"Competition" to permit unqualified nurses in SA

The SA Government is in the process of passing changes to the Nurses Act 
that would allow employers to use unqualified or unlicensed nurses in the 
place of properly qualified Registered Nurses.

The changes have the potential to open nursing to complete deregulation and 
give employers the freedom to set standards for the quality of nursing they 
offer.

The Nurses Act has been under review for the past decade. During this time, 
National Competition Policy was introduced with the requirement that any 
new legislation has to comply with Competition Policy principles.

These principles require the removal of all barriers to open competition in 
an industry to create a "level playing field".

Licencing, registration and other forms of regulation (in this case 
qualifications) that restrict entry to nursing (or any other "industry") 
are seen as barriers. Nurses — qualified and unqualified — could compete 
on the market for jobs.

While, to most people, nursing would not seem to be an area that would 
easily lend itself to "competition", to the economic rationalists behind 
Competition Policy, nurses are just another group of employees who should 
be made more flexible.

Gail Gago, Secretary of the SA Branch of the Australian Nursing Federation 
(ANF), told The Guardian, "The issue is about barriers to 
employment". It is about removing barriers to the industry employing 
whoever they like.

The Nurses Bill 1998 passed through the Lower House late last year and is 
currently before the Upper House.

Ms Gago said last week that she had just come from a meeting lobbying one 
of the Independents, "We are in the last round of negotiation and 
lobbying".

The Balance of power in the SA Upper House rests with the Democrats and two 
Independents, Nick Xenophon and Terry Cameron.

Under the changes Enrolled Nurses (unqualified nurses) can seek exemption 
from the requirement to be supervised by a Registered Nurse (qualified 
nurse).

These changes open the door for complete deregulation of nursing standards 
in the near future.

This will lead to fewer Registered Nurses and enable employers to employ 
cheaper unqualified nurses instead of properly qualified Registered Nurses.

The ANF's position is that Enrolled Nurses are trainee nurses and their 
training and education is premised on supervision.

The changes would also remove legislative requirements for midwives or 
mental health nurses to have specialist qualifications in that area.

The consequences of this would be that patients needing and expecting 
experienced specialist care during child birth or at a mental hospital 
would be cared for by someone who is not an expert in that area.

"If you go down to Glenside, our local mental health hospital, you would 
assume when you go into one of those wards that all of those nurses are 
qualified to look after people with mental illness". But, this would no 
longer be the case, under these changes, said Ms Gago.

The ANF says self-regulation by employers is not enough protection for the 
public. "Our health system has been stripped bare of resources, employers 
are under increasing pressure, there are often real shortages of midwives 
and other specialty areas and it's too easy for employers to pressure 
nurses into working in those areas that they may in fact not be competent 
in.

"If you really want to protect the public, then it's got to be legislated."

In addition, the changes would not regulate the use of unlicensed nurses, 
workers who are not trained as nurses but are performing nursing duties.

"There has been a proliferation of unlicensed workers performing nursing 
work. That's been a trend over a number of years."

"Nursing needs to be regulated so that nurses are monitored in a way that 
requires that they reach certain public standards", said Ms Gago.