NSW health budget going backwards in real terms

With NSW voters preparing to head to polling booths next March and support for One Nation continuing to rise, the Minns Government has unveiled a pre-election budget it claims will strengthen the state’s health system while delivering cost-of-living relief.

But critics argue the headline promises mask a deeper problem. The NSW Government will point to this Budget as a record investment in health. Yet, health funding has gone backwards in real terms despite record activity.

With health inflation at 4.9%, this Budget is funding growth at only 4.2%.

“It is extraordinary that this Budget fails to keep pace, despite extra Commonwealth funding and the mandated wage increase for nurses and midwives,” said Dr Fred Betros President of the Australian Medical Association (NSW).

The Government’s claim of a health funding boost is also facing scrutiny, with critics arguing that a significant portion of the money is simply being absorbed by wage increases imposed through the Industrial Relations Commission rather than delivering new frontline capacity.

The NSW Government has promised 9,000 additional health workers, including paramedics, nurses and allied health staff, but there is no mention of doctors. For patients already struggling to access care, the omission raises questions about whether the NSW Government’s workforce plan can actually address the pressure confronting hospitals.

“As a surgeon in western Sydney, I see the impact of this pressure on the front line. I see patients waiting too long for care, doctors and clinical teams stretched too thin, and hospitals trying to manage demand they were never properly resourced to meet,” Dr Betros added.

The NSW Government has highlighted hospital infrastructure spending as evidence of progress. However, critics say many of the major infrastructure announcements were already committed under the previous government, raising questions about whether today’s Budget delivers genuine new solutions or simply repackages existing plans. A new hospital without doctors is not a health service. A new emergency department without doctors will not reduce waiting times.

The Minns Government may also point to elective surgery activity and claim progress. But more than 92,000 patients remained on the elective surgery waiting list at the end of March, including almost 4,000 who had waited longer than clinically recommended. Those figures represent thousands of people living with pain, reduced mobility, reduced independence and declining quality of life.

The number of elective surgeries contracted to private hospitals has also almost tripled in a year. While using private hospitals can help patients receive care sooner, questions remain over whether this approach addresses the underlying strain on the public system.

RACGP NSW&ACT Chair Dr Rebekah Hoffman said, “Over the last decade, NSW hospital costs have grown by more than 60% – it’s not sustainable. GPs can help to cure a healthcare system struggling under the burdens of an ageing population, an epidemic of chronic disease, and a growing need for mental health care. There are some welcome measures in the Budget. We’ll be meeting with the Government to discuss the more granular details.”

Beyond health, the Budget also contained a politically difficult decision for the Minns Government, with public sector pay rises effectively put on hold.

According to the budget papers there will be a two-year remuneration freeze for Members of Parliament and senior staffers. In addition, the Minns government confirmed a 15% reduction to Public Sector Senior Executive (PSSE) headcount. This has resulted in around 615 workers losing their job.

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