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To the surprise of many, New South Wales Labor decided in May that it was backing away from its 2015 and 2019 policy for mandated nurse-to-patient ratios in hospitals.

It announced in September that, if elected in March 2023, it would support replacing the current nursing-hours-per-patient day rostering system with an “enforceable, minimum shift-by-shift staffing model from mid-2023”.

It departs from safe ratios being made law, making hospitals responsible for fulfilling mandated minimum staffing ratios.

Labor’s new policy means the onus will fall on workers to fight for safe ratios in their awards.

Without having discussed it with its membership, the NSW Nurses and Midwives Association (NSWNMA) issued a statement supporting Labor’s new policy.

Even its : “Victoria, Queensland and the ACT have made nurse-to-patient ratios law. NSW should be leading, not lagging behind.”

The campaign for safe ratios has been stepped up over the last two years of the pandemic, with widespread public support.

Nurses point to the , money and encourage nurses to remain in the profession.

The Lancet last year that independent research conducted at the University of Pennsylvania found that a safe nurse-to-patient ratios policy improved patient outcomes and specifically patient mortality rates, seven-day readmissions and lengths of stay.

“These outcomes resulted in cost savings that were more than twice the cost of the additional nurse staffing required by the ratios policy,” The Lancet said.

Asked about Labor’s new policy, JP Marx, who is running for the assistant secretary position in the NSWNMA election, told 91������̳: “It’s not clear. We haven’t seen the detail. It does not cover paediatrics … While [it's] a step in the right direction, it does not cover the whole of our claims across the board.”

Many nurses are expressing concern and are confused about Labor’s position.

“Why is Labor so scared about enforceable ‘ratios’,” one asked on the . “Is it because they [ratios] are so straight forward, they can’t be fudged and nurses everywhere would have the means to ensure safe staffing?”

“I remember last time Labor promised a better deal for nurses before they got into power — nothing really changed once they got in,” another said.

“I don’t trust that they will follow through on their promise.”

Another said: “I’m not a nurse, but I am a Labor member and an admirer of your union. This commitment from NSW Labor does not go far enough. I encourage you all to keep fighting.”

The NSWNMA Facebook page features stylised graphics with a logo proclaiming “Ratios: it’s a life saver”, accompanied by “1:4 in medical/surgical committed to by Labor”.

Labor’s actual policy on ratios is not visible.

NSWNMA Maitland branch president Kylie Goodwin told the Newcastle Herald on October 11: “We have half a commitment from Labor in regards to safer patient care … We’re trying to encourage our staff to continue the fight.

“[Labor] won’t say the word ratios; it’s absolutely ludicrous.”

Probably what confuses NSWNMA members is why Labor is refusing to use the word “ratios” yet their union is suggesting that Labor is committed to them.

[Niko Leka is a retired nurse and long-time member of the New South Wales Nurses and Midwives Association.]