In July, Victorian public hospital doctors voted 97 percent in favour of taking industrial action for the first time in 20 years. The reason is simple: the healthcare system is unsafe for patients and staff.
The Victorian healthcare system is in crisis. Systemic failures at every level compound one another. Limited access to primary care and community services leaves people more unwell and reliant on emergency departments for care. This results in long wait times, overcrowding and unsafe workloads.
Bed shortages, often caused by delays in discharging patients due to the lack of support services, are also an issue. For example, recent data from the Victorian Health Department shows that nineteen of 21 mental health units fail to admit acutely unwell patients from the emergency department within eight hours. This results in staff attempting to care for patients in under-resourced and unsuitable environments where they are at greater risk of violence. The lack of suitable facilities for mental health patients and adequate staffing also contributes to the ongoing failures to meet goals for the reduction in use of restrictive interventions such as seclusion and restraint.
Burnout
It is no wonder then that burnout is endemic among public hospital doctors like me working in this broken system. We are expected to cope with unsafe workloads, under-resourcing and excessive hours without complaint. The system relies on unpaid overtime, guilt and obligation to keep going.
The industrial claims of public hospital doctors include a pay rise in line with what the nurses won in 2024; better guarantees of overtime for all non-rostered hours worked, permanent employment as a default model (instead of many thousands of “junior” hospital doctors, many with over a decade of experience, being given only yearly contracts); maximum shift lengths of 12.5 hours (rather than the 14 hours commonly worked at the moment); at least four rostered days off per fortnight including two consecutive days; a maximum of four consecutive night shifts; minimum doctor-to-patient ratios for safe care; and mandatory 30-minute paid rest breaks every five hours.
During the fourteen months of unsuccessful bargaining discussions, the Victorian Hospitals Industrial Association (the association of employers in the public health industry) backpedalled on its previous agreement to simplify overtime payments, arguing it would cost too much to pay doctors the hours they actually work.
We have so far had multiple four-hour stop-works across different sites and services on different days. At these rallies, workers were asked to vote on whether they supported a statewide strike on 14 September. The response was almost unanimous—doctors voted for a statewide strike.
But the government wasn’t having it. It launched a legal challenge based on patient safety which forced the union to withdraw the notice (the union representing public hospital doctors is AMA Vic/Australian Salaried Medical Officers Federation) and cancel the strike. Patient safety only matters when it comes to preventing doctors from taking industrial action, not when hospitals are chronically understaffed and overstretched day in and day out.
Under sustained pressure from the membership, a four-hour statewide stop work took place on 1 October and hundreds of doctors rallied outside state parliament. Union leaders attempted to cancel the rally the night before, but members held firm, fed up with tactics aimed at impeding industrial action.
Following the 1 October strike, the government said a new agreement wasn’t possible because it was about to enter caretaker mode. We were presented with a one-year interim offer (not an enterprise agreement but an unenforceable “memorandum of understanding”), which was the government’s first offer in fourteen months. This would have, conveniently for the government, prevented us from taking industrial action in the lead-up to the election.
The union bargaining team and state council both voted to recommend that members reject the offer, because it failed to adequately address key concerns about pay and conditions. More than half of union members voted in an online ballot—with 89 percent voting no. We now have a 12-hour statewide strike set for 21 October.
Our fight is important, not only because of our poor conditions, but because other healthcare workers, including allied health staff, are also fighting for better conditions. If we can win significant gains, everyone will benefit—other medical staff, workers in other industries and patients.
Government stalling and legal sabotage of our campaign has put us in a position where we may well be facing a Liberal or One Nation government when negotiations resume. Labor have shown themselves to be no allies of health workers, and a conservative government will be no better. Whoever is in power, we need a serious fight. Hospitals are massive workplaces with real industrial power. We need to rebuild a socialist current as part of reviving rank-and-file trade unionism and solidarity among healthcare workers. Together, we can win the system we deserve.
Free speech for healthcare workers!
It is not only at work that public hospital employees are coming under attack. Recently we have seen our regulator, AHPRA, conflate antisemitism with anti-Zionism to silence healthcare workers speaking up about Palestine, including outside of work and on social media. This violates democratic rights and sets a terrible precedent for other professions.
Many healthcare workers feel particularly obliged to advocate for Palestinians. We suffer moral injury when we are prevented from speaking out about the atrocities committed against our colleagues in Gaza and against the Palestinian people as a whole.
When confronted about the lack of a public response to this attack on our freedom of speech, the Victorian branch of the Australian Medical Association admitted it was scared to address it publicly for fear of backlash, and that the federal organisation was engaged in back-room discussions with AHPRA. This approach aligns more with a lobby organisation than a trade union.
A union’s strength comes from its members’ involvement and activity. This also protects unions when they want to speak out about political issues important to their members. There is a reason that the Australian Salaried Medical Officers Federation (the part of the Australian Medical Association that is engaged in bargaining) in New South Wales—the branch involved most recently in prolonged industrial action, with an active rank and file—was the only branch of our union that put out a statement condemning the AHPRA adoption of the pro-Israel International Holocaust Remembrance Alliance definition of antisemitism.
Our battles for industrial rights, and for free speech, can strengthen each other.