The South Australian state government will this week introduce landmark legislation to mandate nurse-to-patient and midwife-to-patient ratios across public hospitals, delivering on its pre-election commitment.
The proposed new laws, strongly lobbied for by the Australian Nursing and Midwifery Federation (ANMF SA Branch), are modelled on Victoria’s pioneering ratios legislation, which prioritise patient care, safety, and staff wellbeing.
The proposed new laws include:
- Adelaide’s four largest metropolitan hospitals (the Royal Adelaide, Flinders, Lyell McEwin and Women’s and Children’s) will be required to have one nurse for every four patients, along with a nurse in charge, in general medical and surgical wards during morning and afternoon shifts. For night shifts, it will be one nurse for every eight patients with a nurse in charge.
- Other hospitals across metropolitan Adelaide (including Modbury, Noarlunga and the Queen Elizabeth) will be required to have the same ratios as above for morning and night shifts, and one nurse for every five patients with a nurse in charge for afternoon shifts.
- Regional sites, such as the Port Lincoln and Southern Fleurieu Health services will require one nurse for every five patients with a nurse in charge for morning shifts and one nurse for every six patients with a nurse in charge for afternoon shifts. A night shift will require one nurse for every ten patients with a nurse in charge.
- In a coronary care unit, the ratio will become one nurse for every two patients and one for every three overnight, regardless which hospital they are in.
- An antenatal ward will require one midwife for every four patients and one for every six patients overnight, across all public hospitals.
It is expected that the Bill will pass through Parliament and become law before the end of the year, with ratios coming into effect in early 2026. There will be a two-year rollout period to allow local health networks to reconfigure staffing and recruit where required. During that time, there will be a moratorium on non-compliance. At the end of that two-year period, any deliberate or systematic breaches of the legislation as determined by the South Australian Employment Tribunal could attract a fine of up to $10,000.
ANMF (SA Branch) Secretary Elizabeth Dabars commended the government for introducing the landmark legislation.
“The introduction of this legislation is an historic milestone and a cause for celebration. It represents long-overdue recognition of the vital role nurses and midwives play in safeguarding the health of South Australians,” Ms Dabars said.
“Safe care depends on safe staffing. Legislating nurse and midwife ratios is a vital step in supporting our workforce and ensuring every South Australian receives high-quality care.”
“This legislation honours the dedication of nurses and midwives and provides the support they need to continue delivering safe, sustainable care. It is also an investment in a stronger, more resilient health system for all South Australians.”
SA Premier Peter Malinauskas described the legislation as a clear win for South Australian patients, nurses and midwives.
“We’re delivering on our promise to South Australia’s hard-working nurses and midwives to introduce staff ratios to help them provide the best and safest care to their patients,” he said.
We have seen nurse-and-midwife-to-patient ratios work interstate and we’re following through with our commitment to introduce them here.”
