Enshrining Nurse and Midwife to Patient Ratios into Law
Tuesday 16 September
Second Reading Debate - Nurse and Midwife to Patient Ratios Bill 2025
Ms CLANCY (Elder) (16:36): I rise today in support of the Nurse and Midwife to Patient Ratios Bill 2025, which seeks to introduce a new nurse and midwife to patient ratios act and amend the Fair Work Act 1994. The bill before us today seeks to enshrine safe nurse-to-patient and midwife-to-patient ratios in our state's law. This is about ensuring safety for both South Australian patients in their time of need and safety for South Australian nurses and midwives who provide frontline care to our community every single day. We know that safe staffing levels save lives, and we also know that transparent, mandated ratios are critical to delivering high-quality health care and the best outcomes possible for patients.
This bill establishes minimum nurse and midwife staffing levels across a wide range of wards, from general medical and surgical wards to oncology, palliative care, neonatal intensive care, and birthing suites. This will also cover all our major public hospitals, from Flinders and the RAH here in Adelaide to regional hospitals such as Mount Gambier. Crucially, these ratios will apply shift by shift, providing certainty for staff and families. Nurses will no longer be stretched between too many patients or midwives tasked with an impossible workload of postnatal care. Instead, this Malinauskas Labor government is stepping up and stepping in to guarantee minimum safe levels of care.
This important reform will be rolled out over two years, giving SA Health and our local health networks the time they need to smoothly implement these changes. During this moratorium, hospitals will be supported to comply with the new ratios until 2028, when any deliberate or systemic breaches may attract a penalty. It is critical that this reform also recognises the importance of flexibility, allowing for variation in mixed wards; protects the higher minimum staffing requirements for nurses in the enterprise agreements; and protects hospitals if they cannot meet their ratios during genuine emergencies. This reform does not stand alone. This is part of a suite of legislative change and work the Malinauskas Labor government has done and will continue to do to build a bigger, better healthcare system.
In early 2022, before I was elected to this place, a priority 1 emergency ambulance only arrived on time for one in three South Australians—now, it is more than two in three. In the little over three years since we were elected, we have recruited more than 1,460 additional nurses and midwives, and that is part of more than 2,700 extra doctors, nurses, midwives, ambos and allied healthcare workers we have recruited over attrition. We are delivering more than 600 new hospital beds and opening a range of services, such as 24/7 pharmacies, including the very successful 24/7 pharmacy in my community in Clovelly Park, to significantly relieve pressure on our emergency departments.
Just this weekend, I had the pleasure of joining the Premier, our Minister for Health and Wellbeing, Chris Picton, as well as our fabulous candidate for the seat of Colton, Aria Bolkus, as we opened a brand-new, 24-bed rehabilitation service opposite The Queen Elizabeth Hospital. It would be remiss of me not to also mention that the member for Cheltenham was there—sorry, minister; Minister Boyer will love that. This purpose-built facility was designed with the input of both consumers and carers, to ensure it can provide appropriate high-quality health care for mental health patients, taking much-needed pressure off our emergency departments.
I really want to thank Brooke, whom I met with on Sunday, for all of her work as a consumer on the consumer reference group, to ensure this new facility meets the needs and expectations of consumers. The importance of lived experience in the design of these facilities is really, really important and cannot be overstated. The new unit is part of a huge expansion at The QEH, and will soon be joined by two more 24-bed rehabilitation units that are currently under construction at Noarlunga and Modbury.
In closing, I would like to thank the nurses and midwives, and their union—the Australian Nursing and Midwifery Federation (SA Branch)—for their tireless advocacy, to see this reform brought to this place. It has been a long journey for them. I remember meeting with the SA branch of the Australian Nursing and Midwifery Federation on this same issue of nurse and midwife ratios more than five years ago now—I guess six years ago; it seems like a lifetime ago—when I was running for the federal seat of Boothby. I supported them then and I support them now, and I am so happy that we have got them there.
Labor governments are always at their best when they are reforming in the interests of working people, and we simply would not be able to make the change we do without your struggle—so thank you. I would also like to thank our Minister for Health and Wellbeing and everyone in his team, who have worked incredibly hard to see this election commitment come to fruition. I also want take this opportunity to thank all of the nurses and midwives in our state who work so incredibly hard to keep us safe, to care for us, to keep us calm. Luckily, I myself have only ever had to turn up to an ED a couple of times as an adult. Each time, I have felt that I was allowed to be there, that I was meant to be there and I felt sure that I was going to be getting the service that I needed and the support that I needed. That was in large part because of the nurses.
Back in November 2018, I remember turning up to Flinders hospital with a very sick little toddler whose temperature I could not get down. I had been getting it down with medication for a few days, but at this point there was no way; she was shaking and it scared me so much. I just turned up to Flinders emergency. The triage nurse was incredible. She calmed me down and made me feel like I was a really, really good mum and not just freaking out unnecessarily. I was quickly taken into the paediatric emergency department and the care that we received over the next 24 hours while they ran tests and helped to make her better was just extraordinary, and I am so grateful to those nurses.
I also want to thank the nurses who recently took great care of my dad when he got a pacemaker put in. Now he and my mum both have pacemakers and get to use a different line in security, which mum is really excited about. I actually think it probably takes longer—but they are pretty happy with their pacemakers. I also want to thank Talia at Flinders' neonatal intensive care unit, who is a good friend; my friend Anna, who is a midwife at Flinders as well, so they get to work together; and also the wonderful Maddie, who works in oncology at the RAH. They are some of my favourite nurses and I am very grateful to them, and I am really pleased that these changes are going to make a difference for all of our nurses.
We promised to legislate safe nurse and midwife to patient ratios, and today I am really proud that we are delivering on that promise. We are standing with workers, their union and the community to deliver better health care for South Australians, and I commend this bill to the house.