Arbitration Week 3 Recap

We’ve wrapped up the final week of hearings for 2025 in our Public Hospital Doctors Award arbitration. Read on for a full recap and highlights from the Bench, plus how you can support your colleagues as we continue our case in 2026.

Week 3: Highlights From the Bench

Monday Highlights

Monday’s evidence highlighted the deepening mental health workforce crisis in Northern NSW and the consequences of an uncompetitive Award.

The main witness, a Staff Specialist Psychiatrist and recently Director of Medical Services for Mental Health, Alcohol and Drug Services in Northern NSW LHD, described severe recruitment and retention failures driven by NSW’s proximity to Queensland and significantly higher interstate pay.

She explained that the district is funded for approximately 24 full-time equivalent permanent Staff Specialist psychiatrist positions, but only around 4.5 FTE were filled. The remainder were either vacant or inconsistently filled by locum psychiatrists and VMOs. Locum psychiatrists were typically paid between $2,500 and $3,000 per day, yet were often unreliable, with around half failing to commence or complete their contracts.  

She also described a significant increase in work value over the past 20 years, noting a marked rise in mental health presentations. Emergency department presentations related to mental health in Northern NSW increased from approximately 1,526 per 100,000 people in 2013 to around 1,943 per 100,000 people in 2025.

Tuesday Highlights

On Tuesday, we heard from an Advanced Trainee in Neurosurgery at Liverpool Hospital. He described a marked rise in critically unwell and medically complex patients over recent years, linked to cost-of-living pressures and reduced access to private care.  

He gave evidence about the burden of unrostered overtime and the practical barriers to being paid for additional hours worked, noting that overtime claims are often rejected and responsibility shifted back onto junior doctors for working beyond rostered hours.  

Fatigue was a central theme of his evidence. He described long hours, frequent on-call and recall, disrupted sleep and missed breaks as routine and unsafe, contrasting this with other safety-critical industries where fatigue controls are enforced.

We also heard from a Senior Staff Specialist Anatomical Pathologist and Head of Laboratory and Clinical Director of Anatomical Pathology, who described sustained workload growth driven by rising volumes and increasing complexity, particularly in quaternary cancer care. He explained that staffing has not kept pace with demand, forcing work beyond nominal hours and creating real clinical risk, as pathology results are often the gating step for treatment decisions.

Wednesday Highlights

The first witness of the day, a Staff Specialist from the Department of Anaesthesia and Perioperative Medicine at Westmead Hospital, gave evidence of widespread recruitment and retention failures driven by interstate pay disparities and competition from private practice, locum and VMO work. He described the loss of NSW-trained registrars and early-career fellows, stagnant staff specialist FTE despite workload growth, increasing reliance on VMOs, and routine work beyond rostered hours due to ICU bed block.

We also heard from an Advanced Trainee in Cardiology at RPAH, who described how temporary contracts undermine workforce stability and make parental leave difficult without career risk. She gave evidence of discriminatory treatment linked to pregnancy, the expectation that doctors self-fund thousands of dollars each year in training and exams, and junior doctor salaries failing to keep pace with real costs such as childcare, parking, and schooling.  

The third witness, a Paediatric Registrar at The Children’s Hospital Westmead, gave evidence of pay stagnation and unsafe workloads. Despite being PGY14 with more than 13 years’ experience, he has been capped at Registrar Year 4 for many years, supporting ASMOF’s claim for an extended registrar scale to Year 9. He also described routinely missing meal breaks in NICU due to unsafe staffing levels, with minimum doctor numbers required at all times to maintain patient safety.

Thursday Highlights

Thursday marked the conclusion of the 2025 arbitration hearings, with the Full Bench undertaking a site visit to The Children’s Hospital at Westmead and the Westmead Emergency Department. The visit gave the Bench a firsthand view of the daily realities facing doctors, the growing complexity of care, and the pressures on hospital services.

The Bench toured Radiology, Cardiology, the Paediatric Intensive Care Unit (PICU), the Neonatal Intensive Care Unit (NICU), Virtual Kids, and the Westmead Emergency Department. They were accompanied by ASMOF-nominated Staff Specialists, management representatives, and legal teams.  

During the visit, the Ministry’s barrister sought to tightly control and limit what the Full Bench could see, including attempts to restrict access to clinical areas. Despite these efforts, ASMOF members shared candid accounts of their day-to-day work, the challenges they face, and how Award conditions operate in practice.

These site visits - strongly advocated for by the ASMOF legal team - were a critical opportunity for the Bench to see how Award conditions operate in practice, reinforcing the urgent need for Award reform.

We would like to thank all the Staff Specialists who rearranged their schedules at short notice to participate and answer the Bench’s questions.

2026: The Year Ahead

Hearings for this phase of arbitration have now concluded, and ASMOF’s daily updates will pause until proceedings resume in February 2026. We’ll share exact dates as soon as they’re confirmed.

When hearings resume, we strongly encourage members to continue showing your support for your colleagues and our witnesses who have dedicated hours to the arbitration process - not to mention the uncomfortable and challenging experience of being cross-examined in court.

As we move into the next phase of arbitration, the support of our members remains critical.

Attend the Hearings in Person

A strong member presence in the courtroom is a powerful display of support. It shows our witnesses – and the Commission and NSW Health – that doctors are united behind Award reform.

Once dates are confirmed, we’ll share registration details so members can join in person or watch via livestream.

Support on Social Media

Your social media messages of solidarity not only help boost morale for our witnesses but also highlight the dedication and pressures facing doctors in NSW right now.

You can share our daily updates, repost our tiles and stories, share messages of thanks to witnesses and anything else you can think of to show your support!

Make sure to follow us on Instagram and Facebook!

We’ll continue to provide members with regular updates on the proceedings and ensure you know exactly what is happening inside the Commission as the case progresses.

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