January 14, 2025 • 13 mins
At least 200 psychiatrists have resigned from NSW public hospitals. It comes amid an ongoing dispute with the State Government, as psychiatrists call for better pay and working conditions. There are fears the sector could be reduced by two-thirds before the end of the month, triggering a "mental health crisis" for GPs. In today's deep dive, we’ll unpack the stalled negotiations between the NSW Government and the doctor’s union, and what it could mean for the state's health system.
Hosts: Emma Gillespie and Sam Koslowski
Producer: Orla Maher
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Already and this is the daily This is the Daily OS.
Speaker 2 (00:05):
Oh, now it makes sense. Good morning and welcome to
the Daily OS. It's Wednesday, the fifteenth of January. I'm Emma,
I'm Sam. At least two hundred psychiatrists have resigned from
New South Wales public hospitals after a mass departure of
(00:27):
psychiatrists from the sector last year. It comes amid an
ongoing dispute with the state government, a psychiatrists call for
better pay and better working conditions. After this latest round
of resignations, there are fears the sector could be reduced
by two thirds before the end of the month. GPS
a warning it could trigger a mental health crisis on
(00:48):
their end. So what's going.
Speaker 1 (00:50):
On, well, Emma, today will talk you through this ongoing
dispute and unpack the stored negotiation between the New South
Wales government and the Doctors' union. But first, I think
a lot of people can get mixed up between psychiatrists
and psychologists. Give us a quick recap on the difference
between the two and who are actually talking about today.
Speaker 2 (01:13):
Yep, So psychiatrists, that's who we're talking about today are
medical doctors and they specialize in the diagnosis and the
treatment of mental health conditions. The biggest thing that separates
them from psychologists, you could argue, is that psychiatrists can
prescribe medications, so they're doctors, they prescribe meds. Psychologists are
(01:34):
the people that we might go and see to do therapy.
We might not get a prescription for medication from them,
So that's the important distinction. Another important distinction today, before
we get really stuck in, is that we're talking today
about psychiatrists who work in the public health sector. So
we're not talking about psychiatrists in private practice. We're talking
(01:54):
about the ones that might work in hospitals are the
state run mental health services. So that's the kind of
claimer ahead of today's chat.
Speaker 1 (02:01):
So they on their pay statements at the end of
the month would have the new South Wales government as
their employer exactly. Okay, So there's been a mass resignation
of psychiatrists who work in this public health space. Where
have these walkouts come from?
Speaker 2 (02:15):
Essentially it all boils down to a dispute over pay
and over working conditions. So psychiatrists in this instance a
work is represented by a union, the Australian Salaried Medical
Officers Federation, of New South Wales. But thankfully for us,
they're also called the Doctors Union, so I'll be calling
them the Doctor's Union to the.
Speaker 1 (02:36):
Episode, I prefer ASTHMOV now ASMOV.
Speaker 2 (02:39):
New South Wales or the Doctors Union have been advocating
for reform for several months to improve what they say
is a dangerously understaffed sector. Now, before these fresh resignations,
about a third of psychiatry positions in public health were
vacant in New South Wales. The union says this presents
(03:00):
a risk to patient welfare, so there's an impact on
the type of care that patients are able to receive.
But that also there is a staff shortage placing enormous
pressure on the existing workforce. So the psychiatrists left behind
are kind of suffering under all of that pressure.
Speaker 1 (03:17):
And I know that today's discussion is about the New
South Wales division of this union, the psychiatrists in the state.
Does it represent a national trend? Is this happening all
over the country?
Speaker 2 (03:28):
Yeah, I mean we know, especially on the other side
of COVID, that health providers and hospitals right across the
country have been struggling. There's resourcing and staffing issues all
around the country in various sectors. But there's an interesting
separation here which is about a pay disparity when it
comes to New South Wales health specialists, and this has
(03:49):
really formed the basis of these negotiations. The Doctors' Union
released a report last year that found a thirty percent
pay gap between what New South Wales public health psychiatrists
learn and what their counterparts interstate are earning. So that's
really the gap that the Doctors' Union has formed the
basis for its negotiations what it's demanding, and that pay
(04:12):
gap is kind of really driving those staff shortages currently
seen in New South Wales. As the union said, why
would a psychiatrist want to work for New South Wales
Health when they could make thirty percent more or be
thirty percent better off working somewhere else.
Speaker 1 (04:27):
Okay, so let's take stock of all of this. We've
got a workforce of psychiatrists in New South Wales who are,
according to them, not only paid less but also overworked,
which they say presents dangers to patients and also to
the psychiatrists themselves. That's the position they took into the
negotiations with the state government. What are the specifics of
(04:47):
those negotiations, like, what are both parties trying to reach
here to make the conditions better? Is it just pay?
Speaker 2 (04:53):
So, as it so often is in these cases, it's
a lot more complicated than just pay. Negotiations began back
in September, and I think it's probably fair both sides
would probably agree that very little progress has been made
so far. The Doctor's Union is seeking a twenty five
percent pay increase for psychiatrists and as we mentioned, improved
(05:15):
conditions to address these concerns in the mental health system.
So that includes things like improved rostering systems and job security,
better workplace safety, safer working hours, and access to certain
entitlements like parental leave. The New South Wales government, in reply,
has proposed a ten point five percent pay increase over
(05:36):
three years.
Speaker 1 (05:37):
So we've got almost a fifteen percent gap between the
positions of the two parties around the negotiating table. I'm
assuming that offer was rejected. So what's happened since September?
Speaker 2 (05:47):
Yeah, so the union, as you rightly guessed, rejected that
offer immediately in September, and it's claimed since then that
the government has refused to budge on these negotiations. So
since then, half of New South Wales' public psychiatry workforce
has submitted their resignations. We had a tranch of resignations
in November around one hundred and forty people. That number
(06:10):
has now increased to two hundred resignations and the union
has reiterated this idea that the doctors really don't want
to quit. It's not that they want to walk away
from the sector or their jobs in public health. It's
more about being overworked, overwhelmed, and the union says these
workers are completely demoralized from working in a broken system
(06:31):
and basically they've been left with no other option.
Speaker 1 (06:34):
And give me a sense of two hundred psychiatrists resigning,
what does that mean in the broader picture of the
New South Wales health system in psychiatry.
Speaker 2 (06:43):
Yes, so in total there are about two hundred and
ninety five psychiatrists working for New South Wales Health so
we're talking about more than two thirds.
Speaker 1 (06:52):
That's a serious chunk, exactly force.
Speaker 2 (06:54):
A massive chunk. And the resignations are expected to take
effect from the twentieth of January.
Speaker 1 (07:00):
So technak day, isn't that's also the inauguration of Donald
Trump in the US.
Speaker 2 (07:04):
Yeah, the TikTok. Then a little bit on what that
could mean is that we see those psychiatrists moving into
private practice, but it does leave that gap for urgent
psychiatry care. The Royal Australian and New Zealand College of
Psychiatrists is the peak national body for the sector and
(07:25):
it's been pretty vocal about wanting to reach a resolution
before that twentieth of January deadline to avoid these gaps.
It says that previous staffing gaps have created a crisis
for the psychiatry workforce in New South Wales and it's
worn the mass resignations would significantly impact some of the
most vulnerable people in our community, which is important to
(07:46):
remember when you think about who is accessing urgent psychiatry care.
RA and ZCP released a statement saying disruption to care
for those vulnerable people will have wide ranging impacts. And separately,
there's this interesting conversation going on with the general practice industry.
The peak body for GPS has warned that failure to
reach an agreement could impact gps who are already managing
(08:09):
high demand for mental health consult Sure.
Speaker 1 (08:11):
Well, they'll have to kind of fill a vacuum almost
because the number of people who would presumably need psychiatry
services would not magically decrease by sixty percent, So that's
going to need to be serviced by somebody else exactly.
Speaker 2 (08:23):
And there's a whole other separate issue of what psychiatrists
can prescribe for treatments us as what gps can prescribe.
If you're familiar with ADHD medication, psychiatrists can prescribe that.
There's a lot of regulations and loopholes. You can't just
walk into a GP if you have an ADHD diagnosis
and get that medication straight away.
Speaker 1 (08:42):
I want to understand the response from both New South
Wales Health and the New South Wales government. They're different bodies.
The negotiations are happening with the government, but New South
Wales Health as the employer, is obviously going to feel
the impact of this as well. How are they planning
to address this sudden shortfall in psychiatrists.
Speaker 2 (09:00):
Yeah, so the Department of Health has issued an update
in anticipation of these disruptions to its public mental health services.
It said it's working on plans to manage the impact
of this proposed mass resignation of around two hundred psychiatrists.
The specific details of what those plans look like are
(09:20):
yet to be seen, but it did warrant that there
could be extensive disruption to services and the broader public
health system from the twentieth of January. So not a
lot of detail, but essentially the Department of Health conceding
that this could be significant for a lot of people.
Speaker 1 (09:37):
And so then the New South Wales government as the
opposing side in these negotiations, they must have their own
position on why they're not coming to the table. Explain
to me why there hasn't been a resolution from their perspective.
Speaker 2 (09:47):
Yeah, I mean, more broadly, the New South Wales government
has been locked in a range of bargaining agreement renegotiations
with health employees. One of the more high profile breakdowns
in negotiattions people might remember is the nurses and midwife
negotiations that led to mass strikes last year, delays inelective surgeries.
(10:08):
In between all of that, of course, we have this
going on with the psychiatrists. The state's Health Minister, Ryan
Park has basically said that their requests are impractical. The
pay increase requests specifically is not feasible. He said that
the government doesn't want this action to take place. He
told psychiatrists their work is valued, but that the government's
(10:29):
not in a position to offer wage increases to the
amount that psychiatrists are calling for. Park said that it's
absolutely critical that both parties remain at the negotiating table,
but the government is also working through action with the
Industrial Relations Commission that could try to prevent or delay
these resignations from proceeding if there's not some kind of
(10:53):
progress in the negotiations now. In terms of the New
South Wales Premier Chris Mins, he conceded at a press
conference on Sunday that part of the health network will
face real pressure if these staff numbers are harved. He
said there'll be enormous pressure on the police force, on
corrective services, on public hospitals and emergency departments. Mins noted
(11:16):
that this twenty five percent annual pay increase would be
a salary increase of about eighty to ninety thousand dollars.
He said that's the equivalent of the entire salary for
a first year nurse. It's just not justifiable. And then
we have also heard from the New South Wales Liberal opposition.
It's accused the min's government of abandoning the state's most vulnerable,
(11:41):
and it's said that the psychiatrist's shortage is going to
leave people without the care they urgently require. Shadow Health
Minister Kelly Sloan said Labor must address the issue as
a matter of urgency for psychiatrists, patients and the broader community, who,
she said, are all at risk if a solution is
not broken.
Speaker 1 (11:58):
And I think it's an important piece of text here
to remind everybody that historically this is not unusual, no
matter what the sector is. I mean, we've seen it
with train drivers for example, in recent months. Then normally
is some sort of resolution reached between the warring parties, often,
you know, five minutes to midnight on the last day
exact negotiation.
Speaker 2 (12:19):
It's all about compromise, and there is still.
Speaker 1 (12:20):
A little bit of time before that twentieth of January deadline.
But I really appreciate you talking us through the context
behind this so that when we hear about whether there's
negotiations reach a tipping point and in fact a resolution,
hopefully that we understand a bit about where that's come from.
Speaker 2 (12:36):
Thanks so much for having me, Zam.
Speaker 1 (12:37):
And thank you for joining us on the Daily OZ today.
If you enjoyed this episode. It would mean a lot
to us if you shared it with a friend. It
really helps us grow. Perhaps somebody who is a listener
of other podcasts and they're ready for a news one,
sending it to them would make our day. We'll be
back again in the afternoon with your headlines. Until then,
have a great day, Miss Lily Maddon, and I'm a
(13:01):
proud Arunda Bunjelung Calkatin woman from Gadighl Country. The Daily
oz acknowledges that this podcast is recorded on the lands
of the Gadighl people and pays respect to all Aboriginal
and torrest Rate island and nations. We pay our respects
to the first peoples of these countries, both past and present.
Already and this is the daily This is the Daily OS.
Speaker 2 (00:05):
Oh, now it makes sense. Good morning and welcome to
the Daily OS. It's Wednesday, the fifteenth of January. I'm Emma,
I'm Sam. At least two hundred psychiatrists have resigned from
New South Wales public hospitals after a mass departure of
(00:27):
psychiatrists from the sector last year. It comes amid an
ongoing dispute with the state government, a psychiatrists call for
better pay and better working conditions. After this latest round
of resignations, there are fears the sector could be reduced
by two thirds before the end of the month. GPS
a warning it could trigger a mental health crisis on
(00:48):
their end. So what's going.
Speaker 1 (00:50):
On, well, Emma, today will talk you through this ongoing
dispute and unpack the stored negotiation between the New South
Wales government and the Doctors' union. But first, I think
a lot of people can get mixed up between psychiatrists
and psychologists. Give us a quick recap on the difference
between the two and who are actually talking about today.
Speaker 2 (01:13):
Yep, So psychiatrists, that's who we're talking about today are
medical doctors and they specialize in the diagnosis and the
treatment of mental health conditions. The biggest thing that separates
them from psychologists, you could argue, is that psychiatrists can
prescribe medications, so they're doctors, they prescribe meds. Psychologists are
(01:34):
the people that we might go and see to do therapy.
We might not get a prescription for medication from them,
So that's the important distinction. Another important distinction today, before
we get really stuck in, is that we're talking today
about psychiatrists who work in the public health sector. So
we're not talking about psychiatrists in private practice. We're talking
(01:54):
about the ones that might work in hospitals are the
state run mental health services. So that's the kind of
claimer ahead of today's chat.
Speaker 1 (02:01):
So they on their pay statements at the end of
the month would have the new South Wales government as
their employer exactly. Okay, So there's been a mass resignation
of psychiatrists who work in this public health space. Where
have these walkouts come from?
Speaker 2 (02:15):
Essentially it all boils down to a dispute over pay
and over working conditions. So psychiatrists in this instance a
work is represented by a union, the Australian Salaried Medical
Officers Federation, of New South Wales. But thankfully for us,
they're also called the Doctors Union, so I'll be calling
them the Doctor's Union to the.
Speaker 1 (02:36):
Episode, I prefer ASTHMOV now ASMOV.
Speaker 2 (02:39):
New South Wales or the Doctors Union have been advocating
for reform for several months to improve what they say
is a dangerously understaffed sector. Now, before these fresh resignations,
about a third of psychiatry positions in public health were
vacant in New South Wales. The union says this presents
(03:00):
a risk to patient welfare, so there's an impact on
the type of care that patients are able to receive.
But that also there is a staff shortage placing enormous
pressure on the existing workforce. So the psychiatrists left behind
are kind of suffering under all of that pressure.
Speaker 1 (03:17):
And I know that today's discussion is about the New
South Wales division of this union, the psychiatrists in the state.
Does it represent a national trend? Is this happening all
over the country?
Speaker 2 (03:28):
Yeah, I mean we know, especially on the other side
of COVID, that health providers and hospitals right across the
country have been struggling. There's resourcing and staffing issues all
around the country in various sectors. But there's an interesting
separation here which is about a pay disparity when it
comes to New South Wales health specialists, and this has
(03:49):
really formed the basis of these negotiations. The Doctors' Union
released a report last year that found a thirty percent
pay gap between what New South Wales public health psychiatrists
learn and what their counterparts interstate are earning. So that's
really the gap that the Doctors' Union has formed the
basis for its negotiations what it's demanding, and that pay
(04:12):
gap is kind of really driving those staff shortages currently
seen in New South Wales. As the union said, why
would a psychiatrist want to work for New South Wales
Health when they could make thirty percent more or be
thirty percent better off working somewhere else.
Speaker 1 (04:27):
Okay, so let's take stock of all of this. We've
got a workforce of psychiatrists in New South Wales who are,
according to them, not only paid less but also overworked,
which they say presents dangers to patients and also to
the psychiatrists themselves. That's the position they took into the
negotiations with the state government. What are the specifics of
(04:47):
those negotiations, like, what are both parties trying to reach
here to make the conditions better? Is it just pay?
Speaker 2 (04:53):
So, as it so often is in these cases, it's
a lot more complicated than just pay. Negotiations began back
in September, and I think it's probably fair both sides
would probably agree that very little progress has been made
so far. The Doctor's Union is seeking a twenty five
percent pay increase for psychiatrists and as we mentioned, improved
(05:15):
conditions to address these concerns in the mental health system.
So that includes things like improved rostering systems and job security,
better workplace safety, safer working hours, and access to certain
entitlements like parental leave. The New South Wales government, in reply,
has proposed a ten point five percent pay increase over
(05:36):
three years.
Speaker 1 (05:37):
So we've got almost a fifteen percent gap between the
positions of the two parties around the negotiating table. I'm
assuming that offer was rejected. So what's happened since September?
Speaker 2 (05:47):
Yeah, so the union, as you rightly guessed, rejected that
offer immediately in September, and it's claimed since then that
the government has refused to budge on these negotiations. So
since then, half of New South Wales' public psychiatry workforce
has submitted their resignations. We had a tranch of resignations
in November around one hundred and forty people. That number
(06:10):
has now increased to two hundred resignations and the union
has reiterated this idea that the doctors really don't want
to quit. It's not that they want to walk away
from the sector or their jobs in public health. It's
more about being overworked, overwhelmed, and the union says these
workers are completely demoralized from working in a broken system
(06:31):
and basically they've been left with no other option.
Speaker 1 (06:34):
And give me a sense of two hundred psychiatrists resigning,
what does that mean in the broader picture of the
New South Wales health system in psychiatry.
Speaker 2 (06:43):
Yes, so in total there are about two hundred and
ninety five psychiatrists working for New South Wales Health so
we're talking about more than two thirds.
Speaker 1 (06:52):
That's a serious chunk, exactly force.
Speaker 2 (06:54):
A massive chunk. And the resignations are expected to take
effect from the twentieth of January.
Speaker 1 (07:00):
So technak day, isn't that's also the inauguration of Donald
Trump in the US.
Speaker 2 (07:04):
Yeah, the TikTok. Then a little bit on what that
could mean is that we see those psychiatrists moving into
private practice, but it does leave that gap for urgent
psychiatry care. The Royal Australian and New Zealand College of
Psychiatrists is the peak national body for the sector and
(07:25):
it's been pretty vocal about wanting to reach a resolution
before that twentieth of January deadline to avoid these gaps.
It says that previous staffing gaps have created a crisis
for the psychiatry workforce in New South Wales and it's
worn the mass resignations would significantly impact some of the
most vulnerable people in our community, which is important to
(07:46):
remember when you think about who is accessing urgent psychiatry care.
RA and ZCP released a statement saying disruption to care
for those vulnerable people will have wide ranging impacts. And separately,
there's this interesting conversation going on with the general practice industry.
The peak body for GPS has warned that failure to
reach an agreement could impact gps who are already managing
(08:09):
high demand for mental health consult Sure.
Speaker 1 (08:11):
Well, they'll have to kind of fill a vacuum almost
because the number of people who would presumably need psychiatry
services would not magically decrease by sixty percent, So that's
going to need to be serviced by somebody else exactly.
Speaker 2 (08:23):
And there's a whole other separate issue of what psychiatrists
can prescribe for treatments us as what gps can prescribe.
If you're familiar with ADHD medication, psychiatrists can prescribe that.
There's a lot of regulations and loopholes. You can't just
walk into a GP if you have an ADHD diagnosis
and get that medication straight away.
Speaker 1 (08:42):
I want to understand the response from both New South
Wales Health and the New South Wales government. They're different bodies.
The negotiations are happening with the government, but New South
Wales Health as the employer, is obviously going to feel
the impact of this as well. How are they planning
to address this sudden shortfall in psychiatrists.
Speaker 2 (09:00):
Yeah, so the Department of Health has issued an update
in anticipation of these disruptions to its public mental health services.
It said it's working on plans to manage the impact
of this proposed mass resignation of around two hundred psychiatrists.
The specific details of what those plans look like are
(09:20):
yet to be seen, but it did warrant that there
could be extensive disruption to services and the broader public
health system from the twentieth of January. So not a
lot of detail, but essentially the Department of Health conceding
that this could be significant for a lot of people.
Speaker 1 (09:37):
And so then the New South Wales government as the
opposing side in these negotiations, they must have their own
position on why they're not coming to the table. Explain
to me why there hasn't been a resolution from their perspective.
Speaker 2 (09:47):
Yeah, I mean, more broadly, the New South Wales government
has been locked in a range of bargaining agreement renegotiations
with health employees. One of the more high profile breakdowns
in negotiattions people might remember is the nurses and midwife
negotiations that led to mass strikes last year, delays inelective surgeries.
(10:08):
In between all of that, of course, we have this
going on with the psychiatrists. The state's Health Minister, Ryan
Park has basically said that their requests are impractical. The
pay increase requests specifically is not feasible. He said that
the government doesn't want this action to take place. He
told psychiatrists their work is valued, but that the government's
(10:29):
not in a position to offer wage increases to the
amount that psychiatrists are calling for. Park said that it's
absolutely critical that both parties remain at the negotiating table,
but the government is also working through action with the
Industrial Relations Commission that could try to prevent or delay
these resignations from proceeding if there's not some kind of
(10:53):
progress in the negotiations now. In terms of the New
South Wales Premier Chris Mins, he conceded at a press
conference on Sunday that part of the health network will
face real pressure if these staff numbers are harved. He
said there'll be enormous pressure on the police force, on
corrective services, on public hospitals and emergency departments. Mins noted
(11:16):
that this twenty five percent annual pay increase would be
a salary increase of about eighty to ninety thousand dollars.
He said that's the equivalent of the entire salary for
a first year nurse. It's just not justifiable. And then
we have also heard from the New South Wales Liberal opposition.
It's accused the min's government of abandoning the state's most vulnerable,
(11:41):
and it's said that the psychiatrist's shortage is going to
leave people without the care they urgently require. Shadow Health
Minister Kelly Sloan said Labor must address the issue as
a matter of urgency for psychiatrists, patients and the broader community, who,
she said, are all at risk if a solution is
not broken.
Speaker 1 (11:58):
And I think it's an important piece of text here
to remind everybody that historically this is not unusual, no
matter what the sector is. I mean, we've seen it
with train drivers for example, in recent months. Then normally
is some sort of resolution reached between the warring parties, often,
you know, five minutes to midnight on the last day
exact negotiation.
Speaker 2 (12:19):
It's all about compromise, and there is still.
Speaker 1 (12:20):
A little bit of time before that twentieth of January deadline.
But I really appreciate you talking us through the context
behind this so that when we hear about whether there's
negotiations reach a tipping point and in fact a resolution,
hopefully that we understand a bit about where that's come from.
Speaker 2 (12:36):
Thanks so much for having me, Zam.
Speaker 1 (12:37):
And thank you for joining us on the Daily OZ today.
If you enjoyed this episode. It would mean a lot
to us if you shared it with a friend. It
really helps us grow. Perhaps somebody who is a listener
of other podcasts and they're ready for a news one,
sending it to them would make our day. We'll be
back again in the afternoon with your headlines. Until then,
have a great day, Miss Lily Maddon, and I'm a
(13:01):
proud Arunda Bunjelung Calkatin woman from Gadighl Country. The Daily
oz acknowledges that this podcast is recorded on the lands
of the Gadighl people and pays respect to all Aboriginal
and torrest Rate island and nations. We pay our respects
to the first peoples of these countries, both past and present.
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