Oh boy, things are about to get real.
At the risk of invoking an image that may be hard to dispel, NSW health minister Ryan Park and department secretary Susan Pearce need to remove their respective craniums from their respective rectums.
Mr Park and Ms Pearce have misread the room, badly.
In three days’ time about 200 state-employed psychiatrists are resigning. They’re not going on strike. They’re not bluffing. They’re not playing the ambit claim game.
They are walking away from their public sector careers.
Some will go to the private sector and earn twice as much. Some will go to other states and earn, if not twice as much, then significantly more than NSW seems willing to pay them.
And some – like Dr Helen Schultz, will never treat another patient again.
This isn’t a normal industrial campaign. It’s not about pay. At least, it’s not just about pay.
It’s about trauma, and fear, and exhaustion, and demoralisation, and disrespect.
We have spoken to a lot of psychiatrists this week. Not one of them is backing away from the prospect of quitting on Tuesday. Not one.
Spare a thought for the 80-90 trainees who are about to walk into NSW hospitals expecting to be supervised by staff specialists by their sides as they deal with patients.
Those supervisors are about to disappear in a cloud of smoke. NSW Health has said the trainees won’t be expected to operate beyond their scope, but the reality on the ground suggests differently.
Dr Lauren Amor should know. She’s two months from finishing her training and she will see it to the end, but then she will likely leave the NSW public system. Which is a shame because her passion is right where she currently works. She just can’t see that it will be safe, for her or the patients.
She made the move from the NHS in the UK searching for better working conditions. Now, returning to the UK is one of her options.
That’s irony for you. The NSW public mental health system is WORSE THAN THE NHS. Let that sink in.
Mr Park and Ms Pearce are bleating about it being all too expensive to pay their psychiatrists what they’re worth to other states and territories.
“No government would be expected to pay that much over one to two years,” said Mr Park on Saturday in what was one of the most tone-deaf press conferences ever delivered by a politician.
Wait until they get the bills from all the locums they’re going to need to employ to fill in the gaps – assuming there are any locums willing to put themselves in that situation.
Mr Park is trying to say the money isn’t there. It is, of course. It’s just sitting in some other department’s bucket. Or in some other bucket within NSW Health that isn’t marked “staff specialist salaries”.
It’s a matter of priorities, and the NSW government is showing just how low down the totem pole of priorities psychiatrists and psychiatric patients are.
It’s a pity psychiatrists don’t operate trains or arrest people.
The speculation is that what Mr P and Ms P are really worried about is the effect the psychiatrists’ mass resignation will have on other healthcare workers.
Word is the mental health nurses – who, let’s face it, are about to be hammered with extra work and responsibility – are considering quitting as well. Then there are the obstetricians and gynaecologists.
What’s been very interesting to watch has been the sparkle in the eye of GPs who are watching on from the sidelines with a sense of amazement.
One senior GP said to me this week that it was “very refreshing to see” the psychiatrists getting so much support for their decision to walk away.
“Imagine if we got that brave,” she said.
Indeed.
It’s not the Minns government’s fault, though, naturally. Just like Queensland Health’s dire straits aren’t the Crisafulli government’s fault, apparently.
Bad luck, Mr Park. You wanted to be in government, now you are. Stop whining about who got us into this mess (you helped, by the way – you were told even before your government won the election that this crisis was coming), and do what has to be done.
My thoughts are with the mental health nurses, the emergency department staff, and yes, the GPs and urgent care clinic staff who are going to be swamped by patients in need who can’t be treated by a public health psychiatrist any time soon.
Then there are the patients – and not just those who need the psychiatrists and will likely find themselves waiting for days in EDs. These might be patients in the throes of psychosis – the bright lights and chaos of an ED is hardly an environment to keep them safe and help ride through it. One can only hope that these patients don’t end up in police custody instead, simply because there is nowhere else to go.
I am not confident in that hope.
Then there are the other patients who are also lining up at EDs with life-threatening conditions, the heart attacks and the strokes and the children with dangerously high fevers. Emergency doctors and nurses are facing dark days ahead.
The AMA NSW said this week that the psychiatrists’ crisis was just the tip of the iceberg that is the broken state public health system.
Let’s hope the government wakes up before that iceberg becomes a snowball that takes whole other departments down with it.
Because you can be sure that other specialists – like GPs – are watching this crisis unfold through the lenses of their own system shortfalls.