Refresher course fee discriminatory: union

NSW nurses union questions the legality of recency of practice standards By Darragh O Keeffe.

Requiring NSW nurses to undertake a refresher course at a cost of $10,000 before returning to the workforce after lengthy absences is potentially at odds with the Sex Discrimination Act, said the NSW Nurses’ Association.

The National Registration and Accreditation Scheme, which came into effect in July 2010, includes a “recency of practice” standard which the union said is a deterrent for experienced nurses who the system needs most.

Before the national scheme came into effect, NSW was the only state not to have any recency of practice requirements.

Brett Holmes, general secretary of the NSW Nurses’ Association, said he had twice written to the Nursing and Midwifery Board of Australia, which developed the national professional standards, outlining the union’s concern that the requirement contravened section 18 of the Sex Discrimination Act.

The union was still awaiting a response to the letters, sent in August and late November, 2011, and Holmes said if the board did not respond the union would seek legal advice as to the merits of a case. The majority of nurses affected by the practice requirement were women who had left the workforce to start families, he told Nursing Review.

About 10 nurses have contacted the union in relation to the issue but Holmes said this was likely to under-represent the level of concern amongst returning nurses as many in this cohort were not current members of the union.

A spokeswoman for the Nursing and Midwifery Board of Australia (NMBA), said the national standard, signed off by all state and territory ministers and passed by every state parliament, set out two re-entry pathways for returning nurses.

Nurses who have been out of the workforce for a period of at least five years must either undertake a return to practice fresher course or go back to their original education provider for a period of further study. The path they take is determined by the board on an individual basis and is judged by the nurse’s original qualifications, skills and experience, and the length of time out of the profession.

“The first pathway is for people who almost meet the recency standard but not quite. Otherwise, if a practitioner has been out of the workforce for a long time, then [the board] recommends that person goes back to their education provider for retraining. The education provider makes an individual assessment of how much recognition of prior learning is granted, and what is required,” she said.

Unlike the other jurisdictions that have had recency of practice requirements for some time, in NSW there is currently just one approved provider of a refresher course - the College of Nursing, which charges $10,000 for its Assessment of Competence Program.

That compares with, for example, more than 40 similar courses in Victoria, eight in South Australia, seven in Western Australia and two in both the ACT and Tasmania, according to the Nursing and Midwifery Board of Australia’s list of approved providers.

The board’s spokeswoman said that the availability of courses and the fees charged were matters for the NSW government and the education providers.

NSW Health acknowledged the College of Nursing was currently the only organisation with an accredited return to practice program but said that “other education providers based in NSW are welcome to put forward a course for accreditation”.

“It is expected [over time] that more organisations in NSW will undertake accreditation to provide these programs,” a NSW Health spokesperson said.

NR contacted several education providers in other states offering similar return to practice programs. West Gippsland Healthcare Group and Alpine Health, both in Victoria, said they charged about $2000 for their courses. Stawell Regional Health said it did not charge nurses for its return to practice program. A fourth provider, the Royal Women’s Hospital, said while it had no return to practice programs scheduled for 2012 it did offer this course free of charge to Victorian nurses and midwives. The Department of Health and Human Services in Tasmania also covers the cost of students’ enrolment fees delivered by the University of Tasmania or Tasmanian Polytechnic.

Holmes said the limited number of return to practice programs in NSW was a factor and criticised current arrangements for requiring an upfront $10,000 payment and a minimum attendance of four weeks in Sydney. He said these requirements could disadvantage regional nurses with substantial additional costs in the form of childcare and accommodation.

NSW Health said it was considering options to better support the re-entry of nurses required to undertake the course. “As one response, the NSW government offered 25 scholarships each valued at $6000 for individuals seeking to return to nursing after a significant period out of the workforce,” a spokesperson said.

When asked about the number of applications for these grants, the spokesperson said that the Local Health Districts were currently finalising the selection of applicants but that “overall the total number of applicants was not at the level anticipated”.

Elsewhere, Lee Thomas, federal secretary of the Australian Nursing Federation, has raised the issue at a national level. In a statement welcoming Tanya Plibersek as the new Federal Health Minister she cited the recency of practice requirements as one of the key areas the minister needed to address.

At the time of going to press, the College of Nursing had not responded to requests for comment.