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Mr Chair, I rise to make comments to the Minister's contribution to Estimates last week and my focus will be in the area of Health.
Before I start speaking to this particular matter, there is a consistency and a theme that I am picking up across a number of portfolio areas and a lot of Ministerial contributions in terms of major infrastructure announcements.
Earlier, I had the opportunity to reflect on Mr Barnett's contribution and express some disappointment in the process of making timed announcements in election campaigns to raise signature expectations in a community where a funding commitment is made, delivered, and then followed up with actual input into the budget. On that matter it was $100 million for irrigation which is critically important to all of Tasmania.
Earlier, Mr Ferguson said the reason we are not seeing things included in these current Estimates is because industry is calling out for longer-term consideration of infrastructure development and rollout. From the little, old world of local government where I come from, we run budget estimates every year. The particular council I have experience with, the Launceston City Council, embarked on a major project over the last few years. It was nation-leading in having long-term financial plans and strategic asset management plans where they not only dealt with their current estimates in current and immediate years, but were projecting over 10 years and beyond and doing it publicly so the community could see, where they were committing to certain projects they were actually committing to it.
Although real-term dollars in the future may be different, with the announcements that you are making now, with the expectations that you are raising, you are saying there is a commitment to deliver into the future. 81 My contribution today is in the area of health and in particular to the LGH (Launceston General Hospital). It would have to be characterised, I think, as a signature announcement for the stage two masterplan of the LGH.
As I do with every contribution, I acknowledge the good work that is currently happening. There are some funds in the Budget for some works right now. The challenge is always infrastructure. Development, in and of itself, used to be, or could be, determined as the easy part of a delivery. Staffing and operating new infrastructure is always where the heavy spend ends up and where the focus on ongoing investments needs to be made, particularly in relation to recruiting and securing staff.
In acknowledging the things that are happening, there was a signature announcement about the $580 million for the stage two redevelopment of the LGH. It raises expectations in a community where there is immense pressure, immense disappointment and often complete letdown in the current health system.
Just recently, the dashboard data across Tasmania showed 11,000 Tasmanians remain on the elective surgery wait list and only half of them are being able to be seen within the clinically recommended times. When they see an announcement, people expect that means that it is something that is immediate. We live in a world where we understand future management or future commitments. However, in the real world, when someone in the community hears that there are problems at the LGH and there is an announcement that it is going to be fixed, they would see something being delivered in the Estimates.
It was my first year opening the Budget papers and understanding how to navigate them, crazily looking through lots of pages and lots of volumes to find the detail.
When I did find the detail in regard to the stage two masterplan of the LGH, there were zero dollars allocated in any of the years of the forward Estimates. Having a long-term future plan is important but raising expectations and then not delivering in real time is challenging. In my contribution to the efforts of the Government and in response to the minister's Estimates last week, my trust is that where an announcement is made, a light conversation occurs.
Again, it is not dissimilar to the conversation I reflected on with Mr Barnett. You can quickly write a letter and say that I am going to ask for this money but not have done the work early to actually know that it can be secured or the business case has been done.
I trust that the Minister will follow up and make strong representations, ensure the funds are secured so the people in Northern Tasmania who are concerned about their ability to access and be supported by the LGH can be assured that stage two of this project will be delivered, staff will be secured and maintained in the facility and our community will be served by what we hope will be a strong investment into health services in northern Tasmania.
September 15, 2021 - 4:25pm
Video - YouTube
Mr Speaker, I rise to make my contribution on this matter of public importance in regard to a facility in my electorate of Bass.
It is a facility that serves not only our community but has a responsibility across much of the North of the state for not only members of our community that need to access health services, but, of course, the many people in our community who go above and beyond, day and night, often days and nights in a row, to serve our community as health professionals.
At the moment they are struggling under the pressure. When you wake up and you see an announcement that people are being encouraged not to attend the hospital because they fear their capacity to deliver great care to our community, you have to wonder just what is going on. This is beyond a crisis. These are dire circumstances where people in our community are being told despite all the best efforts of people working in our frontline services, our nurses, people providing care in our community, they are just not going to be in a position to be able to provide that care if you attend the hospital.
With pressure on the Emergency Department, sustained staff shortages, bed block and ambulance ramping, the time has passed to having staged, considered responses.
Right now we need to have a government that is making committed and priority actions to support our community and also those people working in our community to support the healthcare needs of Launceston, Bass and northern Tasmania. As our shadow minister for health mentioned earlier, at the LGH in Launceston we have the worst bed block in the country.
There are so many things in the history of Launceston that we have been so proud of, that we are the greatest at, that we are the most at, the best at, but to have the worst in the country at anything in our healthcare is something that needs the immediate and robust attention of this Government to address. That patients are being turned away but staff want to provide care and they cannot is a real reflection on this Government and its ability to deliver for Tasmanians.
There was a comment this morning in response to a question that I want to address. The Attorney-General said something about always delivering on their commitments. You would think in that role that only ever being truthful in comments would be important in the Parliament, but the people of Bass know that this Government does not deliver on their commitments.
As our Shadow Minister for Health said, there was a signature announcement in the last election of $580 million for the second stage of the masterplan of the LGH. I have been across budgets and budget commitments and elections for a really long time, having started at the Launceston City Council over 22 years ago. I know my way around a budget and I was gob-smacked to see the budget papers after this massive announcement, on the eve of an election, and there is a line that has four-year forward Estimates - dash, dash, dash, dash.
You would never get away with that in the City of Launceston, making an announcement for a massive commitment in a community having zero dollars. The announced budget for this big project was $580 million to bring in the votes, but then you have dash, dash, dash dash. That means zero dollars committed in the budget in the four-year forward Estimates for that project to be delivered.
That election was a while ago, early of course, so maybe it is going to take the Government a little while to get their act together on that, but you cannot make commitments to a community and not follow up and then expect them to think that they cannot come to the hospital this week because they are not going to be able to be looked after.
It is a bit like the commitment around the Tamar Bridge, it is a bit like the commitment around the dredging - when are these things going to happen? A community needs to trust that a government will deliver on its commitment and at the moment there is no trust or confidence in the Government that they will deliver on their commitments.
In response to the announcement yesterday that people are being discouraged to attend the LGH, there is a whole range of comments on local social media feeds, and on my own feed, a member of our community this morning said, 'It's really scary, any of us are an accident or a diagnosis away from seeing the disaster from the inside'. I know that is anecdotal, but talking to nurses, a lot of them are fed up with double shifts and feeling guilted into working extra hours because of the lack of resources, and so many are wanting to change their career entirely.
We cannot have people walk away from this career. We are already struggling to get healthcare professionals in our community. We already struggle to get the people to deliver the support that we need in our community. We cannot afford for this to continue for our workforce and our community. We know there are challenges. We know that we have a small population that is widely dispersed, and one of the biggest challenges is that we have an ageing community.
I know the Premier and Minister for Health announced this morning that $150 million will be in the Budget for digital innovation and suggested that perhaps on this side we do not believe in innovation. I can tell you I am one of the strongest supporters in Tasmania about the potential of innovation for our state. However, when you cannot get the basics right, you cannot cream on top of nothing with innovation. We need to make sure that the basics of the services, the support for our healthcare workers and the support for our community, is delivered through the Launceston General Hospital.
There was a comment this morning about wanting to work with the new Labor federal Government, which is fantastic. Labor gets what is needed and thank goodness on Saturday Anthony Albanese, the now Prime Minister, committed to delivering urgent medical healthcare clinics across the country, and particularly one in Launceston.
This is going to make it easier for people to attend when they have things that do not need to go to the emergency department, and that will be great because it will take pressure off, but we have needed these sorts of responses for a really long time.
Labor is also committed to cutting the cost of medications and to supporting nurses and the mental health of the people seeking to support our community. It is not good enough that we have a facility to deliver for Northern Tasmania that cannot take people at the moment and is recommending and encouraging people not to attend.
I will finish on a positive note and say that after many years, with the support of Federal Labor, we are going to be able to provide a hospice in Northern Tasmania which will again take pressure off the ED, but this Government needs to get the basics right at the LGH in order that our healthcare workers can deliver for the community of Launceston and northern Tasmania.
May 25, 2022 - 11:48am
Video - YouTube
Mr Speaker, I rise this evening to make a contribution on this bill. As has already been indicated by previous speakers, Tasmanian Labor supports the miscellaneous amendments, noting that it has taken a little while to get here but it is important nonetheless when there is an opportunity to speak about the health system and any improvements, as administrative as they may be, to take this opportunity to stand on the way through.
I want to add to the comments that have been made in regard to the current status of our Tasmanian health system that seeks to support, or tries its best to support, Tasmanians not only in our urban areas where our major hospitals are but also reach right across Tasmania.
We have no doubt heard in all of our electorates, particularly over this break when we have been back in the electorate, of the massive load being felt, not only the professional load being felt by health professionals across Tasmania but the emotional and mental load as a result of that being carried by so many.
Taking the opportunity to read some statistics into Hansard, weekly updates have been provided to back-in our great health professionals and share with the community the pressure that they are under and the load they are carrying for Tasmanians. Sometimes when I am in this place, and whether it be health, education or any of the other areas that are under stress in Tasmania, sometimes it feels like the Government does not deeply feel the realities of what is going on across Tasmania. I thought I would share some of these updates to make sure the Government does understand the depth and weight of these responsibilities.
For 22 July 2022, there are some statistics recorded about double shifts. There were 339 double shifts in that period, shifts worked short were 170 but staffing impacted due to COVID-19 was 328. Now as we go through weekly updates, the double-shift statistic is growing. On 22 July it was 339, by 29 July it was 388, by 5 August it was 642, and by 16 August it was 683.
I have friends and family working in the system. I know that we hear from people all around but initially you would hear about health professionals feeling fatigued, stressed and upset about the challenges they faced. Now people are quite rightly concerned for both themselves and their colleagues' welfare in terms of the expectation of these loads, these extra shifts and the implications of not making yourself available and not being up to being able to deliver.
People are falling away from the service: great people, great Tasmanians, are falling away from the service because they do not have the internal feeling that they can continuee. That is such a tragedy for Tasmania. Recently, there has been a really powerful campaign by the ANMF. I am not sure whether everyone in this place has been aware or taking note but there have been personal stories regularly shared. I have been engaging with the campaign through social media. I am sure these things have been shared directly with the Premier, the minister. I know that others will be having face-to-face conversations with people but I want to take this opportunity to put on record some of the personal stories of people in our health service. As we know personal stories are so impactful and that is often what drives action. At lunchtime today we had the opportunity to hear personal stories from a different sector.
Choosing not to engage, or feeling that you actually understand when you have not heard directly - I do not think this provides the foundation for great policy, legislation or understanding to drive action. I will read some of these stories in. This letter to the Premier: We can't support our new grads under the pressure of the system. They're thrown in the deep. Staff are leaving in huge numbers to work interstate for higher rates and safer staffing levels. That was from an enrolled nurse in southern Tasmania. All of these letters are addressed to the Premier who is carrying the almost unbelievable load of being the Premier of Tasmania and the Minster for Health.
This is a letter to the Premier from an assistant in a nursing student area of southern Tasmania: I work as an AIN and I am also about to finish my nursing degree. To say that I am scared about practising as a graduate nurse is an understatement. My work as an AIN has been eye opening into just how cracked and broken our health system is. Constantly I am doing double shifts, 17 hours sometimes to ensure patients are safe, because if I am not there, no one can give them the one-to-one care they desperately need to keep them safe. I work one on one with patients who are at significant risk of falling or injuring themselves due to dementia, delirium et cetera.
I work closely with nurses all shift. The amount of nurses who stay on to do double shifts is ridiculous. Not only that, but I am a full-time nursing student. I get paid absolutely nothing to work my butt off for a total of 800 hours. My last placement was a shock. Every shift we were struggling to get a safe amount of nurses on the floor.
One day, we only had three nurses for 15 high needs patients and without me, these patients would not have received a wash until night time or have even eaten their food. To get this sense that we have people who have been in a system, dedicated their lifetime to these careers that are under pressure. To know that students at the early level of deciding to enter this career, conversations that I have had with people who thought they might want to be a nurse or another health professional but have decided to go on another path.
We are losing such great opportunity and capacity from Tasmania because of these horrendous circumstances. Another letter to the Premier, a registered nurse from southern Tasmania: We are often understaffed with demands of acute and unwell patients. They are often abused by patients for wait times that they have been barely seen for about the last five or more hours. We are sick and tired of bearing the brunt and chaos that is from an under supported and underfunded failing health care system. We are angry and we are tired.
Please help us. Premier, we are not coping. We are at breaking point and the only reason we stay is for our colleagues and the patients who deserve more. Working consistently short staffed every shift and being a senior nurse is exhausting. We are trying to support our junior colleagues in an acute setting while looking after the most unwell on the ward and short staffed. I can't count the overtime and doubles I've done in this last year.
I can't count the amount of times I have gone home and crawled into bed because I've got nothing left for my family. I can't count the times I have not had a break on an eight or a 16- or 18-hour double. We work in PPE, we don't get to hydrate because we don't have time and staffing just does not allow it. We barely get time to even go to the bathroom. We are burnt out and broken.
Patients will start dying due to the unsafe conditions we are working in and we will not be responsible. You will. Letter to the Premier: Last week I resigned. I have had enough. I have been a midwife for 10 years and whilst there have been tough times, I can say I have loved my job, and been proud to say what I do. Until now.
I am not proud to be a midwife. I am not proud to give sub-par care to vulnerable women, their babies and their families. I am not proud to work in an environment where every single employee wants to find another job. I am not proud of a workplace that can't allow their staff to have a meal break, toilet break or go home on time because there is no-one else to care for their patients.
I am not proud to work somewhere that there are often 50 per cent less staff than what is benchmarked as the safe requirement. I am not proud to go to work every day and wonder if today will be the day that that catastrophic event occurs and leaves me destroyed, having that on my conscience for the rest of my life. I am proud of my incredible colleagues who turn up every day, often for double shifts in horrendous conditions to continually give their all in a damaged and broken system. I want to be a proud midwife again one day, but for now, I'm out.
A registered nurse from the north-west of Tasmania: I am a junior nurse on a busy medical ward. I have completed two double shifts back-to-back with five hours of sleep and need to return again in the morning for my short-staffed shift. This isn't fair on the patients and isn't fair for my family. Closer to home in northern Tasmania: I'm a registered nurse with 10-plus years in emergency department experience. However, currently I'm not practising because of the stress of working in a chronically underfunded and understaffed system that took a toll on my mental health.
Premier, working short-staffed repeatedly, going home tired, pressured and unsupported, dealing with frustrated patients when they have their surgery cancelled after extended time on the waiting list, or having no post-op bed to go to constantly, payroll mistakes, unrealistic goals that are not achievable with current pressures on the health system, especially with the added impact of COVID-19. An account from a registered nurse on the north-west coast.
Also from the north-west coast: The way COVID has impacted the nursing profession as a whole is encompassing. The job we signed up for and the landscape in which we are practising is forever changed, and so our conditions and pay need to also change. I thought I knew where I would work and how I would progress in my career.
Now I'm questioning if nursing will even be my profession. The staffing pressures, the high acuity of patients, the administrative demands and the unrelenting demands to function in a system that is not set up to respond quickly is breeding unheard frustration within nursing peers. We cannot go on like this. The people of Tasmania need a functional health system. That system needs nurses. We need to feel valued and supported.
To alleviate the staffing pressures, we need to be able to competitively recruit with our mainland hospitals but we cannot offer the same rates of pay, so why would they come? We are trapped in a cycle that feels unending and there is only so much resilience, grit and collegial goodwill to get us through. It's exhausting; physically and mentally. Two-and-a-half years into the pandemic and no end in sight. We're all running on empty. Back in the south, in southern Tasmania, a comment from a registered nurse: We're being pressured to keep unwell patients out of our emergency department, even though we know they cannot get into their GPs. I get calls from their distraught family members when they end up waiting in emergency for 30-plus hours for a bed. I take their stress home with me and dread going back to work.
In the north: We currently have a COVID outbreak on our ward. Staff are tired, staff are calling in sick because they're tired of working short. I feel like we're just surviving in damage control, trying to keep the patients safe. We are always working short and begging people to do extra hours or double shifts. On the north-west: Sometimes, no-one turns up to receive handover, so we are asked to do a double shift, after already working in such a chaotic, almost unmanageable shift with minimal to no help. You receive messages to work extra or double shifts constantly while already at work and on days off. There is no escape.
Previously encouraged to take hydration breaks, despite barely being able to take a toilet break and then receive an email reminding us of our paid meal break and that we are to return to work if our workload does not allow us to have an adequate break, which is a regular occurrence.
Often minimal support from NIC, NUM, and OHC on shifts for breaks. No-one is staffed to relieve breaks. We rarely get morning tea. You spend your breaks stressing about the accumulating jobs to complete when you return because no-one is relieving you.
From southern Tasmania: Premier, I have never felt so disheartened to go to work. We see so many people suffer unnecessarily because of ramping and bed block and we are the ones that get yelled at and abused about not having beds available when we have no say in how the hospital is staffed or run.
We get consulted but no-one ever collaborates or listens to us. In any other profession our working conditions would be considered abuse. In the north: I am a newly-graduated nurse and constantly question whether I made the right decision to be a nurse. I am anxious before every shift and feel guilty every time to have to turn down a double shift to maintain any sort of mental wellbeing. From the south: I am a registered nurse in the Emergency Department at the RHH.
I have used all of my sick leave on mental health days away from the department as it is spirit-crushing, every single shift walking through the doors, seeing the defeated faces of my colleagues who don't have the staff, resources or support we need to provide adequate and safe patient care. I see otherwise avoidable incidents occurring on every single shift as a direct result of the lack of support from the Government. We write copious amounts of SRLS's, safety reports, regarding incidents in the workplace that either cause direct harm to patients and staff or have the potential to cause harm to patients and staff, and we're simply not seeing any real tangible action occurring once we've reported them.
Our department is stretched so far beyond our limitations that it is quite frankly a dangerous and terrifying place to work. We are the lowest paid nurses in the entire country. A nurse working in Queensland took an eight-hour pay cut to come and live back in her home state of Tassie to get some time away. We are, to put it bluntly, heartbroken.
These personal stories - there are so many to recount and these are the stories that have been collected and shared but they're not all the stories and they're not the only stories that we hear from time to time. There are so many with consistent themes and consistent challenges that demand and require a response in a way that respects the efforts and the burden that is being carried by health professionals.
From northern Tasmania: Premier, we are not working tirelessly; we are absolutely exhausted. We have been gaslighted for long enough and the thanks is not enough to compensate for the work and responsibility we have.
We are constantly told by management never to show our patients the distress of being under-staffed but when we're running out of chairs or beds in our clinic and there are up to 10 patients waiting for an average of one to two hours for their treatment, what can we say?
I am not taking the blame for the lack of patient safety anymore. I have a lot of passion for my work but more often than not I'm wondering if I'd be better off packing boxes in a warehouse for the same pay than day in, day out risk people's lives due to the unsafe staffing and working conditions. I'm not alone.
Wearing full PPE during our shift, not able to have a sip of water until the measly 30-minute lunch break we get. We're dehydrated. When I vent about my day to friends that have office jobs or other normal jobs, they get shocked at the working conditions we have in a country like Australia.
Meanwhile, this has become the norm. I'm tired and if it doesn't improve soon, I'll put my scrubs to rest for good. I'm a midwife and our conditions are shocking. The majority of our shifts do not get breaks and the care we're able to give patients is average. We have new midwives coming through, working and learning in these conditions.
It's a huge concern because these junior midwives are required to try to learn in these conditions but are unable to and we are unable to give them the support and education they need and, therefore, this will be detrimental in the future of nursing and midwifery in Tasmania. Not only is this unsafe for our patients, it also means that we have midwives that have just trained and leave the industry straight away because who wants to work in these horrible stressful environments? Most of the midwives I work with discuss on a daily basis how they want to leave the industry and if the Government doesn't do more there won't be midwives left to deliver safe care to women and babies and, therefore, there will be a higher morbidity and mortality rate in maternity areas.
From an enrolled nurse in northern Tasmania: We are so short-staffed we had to call elderly clients who live home alone and tell them we have no nurse to attend for their clinical and personal care needs. Premier, I am a mum of three, two with special needs, and a passionate nurse that has chosen to dedicate my career and my life to caring for others.
This gives me purpose and I'm damned good at what I do but, far out, we're stretched beyond our means. We're tired, exhausted. We're working so many hours, often without a break, or most of the time going without basic necessities like a drink of water because we can't take off our PPE unless in the staff room. And if you do go and have a second to grab a drink in the staff room and there's too many in there already, well too bad, go without. This is the reality for us. You have no idea. I work my eight- to 10-hour shifts and often don't have time to do a wee. Is that too much information? Well, that's the hard truth.
But you know what? I still give my absolute all, until the soles of my feet burn and my eyes sting with tiredness. We all keep going because we care, because we made an oath to the patients we care for. Show some compassion and start caring for us. The burnout is massive. Premier, our job used to be fulfilling because we knew we were making a difference and now we're just hoping we'll be able to do the bare minimum our patients need to get better. I hate to say it but I would dread having a loved one or myself come into this hospital because, depending on the day and the staffing, they may not get the care they should be getting because there's not enough staff.
It's not good enough and it's heartbreaking. I personally had to start anti-depressants because this job made me so depressed. My psychologist, who I didn't have until a few months ago, has said that my mental illness is a direct relation to my work environment. How can I give my all and look after my patients when I'm breaking at the seams?
We need help. I'm so worried about where we're heading and hope every single day that someone doesn't die as a result of the staffing shortages. From southern Tasmania: I've nursed for 15 years and I've moved away from direct-care nursing because my body literally can't handle the shiftwork any more, diagnosis after diagnosis, associated with burnout and fatigue.
Those of us who can are called back to the floor in tough nursing shortages. I've never seen the hospital so bad. It's messy. The patients are not getting the care they deserve and the morale and ethical distress we face as staff is the highest it has ever been.
I genuinely cannot work in the clinical space any more due to PTSD. Opening more beds in the hospital is not actually helping anyone any more, especially when the unit opens without education support, safe staffing levels or an appropriate model of care.
Yes, COVID-19 has been hard and, yes, we need to adapt, but how much more can we adapt before you recognise that we cannot give the care we need to? From north-west Tasmania: Double shifts are always on offer but due to the workload, we just physically cannot work another shift. I'm actively seeking work elsewhere because the thought of going to work gives me anxiety, lack of sleep and stress. This is just not sustainable. When I hear people, they want to go into nursing; I tell them not to, worse decision I ever made.
From Hobart: Premier, the chronic shortage of midwives in Tasmania is having a massive impact on our staff and the women of southern Tasmania. We have not had a fully staffed roster for years and cannot retain interstate graduates due to the cost of living. We are desperate and burnt out. The lack of pay parity with the mainland and the cost of housing in Tasmania are issues that need addressing. You cannot continue to ignore us.
Lives are being affected, women's birthing experiences and levels of care are being affected and we cannot go on like this. Please, please help us. The morale injury nurses feel as we are unable to give patients the care they deserve is real and distressing. The number of new and younger nurses I find in tears due to overwhelming work conditions is just not fair.
The number of days off I spend thinking about things that have happened at work interferes with the quality of life. The anger people direct at us at work due to their long wait times of LOS et cetera is not fair. I doubt there are many other jobs where you cop abuse so regularly. From southern Tasmania: A letter to the Premier, Premier, during 2021, I was working at least one 18-hour shift a week on top of my usual hours. During an 18-hour double shift it is not uncommon to not have a break at all, not even to empty your bladder.
The acuity and needs of patients cannot be met with current staffing levels. My heart breaks as these patients are not receiving the care that they require and are entitled to. I frequently go home from my shift in tears because I know I could do better for my patients but the dire staffing levels make it almost impossible to provide even the basic care. In the north: Working short-staffed is a serious safety issue for both patients and staff.
Adverse health outcomes for patients increase and staff become stressed and fatigued, leading to increased sick leave, which further compounds the issue of short-staffing. The amount of overtime used to complete elective surgery lists is excessive, and we should not be relying upon the goodwill of nurses to reach elective surgery targets. I love being a nurse.
However, the state of our healthcare system has left me questioning my career choice. The knowledge that patients are not receiving the care they deserve due to under-resourcing and unsafe staffing conditions weighs heavily on my shoulders. To complete these personal stories, from southern Tasmania: Premier, I work in the emergency department in the largest public hospital in Tasmania. I very rarely turn up to a shift that is fully staffed.
I have worked many 18-hour double shifts due to the lack of staff. I have seen so much pain and suffering from acutely unwell patients and patients left without a bed for eight-plus hours because staff and the department cannot cope with the pressures. I am anxious before I go to work, worried about what emotional or physical trauma I may face. I feel undervalued, I feel underpaid and I feel underappreciated.
To complete a degree dedicated to helping others where I feel I come home left not knowing if I made a difference is heartbreaking. For how physically and emotionally demanding to spend all the time studying, and being so underpaid, makes me feel like it's not worth it.
Premier we know the load for you as Premier and Health minister is monumental. There is no doubt, having listened to the personal accounts of health professionals from across Tasmania, that the task is enormous. Right now we know that our nurses, our midwives, our paramedics, everybody working in the health system need a government to hear the story, understand the load and take action to support. Yes, we support the miscellaneous amendments bill. Yes, it is administrative and it will make a difference.
However, what will really make a difference is responding to the stories and understanding the impact of those working in our health system, and make changes that support them to do what they are so passionate about, to give them the support to deliver the level of care they are committed to and to support their professional, emotional and physical wellbeing as they are out there supporting Tasmanians.
16th August 2022 - 6:06pm
Video - YouTube
Mr. Speaker, I rise this morning to speak on our health system in
Tasmania. I want to reflect on a couple comments that were made this morning in question time - one about our incredible health care workers and one about the health care system. There was a reference this morning that our nurses, our midwives, our paramedics are resilient. There was another comment made this morning about keeping people out of hospital.
I want to open with a comment on that. Anyone who has worked in an environment or has had a personal experience of trauma or fatigue or exhaustion, or just trouble, they like to support themselves and say 'we're resilient, we can be resilient, we encourage people to be resilient'. But when time on time, trauma on trauma, tough on tough, hard on hard, someone says to you, 'It's so good that you are resilient'
and celebrates that you are resilient when you are completely spent, is so disrespectful. It is so outside the realm of understanding how hard and how horrible life is for the person that is then celebrated to be resilient.
Yesterday, I read into the parliamentary records some personal experiences and personal letters from nurses and midwives who work within our system. Today we have nurses and midwives striking on the north-west. They have had to, in complete frustration, walk out and strike this afternoon. This letter is from one of those members on the north-west, one that had already been written and had raised their concerns to the attention of the Premier and Minister for Health but with no response that adequately addressed their concerns. They said:
Yesterday I left work in tears. I physically walked out of my shift once again in tears at the poor workload I had walked into at the commencement of my shift at 7 a.m. We were working two staff down that day, again, with highly vulnerable patients. No meal breaks were taken. Only one at 1.30 when I was mentally exhausted and I walked out crying. The workload pressure of double shifts, working staff down, is a mental strain no one should have to face. We, as all nurses, are beyond exhausted. How can we look after acutely unwell patients when all your workforce is burnt out? We're going on strike.
These are people that are burnt out, who are emotionally exhausted and in tears before, during and after a shift. They do not want to be called 'resilient'. They do not want chocolates and a cuppa.
They want a government that is going to respond to the realities of the concerns they are raising around being able to recruit, retain and look after the staff in the system. As others have said this morning, people do not want to take this type of action. People go into these careers, committing their life time, dedicating their hours away from their families to caring for Tasmanians. That is what they want to be doing but they want to be doing it in a safe way. They want to be doing it in a way that is recognised and supported so they can deliver the reasonable care, to look after the basics of care for Tasmanians. This morning there was also a comment about we are working to keep people out of hospital. Tasmanian Labor have been committed to raising their concerns about the cost of living, the pressures in our community and whether it be fuel, whether it be groceries, but we are really committed to highlighting the concerns around the increase in energy prices.
We had the energy conversation and then we had a health conversation with the
Government saying, 'We have to keep people out of hospitals'. I do not know whether this
Government is in touch enough to hear the stories from people. Just recently in the northern suburbs of Launceston, I was told that families, multiple people - not just one person but multiple households - are going to bed at five o'clock so they do not have to turn the lights on, so they do not have to have heating. They are not using power at the moment in their community.
This raises illness, this heightens the need for health services in our community when all of these things intersect. You cannot, as someone just said, list out all of the things that you are doing and the new services that you are offering without caring for the core of the service, which is the people. This letter was written by a midwife on the north-west coast: I am a midwife and our conditions are shocking. On the majority of our shifts, we do not get breaks and the care we are able to give our patients is average.
We have new midwives coming through, working and learning in these conditions and it is a huge concern because these junior midwives are required to learn and try their best in these conditions but are unable to. And we're unable to give them the support and education they need and therefore, this will be detrimental in the future of nursing and midwifery in Tasmania.
Not only is this unsafe for our patients, it also means that we have midwives that have just trained and then leave the industry straight away because who wants to work in these horrible, stressful environments. Most of the midwives I work with discuss, on a daily basis, how they just want to leave the industry. If the Government doesn't do more there won't be midwives left to deliver safe care to women and babies and therefore there will be highly morbidity and mortality rates in maternity areas.
When we are having this information shared with us directly, when we are out in the community and hearing from or taken note of the messages that are shared, you get to understand what is needed in response but it feels like this Government is protected away in some sort of bubble where this information is not getting through, where an understanding of the realities in the community is no longer just vulnerable low-income workers. People across all demographics in our community are struggling from the lack of health service to support themselves to live a good life and from the increasing cost of living, which is seeing them being more and more unwell in the community.
We do not need to celebrate our health workers and say that they are resilient, we need to celebrate the great work that they do but, more importantly, what they want is they want support with recruitment, with retention and with support for them while they are at work.
They want to be heard and understood so they do not have to be anxious about the idea of waking up and going to work. Someone I know in my community has stopped taking shifts and is now doing fewer and fewer hours because they cannot cope with the thought of going to work and going back into that environment.
We do not want people to break down in the middle of the shift and cry, or to go home and cry, stressed, unable to connect with their family. We need a government that supports our health care workers, that puts in place a great system to support Tasmanians and we need that action today.
Video - YouTube
17th August 2022 - 11:43am
Mr Speaker, I rise to speak on this matter of public importance to highlight the many concerns in our community regarding the health systems and delivery of health services to Tasmanians. I will highlight the intertwined nature of the challenges being faced by Tasmanians at the moment that add to the burden on the health system.
As our Deputy Leader and shadow for health has outlined, we know the statistics around health.
Someone once told me that when you go into statistics, people switch off. When we talk about numbers, it can distract from the fact that we are actually talking about the experiences, the wellbeing and often the pain and trauma of people.
This morning, in response to questions, people would stand on their feet and rattle off a whole lot of statistics as if that was an answer to the question, without actually really having a heart or an understanding of the impact that the challenges in our health system are having on Tasmanians. We know how many people are waiting for critical services, how often ambulances are ramped, how impactful the bed block is. We know the issues with access to dental health, the impact that can have on people when they are growing up and the other health issues that might create in the community.
We also know that, despite some activity and some announcements by the Government about their response, not enough is being done to ensure that the Tasmanian community can feel confident when they need support, whether it be with their physical wellbeing through the primary health system or with their mental health.
We know that the more someone is in pain or traumatised, the more someone needs support and they cannot get it, or they cannot get support for their family members or their children, it puts a burden on an already complex experience of living.
We know that the pressures of the cost of living across Tasmania at the moment are requiring people to make choices that have an impact on their health, which is then further burdening the health system. I know in Bass, members of our community are talking to me about the choices they are making about whether they have heating on in their homes.
By not heating their homes, they are putting their health at risk by living in sub-standard accommodation that is presenting all sorts of health challenges. We have had episodes of black mould being presented to us. We know that people having to continue to live in those circumstances is contributing to their poor health, which is putting greater pressure on the health system. This Government has so many challenges being left unaddressed right now or not being attended to in a way that makes a real difference, which is growing this massive burden on an already overstretched health system.
This morning we were attempting to interrogate the priorities of this Government and the way they are out of touch with the needs or the expectations of our community in terms of their expenditure and effort into infrastructure. For instance, the two stadiums, one in the north and one in the south, and this contemplation of an immediate investment in a third stadium when reports have said 'maybe in the next 10 years, maybe down the track we might need to invest in that' but right now, when Tasmanians are hurting, when they cannot get access to the healthcare they need when they need it where they need it, when they are struggling with the expanding costs of living and when they are not able to pay their bills or buy the medication.
We are aware of people making daily choices about the medication they purchase because they cannot afford it all, about the services they engage with because they cannot afford it all. Imagine you are a parent and you cannot provide either the medication or the access to the service required for your child. It was heartbreaking to hear another member this morning recount the story of a parent who had to go through the experience with their child of not being able to get an ambulance when it was needed. Other people waiting for delayed ambulance services have passed away before care can be provided.
These are the traumas piling up upon people in our community where they are just nervous and cannot trust the health service in Tasmania. We know that more needs to be done, that rattling off statistics and announcements does not equal action and it does not build a feeling of confidence in the Tasmanian people that this Government understands the issues and is in touch with what they need. I talk about the way these issues interweave.
There was a mention this morning about a response to the housing issue. When you are homeless and sleeping rough, and you have layer upon layer of physical or mental health issues and you do not have stable accommodation, the issues people are presenting with that should have been dealt with and supported long ago are adding to the burdens on the health system. When you are a young person and you cannot access education, this impacts your literacy levels, which impacts your health literacy levels and as you grow up, your ability to engage in and advocate for yourself in a failing health system is also a challenge.
People in our community feel deflated that they are not able to advocate to the point where they can access the health system that they need. I had a message yesterday from someone in our community who has been waiting for years to get support with mental health via GP referrals, not always having the funds to go to the GP, but when going to the GP, not being able to get the support for the mental health support they need. In a message to me just yesterday, they are saying that they are struggling, that this is really hard, and they are a small business operator. When you are personally struggling, that makes your business struggle and then you cannot provide for your employees and your team.
These layers upon layers of concern are facing Tasmanians every day, whether it be with housing, health or education. It is building up people in our community who have much greater issues that are putting a much greater burden on our health system. What we need is a government that actually admits the challenges before them and addresses those challenges immediately for the people of Tasmania.
Video - YouTube
6th September 2022 - 3:24pm