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Wednesday, 20 May 1970

Mr REYNOLDS (Barton) - The Australian Labor Party believes that an absolute fundamental to the success of a national health scheme is the availability of an adequate supply of effectively trained and professionally contented nurses. Quite frankly, I was very disappointed in the statement made today by the Minister for Health (Dr Forbes). He chose at least 2 areas in which to shunt responsibility onto other people. Firstly he blamed the States for a lot of the crises in the nursing profession today. He said that nursing was the prime responsibility of the States except in the Australian Capital Territory and the Northern Territory. Secondly - and this train of thought was continued by the honourable member for Lyne (Mr Lucock) - he said that the matter of salaries in particular was one for the courts. I think I quote the Minister correctly when I say that he said that the wage claims of the nurses are best settled by the court. The honourable gentleman for Lyne elaborated on this point and said that this was not a matter over which there should be political action. Yet only a few days ago in this place, in a very political setting and in a very political sense, we finally determined to some extent the salaries of doctors throughout the community and the remuneration that they are likely to receive.

I do not think many people in the community would have blamed the Commonwealth Government if it had gone into the Conciliation and Arbitration Commission hearing of the nurses case and had pleaded the public cause. Never mind just the nurses cause. It should consider also the public interest about which we hear so much. The Commonwealth should have gone to the Commission and drawn attention to the fact that the Government's great investment in the whole of our national health scheme could be seriously undermined because of the inadequate number of nurses in our community. I do not think I need quote statistics to illustrate the problem. The problem is well enough known. It has already been referred to. We hear of wards being closed in hospitals all over the place, not only in South Australia and Victoria, but also in my own State of New South Wales and in Queensland. Wherever one goes in the country or the city the situation is the same. This means that a whole lot of sick people are unable to gain admission to hospital. Nurses, on the other hand, already in short supply, are becoming physically exhausted because they are overworked. This in turn leads to further resignations. It all snowballs.

There has been no great increase in the intake of student nurses in the last 10 years. In Melbourne fewer nurses were entering the profession in 1969 than in 1967, 2 years earlier. Doctor J. S. Lawson, the Medical Superintendent of the Footscray and District Hospital, in an article in the 'Medical Journal of Australia' of 26th July 1969 entitled 'Who will Nurse the Sick in the Seventies?' made some very important points regarding the shortage of nurses in Australia. He indicated that the position was more likely to get worse than better, and he gave his reasons. First of all, the proportion of females in the population aged between 15 and 19, from which we are likely to recruit trainee nurses, is declining in relation to the number of males and females over 65 in the community - the people who will make the greatest demands on hospitalisation. He says in fact that, according to his projections, the ratio will deteriorate by 10% between 1969 and 1979. He went on to mention that the duties of the nurse are becoming more complex and more sophisticated. New techniques are being introduced and new technology is involved. He mentioned such things as spare parts surgery - we are just at the outset of this development and tremendous things could happen in the future - the whole range of coronary care, respiratory assistance units and the monitoring of unborn infants. These are all comparatively new fields, all making their demands on the nursing profession.

Thirdly, he mentioned the fact that national health schemes surely aspire to making it easier for more people to get the kind of medical and hospital care that they need. The introduction of means test, free public wards in hospitals must all add up to a greater number of people entering hospital, while at the same time the pool from which we can draw trainee nurses is reducing comparatively. Talking of wastage, not only of nurse trainees but also of those who have graduated as nurses, he makes the following remarks: Of the 1965- 66 intake of trainee nurses in Victoria, 34.4% were lost to the profession before they had graduated. In New South! Wales the figure was as high as 50% in certain places. The highest loss of ali is in the first year of traineeship.

This is the place above all where new educational techniques ought to be applied. 1 can only wonder where the tutors in nursing hospitals get their training. As one who has been involved in educational training, I can say that they certainly do not get it in our teachers colleges. I am not aware of them having any professional qualifications as educators. In fact this was one of the points made in a recent report by the nursing profession itself. I wonder how many of the new teaching techniques and teaching aids are available to the tutors. They do have some training in imparting their knowledge. But what of the training that is provided by the medical staff, the honorary doctors and honorary specialists? How much training have they had in the art of imparting their skill and knowledge. There seems to be implicit in this whole business the old concept that applies in technical education. If someone is well qualified and knowledgable in a particular field he is accepted as being qualified to impart his knowledge. This is a belief we have to get over, and 1 am heartened to hear that at least here in the national capital inquiries are being made and moves are afoot, to bring nursing training within the province of colleges of advanced education.

Mr Luchetti - lt is to happen at Bathurst in New South Wales.

Mr REYNOLDS - It is heartening that it will happen in the new college of advanced education at Bathurst. This will be a big step forward. When talking of nursing as a profession, the nurses themselves have to recognise that they will receive professional recognition, of which salaries are a part, only if they are qualified. Not only must they undertake certain responsibilities but they must have what are commonly regarded as professional qualifications. As members of a profession, they would be well advised to seek opportunities for better training not only for under-graduates but for those who have graduated. I think they ought to plug very hard for the setting up in every big hospital of a counselling service so that youngsters, when they are having difficulty in their training or in their operations within the hospitals, will have someone to turn to for help in the art of communicating with those in authority. It has been represented to me by senior nursing staff that one of the great problems in our hospitals today is this break down of communications, this sense of isolation, this sense of frustration, of not knowing where to turn. This is something that could be done quite readily along with relieving nurses of the non-professional duties that were enumerated by my colleague, the honourable member for Oxley.

In my former field of teaching these things have been happening for so long. Headmasters and teachers were filling in form's, doing playground duties and a whole host of other clerical duties that could well have been performed by people who did not need the same professional qualifications. The number of nurses in the community is relatively scarce. This imposes even greater responsibility on us to make the best possible and the most economical use we can of those scarce and valuable nursing resources. Obviously what is needed is a greater knowledge of the facts of the situation. For that reason we ought to be conducting a national inquiry, and not a little piecemeal inquiry, as valuable as it might be, here in the Australian Capital Territory or may be in one or two States. What is needed is a thorough, systematic national inquiry into the state of nursing. Such an inquiry is coming far too late. It should have come years ago. If it had we would not have reached this crisis situation. But it is better late than never. Such an inquiry is already under way in Great Britain. I will quote the terms of reference.

Last year the British Government set up an inquiry:

To review the role of the nurse and the midwife in the hospital and the community and the education and training required for that role, so that the best use is made of available manpower to meet present needs and the needs of an integrated health service.

This sort of inquiry, to which public testimony of all kind can be made, could do nothing but a lot of good for our health services.

Mr DEPUTY SPEAKER (Mr Hallett)Order!The honourable member's time has expired.

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