Nick Blake, Senior Federal Industrial officer at the Australian Nursing Federation, writes:

The Howard Government appears to have come unstuck in its indecent haste to make political capital over its decision to assume responsibility for the running of the Mersey hospital in northern Tasmania.

When announcing the decision in August, the PM and Minister Abbott were all over euphoric staff, boldly declaring they would save their hospital and their jobs. It has now become public knowledge that the government’s assurances to staff that they will not be adversely affected by the takeover may not be met.

While the details remain sketchy, it appears that the federal government’s original plan to second the staff on an interim basis has become unstuck due to the government’s own policy which requires seconded employees to be under AWAs.

In addition to this, the government is grappling with the problem of protecting nursing conditions that are prohibited under the Howard Government’s WorkChoices regime. Prior to the takeover, the nurses and other hospital staff were employed under a Tasmanian industrial agreement which provided for a range of benefits that are not available under WorkChoices including existing nursing workload arrangements and the right to be represented by their union. In addition staff will be covered by WorkChoices unfair dismissal laws which provides far less protection than those provided under Tasmanian law.

It has been reported that the federal government has been aware of this issue for a number of weeks and has been desperately attempting to find a solution while at the same time keeping the matter out of the public domain and out of earshot of employees at Mersey Hospital. Of course this also came unstuck and it is typical of the government’s refusal to consult or consider the views of staff, their representatives or the community unless it suits their political imperatives.

With the transfer to occur on 1 November it is not surprising that nursing staff are now confused and fearful that the federal government’s commitment that they would not be forced onto AWAs will not be met and their conditions of employment will be inferior to what they now enjoy.

For nurses and hospital staff across the country the wider question remains; that the government’s Mersey hospital experiment could become common place, with the government assuming control of public hospitals wherever and whenever they see fit. For nurses this proposition has always been unnerving and now, with the latest debacle on the Mersey experiment, nurses everywhere are fervently hoping their hospital does not become the next federal target.

Meanwhile, Ian McAuley, a Centre for Policy Development Fellow and lecturer in Public Sector Finance at the University of Canberra, writes: 

Another hitch in Abbott’s plan to take over the Mersey Hospital — this time it’s the transfer of 400 staff from state to Commonwealth employment.
Lara Giddings, Tasmania’s Health Minister, claims that “deeply unpopular AWAs are the only legal way they have of taking over the staff”.

If so, the future of the hospital itself is uncertain, because AWAs are indeed unpopular, particularly among nurses who are already feeling the stress of work pressure. And health professionals are in short supply; they can easily find work somewhere other than in Devonport.

Even in the unlikely event that generous salaries and hours are offered, health professionals will still find it unattractive to work in what, thanks to the Commonwealth intervention, has become an increasingly fragmented system in Northern Tasmania. The isolation of Mersey Hospital from Launceston and Burnie hospitals puts an end to any plans for regionally specialised services, where professionals can exercise and develop their skills.

While Rudd has promised to go along with the takeover, it is possible that these labour troubles give him a face-saving way to reverse his support if he is elected. For, as he has said in relation to the Mersey takeover:

We believe that what Tasmania needs and what Australia needs is a national approach, an integrated national approach to dealing with health and hospital services, not just one plan for one hospital in one seat in the country.

Delivery of health services is already fragmented, with the states generally running hospitals while the Commonwealth administers medical and pharmaceutical programs – and even these two programs operate without any integration.

Taking one hospital out of the state system adds to that fragmentation and adds to incentives for cost-shifting and costly competition for scarce resources, particularly professional staff. However well the community board performs, its concerns will be the Mersey Hospital, not the hospitals in Northern Tasmania, not the hospitals in Tasmania, and not those people in Tasmania whose health care needs may have nothing to do with hospitals.

If Rudd wins the election he should ask the Tasmanian Government to return the dollar the Commonwealth paid for the Mersey Hospital, and set about developing a state-wide integrated health service, in consultation with the Tasmanian Government and community representatives – as a model of a truly integrated health care system for other states to emulate.