Arbitration Week 5 Recap

We’ve wrapped up the second week of hearings for 2026 in our Public Hospital Doctors Award arbitration. Read on for a full recap and highlights from the Bench.

Week 5 of Hearings: Highlights From the Bench

Monday Highlights

Monday’s evidence focused on how comparatively low pay and staffing shortages are undermining patient care, worsening delays and driving doctors out of NSW hospitals.

A Staff Specialist Cardiologist from SWSLHD described how comparatively low pay is driving anaesthetists to private or VMO work, leaving his hospital without specialist anaesthetic support for cardiology procedures. Public patients face waits of 2–3 years for ablations, compared with 2–4 weeks privately, and some procedures require heavy sedation, falling short of accepted standards.

A Senior Registrar in Emergency Medicine at SWSLHD gave evidence that colleagues are leaving NSW Health because of pay that lags behind other states, while others are resigning or taking extended breaks due to burnout. She described escalating aggression and violence in the ED, saying security is called almost every shift. She also outlined the growing complexity of presentations linked to ageing, obesity, diabetes, heart disease, drug use and mental health disorders, compounded by language and cultural barriers in a diverse community.

A Staff Specialist from the Aeromedical Services Division of NSW Ambulance and WNSWLHD addressed training requirements for Registrars and supported additional pay increments, arguing that Registrars beyond their fourth year should be recognised and properly compensated for their higher skill and experience.

Tuesday Highlights

Tuesday’s evidence laid bare system-wide failures in workforce planning, safety and pay, fuelling ongoing recruitment and retention problems.

A Staff Specialist in Palliative Medicine from NSLHD highlighted how an ageing population and increased longevity have driven higher demand, including for patients with dementia and non-malignant conditions. Advances in medicine, subspecialisation, and new evidence-based treatments have increased the responsibility and clinical judgment required, yet chronic staffing shortfalls remain.

A Staff Specialist Emergency Physician from SWSLHD supported ASMOF claims for protected clinical support time, safe staffing, and professional development. He explained that insufficient staff numbers and the lack of rostered CST have resulted in serious deficiencies in education, supervision, policy development, and incident review.

A Staff Specialist Psychiatrist and Clinical Director of Youth Mental Health NSLHD said vacancies are increasingly filled by locums and VMOs, which are more expensive and administratively burdensome. Recruitment and retention are difficult, with private sector and VMO pay higher, and NSW Health workload pressures severe.

A Staff Specialist Neurologist from SLHD outlined that a wages-based model for Doctors in Training could be extended to Staff Specialists, and logging hours would improve transparency and address unrostered overtime. He said staff should receive recognition and pay where extra work is necessary for patient care.

A Staff Specialist in Obstetrics and Gynaecology from WSLHD explained that serving a socioeconomically disadvantaged, multicultural population increases clinical complexity, requiring more antenatal visits, multidisciplinary care, and close monitoring. She highlighted that rising patient numbers, extended service hours, and escalating governance requirements have increased workload, while NSW Staff Specialist salaries remain below those of interstate colleagues.

Wednesday Highlights

Wednesday’s evidence focused on how comparatively low pay, long hours, and insecure contracts are affecting Doctors in Training and patient care in NSW hospitals.

A Paediatric Physician Basic Trainee described how unpredictable rosters and short-term contracts harm health and wellbeing, make it difficult to maintain life outside work, and discourage claiming entitlements, particularly for pregnant trainees. She supported ASMOF’s claims for better pay and professional development leave, saying remuneration should reflect training length, debt, hours worked and responsibility.

A Basic Physician Trainee from SESLHD said base pay does not reflect the intensity or emotional toll of work and is insufficient to cover living and training costs without overtime. She described workloads of up to 40 patients and 70-hour weeks, which undermine learning and increase burnout, and supported additional study leave and a PDL allowance.

A Basic Physician Trainee and Haematology Registrar from Northern NSW LHD supported ASMOF’s claims on overtime, rostering, WHS, and professional development leave. He explained that current overtime rules don’t reflect clinical reality, and study leave arrangements force doctors to use annual leave or ADOs. He described studying after 14-hour shifts, causing sleep loss, burnout, and strained relationships, and said he feels honoured to work as a doctor, but increasingly drained, burnt out and frustrated by the pressures of the system.

Thursday Highlights

Thursday’s evidence highlighted escalating workloads, unsafe hours, workforce shortages, recruitment and retention failures, and the growing complexity and responsibility of clinical care.

A Registrar from Northern Sydney LHD gave evidence that comparatively low pay and insecure contracts are driving interstate relocation and weakening retention. She said the Medical Officer In Charge allowance is inconsistently paid and that $22.80 for a 12-hour shift does not reflect the responsibility or risk involved and supported ASMOF’s proposed increase.

A Haematology Registrar from Northern NSW LHD said overtime provisions failed to reflect clinical reality, requiring pre-approval even when urgent tasks prevent handover. He described routinely studying after shifts of up to 14 hours, leading to exhaustion and burnout, and supported ASMOF’s education leave proposal.

A Postgraduate Fellow formerly with SLHD, now working in Queensland, described near-constant on-call demands in a hyper-acute emergency specialty, with most recalls requiring hospital attendance. He said the excessive hours led to burnout and confirmed he does not intend to return to NSW Health.

A Registrar from WSLHD compared NSW unfavourably to Queensland on pay and conditions, citing rising demand without matching health investment and significant cost-of-living pressures.

A Senior Staff Specialist Neonatologist from SCHN/NETS NSW described 18–24 hour retrievals and a 72-hour deployment during Cyclone Alfred on top of ordinary shifts, with no additional pay due to Award limits. She also said the gap between workload and pay is driving burnout and threatening paediatric services.

The Week Ahead: Key Update

Next week, the spotlight turns to the Ministry’s case, as the Health Secretary’s witnesses give evidence and face cross-examination. We strongly encourage all members to tune in - this is a critical stage in the arbitration to secure fair pay, safe hours, and proper access to professional development leave and allowances.

On Tuesday, Melissa Collins, Director of Industrial Relations and HR Policy for NSW Health, will give evidence as a key witness for the Ministry. She is expected to be in the box for the full day.

We also continue to urge members to attend the hearings in person wherever possible - a strong member presence is a powerful display of support, showing the Commission and NSW Health that doctors are united behind Award reform.

We’ve wrapped up our witnesses, though one more may still appear, which is not yet confirmed. Our expert witnesses are still scheduled for March.

Daily details of all the Ministry’s witnesses appearing will be shared each morning in the WhatsApp Groups so you can follow along.

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.