“Wise and humane management of the patient is the best safeguard against infection” was once said by Florence Nightingale, an English nursing pioneer and health-care reformer. Indeed, a resilient health system relies on skilled and motivated health-care workers. The critical role played by health-care workers in protecting patients during the COVID-19 pandemic has been celebrated worldwide. Tributes to Australian health-care workers have ranged from street art to community-initiated fundraising campaigns. However, more than 2 years into the pandemic, with over 6 million cases and 7000 deaths as of May, 2022, the constant emergence of new variants, and the relaxation of public health restrictions, health-care workers are understandably facing burnout. As such, the resilience of Australia's health system hangs in the balance.
Not long after the first human case of COVID-19 in Australia was identified in January, 2020, the Australian Government was heavily criticised for being too slow to act. The lack of health system preparedness was a key reason proposed for soaring cases in the critical early stages of the pandemic. Stockpile of personal protective equipment (PPE) was not secured, and a COVID-19 plan for the aged care sector was non-existent. The success of restrictions was later undermined by a slow vaccine roll-out, especially among vulnerable populations at increased risk of contracting COVID-19 such as people living in nursing homes. To improve future health emergency preparedness and response, a 6-month independent inquiry into Australia's management of the pandemic is underway. The panel has called for public comments to identify areas of improvement in the Government's COVID-19 response to ensure future health system resilience. Their report is anticipated to be released in September, 2022.
However, much more needs to be done now. Nurses and midwives represent the largest group of registered health-care workers in Australia. An estimated 20 000 Australian nurses have quit the profession as of November, 2021, due to heavy workloads associated with staffing shortages. On February 15, 2022, thousands of nurses in Sydney went on strike for the first time in nearly a decade in response to the recent spike in COVID-19 cases due to the omicron variant. Their slogans read “Stop telling us to cope!” and “Ratios. It's a matter of life or death.” They demanded fixed nurse-to-patient ratios and a pay rise of over 2·5%. Nurses are not alone. Paramedics in Sydney also walked off the job on March 21, 2022, due to pay and staff shortages. Similarly, on May 10, 2022, hundreds of workers in the aged care sector in Perth held a strike to demand higher pay, better staffing and care.
These strikes demonstrate that while many of us understandably want to move on and live what is being referred to as the new normal, health-care workers are being left behind. Long shifts wearing full PPE, increased pressures and risks to safety and health associated with caring for patients with COVID-19, and concerns about infecting family members remains the everyday reality for health-care workers. This is on top of the massive backlog of surgical, mental health, primary, and community health care caused by the pandemic. It is not surprising that Australia is in the grips of a health-care workforce shortage. Recently, the Victorian Government invested AU$2·5 million to recruit overseas health-care workers to Victoria, which has endured the most lockdowns out of all Australian states. However, this does not address the core issue of health-care workers feeling undervalued for their critical role in the ongoing pandemic.
The theme for International Nurses Day on May 12, 2022, the anniversary of the birth of Florence Nightingale, is “A Voice to Lead – Invest in nursing and respect rights to secure global health”. The day will focus on the need to support and invest in the nursing profession to strengthen health systems worldwide. Australia needs to refocus by investing in both short-term and long-term drivers of health system resilience. Federal funding to support the pandemic response and surveillance must continue. Investment in recruiting and retaining skilled health-care workers by promoting fairer pay and better support are urgently needed. This could also include improving the education and training pipeline to facilitate workforce skills and transition and providing more opportunities for health-care workers to upskill and hold leadership roles. In this light, Australia would be investing in not just its own health system resilience, but also global health system strengthening.