Like vaccination, union membership benefits all


Nurse Uncut is pleased to bring you the first in a regular post by Coral Levett, President of the Australian Nursing and Midwifery Federation and of the NSW Nurses and Midwives Association. Coral’s columns appear in the Australian Nursing and Midwifery Journal, which goes to more than 120,000 members each month.

In this stimulating piece, Coral compares vaccination with unionism – and finds many similarities.

Since 1945, when vaccines first came into widespread use in Australia, we’ve seen a significant and steady decline in vaccine-preventable disease across all populations. Vaccines available until the late 1960s included tetanus, diphtheria, pertussis and polio. The ‘70s and ‘80s added measles, mumps, rubella and hepatitis B to the mix and eventually in the last 20 years we’ve seen the widespread use of Haemophilus influenzae type b (Hib), hepatitis A, influenza, varicella, pneumococcal, meningococcal, human papillomavirus and rotavirus vaccines throughout Australia.

Coral is second from left in the red cape with members of the NSWNMA holding placards showing gains made by unions for nurses and midwives (Sydney May Day 2013).

The evidence that Australia has one of the highest rates of immunisation is well reported in the literature. A better understanding of disease processes, the human immune system and the spread of disease has focused Australian efforts towards a number of initiatives that have led to improvements in immunisation rates, particularly over the last 10-15 years. Many vaccines are provided free through the Immunise Australia program to certain members of the community, especially infants and children, and those with special health needs such as the elderly and indigenous peoples.

Immunise Australia is a Commonwealth Government funded program that is also responsible for:

• Parent and provider incentives such as cash payments to those parents who provide evidence of immunising their children

• The Australian Childhood Immunisation Register (AICR) – a national register to record the uptake of immunisation programs and activities

• The National Centre for Immunisation Research and Surveillance (NCIRS)

• General Practice Incentive Programs – where GPs (or their practice) are paid if they reach determined targets of immunisation.

These initiatives and continued progress in this field of health promotion are truly remarkable and thousands of unnecessary Australian deaths have been prevented as a result.

Without unions…?

In my reading about vaccination and immunity in recent times, I’ve come to the realisation that my interest in this field probably lies with its similarities to unionism. Now, I know some of you will think this link is a bit of a stretch, but let me tell you why I think the link exists.

For those not currently working in an immunisation context, you may remember the concept of ‘herd immunity’ from your training days. It occurs when a significant portion of individuals within a population are protected against a disease through immunisation. It offers indirect protection for people who are still susceptible to the disease by making it less likely that they will come into contact with it. It also benefits a small number of people who fail to respond to vaccines or who cannot be vaccinated for medical reasons. So the more people who are vaccinated (or have immunity by another means) in a given group, the more protection is afforded to the whole group.

Similarly, we know in our industry that where more nurses and midwives are union members, they tend to be better off in terms of pay, work conditions and patient ratios. Although there are always exceptions to this rule, it is particularly well demonstrated in nursing and midwifery when you compare these outcomes in the public sector (highest level of union membership), the private sector (lower level of union membership) and the aged care sector (lowest level of union membership).

From the National Tertiary Education Union.

The concept of ‘herd immunity’ is a key determinant of the success or otherwise of vaccination programs in Australia. Until we achieve vaccination rates of 100 percent, we will continue to have the potential for disease outbreaks. The closer we are to achieving that 100 percent figure, the better the situation for those unable to be vaccinated (for health reasons) and those who despite vaccination do not seroconvert.

The same can be said for union membership. If all nurses and midwives were members of the Australian Nursing and Midwifery Federation (and their relevant state union), our potential for best outcomes in pay, conditions and ratios is far higher. Conversely, low and non-unionised workplaces will continue to bear the brunt of unscrupulous employers who will always take advantage of this fact.

Further information:

Australian Government Department of Health, Immunise Australia Program, accessed February 2014

Australian Technical Advisory Group on Immunisation (ATAGI) 2013, The Australian Immunisation Handbook, 10th edn, Department of Health and Ageing, Canberra. Accessed February 2014

Thank you to Coral Levett and to the Australian Journal of Nursing and Midwifery for permission to republish this article.



  1. Great article promoting union membership and immunisation. Unfortunately, the article did misrepresent general practice as the GP immunisation incentive payment ceased in 2013.

  2. I’d like to play devil’s advocate here and explain why I chose to leave the ANMF and go elsewhere. In my opinion, the (significant and expensive) contributions union members make are to fund fulltime union staff to advocate for and ensure the industrial interests of nurses. However, over the last two or three years (especially) I noted that the ANMF were branching out into education, which is most definitely not the core business of any union (other than educating their own employes on industrial processes and educating nurses on their rights).

    Setting up online education on the union website would have been an expensive exercise (using members’ contributions) and I note that even if you are a member of the union, you still only have access on a ‘pay per use’ basis, which represents a double financial outlay for members (paying to set up the site, then paying to use it). Further, and perhaps the killer for me, was the ANMF setting up a multi million dollar, state of the art training facility in Tasmania, which resulted in over 50% of the union staff there now being employed in education, rather than being engaged with the core business of the union, which is advocating for and safeguarding the rights of nurses. On top of that, and perhaps almost insultingly, I note that the very large majority of the training that the facility is used for revolves around training non-nurses enrolled in the Certificate III and IV in community services and aged care. So members are funding a training facility and its associated staff to train non-nurses in roles that are constantly touted as being potential replacements for nurses at ward level.

    The ANMF lost it’s way a fair while ago, I’m afraid.

    • Continuing Professional Development (CPD) has always been a part of ongoing registration for Australian nurses and midwives and with National Registration it became a standardised requirement of 20 hours of CPD annually. The ANMF take great pride in supporting their members in all areas of their profession, including assisting them to achieve their education standard for ongoing registration. This is why the ANMF decided to provide their members with an education portal where they could access best practice learning relevant to their area of practice and to assist them in meeting their registration standard in a convenient and affordable manner.
      Our Continuing Professional Education (CPE) website offers members 11 free topics and a free online professional development portfolio to assist them with compliance with the Nursing and Midwifery Board of Australia’s CPD standard for continued registration. The remaining topics are at a member price of $7.70, which covers the cost of maintaining the website. This includes the fulltime employment of a webmaster offering almost 24-hour technical support, a manager to oversee the website, payment for authors writing the topics, the housing of the members’ records to ensure they remain safe and secure for members at all times and the cost of updating software to ensure the site remains technically viable.
      The ANMF’s two other online portals, Simulation Online for Nurses and the Aged Care Training Room (ACTR), were both set up with no cost to members and no use of member funds. The Simulation Online website was funded by ME Bank and the ACTR was created through a partnership with another company. Both of these websites require members to pay a minimum fee for access to the content, once again to maintain the content and the quality of the service.
      Our education online is also available to non-members but obviously at a much higher fee and without some of the member benefits such as free topics and a CPD portfolio. The ANMF believes that all Australian nurses and midwives should have access to affordable, high quality and best practice education.
      Most of the ANMF Branches offer education in areas of nursing and some in the areas of aged and community care depending on demand. The reality is that we cannot work without assistants as there are currently not enough nurses and with the ageing of not only our population but also our workforce we need to ensure that those assisting us have the required skills and knowledge to allow us to delegate safely to them. How better to ensure these third level workers are trained appropriately than to offer this training by the nurses who work with them. Education is a huge part of our profession and will continue to be so. It is also important to note that the majority of funds expended on this education are sourced through government funding and by the students’ own self-funding of course fees, most definitely not members’ union contributions.
      The ANMF Branches and Federal Office continually lobby relevant parties and organisations to ensure that nurses are not replaced by third level workers but rather supported by them to ensure quality patient/resident care. The ANMF takes this fight extremely seriously – nurses and midwives always come first in our eyes and in our union priorities.


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