into Hansard.

Incorporated speech as follows:

This Bill delivers on the Government’s commitment to further strengthen and protect nurse to patient and midwife to patient ratios and – in doing so – to improve the safety and quality of patient care for all Victorians as well as workload arrangements for our nurses and midwives. This reflects the fact that safety is – and always will be – our highest priority.

Our nursing and midwifery workforce is at the heart of our Victorian public health system and continues to be the most trusted profession in Australia. There are over 50,000 nurses and midwives in our public health system committed to providing patient-centred, empathetic and individualised care.

Since its introduction in 2015, the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act in 2015 (Safe Patient Care Act) has successfully protected minimum workload arrangements – creating a safe, supportive and productive environment for nurses, midwives and patients.

The Government has already delivered two phases of improvements to the Safe Patient Care Act in 2019 and 2020. As a result of these amendments, an additional 1,100 nurses and midwives have been employed over the five years of implementation within general medical/surgical wards and specialist areas of palliative care, haematology, oncology, acute stroke, aged care, rehabilitation, emergency and maternity services.

This Bill proposes a third phase of amendments, delivering the Government’s election commitment to create better staffing and stronger ratios in Intensive Care Units (ICUs), High Dependency Units (HDUs), Coronary Care Units (CCUs) and Emergency Departments. It also provides more support for hardworking midwives to improve the quality of care for parents and their babies.

The Bill advances the intent of the Safe Patient Care Act and demonstrates the Government’s focus on safe and high-quality patient care in five key ways.

First, the Bill introduces staffing ratios into ICUs through the establishment of a 1:1 ratio for ICUs on all shifts in Level 1 and Level 2 ICUs.

Second, the Bill improves staffing ratios in resuscitation bays in Level 1 hospitals with Emergency Departments on morning shift by prescribing one nurse for each resuscitation cubicle on a morning shift in hospitals specified in Schedule 3 Part 1 of the Act.

Third, the Bill improves staffing ratios in postnatal and antenatal wards by enshrining a 1:4 midwifery ratio on night shift in prescribed health services. Maternity Capability Level 5 and 6, as well as Level 4 services that are part of a larger multicampus metropolitan health service will be prescribed for this purpose.

Fourth, the Bill introduces an in-charge nurse on night shift in standalone High Dependency Units and Coronary Care Units. An increase in overnight rostered nursing staff will help reduce clinical risk, improve patient safety and ensure patient and staff wellbeing.

Finally, an in-charge nurse, a team leader and liaison nurse will be introduced in addition to the specified ratios on shifts in Level 1 and Level 2 ICUs to provide essential support to staff, patients and their families.

The Bill also updates the list of hospitals in the Schedules to the Act to ensure they reflect current nomenclature.

A staged implementation process will occur to enable health services to plan and prepare for these improvements. The improvements will be phased in at 25% of the additional staffing implemented from the day after Royal Assent, 75% from 1 December 2025 and 100% from 1 July 2026.

Together these ratio improvements in the Safe Patient Care Act will contribute to the 457 additional nursing and midwifery FTE in the public health system committed at the 2022 State election.

This Bill provides the opportunity to further improve the workplace conditions for our hardworking nurses and midwives, and to make a substantial and positive impact on the provision of safe and high-quality care for all patients in Victorian public hospitals now and into the future.

I commend the Bill to the house.

James NEWBURY (Brighton) (10:38): I move:

That debate be adjourned.

Motion agreed to and debate adjourned.

Ordered that debate be adjourned for two weeks. Debate adjourned until Wednesday 5 March.