Principles
The Greens NSW believe:
1. Health is affected by physical, mental, cultural, and social well-being, as well as the presence or absence of disease or impairment.
2. Public funding and management is the most equitable and efficient way to resource and deliver health services.
3. Providing well-resourced quality public health services is a core government responsibility that should not be outsourced.
4. Access to health services is a human right and should be based on health need, not on ability to pay or where the person lives.
5. An effective health system must be based on primary health care and preventive measures such as health promotion, disease prevention, risk reduction and early intervention.
6. Individual and population health outcomes are strongly influenced by the social, economic and environmental conditions in which people live and work.
7. Poverty, disadvantage, and social inequity must be addressed to improve the health of the whole population.
8. The climate crisis is an existential threat to global human health and urgent action is required to minimise catastrophic health impacts.
9. Barriers to health care need to be identified and addressed with specific programs for vulnerable and disadvantaged populations, including:
- children and the elderly;
- First Nations peoples;
- residents of rural and regional areas;
- people with disability;
- people with mental illness;
- culturally and linguistically diverse communities;
- institutionalised people including people in detention;
- refugees and asylum seekers;
- LGBTQIA+ people.
10. The unacceptable health status of Australia’s First Nations peoples must be recognised and responded to with levels of funding sufficient to create health outcomes equivalent to the broader population.
11. Fee-for-service funding of health services does not meet the needs of many communities.
12. The private health system should not receive public subsidies.
13. Impacts on health should be considered in all decisions at all levels of government across all portfolios.
14. Health workers have a right to safe working conditions and fair remuneration.
15. All new hospitals, and an increasing proportion of hospitals and health services should be publicly owned and run.
16. All current public health assets should be retained in public ownership.
17. Dental and mental health services are essential, and should be available at no out-of-pocket cost.
18. People with a disability, including physical disability, intellectual disability, sensory disability or mental illness have a right to appropriate and accessible inpatient and outpatient health services.
19. Local government should be funded for and have an active role in health promotion, education and prevention.
20. Contraception, abortion and fertility services are essential components of comprehensive reproductive health care.
21. Individuals have a right to self-determined end of life care, including palliative care, and access to voluntary assisted dying.
22. Participation by members of the health workforce and the broader community is important to health service planning and decision-making.
23. A single, national, centralised, voluntary and secure medical record system used and updated in all health care facilities would improve communication between health workers and improve patient safety and health outcomes.
Aims
The Greens NSW will work toward:
Primary care and community health services
24. All communities having access to publicly-funded clinics that provide primary, specialist, and allied healthcare with no out-of-pocket costs, including telehealth and home visits where clinically and culturally appropriate.
25. Providing primary care services at no out of pocket cost to patients, by exploring health service models including but not limited to block funding models, the Victorian community health centre model and community-controlled health organisations.
26. Improving linkages and collaboration between hospitals, aged care facilities and community-based services to ensure smooth and effective transfer of care, admissions where necessary, and timely relevant follow-up.
27. Further investigation of patient enrolment models to incentivise continuity of care.
28. Increasing the role of nurse practitioners in appropriate settings including outpatient services, in collaboration with allied health practitioners and GPs, especially in rural areas.
29. Reduce tax burdens on employment in the primary care sector.
Hospitals and emergency care
30. Ensuring equitable access to quality emergency health services, including no out-of-pocket expenses for ambulance services.
31. Ensuring free, needs-based access to hospitals.
32. Delivering public hospital services as close as possible to the communities they serve.
33. Phasing out public-private partnerships for provision of public hospital services, and restoring public ownership.
34. Supporting telehealth in rural and regional emergency departments where this service supports and does not replace on-site staffing.
35. Improving emergency department waiting times by funding adequate staffing, equipment, bed availability and alternative out-of-hours care.
36. Replacing the harmful 4-hour target for emergency departments, with patient-centred outcome measures to be determined by health services in consultation with clinicians and communities.
37. Opposing the development of Urgent Care Centres as replacements for emergency departments and quality primary care.
38. Facilitating early recovery for surgical patients using a multidisciplinary approach.
39. Employment of mental health clinicians or social workers to attend ambulance calls for mental health as well as in emergency departments.
40. Increasing patient transport services and decreasing reliance on NSW Ambulance to fill gaps in transport services.
Mental Health
41. Significantly increasing funding for public mental health services, including public hospital inpatient services, psychologists, community-based outpatient and outreach services, and case managers.
42. Addressing the high rate of homelessness among mentally ill people by establishing supported accommodation, including crisis, medium-term and long-term accommodation with rehabilitation programs.
43. Increasing support and respite services for those that care for people with mental illness.
44. The provision of mental health services within schools and other educational institutions.
45. Programs in schools and in the wider community about the prevention of suicide.
46. Improving funding for services and research to address the complex needs of people who require support for both mental health and addiction.
47. Support services for alcohol and other drug addiction to be sufficiently resourced so as to be available within 24 hours, including but not limited to counselling, voluntary group recovery programs, and both inpatient and outpatient detoxification and rehabilitation programs.
48. Providing appropriate mental health care in institutions such as public health facilities, prisons and other correctional facilities.
Health Workforce
49. Improving the working conditions, training, supervision and career structures for nurses, midwives, medical, paramedic and allied health professionals by:
- Improving continuing professional education including the use of interdisciplinary simulation and communication;
- Improving staff wellbeing to prevent burnout including eliminating unsafe and excessive work hours and unrostered overtime;
- Ensuring sufficient training positions for junior medical staff are available every year;
- Development of structured pathways for new enrolled nurses to gain experience in a variety of clinical environments;
- Supporting specialist colleges to provide training that reflects community needs;
- Ensure sufficient numbers of health professionals are being trained in Australia to meet future workforce needs;
- Enabling paramedics to train as Intensive Care or Extended Care Paramedics in regional areas;
- A single employer model for General Practice Registrars with portability of entitlements accrued during hospital-based employment.
50. All health workers having access to appropriate personal protective equipment.
51. Improving the conditions of all public sector healthcare awards to ensure NSW healthcare workers’ pay and conditions, at a minimum, maintain parity with comparable interstate awards to promote recruitment and retention.
52. Advocating to the national cabinet for national awards for all public sector healthcare workers.
53. Implementing shift by shift ratios for nurses and midwives, and guaranteeing appropriate skill mixes, in consultation with the NSW Nurses and Midwives Association. Abolish the ineffective “Nursing Hours Per Patient Day” and “BirthRate Plus” staffing models for nurses and midwives.
54. Medical practitioners, including registrars, working in publicly-funded clinics should have the option of salaried employment rather than contractor agreements.
55. A centralised state-wide system to link public health services that have temporary or permanent vacancies to health workers available to travel or relocate.
56. A regulatory body to address working conditions in health services including but not limited to reducing occupational violence, retention of experienced staff and eliminating excessive and unsafe work hours.
57. Implementing accreditation standards for complementary practitioners and medicines, and establishing registers, professional conduct standards and complaints mechanisms for all therapeutic practitioners.
Dental Care
58. Appropriate funding for public dental services to reduce wait times and deliver services at no out of pocket cost to patients.
59. Prevention and awareness programs to improve dental health for people at a higher risk of poor dental health.
Reproductive health
60. Contraception, abortion, fertility treatment, and menopause care being provided in the public system.
61. Supporting maternity and birthing services (including preconception care) that are sensitive to individual needs, and that give people control, choice, and continuity, and allow them to remain active in the labour and birthing experience.
62. Increasing the availability of midwife-led birthing services, breastfeeding support programs,and maternal and child health services, particularly in rural and remote areas, and delivered with a culturally safe approach.
63. Support and facilitation for all GPs who are not individual conscientious objectors to provide medical termination of pregnancy.
64. A publicly available searchable database of contraception and abortion providers.
Public and population health
65. Increasing funding for health promotion and preventive health.
66. Funding and support for local government to provide built and natural environments conducive to health and wellbeing.
67. Making all vaccines as recommended by the Australian Immunisation Handbook available for free.
68. Increased funding for education and programs to promote the benefits of immunisation.
69. Ensuring that only NSW Health can have primary responsibility for controlling the response to pandemics
70. Increased public awareness of and research funding for post-acute infection syndromes.
71. Restrictions on advertising of junk food, gambling, alcohol and tobacco products.
72. Improved food health regulations:
- Requiring public and private sector food services, hospitals, and child care centres to offer a variety of healthy food choices consistent with recognised dietary guidelines;
- Strengthening the regulation of foods served in school canteens;
- Banning the sale and manufacture of products containing trans fats;
- Improving and enforcing accurate and comprehensive labelling of all fast foods.
73. Urgent improvement of air and water quality, with a benchmark standard of no adverse impact on human or ecological health.
74. Increasing funding for the promotion of healthy lifestyle choices, including but not limited to
- healthy food and drink choices;
- the benefits of physical activity;
- potential health effects of social media;
- risks associated with smoking including vaping;
- responsible use of alcohol and other drugs.
75. Providing a variety of structured physical activity programs in schools, other educational institutions, workplaces, and in the community.
Digital Health
76. Implementation of a single national digital service that includes:
- Storage of all patient records;
- Provision for patients to co-design their care on an opt-in basis;
- Appointment and referral information;
- Preferences for end of life care and advance care directives;
- Links to quality patient information;
- Strong privacy protections to ensure patient data is not available to unscrupulous actors;
- Capacity for providing hard copies to patients on request;
- Adequate resourcing of this service for health services.
77. Addressing the current disconnect between inpatient, outpatient and community services through integration of digital health technologies nationally.
78. Ensuring that in procurement of digital technologies, quality is prioritised over price.
79. Ongoing support and training in digital health technology for health services to continue after implementation.
General
80. Transitioning aged care facilities into public ownership and management.
81. Organ donation to be provided on an opt-out rather than an opt-in basis.
82. Public funding of data collection and research to evaluate health interventions and service delivery including primary care and preventive health.
83. Allocation of resources based on evidence-based improvement in long-term health outcomes.
84. Exploring alternatives to activity-based funding, and advocating to the federal government for a health services funding model that incentivises investment in preventive and primary care.
85. The redirection of public subsidies from private health insurance to the public health system and abolishing all tax penalties and incentives related to private health insurance.
86. Regulating evidence-based cannabis-derived pharmaceutical drugs to improve their accessibility and affordability, including improving access to over-the-counter cannabinoid drugs where appropriate.
87. Ensuring patients’ privacy and the confidentiality of their health information.
88. The abolition of co-payments for prescribed medicines that are listed on the Pharmaceutical Benefits Scheme.
89. Critical Disability Theory to be included in continuing professional development for health professionals so that people with a disability are provided with holistic health care that does not focus on impairment, and are also supported and empowered to participate in decision-making.
90. Providing incentives for health services to improve performance and enable transparency around improving health outcomes for disadvantaged communities.
91. Establishing an independent Rural and Remote Health Commissioner to monitor and report on the performance of NSW Health in meeting rural health workforce, service accessibility, service coordination, and health outcome targets, and to advise the NSW government regarding health policy and reform.
92. Mandating the inclusion of local clinicians and community representatives on the governing councils of local health networks.
93. Expanding and increasing public awareness of programs that facilitate people living in rural and remote areas to access health services in other regions when required.
Revised October 2022