Psychiatrists warn new mental health unit at Westmead could be an ‘empty shell' as workforce dispute drags on
The peak body for psychiatrists has said the $540m Westmead integrated mental health complex is likely to suffer the same fate as several recently opened facilities in western Sydney, which are only able to operate at less than half the available beds due to lack of staff.
Over a third of the permanent public sector psychiatrist positions were already vacant in the state before the remaining specialist doctors resigned en masse in a high-profile dispute with the state government which remains in arbitration before the NSW Industrial Relations Commission.
The doctors union, the Australian Salaried Medical Officers' Federation (Asmof), representing psychiatrists, is arguing for a special levy to increase pay by 25%. The union claims the boost will stem the flow of specialist doctors leaving the state's public system, which is caught in a vicious cycle where remaining staff are left to pick up the slack of the understaffed system, meaning more suffer moral injury and leave.
Rose Jackson, the NSW mental health minister, on Wednesday said the 'state of the art' facility at Westmead would have 250 to 300 beds to be able to care 'across the continuum from those experiencing severe, acute mental illness, eating disorders, adolescents, older people, to those who are experiencing situational distress, anxiety, depression. It's all here under the one roof in an integrated complex.
'We don't want people experiencing mental distress shunted away in small, isolated facilities. We want to bring their care into an integrated network of health facilities,' Jackson said.
The hospital is due to open in 2027, Jackson said, 'if the weather goes our way'.
Sign up for the Afternoon Update: Election 2025 email newsletter
Dr Pramudie Gunaratne, the chair of the NSW branch of the Royal Australian and New Zealand College of Psychiatrists, said that 'as it stands, the fate of the new Westmead unit will be the same as other newly built units, it will either remain empty once built, or it will run at only a fraction of its capacity'.
Gunaratne said at the new facility at Campbelltown, only two of six beds are open at the mental health intensive care unit (MHICU) while only eight of the 16 beds are open in its high-risk civil rehab unit, including the only female high-risk civil rehab beds in the state – all due to lack of staff.
'None of the female beds are open so there are no high-risk female beds in NSW. Currently the waiting time for patients accepted to this unit is over 6 months,' Gunaratne said.
At the new forensic facility at Blacktown, completed and opened in September, which is a 44-bed unit, only 16 beds are open due to lack of staff, she said.
'Until we sort out crisis in our mental health workforce in NSW, opening such new units will be a waste of time and money.
'Furthermore, dangling a mirage-like new unit we know can't fully function, mocks the anguish of those patients and their families who are crying out for proper care.'
Ian Lisser, Asmof's manager of industrial services, said: 'Emergency departments are overwhelmed. Patients in crisis are waiting up to 90 hours for care. Unless the government takes urgent steps to attract and retain psychiatrists, this new complex will be an empty shell.'
Asked about the workforce shortage at a press conference, the premier, Chris Minns, said the government believed it would have enough mental health professionals, 'whether it's psychiatrists or others that work in the system' and was now recruiting, paying what it regards as competitive salaries.
Minns said the government had come to the table with the 'best offer for psychiatrists and doctors and public sector workers in this state for over a decade' and it would accept the decision of the independent umpire (the IRC). 'What we can't do is hand over a blank cheque.'
The health minister, Ryan Park, denied the government was investing in bricks and mortar and not the workforce, saying 'the biggest challenge that I see is not new buildings, [it] is in staffing. That remains the thing that keeps me up at night.'
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Powys County Times
28-06-2025
- Powys County Times
Woman airlifted from Llanymynech raises funds for rescuers
A woman who was airlifted from a field on the Powys border is now hoping to raise money for her lifesavers. Carla Jackson, a group finance manager and company secretary with the TG Group, was flown to safety by an air ambulance after a serious accident in Llanymynech in 2005. Now, as she marks the 20th anniversary of the dramatic rescue, she is taking on her longest-ever run to raise money for the County Air Ambulance HELP Appeal. Ms Jackson said: "The air ambulance receives no government funding. "They were there when I needed them, and I want to do my part to make sure they're there for others. "This challenge is about pushing my own limits to support an incredible cause." She will take part in the Gower Peninsula Ultra Challenge, a 100km endurance event along the South Wales coast, on July 19. The HELP Appeal funds the construction and maintenance of helipads at hospitals and air bases across the UK, supporting critical emergency infrastructure. Ms Jackson also suffered a separate brain injury two years ago and described the run as a way to give back on the 20th anniversary of her original rescue. TG Group said it was proud of Ms Jackson's determination and is supporting her fundraising efforts. The HELP Appeal is the only UK charity dedicated to funding helipads at hospitals and air ambulance bases.
The Guardian
20-06-2025
- The Guardian
Psychiatrist body holds firm on 25% pay bid but NSW Health says shortages are ‘more nuanced'
Closing submissions have been heard in the long-running dispute between psychiatrists – who are pushing for a 25% pay increase – and the New South Wales department of health, bringing to a close a landmark legal action brought by the psychiatrists, who argue psychiatric care in NSW is facing 'collapse' because of poor pay and conditions. Over two days this week, the Industrial Relations Commission court in Sydney heard closing submissions from lawyers, before the full bench retired to consider their decision. At the heart of the dispute is the proposition from the psychiatrists, represented by the Australian Salaried Medical Officers Federation (Asmof), that NSW staff specialist psychiatrists are significantly underpaid compared with their interstate counterparts. This, they argued, has led to an exodus of qualified psychiatrists to other jurisdictions or the private sector, leading to drastic and dangerous understaffing of psychiatric units and overwork and moral injury of staff. Asmof is arguing for a special levy to increase their pay by 25% to stem the flow of specialist doctors leaving the state's public system. In January, 206 psychiatrists in NSW threatened to resign; 62 have resigned, while others await the commission's decision. In closing submissions Thomas Dixon, the barrister for Asmof, pointed the commission to evidence it had heard about the 'proliferation' of mental health patient presentations in the public health system in recent years, at the same time there has been a reduction in the number of public psychiatric specialists. Dixon said that in the five years from July 2019, the number of staff psychiatric specialist vacancies in NSW increased from 35 full-time equivalent (FTE) roles to 131, a near 400% increase. 'Why is this occurring?' he asked the full bench. 'The reasons are many, including pay … stress, overwork and concern for patient outcomes. All of these factors were caused or exacerbated by staff shortages. 'Staff shortages are having a negative impact on the quality of patient care and integrity of the health system.' Sign up for Guardian Australia's breaking news email According to Asmof, psychiatrists are paid significantly more in states other than NSW. Salaries were up to 51% higher in Western Australia, 44% higher in the Northern Territory, 38% higher in South Australia, 28% in Queensland and 25% in Tasmania. They are 2% higher in Victoria, but Asmof said that in Victoria, as most psychiatrists do not work full-time, they are paid an hourly rate which amounts to 31% more than in NSW. Dixon reminded the court of evidence it had heard that giving a pay rise to psychiatrists would actually end up costing the government less than its current policy, which was to fill gaps in staffing with locums or visiting medical officers (VMOs). Dixon said that a full-time staff psychiatrist cost the same as a VMO working at 0.6FTE. Ian Neil SC, the barrister representing the secretary of health and the NSW department of health, argued that there was no evidence that increasing the pay of psychiatrists with a special levy would have any impact on the attraction and retention of staff, except for stopping those who had threatened resignation pending the outcome of the arbitration, which he urged the court not to consider. 'Asmof loaded up the gun and pointed it at our heads,' Neil said of the mass resignation threat. 'That ought not to be taken into account.' Neil told the court that increasing the pay for psychiatrists by 25% in an interim 12-month order was problematic in that it meant the commission would have to keep that pay uplift in other award negotiations going forward, and that it would not address the issue that Asmof hoped it would remedy. 'Wage fixing is not an appropriate mechanism to address the problem of attraction and retention, of itself,' he said. 'The problem of workplace shortages … are a much more nuanced problem that requires a nuanced response.' Neil was pushed by the justices to give an account of what the health secretary contended the solution was for the problem of attraction and retention, if not a pay increase, to which he said: 'There is no simple answer to that question because it's not a simple issue. It would be a simple issue if funds were infinite, it would be a simple issue if the source of trained staff specialist psychiatrists were infinite, but none of those propositions are true or realistic.' The full bench has adjourned to consider its judgment.
NBC News
11-06-2025
- NBC News
How CDC cuts affect women with chronic diseases like sickle cell
WESTLAND, Mich. — For D'Asia Jackson, every day is a guessing game over whether excruciating pain will upend her life. The 28-year-old medical assistant was born with sickle cell disease, an inherited condition that causes red blood cells to be shaped like a crescent moon. The anomaly can cause blood clots, organ damage and excruciating pain, which can worsen during the menstrual cycle. 'Pain-wise, I always describe it as like being hit by a Mack truck,' Jackson said. 'When I know my period is coming, I know pain is probably right behind it.' Over the last 10 years, Jackson has worked with her doctors to try a variety of contraception options to get her symptoms under control, from the Depo-Provera shot, a hormone injection given every three months, to an IUD to different forms of birth control pills. According to Jackson, none of them helped. Some made her periods even worse. 'I might have a good four or five good days of not bleeding in a month,' she said. 'Over the years, it's like the period actually started getting heavier, and that's when it started affecting my sickle cell.' At times, she's ended up in the hospital needing iron infusions due to loss of blood. Doctors don't know how to manage her symptoms. Sickle cell has no cure and treatment options are variable. 'The lack of education on sickle cell is very frustrating,' she said. 'I go into hospital stays having to educate doctors and nurses.' Now, women like Jackson are worried that lack of knowledge, particularly about how contraception affects their conditions, could get worse. In April, a small team that compiled information into what some consider the country's 'contraception bible,' a set of guidelines used by physicians to assess which types of birth control are safe for their patients, was fired from the Centers for Disease Control and Prevention as part of mass layoffs from the agency. The eight-person team was responsible for evaluating research and recommending birth control methods for patients with various conditions, from sickle cell disease, kidney disease and lupus to those at risk for HIV. The guidelines, called the U.S. Medical Eligibility Criteria for Contraceptive Use, provided the latest research for doctors, including an app that recommended which contraceptive methods were safe. The app has been downloaded more than 440,000 times, according to the CDC. Now, the work of that team has been halted as part of the reduction of the Women's Health and Fertility Branch of the Division of Reproductive Health. 'These are the only federal guidelines that focus on the safety of contraception for women with certain medical conditions,' said Lee Warner, the former chief of the Women's Health and Fertility Branch. 'This work exists nowhere else, and these individuals specialize in this area. Without their presence, the work stops.' Warner retired from the agency in April just after learning his team was being eliminated. 'While most women are able to use most methods, we looked at 60 conditions and over 1,800 evidence-based recommendations across an array of contraceptive methods,' he said. 'For some women, it is very dangerous for them to become pregnant at a certain point. So having contraception available to them that they can choose can help protect them.' At least 90% of people in the United States with sickle cell disease are Black. The maternal mortality rate for Black sickle cell patients has been found to be 26 times higher than for non-Black people. 'The CDC's decision to cut the team responsible for contraceptive guidelines is especially troubling for the sickle cell community, where pregnancy can carry severe health risks,' said Teonna Woolford, who founded the nonprofit Sickle Cell Reproductive Health Education Directive to advocate for patients and expand knowledge about the often-misunderstood disease. 'Eliminating this resource will disproportionately impact a community already facing significant barriers to care, further deepening health disparities.' In response to a request for comment, an official for the Department of Health and Human Services did not explain why the team was cut. In May, Health Secretary Robert F. Kennedy Jr. defended the cuts in a hearing before the Senate Health, Education, Labor and Pensions Committee. ' Right now we have 42 divisions that do maternal health,' Kennedy testified. 'They're not cuts. They're consolidations. It's ridiculous to have 42 divisions that are all supposed to be doing the same thing.' Warner disagreed with Kennedy's testimony. 'Especially with this branch,' he said, 'the expertise is not redundant of that elsewhere in the federal government.' 'Once this expertise is gone, it is permanently gone from the agency. It is going to be very hard to resume and re-create,' he said. 'The HHS restructuring consolidates maternal and child health programs into the new Administration for a Healthy America (AHA) to improve efficiency and better address public health needs,' an HHS official said in a statement to NBC News. 'The reorganization aims to streamline operations, maximize resources, and support key priorities like maternal mental health and data collection. We remain committed to improving health outcomes for American families.' Representatives for HHS did not specify if work on the contraception guidelines would continue. The Trump administration did not respond to questions about why the team was cut or if its work would continue. The CDC's most recent update to the contraception guidelines was published in August. The updates included new recommendations for people with sickle cell disease, finding that combined hormonal contraception presents an 'unacceptable health risk' due to patients' risk of life-threatening blood clots. In previous versions of the guidelines, the CDC found the advantages of combined hormonal birth control, which contains estrogen and progestin, outweighed potential risks such as blood clots or stroke. The newest guidelines also increased the risk category for the Depo-Provera shot, while ranking methods like progestin-only pills and IUDs as generally safe. Jackson was unaware of the updated guidance until her interview with NBC News. She said she is using an IUD as well as combined hormonal contraception in the form of a pill to try to manage her bleeding. 'I didn't know that,' she said. 'I kind of just hope that my doctor knows a lot and kind of just steers me in the right direction.' Warner said the CDC team should be publicizing the updated guidance now to make physicians aware of the changes and adjust how they treat patients. 'We actually planned to do a road show of the guidelines in the late fall and throughout the spring in which we would disseminate the guidelines and go speak to provider groups,' he said. 'It's not happening.' The severe pain associated with her periods has driven Jackson to seek a hysterectomy for relief. 'I have been asking for a hysterectomy for years. I've seen five different OBs, and no one will do it,' she said. While the current guidelines are still accessible, the August update could be the last, leaving Jackson with little hope that she'll find a method of birth control that works for her.
