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I rise today to speak on the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2025. It is a bill that we do not oppose. The bill starts the third phase of legislation initially introduced by the Andrews government back in 2015 that established minimum staffing levels for both nurses and midwives within the Victorian public health system. Since then there have been two phases of amendments to ratio requirements – first in 2019 and again in 2020. Previous amendments over the last five years include increasing patient ratios in specific settings, including stroke, haematology and oncology wards; palliative care; aged care; and birthing and emergency departments.
The changes to the current ratios include the following. In level 1 and level 2 ICUs a one-to-one nurse-to-patient ratio will be mandated for all occupied ICU beds on every shift. ICUs will now require team leaders, liaison nurses and a nurse in charge of the unit. Each resuscitation cubicle in emergency departments will need a one-to-one nurse-to-patient ratio, which is an improvement on the current one-to-three ratio. In level 4 services that are part of a larger metro hospital and in levels 5 and 6 services under the maternity capability framework a one-to-four midwife-to-patient ratio will be implemented on night shifts in postnatal and antenatal wards, improving on the current one-to-six ratio. An in-charge nurse will be added to night shifts in standalone high-dependency units and coronary care units.
Today’s legislation establishes high minimum staffing levels once again, with new ratios set to be introduced in emergency departments, intensive care units, high-dependency units and coronary care units. The changes aim to improve both patient care and safety by creating legislative requirements for more nurses and midwives across our health system – and we agree. While this bill has the right intent, I have to ask: what good are mandated ratios when the hospitals they apply to are crumbling under the weight of a broken system? What good are promises of better care, when patients are left suffering and, in tragic cases, losing their lives due to the failures of this government? What good are mandated ratios when we do not have the workforce to fill them?
Just this week we were confronted with yet another devastating loss in regional Victoria. A man lost his life after waiting for 5 agonising hours in a ramped ambulance at Albury Wodonga Health. This is not an isolated incident. This is the grim reality of health care in regional Victoria under the Allan Labor government. Statewide ambulance transfer performance for October to December 2024 remained stagnant at under 70 per cent – far short of Labor’s promised 90 per cent target. Instead of fixing the root causes in our health system, the government’s response has been to punish hospitals already struggling under immense pressure. With inadequate resourcing, forced hospital amalgamations, service cuts and overworked paramedics, the Minister for Health has chosen to shift blame rather than implement real solutions. Without systemic reform, expanding hospital capacity, improving staffing levels and streamlining emergency department processes, these failures will continue. This is what happens when a government prioritises spin over substance, bureaucracy over patient outcomes and neglect and ignorance over action.
Let us be clear: the people of north-east Victoria – the people of regional Victoria – are not staying silent. They are not accepting these failures. This week 300 people travelled from across our region, representing councils and communities, to demand better investment in Albury Wodonga Health. They are fighting for a new purpose-built hospital on a greenfield site, a project that would save lives and improve health care for generations. But what do they get from the government? Gaslighting, lies and deflection. The Minister for Health refuses to listen to or even meet with these people. When challenged in the chambers about this, those on the other side were quick to blame members, such as me, with baseless accusations in order to ignore the main issue. The minister refuses to support the project and has been nothing but dishonest. How can you be listening to the needs of the community when most of those in it have been protesting these very decisions? The hypocrisy is staggering. The minister refuses to take responsibility while our health system collapses around her.
Labor once again stands here touting supposed improvements to patient care while simultaneously cutting funding, gutting services and leaving regional Victorians behind. Just this week in the Legislative Council Georgie Crozier asked the Treasurer a simple question: could she guarantee that there would be no funding or services cut at smaller regional hospitals? The response? Silence – a full 20 seconds before the Treasurer sat down without an answer. That silence speaks volumes.
This government is gutting regional health care. It has allowed maternity services to close in Benalla, forcing expectant mothers to travel hours for care. It has driven Kilmore’s maternity health services into restricted operating hours, leaving women without local options. It has overseen hiring freezes and funding cuts that have stripped Wangaratta of midwives and gutted the midwifery group practice program despite an increase in demand. What kind of a government is this? What kind of a government looks a pregnant woman in the eye and tells her to drive several hours in labour because local hospitals cannot care for her? It is not just maternity care; it is every aspect of regional health care.
The Allan government’s so-called Health Services Plan is set to centralise our hospitals, stripping local facilities of autonomy, reducing services and forcing patients to travel further for care. This is not a plan to improve health care; this is a plan to abandon regional Victoria. I think of people like Allan, a Benalla resident who needed transport to Melbourne for an appointment regarding his pacemaker. No patient transport was available. His only option was a taxi for several hundreds of dollars. How many people can afford that at the moment? How many are suffering in silence because this government refuses to provide even the most basic healthcare infrastructure?
These issues cannot be blamed on a lack of trying by our local health services providers. For example, the Royal Flying Doctor Service, a community patient transport team, have been requesting crucial funding – they run out in June – making excellent proposals based on volunteers. It is not a lot of money. Despite incredibly modest requests, the government has again failed to listen to them and provide this critical funding.
I want to do a quick stocktake of what the current state of our health system is under Labor, just to explain how our communities and I are viewing the work this government does. Labor has forced our hospitals to merge. Labor has stripped local voices away from our services. Labor has made regional patients travel further from home to access these services. Labor has left our regional maternity units at bare bones with a hunting licence on those remaining services called the regional maternity taskforce. Labor has failed to support patient transport services while forcing dialysis patients to find their own way to care. Labor has left our ambulance and 000 systems in shambles as pay disputes, missed targets and a lack of resources continue. Labor has left people in pain as surgery waitlists skyrocket. Labor continues to gaslight and lie to our healthcare providers and our communities. I am sure there are many more examples I could think of, because the damage is ongoing, and they are not over.
We do not oppose this bill, but we do oppose the situation this government has created. We support measures that strengthen our health system, but this bill is nothing but a bandaid on a gaping wound. Regional Victorians deserve better than being left on stretchers in ambulance bays for 5 hours. They deserve better than being forced to travel for maternity care, cardiac care and cancer treatment. They deserve better than being ignored by a government that refuses to listen to them. Labor has failed, and the consequences of that failure are being felt in our hospitals and our communities and in the devastating loss of life across the state. Enough is enough. It is time for a government that listens, it is time for a government that acts and it is time for a government that puts regional Victorians first. This is not just policy or legislation, this is life or death now, and we will not stop fighting on this side of the house until every Victorian gets the health care they deserve.
To finish, to the healthcare workers that have to work in these conditions I want to say thank you. So many of you I speak to often, but you are the real backbone of our healthcare system. Thank you for comfort in the toughest of moments. You are the real heroes at the moment.