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The Guardian - AU
The Guardian - AU
National
Kate Lyons

Royal Prince Alfred hospital management pauses cuts across women and babies unit after protests

Staff protesting outside the Royal Prince Alfred Hospital in Sydney earlier this week.
Staff protesting outside the Royal Prince Alfred Hospital in Sydney earlier this week. Photograph: Kate Lyons/The Guardian

Management at Royal Prince Alfred hospital (RPA) in Sydney will pause its cuts to staffing levels across its women and babies unit, just days after staff protested against the changes.

Dozens of midwives and other clinical staff held a snap rally on Tuesday outside RPA, one of the city’s major tertiary hospitals, claiming that management’s decision to reduce the number of midwives rostered on to the birthing unit risked the lives of mothers and babies.

Guardian Australia understands that late on Thursday hospital management reached an agreement with staff to pause the cuts and revert back to previous staffing levels across the birthing unit, effective immediately, while discussions continued between management and staff.

Midwives were called in to fill extra shifts, or stay late on the afternoon shift on Thursday, in order to bring numbers back up to previous levels.

One RPA midwife, speaking on the condition of anonymity, said: “We’re all so relieved that the cuts have been paused. There’s been a lot of uncertainty in the past week … which has taken a toll on everyone.

“We’re all hoping that a fair and safe roster can be negotiated in the coming weeks.”

On 1 July, 20 full-time equivalent roles were removed from across the women and babies service at RPA, including five from the midwifery group practice (MGP).

The New South Wales Nurses and Midwives’ Association (NSWNMA) said that while no jobs would be lost as a result, vacant positions would not be filled and fewer casual staff would be brought in as a result of the changes.

The new plan would mean fewer midwives rostered on to each shift in the labour ward and birth centre, said the NSWNMA, a drop from 26 midwives rostered on across day, afternoon and night shifts each day, to 18 midwives across the three shifts.

“This is not safe,” claimed the NSWNMA president, O’Bray Smith, on Tuesday. “This is about saving lives, having safe staffing. The midwives are absolutely terrified of what could happen here.”

On Tuesday, the NSW health minister, Ryan Park, said that no one at RPA would be losing their job, but midwives were being “redeployed in other parts of maternity services” due to “a slight reduction in birthrates at RPA”.

A Sydney Local Health District (SLHD) spokesperson said local health districts used a model called “birthrate plus” to determine the level of staffing in birthing and maternity services. The tool was implemented in consultation with the NSWNMA and was included in the public health system nurses’ and midwives’ award in NSW, they said.

“This model ensures staffing is matched to demand, based on factors including birth numbers, patient complexity, demographics and skill mix.

“A routine four-yearly review, finalised in 2024, identified a 25% decrease in births at Royal Prince Alfred (RPA) hospital. We are currently meeting with our midwives across the service to understand their concerns and work towards a solution that everyone is confident with.

“We want to assure all women using our maternity services at RPA that they will continue to receive the highest standard of care.”

The NSWNMA previously endorsed the birthrate plus model but has, for a number of years, called for it to be reviewed and the implementation of 1:3 staff ratios. The union argues the current modelling of patient care does not include babies in staff-to-patient ratios.

The health minister’s office was contacted for comment.

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