The journey so far - nursing, midwifery and the QNMU

Nurses and midwives have a long and proud history of making a difference in our workplaces and community at an industrial, professional, social and environmental level.

The courage, commitment and foresight demonstrated by women in the nursing profession; the extraordinary social, political, industrial and economic pressures which have impacted upon nurses’ and midwives’ living standards and working conditions; and the changing status of nursing and midwifery within both the community and the health industry all represent important parts of our history and our current context.

Many of the current barriers to progress on nurses’ employment conditions and their role in the health system do have a historical premise and become more understandable when they are seen as either a reaction to, or a continuation of, the past.

Nursing unionism has developed into a strong and vibrant force with a proud history and a clear political vision for the future industrial and professional needs of nursing.

Below is a very brief historical outline of the development of nursing unionism in Queensland.

 

Our history

 1899

 The Australasian Trained Nurses Association (ATNA) was formed in Sydney by nurses and medical practitioners. The majority of the executive positions were held by male medical practitioners. The ATNA’s concerns were with professional issues relating to education and standards of practice. There were stringent membership requirements relating to length of education, moral character and competency. Final examinations for nurses in education were conducted by the ATNA. Also in this year a Midwifery Nurses Auxiliary Branch was formed for nurses who completed six months midwifery education.

(In 1899, the ATNA had a total of 224 members: of these, 174 were nurses and 50 were doctors. By 1905, the total membership in Australia had expanded considerably to 1389; 1015 of these were general nurses, 249 midwifery nurses and 125 medical practitioners. In 1902 the annual subscription fee was 10 shillings and sixpence for general nurses, 5 shillings for midwifery nurses and one guinea for doctors.)

 1901 

The Victorian Trained Nurses Association was formed. In 1904 this became the Royal Victorian Trained Nurses Association (RVTNA). Royal Brisbane Hospital worked to open an ATNA Branch in Queensland.

 1903

ATNA published a journal titled Australasian Nurses Journal.

 1904  ATNA Queensland Branch was formed by a meeting of 22 doctors and 70 nurses as a consequence of dissatisfaction with some nursing practices, and to exert greater control over the employment of untrained nurses. Its aims were professional and educational—there were no industrial objects. Its State Council consisted of seven medical doctors and fourteen nurses. (Nurses could hold only two executive positions: Joint Vice-President and Joint Hon. Secretary.)

 1905

South Australian Branch of ATNA was formed.

 1907

Western Australian Branch of ATNA was formed.

 1908

Tasmanian Branch of ATNA formed.

 1912

Queensland was the first state to gain government registration for nurses. The Health Act covered the registration of all midwives, nurses and physiotherapists until 1928 when the Nurses Registration Act was passed. When the Bill to establish the Health Act was first introduced in Parliament the ATNA was successful in having the Bill amended and as a consequence a five member Queensland Nurses Registration Board, including two medical practitioners or nurses nominated by ATNA, was established. From 1912, final examinations were conducted by the board rather than by ATNA.

 1921

In Queensland ATNA entered the industrial arena in the legal sense when it was registered as a union of employees. A rival organisation, the Queensland Nurses’ Association (QNA), was formed by nurses in Brisbane hospitals with a membership of 221 nurses. QNA lodged a claim with the Industrial Commission seeking increased salaries, a 48 hour week, payment for overtime and work on statutory holidays. ATNA opposed the claim. An award was granted providing standard hours and wages. However nurses were denied the 48 hour week (introduced by the Industrial Arbitration Act of 1916), and instead the award provided for 112 hours per fortnight (56 hours per week) on the basis of the nature of the work, the unavailability of trained staff and the cost of additional staff and accommodation. In his judgment for the first nurses’ award in 1921 T W McCawley, President of the Court of Industrial Arbitration, Queensland, said that:

The Industrial Arbitration Act of 1916
requires the Court to establish a forty-eight hour week in industries, unless where it can be shown that paramount public importance otherwise requires. It cannot be doubted that the sick ... would be very greatly inconvenienced if the Court were now ... to require all hospitals to establish a forty-eight hour week.

An editorial of the Medical Journal of Australia described the QNA as a misguided body of foolish virgins. It said that while nurses needed protection from exploitative employment practices, they should not be free to conduct their own affairs.

 1924

 The ATNA in five states, and the Victorian Trained Nurses Association, established a Federal Council known as the Australian Nursing Federation (ANF).

An amendment to the Industrial Arbitration Act introduced the standard 44 hour week.

 1925

QNA successfully claimed an 88 hour fortnight (44 hour week) granted by the Commission as an Award entitlement. The ATNA and many of its members were opposed to the reduction in hours, in view of the impact on education and on patients

 1928

The Nurses’ and Masseurs’ Registration Board was set up with all nurses on a register maintained by the ATNA accepted for registration.

 1930

The ATNA Federal Council voted that minimum hours should be 96 per fortnight (48 per week).

Employers successfully appealed the 1925 Award decision.

 1931

Hours were increased to 96 per fortnight (48 per week), salaries reduced by five to ten pounds per annum and annual leave reduced by one week.

 1932

An amendment to the Industrial Arbitration Act reintroduced a standard 44 hour week. Certain occupations (domestic servants and seamen) were excluded, and the court agreed with the ATNA that nurses should also be excluded. Hours for hospital domestic staff were reduced to 40 per week—nurses continued to work 96 hours per fortnight (48 per week).

 1934

The RVTNA was registered under the Companies Act as the Royal Victorian College of Nursing.

 1937

The Federal Council of the reconstituted ANF met. ANF Branches were to make an effort to obtain members, and hospitals were to be approached asking for preference to be given to members of the ANF. The federal body affiliated with the International Council of Nurses (ICN).

Shortly after the outbreak of World War II, the ICN and member associations went into recess for the duration of the war.

 1943

Eunice Paten was the first nurse to be elected President of the ANF Queensland Branch.

The ATNA successfully applied to the Queensland Industrial Court for salary increases—the first increase, apart from basic wage increases, since 1921. (Nurses were leaving the profession in large numbers for more highly paid employment and attracting new recruits had become difficult.)

 1948

 A majority vote to exclude nursing assistants from the new federal body caused a split in the ranks of nursing unions.
The Australian United Nurses’ Association (AUNA) was formed, covering all nurses.
AUNA was registered in the Commonwealth Arbitration Court and successfully made application for an award covering nurses in repatriation hospitals.

The ANF was still in existence due to its affiliation with the International Council of Nurses, with Registered Nurse members only. It did not amalgamate with AUNA which in 1953 became ANF Employees’ Section (ANFES). The NSW Nurses’ Association did not unite with AUNA.

State legislation made all awards conform with the 40-hour week.

 1949

The nursing organisations signed a Memorandum and Articles of Association for the College of Nursing Australia.

 1954

Her Majesty Queen Elizabeth II approved the use of the Royal prefix. The title then became the “Royal Australian Nursing Federation”. From this year onwards, ATNA State Branches (except NSW) altered their own title.

 1956

The ATNA Queensland Branch changed its name to Royal Australian Nursing Federation.

 1959

The National Education Commission was formed and undertook a project on “the wastage of nurses”.

 1961

The College of Nursing Australia established a Branch in Queensland. RANF organised a national biennial conference.

 1969

Following a lengthy political campaign by RANF Queensland Branch for an improvement in nurse education, the Minister for Health announced that the general nursing course would be reduced from four to three years with lectures in employers’ time instead of in the nurses’ own time.

 1970

The state government gazetted a new Schedule of Study to provide an increase in the minimum hours of lectures to be received by student nurses from 148 to 840.

 1971

The newly-integrated RANF came into existence with state Branches, for example RANF Queensland Branch union of Employees. July of this year also saw the launch of the Australian Nurses Journal.

 1976

Two individual legal entities were recognised—the RANF Queensland Branch and the RANF Queensland Branch union of Employees. Proposed elections for both lapsed.

 1982

As a result of the 1981/82 Council ballot, two separate Councils were elected—one for the RANF Queensland Branch union of Employees and one for the RANF Queensland Branch (of the Federal body), thus bringing about the physical separation of both organisations.

In November of this year, the RANF Queensland Branch union of Employees had changed its name to the Queensland Nurses’ Union of Employees (QNU), and continued alone.
It would remain the QNU until midwifery was incorporated into the official name in 2017.

 1983

The Queensland Nurses’ Union had jurisdiction in state award areas; the RANF Queensland Branch had jurisdiction in federal award areas.

 1984

ANF Federal Council voted for removal of the no strike clause from its rules.

Federal government announced support for transfer of pre-registration nurse education to higher education institutions by 1993.

 1985

The QNU affiliated with the Trades & Labour Council of Queensland, now known as Queensland Council of unions (QCU).

 1986

The Australian Industrial Relations Commission arbitrated on an ACTU claim that all workers covered by an Award should be provided with 3% super (that is 3% of their wage).

 1988

The Royal prefix was dropped from the RANF

 1989

ANF and QNU harmonised—this was not a true amalgamation.

 1991

QNU Career Structure and 38 hour week.

Strong Branch, union Representative and Activist structures established and supported in the early 1990s.

Improvements to wages, penalty rates and working conditions – for example the base hourly rate for QH RN Level 1 top pay point in 1982 was $7.55 and in 2007 was $29.05—an increase of 285%.

 1992    

The Federal Labor Government Introduced the Superannuation Guarantee (SG), following a refusal by the AIRC to increase the level of contributions under awards. This increased superannuation from 3% to 9%.

Activist recognition and union encouragement – EB4.

 1993

Hospital-based education finished in Queensland; all nurses university-trained from this point on.

 1994

Working Nation statement which provided funds for education.

 1995

Queensland introduces Workplace Health& Safety Act.

The first round of public sector EB.

 1996

Living Wage claim by the ACTU.

Workplace Relations Act.

The last hospital to stop wearing nursing veils in Queensland was St Andrew’s in Toowoomba.

Howard government introduces its first round of changes to industrial relations legislation, mirrored in the Borbidge government legislation in 1997 limiting award matters to 20 and changing the no-disadvantage test for collective agreements.

 1997

Launch of the No lifting by 2000 campaign.

Howard government passes the Aged Care Act 1997. It provides a significantly different funding arrangement in aged care removing the requirement to spend specifically on care. This results in substantial reductions in nursing hours in the aged care industry.

 1998

QNU applies to the Queensland Industrial Relations Commission for specific staffing ratios and better classification structure in the Aged Care Award. Strongly opposed by employers.

 1999

Employers apply for the making of the The Retirement, Residential and Community Care Award – State. Ultimately defeated by QNU and other health unions.

Zero Tolerance to Violence campaign launched.

 2000

QNU makes written submissions and appearances in the Pay Equity Inquiry conducted by the Queensland Industrial Relations Commission (QIRC) arguing that nursing staff are undervalued historically because the workforce is predominantly female.

 2001

QNU success in bringing in application for better classification structure in Aged Care Award. Unsuccessful in getting staffing ratios into award.
Further two years until all of Commission decision is implemented.

QNU commissions first study into work/life balance in Queensland Nursing.

First independent research of QNU members (Your work, your time, your life) conducted by Professor Desley Hegney, USQ Research.

 2002

Senate Inquiry into nursing results in the publication of Report on the Inquiry into Nursing - The patient profession: Time for action. Federal government responds to this report three years later. QNU put in detailed submission to Senate inquiries.

Queensland Health EB5 campaign—statewide industrial action culminating in a rally of nurses outside state parliament. Queensland Health then took the dispute into arbitration before a full bench of the QIRC.

Nurses. Worth looking after. (NWLA) campaign launched.

Public sector nurses win an entitlement to a qualification allowance, an enforceable workloads management clause, as well as other improvements.

Social Charter for Nursing in Queensland developed and agreed by QNU and QNC.

 2003

Award review process leads to the consolidation and updating of all Queensland nursing awards.

Your work, your time, your life research is again undertaken by Professor Desley Hegney, USQ.

 2005     

Queensland government instigates a Commission of Inquiry (Morris and Davis Commissions) The Queensland Health Systems Review: Final Report September 2005 (Forster Review) as a result of abuses in Bundaberg Hospital. QNU takes active role in ensuring all issues are explored and real answers are found. The QNU provided detailed submissions to both inquiries.

12 weeks paid maternity leave introduced.

ACTU introduces the Your Rights at Work campaign in response to federal government plans to attack worker rights

 2006

WorkChoices legislation passed into law.

Let’s talk nursing sub-campaign of NWLA commenced.

Queensland Health employees move back from the federal system to the state system after the enactment of WorkChoices.

Nurses’ EB6 supported by public sector nurses with significant wage increases and, for the first time, an entitlement to Professional Development Leave and payment of costs

 2007

Your rights at work campaign continues with a focus on 2007 federal election. Let’s talk nursing continues.

EB negotiations in private sector—90 agreements operating with employers increasingly looking to attack the nursing classification structure and right to have a union collective agreement.

Wages gap widening.

Your work, your time, your life research is again undertaken by Professor Desley Hegney—now working at UQ.

 2008

The QNU launches its Nurses. For you. For life. campaign aimed at addressing the significant nursing and midwifery shortages in Queensland.

Increasing problems are identified in the aged care sector – particularly with nurses’ wages up to $300 per week less than nurses in the public sector.

The QNU and Queensland Health commence negotiations for the EB7 agreement in October.

 2009

The QNU achieved a 12.5 per cent pay rise (over three years) for nurses and midwives in the public sector under EB7, which, for the first time, made Queensland nurses and midwives the highest paid in the country in most classifications.

QNU secured 14 weeks paid parental leave for Queensland Health employees.

Along with the ANF and other state branches, the QNU launched a joint Because We Care aged care campaign.This was the first time the Federation embarked on a joint national campaign.

The Fair Work Act (workplace laws) replaced WorkChoices and provided new opportunities for QNU members and the QNU. The new workplace system was underpinned by a strong safety net of minimum wages and conditions, good faith bargaining provisions and improvements to unfair dismissal provisions.

 2010

Nurses Award 2010. As part of the federal government’s process to simplify the award system, nurses won a national occupational nursing Award against strong opposition from employers and other unions.

Professional indemnity insurance for nurses and midwives, a benefit of QNU membership, became more valuable than ever with the introduction in July of a new single national registration and accreditation scheme for health professions overseen by the Australian Health Practitioner Regulation Agency. As part of this new system, the federal government required all nurses and midwives to have insurance that met the  new professional indemnity insurance standard or forfeit registration. The professional indemnity insurance offered as part of QNU membership met the new standard.

At Annual Conference, QNU Branches made the decision to end the QNU’s official affiliation with the Australian Labor Party effective from 2011. The decision was taken for strategic reasons, as the QNU opted for a different approach to its engagement with political entities, governments and the political and public policy process.

The QNU began a campaign to represent public sector members after Queensland Health rolled out a new payroll system riddled with flaws which resulted in many staff being underpaid, overpaid or not paid at all. The payroll debacle was unlike any other, and because it was a series of complex technical shortcomings, the normal industrial and legal remedies did not apply. There was no action QNU members could take to ensure the system errors were fixed, and the result was many months of stress and financial trauma.

 2011

The first Commonwealth funded paid parental scheme was introduced after many years of strong union lobbying. Under the scheme working caregivers are entitled to 18 weeks paid leave at the minimum wage on top of any other workplace parental leave entitlement.

The QNU secured the Queensland Health Nurse and Midwives’ Award–State 2011, the culmination of a number of years’ work to consolidate three federal awards into a single state instrument. The new award was developed in the wake of the Howard Government’s WorkChoices which required Queensland Health employees to move back into state jurisdiction despite not having a state award since the move to a federal system in the 1990’s. The consolidated state award gave public sector nurses and midwives a simplified document making it easier for them to understand their entitlements.

 2012

A new Queensland Health Framework Award was approved giving Queensland Health employees certainty and security in relation to their terms and conditions of employment. This award consolidated the terms and conditions of employment found in existing awards and agreements in relation to job security, contracting out, union encouragement and union Delegate rights, organisational change and consultation, collective industrial relations, consultative forums, grievance and dispute resolution and workload management. It covered all Queensland Health employees from orderlies through to nurses and midwives.

The QNU celebrated its 30th anniversary and reached 50,000 members making it the biggest union in Queensland.

The Nurses and Midwives (Queensland Health) Certified Agreement (EB8) 2012 was officially certified in August marking the end of a ten month public sector EB8 campaign which ran the gauntlet of a state election, the transition to a conservative LNP government and a new regime of public sector cost cutting.
    
The QNU joined forces with its interstate counterparts to launch a new campaign to promote nurses and midwives and their role as champions for quality health and aged care. Australia’s nurses and midwives. You couldn’t be in better hands, was a nationally co-ordinated campaign to harness public opinion in favour of nurses and midwives, then leverage off that community support to position nurses and midwives as leaders, innovators and drivers of better health and aged care. The campaign was also designed to bring more nurses, midwives and assistants in nursing into the QNU nursing family.

The Labor Federal Government passed significant changes to superannuation law in 2012 which will see the Superannuation Guarantee amounts contributed by employers increase over the next eight years. As a result of the changes, superannuation started increasing from 9% of Ordinary Time Earnings to 9.25% from 1 July 2013 and will eventually reach 12% from 1 July 2019.

 2013

The QNU became signatory to the Global Nurses Union and celebrated this inaugural launch on 17 September.

Australian Nursing Federation changed its name to Australian Nursing and Midwifery Federation (ANMF).

The QNU extended its Hands Off campaign to Hands Off Our Jobs after the coalition State Government began axing thousands of jobs in the public sector. Over the next two years more than 5000 Queensland Health jobs would be cut including more than 1800 nursing and midwifery positions. Our campaign included rallies, member petitions and email blitzes, fact based discussions, an extensive media strategy and the careful documentation of every cut.

The QNU's anti-privatisation campaign Our Public Hospitals are not for Sale was a large focus as the State Government announced plans through their Better Health in Queensland blueprint to use competitive tendering and contestability to outsource publically provided health services.

The coalition State Government’s attacks on workers continued throughout 2013 with changes to the Industrial Relations Act 1999 (Qld) that removed the enforceability of our Union Encouragement provisions in Awards and agreements. This meant the loss of the Industrial Relations Education Leave entitlement and no requirement for Queensland Health to provide employees with access to union information.   Other legislative change this year included The Industrial Relations (Transparency and Accountability of Industrial Organisations) and other Acts Amendment Bill 2013. This legislation required unions to ballot their members if they wish to spend more than $10 000 on a political object and also required them to publish credit card statements on a monthly basis. These reporting measures are not required by any other organisation including employer associations. 
   
In June the Health Ombudsman Act (Qld) 2013 was introduced. This legislation replaced the Queensland Health Quality and Complaints Commission with the Health Ombudsman and increased the powers of the ombudsman to take immediate action to stop practice in relation to both registered and unregistered health practitioners such as AIN’s and PCW’s.    
 
Conversely the Gillard Federal Government committed $3.7 Billion to the Living Longer Living Better aged care reforms as part of a ten year plan for a better, fairer and nationally consistent aged care scheme. This scheme included the Workforce Compact which aimed to close the wages gap in aged care.

The QNU Council voted to join the Queensland Community Alliance Project. The Alliance is a community group made up of unions, faith groups, community and ethnic associations to build linkages and voice in local communities.            

 2014

The QNU’s Nurse and Midwife Power Fund began generating funds for the union’s campaign activities on 1 July 2014, but by this stage the concept of Nurse and Midwife Power had gained broader traction with members who embraced it as a reminder of their strength and collective power. From this point Nurse and Midwife Power became the backdrop to many QNU activities.

The QNU made the most of the G20 Summit’s media spotlight in Brisbane to highlight the need to protect universal healthcare and to call for introduction of the ‘Robin Hood Tax’. Our G20 activities included a floating boat protest on the Brisbane River, a global health forum with representatives from Australian, American, Canadian and Nigerian nursing unions, and spokespersons from Oxfam and Public  Service International. We also organised a live cross with a nurses and a paramedic working the frontline of the Ebola crisis in Liberia.
 
QNU lodged an official Right to Information (RTI) investigation into the job cuts under the Newman government and the results were staggering. The RTI data revealed public sector job cuts were almost 2000 positions higher than the Newman government had admitted. The final compilation of our RTI investigation revealed 4821 hospital and health service jobs had been abolished across the state ¬– 1867 more jobs than the Newman government acknowledged. The total cuts figures included more than 1700 nursing and midwifery positions.

One of America’s most influential healthcare professionals, renowned researcher Professor Linda Aiken visited the QNU in December as guest speaker at our inaugural Patient Safety Symposium.Professor Aiken is recognised for her pioneering research which links nurse-to-patient ratios with patient safety; and the material she presented in her keynote speech gave us the hard evidence we needed to support our Ratios Saves Lives campaign.

 2015

The QNU launched its Ratios Save Lives campaign. It was kicked started in the lead up to the January 2015 snap state election with all major parties except the LNP (ALP, Greens, Katter Party, Palmer United and Independent Peter Wellington) pledging to support minimum nurse-to-patient ratios. Our ratios campaign calls for the government to introduce legislated minimum nurse-to-patient ratios, skill mix levels and public reporting initially within Queensland Health, setting a benchmark for a roll-out across all sectors.

2016 

With the support of the Labor Party and all crossbench MPs (including Peter Wellington, Robbie Katter, Shane Knuth, Billy Gordon, and Rob Pyne), Queensland became the fourth jurisdiction in the world to legislate minimum nurse/midwife-to-patient ratios. The Queensland parliament voted on the Hospital and Health Boards (Safe Nurse-to-Patient and Midwife-to-Patient Ratios) Amendment Bill 2015 on 12 May – International Nurses’ Day. From 1 July, minimum ratios of 1:4 (morning), 1:4 (afternoon) and 1:7 (evening) began rolling out in prescribed Queensland public sector facilities. This marked a significant milestone in the QNU’s campaign to achieve minimum ratios in all sectors, including private and aged care.

The new public sector EB9 agreement and variation of the award were certified by the Industrial Relations Commission. The QNU negotiated a 2.5% increase to wages and allowances, improvements to the BPF, improvements to the award escalation process for resolving workload concerns, and more. Department of Education and Training State School RNs were also included in the agreement for the first time, signalling a substantial increase to pay and conditions for those nurses. 

The QNU continued to campaign against federal government cuts to penalty rates. The Productivity Commission suggested introducing a two-tiered system of pay in which hospitality and retail workers would have their penalty rates reduced. Recognising that this could be the beginning of a slippery slope whereby nurses and midwives could be later targeted, the QNU joined with other unions to protect our penalty rates.  Conference delegates voted to change the name of the Queensland Nurses’ Union to the Queensland Nurses and Midwives’ Union. 

Your work, your time, your life research was again undertaken.

2017   The QNU officially changed its name to include midwives. From March this year it formally became the Queensland Nurses and Midwives' Union (QNMU). We currently have almost 60,000 members.