NSW sends residents to Canberra because their hospitals refuse to take them: union

Southern NSW hospitals surrounding Canberra are overwhelmed this winter, struggling with bed block and workforce shortages.

Vice president of the NSW Nursing and Midwives Association, Paul Haines, said systemic issues were being made worse because of the flu season.

"I think that the ACT health system bears the brunt of a lot of southern NSW health problems because they have a bit more capacity and they actually have a better system," he said.

"When it comes to discharging those patients back into NSW Health, [we cannot take them]. That's going to mean a reduced service for the ACT community."

NSW residents make up about one in four public health patients, an ACT government spokesperson confirmed.

In January, Health Minister Rachel Stephen-Smith said the territory would be more strict with NSW patients as the ACT health system struggles financially.

A government spokesperson said there were no service limits for NSW residents.

"ACT recognises its important role as a provider of tertiary and trauma services to the surrounding region," they said.

"Where non-tertiary services may be available closer to home, Canberra Health Services works closely with the surrounding NSW regions to transfer care where it is appropriate to do so."

When the small Yass, Crookwell and Braidwood hospitals cannot take patients, they are supposed to refer them to Goulburn Base Hospital.

But Mr Hains said Goulburn would often refuse.

"There is no governance around what patients go where," he said.

"Goulburn is a referral hospital, but they're not very good at accepting our patients, and they'll often push back for various reasons.

"Most of our patients should go to Goulburn Hospital unless there's a specific clinical reason that they actually need to go into Canberra for treatment."

Doctors prefer to send patients to the ACT because they will receive better care.

"We have to acknowledge that straight up, because the health service is better funded in the ACT than it is in NSW," Mr Haines said.

He said doctors in Canberra were more than happy to take patients from the surrounding region.

"It's often easier for our doctors just to refer to Canberra in the first place," he said.

"We have lots of patients going into the ACT health service that really could have been managed and should be managed in the NSW health service, but there isn't any governance around the acceptance of patients in the ACT.

"It should be a NSW problem rather than an ACT problem."

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Regional hospitals often did not have room to take their residents back once they were seen in Canberra.

A southern NSW Local Health District spokesperson said patients were "always referred to the most appropriate health facility based on multiple considerations including the level of care required, the location of the patient and demand for services".

"Transfer decisions are dependent on a number of factors, but the clinical situation and needs of the patient and their family are paramount," they said.

Mr Haines also said health workforce shortages in the region are made worse because local staff would rather work in the ACT.

The NSW health spokesperson would not comment, but a level 1 registered nurse makes about $81,000 in the ACT and about $72,000 in NSW.

The head of a NSW special commission into health funding, Richard Beasley, said "many in the NSW health system no longer share income parity with their counterparts in other states".

The NSW government pays the ACT per patient treated in the territory, using a price set by a federal government body.

The agreement between the jurisdictions will expire this year, and ACT Health Minister Rachel Stephen-Smith has asked NSW Health Minister Ryan Park to extend it by one year.

Small states and territories like the ACT claim the method used to determine how much Commonwealth funding they get for public hospitals is too low.

They say it does not consider the higher costs of running healthcare in smaller places.