Get nurses paid more by putting them in charge of their local hospitals
NPAA analysis shows that moving administration out of centralised head offices and into local hospitals could fund higher pay for nurses. Add your name to the petition.
NPAA analysis: the savings are in the bureaucracy
NPAA analysis puts Australia at 5 administrators for every 10 nurses. In France and most of Europe it is 1 for every 10 nurses and midwives. Reducing our ratio to 1:10 would save an estimated $6,042,565,719.65 a year across the states and territories. If the savings were passed on as pay, the government could pay nurses on average $32,446.33 more per year without increasing the budget. These are theoretical estimates, and the workings and sources are further down this page.
Local hospitals, run locally
The Australian health system originally started with locally run, autonomous hospitals.
NPAA’s view: the current system is built around centralised control, not around patients, the public or frontline healthcare workers. Decisions are made a long way from the bedside, by people who answer to a head office rather than to the community the hospital serves.
The answer is less bureaucracy. NPAA wants head office administration functions moved into local hospitals, which would employ their own local administrators (in Queensland, that means moving functions out of Brisbane). NPAA estimates that only 10 to 15% of current administrators would be needed once decisions are made locally.
A community-elected board
Each local hospital would be run by nurses and managed by a board elected by the community the hospital serves, not appointed by a politician.
A community-elected board is transparent and accountable to the people who elect it, in ways a bureaucracy cannot be. It means problems are raised and dealt with in the open, and services follow what the community needs rather than what a head office dictates.
Nurses in hospital decision-making
Nurses at each facility have first-hand knowledge of what their patients and community need.
NPAA wants at least one nurse, elected by the nurses at that facility (not appointed by a politician or bureaucrat), on the management board.
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To contact the executive directly, email hotline@npaa.asn.au (ATTN: NPAA Secretary).
Savings by state
- Current system: For every 10 nurses, there are 3.96 administrators.
- Go Local system: By reducing to 1 administrator per 10 nurses, Queensland would have a reduction of 11,882 administrative positions, potentially saving $1,177,634,681.76.
- This could result in an average pay increase of $29,347.01 per nurse per year.
- Current system: For every 10 nurses, there are 5.12 administrators.
- Go Local system: By reducing to 1 administrator per 10 nurses, NSW would have a reduction of 22,389 administrative positions, potentially saving $1,992,335,139.66.
- This could result in an average pay increase of $36,645.51 per nurse per year.
- Current system: For every 10 nurses, there are 4.01 administrators.
- Go Local system: By reducing to 1 administrator per 10 nurses, Victoria would have a reduction of 14,544 administrative positions, potentially saving $1,483,375,992.70.
- This could result in an average pay increase of $30,679.53 per nurse per year.
- Current system: For every 10 nurses, there are 3.16 administrators.
- Go Local system: By reducing to 1 administrator per 10 nurses, South Australia would have a reduction of 2,865 administrative positions, potentially saving $201,731,446.50.
- This could result in an average pay increase of $15,240.72 per nurse per year.
- Current system: For every 10 nurses, there are 5.92 administrators.
- Go Local system: By reducing to 1 administrator per 10 nurses, Western Australia would have a reduction of 9,345 administrative positions, potentially saving $901,167,753.35.
- This could result in an average pay increase of $47,457.04 per nurse per year.
- Current system: For every 10 nurses, there are 3.95 administrators.
- Go Local system: By reducing to 1 administrator per 10 nurses, Tasmania would have a reduction of 1,440 administrative positions, potentially saving $121,885,089.61.
- This could result in an average pay increase of $24,961.11 per nurse per year.
- Go Local system: potentially saving $103,278,323.50 per year (NPAA summary figure).
- Current system: For every 10 nurses, there are 3.66 administrators.
- Go Local system: By reducing to 1 administrator per 10 nurses, Northern Territory would have a reduction of 626 administrative positions, potentially saving $61,157,292.57.
- This could result in an average pay increase of $26,001.40 per nurse per year.
By implementing the Go Local system with a nurse-to-administrator ratio of 1:10 across all states and territories, Australia would have a reduction of 64,113 administrative positions and $6,042,565,719.65 in administrative salaries.
If the saved funds were redistributed to nurses, it would result in an average pay increase of $32,446.33 per nurse per year, based on the total nurse count of 186,229 across all states and territories.
Australian Institute of Health and Welfare. (2022-23). Hospital resources 2022-23: Australian hospital statistics. Table 3.2: Average full-time equivalent staff, by staffing category, public hospital services, states and territories.
Retrieved from https://www.aihw.gov.au/reports-data/myhospitals/content/about-the-data
Note: The analysis and calculations in this summary are based on the data provided in the referenced document. The potential savings and pay increases are theoretical and based on the assumption of redistributing all saved administrative costs directly to nursing staff. Actual implementation of any such changes would involve numerous additional factors and considerations not accounted for in this simplified analysis.
Detailed calculations and references
NPAA analysis. Putting nurses in charge of our hospitals and having fewer administrators running hospitals out of Queensland would cause a saving of ($3,222,300,549.6 per year)
- Average administrator salary per year in QLD Health = $100,881
- Total reduction in administrators = 18000
- Total savings to spend on nurses = $1,815,858,000
- Increase in pay per nurse = $40,352.4
- Average nurse salary in QLD Health = $107,601
- Total percentage increase = 37.5%
- This means there are 22500 administrators in QLD (costing $2,269,822,500 per annum).
- If we did 1 administrator for every 10 nurses that would be 4500 administrators in QLD (costing $453,964,500 per annum).
References
- Average administrator salary per year in QLD Health: https://www.health.qld.gov.au/__data/assets/pdf_file/0022/1245334/Admin-stream_HHS_wage-rates.pdf (original link no longer available)
- QLD Health nurse salary average: https://www.health.qld.gov.au/hrpolicies/wage-rates/nursing#2023
NPAA analysis. Putting nurses in charge of our hospitals and having fewer administrators running hospitals out of NSW would cause a saving of ($2,195,101,480 per year)
- Average administrator salary per year in NSW Health = $99,777.34
- Total reduction in administrators = 22000
- Total savings to spend on nurses = $2,195,101,480
- Increase in pay per nurse = $39910.94
- Average nurse salary in NSW Health = $103,724.4
- Total percentage increase = 38.5%
- This means there are 27500 administrators in NSW (costing $2,743,876,850 per annum).
- If we did 1 administrator for every 10 nurses that would be 5500 administrators in NSW (costing $548,775,370 per annum).
References
- 55,000 FTE nurses in NSW Health: https://www.health.nsw.gov.au/news/Pages/20220210_03.aspx
- Average nurse salary in NSW Health: https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/IB2023_041.pdf (original link no longer available)
- Average administrator salary per year in NSW Health: https://www.health.nsw.gov.au/careers/conditions/Awards/hsu-he-general-administrative-staff.pdf
NPAA analysis. Putting nurses in charge of our hospitals and having fewer administrators running hospitals out of Vic DH would cause a saving of ($1,620,370,976.95 per year)
- Average administrator salary per year in Vic DH = $106,451.8
- The total reduction in administrators = 15221.64
- Total savings to spend on nurses = $1,620,370,976.95
- Increase in pay per nurse = $42,580.72
- Average nurse salary in Vic DH = $101,988.952
- Total percentage increase = 41.75%
- 38,054.1 FTE nurses in Victoria
- 5 administrators for every 10 nurses in Victoria means there are 19,027.05 administrators in Victoria (costing $2,025,463,721.19 per annum).
- If we did 1 administrator for every 10 nurses that would be 3805.41 administrators in Vic DH (costing $405,092,744.238 per annum).
References
- 38,054.1 FTE nurses in Victoriahttps://vpsc.vic.gov.au/wp-content/uploads/2023/04/SOPS-Workforce-2022-Employment-numbers-over-time.xlsx
- Average nurse salary: https://www.anmfvic.asn.au/~/media/files/anmf/eba%202020/campaign%20updates/200120-NandM-EBA-master-clean.pdf
- Average administrator salary per yearhttps://www.vhia.com.au/wp-content/uploads/Bul-2722-Attachment-A.pdf
NPAA analysis. Putting nurses in charge of our hospitals and having fewer administrators running hospitals out of SA Health would cause a saving of ($572,405,299.2 per year)
- Average administrator salary per year in SA Health = $88728.5
- Total reduction in administrators = 6451.2
- Total savings to spend on nurses = $572,405,299.2
- Increase in pay per nurse = $35491.4
- Average nurse salary in SA Health = $103,204.5
- Total percentage increase = 34.4%
- This means there are 8064 administrators in SA (costing $715,506,624 per annum)
- If we did 1 administrator for every 10 nurses that would be 1612.8 administrators in SA Health (costing $143,101,324.8 per annum).
References
- 16,128 FTE nurses in SA Health: https://www.publicsector.sa.gov.au/__data/assets/pdf_file/0008/955304/OCPSE-WIR2023.pdf
- Average nurse salary in SA Health: https://www.anmfsa.org.au/Web/membership/Your_EBA_and_Pay_Rates.aspx
- Average administrator salary per year in SA Health - data found here: https://www.agd.sa.gov.au/industrial-relations/current-agreements/SA-Public-Sector-Enterprise-Agreement-Salaried-2021.pdf
NPAA analysis. Putting nurses in charge of our hospitals and having fewer administrators running hospitals out of WA Health would cause a saving of ($699,940,756 per year)
- Average administrator salary per year in WA Health = $112,415
- Total reduction in administrators = 6226.4
- Total savings to spend on nurses = $699,940,756
- Increase in pay per nurse = $44,966
- Average nurse salary in WA Health = $122,532
- Total percentage increase = 36.7%
- 15,566 FTE nurses in WA Health
- 5 administrators for every 10 nurses in WA means there are 7783 administrators in WA (costing $874,925,945 per annum).
- If we did 1 administrator for every 10 nurses that would be 1556.6 administrators in WA Health (costing $174,985,189 per annum).
References
- Average nurse salary -https://www.health.wa.gov.au/~/media/Corp/Documents/Health-for/Industrial-relations/Awards-and-agreements/Nurses-Registered-and-Enrolled-Mental-Health/Nurses-and-Midwives-Administrative-Payment-2022.pdf
- Average administrator salary per year -https://www.health.wa.gov.au/~/media/Corp/Documents/Health-for/Industrial-relations/Awards-and-agreements/Salaried-officers/WA-Health-System-HSUWA-PACTS-Industrial-Agreement-2022.pdf
Research papers and data sources
The Crisis in Nursing in Queensland: A Deep Dive into Systemic Challenges
View (PDF) →Hospital resources 2022-23: Australian hospital statistics (Table 3.2)
View source →Television appearances and articles
Media enquiries and questions for the executive: hotline@npaa.asn.au (ATTN: NPAA Secretary).
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