The ACT Budget and the entertainment, arts and sports infrastructure plan dominated political discourse this week. Nevertheless, the Legislative Assembly debated light rail, public lighting, restorative justice reforms, nursing and midwifery workers, government board appointments, and bulk billing doctors.
Light rail stage 2B – cost benefit assessment
Canberra Liberals MLA Mark Parton, Shadow Minister for Transport, called for the ACT government to provide a cost benefit assessment before they proceeded with any works contracts or infrastructure procurements for Light Rail Stage 2B (Commonwealth Park to Woden).
“The people of Canberra have never been given a comprehensive and compelling business case for connecting Commonwealth Park to Woden with a tram system,” Mr Parton said. “The people of Canberra have not been told what stage 2B will cost.”
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Mr Parton said that a business case must compare the proposed Stage 2B costs with those of an electric bus service and other transportation options, which Mr Parton considers lower cost alternatives capable of delivering the same or superior public transport services.
The business case must also omit estimates of land value uplift from the public transport route between Woden and Civic. Mr Parton argued that previous stages of the tram project relied on property value uplift to yield a positive benefit, and the proposals did not stand up based on transport benefits alone.
Travel times from Woden to Civic via light rail, Mr Parton believes, will be greater than current bus services. He called on the government to prepare a business case for a public transport solution that was equal to or faster than current buses.
Chris Steel, ACT Minister for Transport and City Services, negated Mr Parton’s motion. He defended the government’s commitment to publishing the business case, but said that releasing costing details before contracts were signed might negatively impact value for money in procurement.
Due to the complexity of the route through the National Capital Area, Mr Steel said, the business case will follow National Capital Authority and Commonwealth Parliamentary approval processes, which include an environmental impact statement and early design to determine the costs and benefits of the project.
Contracts for both Stage 2A (Civic to Commonwealth Park) and Stage 2B would be published once procurements were finalised and contracts signed. The government will publish assessments of benefits realisation for both stages after operations start.
Lighting in public spaces
Greens MLA Andrew Braddock’s motion to implement best practice lighting principles in all public spaces passed the Legislative Assembly.
These principles, he explained, aim to provide adequate lighting for individual areas, “no more and no less”, while avoiding unnecessary glare, preserving safety, and minimising impacts on urban wildlife. He argued that this would allow people (including women and vulnerable active travellers) to move safely and comfortably around the city, and also boost the night-time economy.
“Lighting has a big effect on our neighbourhoods and public spaces,” Mr Braddock, Greens spokesperson for Better Suburbs, said. “When it’s done well, most people won’t think about it. When it’s done badly, people won’t use the space.”
Restorative justice reforms
Labor MLA Dr Marisa Paterson called for an expansion of restorative justice processes in the ACT, particularly for victims of family violence and sexual assault.
The ACT is working towards making Canberra a restorative justice city, Dr Paterson noted, but family violence and sexual assault victims have limited choices in when and how they can access restorative justice.
“In my conversations with local professional organisations, support services and academics, I keep hearing the same thing,” Dr Paterson said. “The criminal justice system is not working for victim-survivors. Statistics back this up – just 2.8 per cent of sexual offence complaints proceed to charge, according to the Justice and Community Safety Directorate’s (JACS) 2021-22 annual report.”
Restorative justice, Dr Paterson explained, is a process of independent, facilitated contact, which supports constructive dialogue between a victim and a person who has harmed, arising from an offence or alleged offence. Restorative justice can work alongside the criminal justice system, or as an alternative pathway to the formal criminal justice system.
She called on the government, in its piloted expansion and evaluation of restorative justice processes, to expand the scope and eligibility criteria of restorative justice in the ACT, and to increase education and awareness of restorative justice pathways for victims of crime.
Dr Paterson’s motion passed.
ACT Health workforce – support for nursing and midwifery workers
Canberra Liberals MLA Leanne Castley, Shadow Minister for Health, criticised the ACT government for failing to improve conditions to attract and retain a health workforce and to provide adequate public healthcare services.
She called on the government to track the implementation or progress of all budgetary measures for the health and wellbeing portfolio since 2014, and the most recent Parliamentary and Governing Agreement and Election Commitment Reporting for the health and wellbeing portfolio.
The ACT government has not met recommendations from as early as 2002 to expand nurse practitioners’ scope of practice, Ms Castley claimed. An evaluation in 2021 revealed that nearly half of the recommendations from nurse practitioner reviews between 2002 and 2018 had not been implemented – resulting in “workforce uncertainty and unhealthy workforce growth”.
The ACT government, Ms Castley continued, failed to meet its own deadline for implementing phase one of nurse-to-patient ratios by 1 June 2022; nurse-to-patient ratios remain non-compliant in public hospitals.
Fewer students are studying nursing and midwifery programs at the University of Canberra (UC), and fewer ANU medical graduates are accepting offers from Canberra Health Services (CHS). UC emphasised a shortage of midwives and insufficient graduate positions to meet demand. This year, CHS offered 94 spots to ANU Medical School graduates, of whom only 59 accepted.
The Australian Nursing and Midwifery Federation (ANMF) and the Australian Medical Association have long advocated for a workforce strategy and for changes for junior doctors, respectively. The ANMF stated that workplace culture improvement at CHS had been “minute”, while the Medical Training Survey 2022 rated the ACT the lowest among all jurisdictions in trainee doctors’ feedback on their workplace.
Work health and safety incidents increased by 28 per cent since 2018-19 despite having the Work Health and Safety Strategy 2018-2022 in place, while the ACT government failed to achieve a 30 per cent reduction in musculoskeletal and general incidents, as outlined in the Strategy. The lack of consistent and sufficient health workforce data impedes the development of a health workforce strategy.
The compulsory acquisition of Calvary Public Hospital further disrupted the ACT’s frontline health workforce: a number of staff were not expected to transition to CHS, putting more pressure on already overstretched front line staff.
ACT Greens MLA Johnathan Davis deleted Ms Castley’s motion.
The Standing Committee on Health and Community Wellbeing, he noted, recently held an inquiry into a recovery plan for nursing and midwifery workers; it would present its report in due course.
ACT budgets allocated $101.8 million to health workforce initiatives. This week’s budget included almost $2.2 million to implement the ACT Health Workforce Strategy 2032–32.
The government and the ANMF are negotiating the framework for phase two of ratios.
Government board appointments
Canberra Liberals MLA Peter Cain, Shadow Attorney-General, called for the ACT Auditor-General to review Government Business Enterprise board appointments with political affiliations.
A Grattan Institute report last year showed that 14 per cent of Government Business Enterprise board members were politically affiliated to ACT Labor, the government that appointed them – the equal-highest rate in Australia.
“Public trust in politics and public offices is of the utmost importance, especially to Canberrans who are so well-versed in public accountability,” Mr Cain said.
“The figures in this report are truly damning, and reflect an absence of integrity and transparency from this ACT Labor-Greens government.
“To be equal-highest in the number of politically affiliated Government Business Enterprise board members with political affiliations as Queensland, a jurisdiction with well-known recent issues of integrity, is disgraceful.”
Chief Minister Andrew Barr amended much of Mr Cain’s motion. He denied claims of favouritism – that the government had ‘stacked’ boards with “jobs for mates appointment practices”, as Mr Cain claimed. The selection process was fair: all appointments were advertised, an independent panel provided a shortlist of suitable candidates, and the minister chose from the shortlist.
Nevertheless, Mr Barr kept Mr Cain’s motion for the Auditor-General to “review current Government Business Enterprise board and other government appointments to ensure [they] are in line with community expectations of merit and integrity”, and to “provide recommendations to improve the principles of merit and integrity in future … appointments”.
Bulk billing general practice services – Access
Johnathan Davis, ACT Greens spokesperson for health, called on the ACT government to improve access to bulk-billing GPs and help Canberrans get access to more timely and accurate information about GP services.
Although general practitioners are the most used healthcare service by Australians, Mr Davis noted, the ACT has a lower rate of bulk-billing GPs than other Australian states and territories. It had the lowest proportion of patients that are always bulk billed (37.6 per cent, compared to a national average of 64.3 per cent); the highest proportion of patients who are never bulk billed (20.6 per cent, compared to a national average of 7.1 per cent); and a higher than national average proportion of patients who are sometimes bulk billed (18.7 per cent, compared to a national average of 8.2 per cent).
Moreover, the ACT had the lowest proportion of clinics that bulk bill all patients (5.5 per cent), and the highest out of pocket costs.
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“I’ve heard from Canberrans who could afford a doctor’s visit 12-18 months ago, but the increasing cost of living means they are forced to choose between groceries, fuel, rent, utilities, and a visit to the doctor,” Mr Davis said.
“And for those people, it’s been the visit to the doctor that’s missed out.
“Too many Canberrans can’t afford to see the doctor and to me, and my ACT Greens colleagues, that is unacceptable.”
Mr Davis’s motion passed. The government will work with the federal government to improve access to bulk billing GP services in the ACT; explore the value of services that provide centralised and transparent information about healthcare services; and consider ways to promote the use of these services, increase healthcare consumer use of these services, and increase GP clinic participation in these services.
Leanne Castley moved an amendment that the government should model the impact on Canberran health consumers of the extension of ACT payroll tax to GPs contracted by ACT medical clinics – which doctors have said will force doctors to increase their bills or close their clinics.
Her amendment failed.
