Tasmania’s crucial cardiac surgery services are facing significant disruptions, with vital specialists withdrawing from planned procedures due to ongoing industrial action. This has forced the state’s health department to drastically cut back on what are usually daily open-heart surgeries, impacting patient care and raising concerns about the future of these highly skilled professionals in the state.
Cardiac Specialists at the Heart of the Crisis
Clinical perfusionists are the unsung heroes of open-heart surgery. These highly trained professionals are responsible for operating the heart-lung bypass machine, a sophisticated piece of equipment that takes over the function of a patient’s heart and lungs during complex surgical procedures.
“We take over the function of the heart and the lungs during open heart surgery by using quite advanced technology and machinery, specifically the heart-lung machine, or the bypass machine,” explained Ghaz Jabur, Head of Clinical Perfusion at the Royal Hobart Hospital. “And then we stop the heart from our end, give the heart drugs, and then the heart gets fixed, and at the end we win.”
The impact of their industrial action is stark. Normally, elective open-heart surgeries are performed once a day, often extending to two a day when emergencies arise. However, due to the perfusionists withdrawing from most planned surgeries, only two elective procedures can now take place per week. While emergency surgeries continue without restriction, the reduction in planned operations is a serious concern.
The Demanding Role of Perfusionists
The demanding nature of the perfusionist role is a key factor in the current industrial dispute. With only three practicing perfusionists and one trainee at the Royal Hobart Hospital, on-call commitments are exceptionally high.
“We do one in three weekdays and one in three weekends on call,” Dr. Jabur stated. “Not only that, it doesn’t mean that sometimes other people that are not on call are needed. That’s happened multiple times, where I’ve got my kids on my lap sitting in my lounge and I get a call saying we need help, and I’ve got to just drop everything and go.” This constant on-call pressure, coupled with the critical nature of their work, highlights the immense dedication required.
A Standoff Over Pay and Conditions
The core of the problem lies in a standstill in negotiations over pay and working conditions between the perfusionists and the Tasmanian government. The specialists are on the brink of leaving the state due to what they describe as the government’s inability to meet their needs.
“If there are no perfusionists, there is no heart surgery, and people will have to be transferred to the mainland,” Dr. Jabur warned. “People who are very sick, it will be very hard for them to transport them to the mainland. They’re unstable, and it will be a logistical nightmare, let alone the financial implications that will go with that.”
Trainee perfusionist Ed Okey echoed these sentiments, expressing his desire to remain in Tasmania but facing significant financial and professional incentives to move interstate. “I’ve been in Tassie my whole life, it’s where I want to live, where I want to raise kids and have my life,” Mr. Okey said. “But then if you look interstate and see the pay disparity, at the top end it’s up to 80 per cent more when it comes to money, and better working conditions, more annual leave if you work extra on call, allowances for if you do higher education, things like that that don’t exist down here.”
He also challenged the long-held notion that Tasmania offers lower pay due to a lower cost of living. “As a Tasmanian, I know the old adage that Tasmania pays less because cost of living is less, but in the current climate, that’s just not true.”
The Locum Conundrum
In an attempt to alleviate the surgery delays, the Tasmanian health department has announced it is exploring options, including the use of locum (temporary) perfusionists. However, this decision has been met with frustration by the local staff.
“How can you justify bringing locums in for a very short period of time when that money could actually go towards our contract, and almost entirely fund what we need for the three year period, I just don’t understand the logic,” Dr. Jabur questioned. “If you have no money, how can you approve locum perfusion — and I know how much locums earn, because I was one of them.”
Dr. Jabur, who previously worked as a locum in Tasmania, highlighted the significant cost associated with bringing in temporary staff, including flights and accommodation. “The money they’ll be spending on locums and their flights and their accommodation and they bring then in for a two or three months, they could cover what we’re asking for,” he argued. “Keep the perfusionists that you have here, invest in them.”
Tasmanian Health Minister Bridget Archer acknowledged the government’s desire to see healthcare workers receive a pay rise and stated they would continue to negotiate in good faith. However, she did not directly address questions regarding the budget for locums or the justification for their use in light of the local staff’s concerns.
Broader Industrial Unrest
The perfusionists’ dispute is part of a wider wave of industrial action affecting public sector workers across Tasmania. The Health and Community Services Union (HACSU) is leading widespread industrial action, with members seeking improved support, safer working conditions, and more competitive pay compared to other states.
This month’s industrial action is impacting a broad range of services, including:
- Building, facilities, and house services
- Environmental services
- Domestic services
- Instrument sterilisation
- Hospital aides, ward clerks, and administration
- Pharmacy
- Mental health
- Oral health
- Child safety
- Cleaning
- Radiation and oncology
- Orderlies
HACSU state secretary Robbie Moore described the situation as unprecedented, stating, “I have never seen a situation where you have got such widespread industrial action. And it’s nearly always happening because the government has said they’ll do one thing, and then they don’t do it. This is a situation where the workforce has absolutely lost confidence in the government and management. This needs an intervention.”
The ongoing industrial action underscores a deep-seated dissatisfaction within Tasmania’s public health sector, with critical specialists like cardiac perfusionists feeling undervalued and facing uncertain futures in the state.
