Potential resignations of psychiatrists in the public health system in New South Wales may force the closure of hospital beds over what has been referred to as a “system constantly on the verge of collapse”.
Close to 200 psychiatrists in the state’s public hospital system have threatened to resign over an ongoing pay dispute with the NSW government.
It’s been reported that 181 doctors will walk off their jobs in the coming days — forcing some hospitals to close wards and reduce hospital bed numbers.
The psychiatrists are seeking a 25% pay increase over one year while the state government is offering a 3% increase.
“NSW is at a critical point and must act urgently to keep psychiatrists in the system,” President of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) President Dr Elizabeth Moore said.

“Countless reports and inquiries have repeatedly confirmed what we already know — there is a critical and chronic workforce shortage hampering the system’s ability to care for the people that rely on it,” she said.
“For the system to work, it needs to be fully staffed, which it has not been because of a lack of a clear plan and investment to grow NSW’s mental health workforce,” Dr Moore said.
“At its heart, the issue is about patient safety and care. The same conditions that lead to burnout among psychiatrists also result in poorer outcomes for the people they’re trying to help, she said.
“The people of NSW deserve better than a system that’s always on the verge of collapse,” said Dr Moore.
The union representing the psychiatrists, the Australian Salaried Medical Officers’ Federation (ASMOF), said salaries are less than their peers across Australia, with a 30% gap between salaries in NSW and other states and that it was underpinning workplace shortages.
The dispute has already affected the state’s largest mental health facility at Westmead and Cumberland hospital. It’s been reported that there will be 71 temporary bed closures with plans to offset the loss by opening private hospital beds nearby.
Australia’s leading organisation representing people living with complex or severe mental illness, SANE, said it was alarmed by the potential resignations of psychiatrists but not surprised.
SANE said its community is heavily reliant on the public psychiatry system and delaying or restricting access to services means worsened symptoms and negative impacts like loss of employment, relationship breakdowns, physical health impacts and increased suicide risk.
SANE said the resignations are a serious threat to the mental health system, with devastating consequences for those with mental illness.
“Timely access to psychiatry services is critical for both adults and children with serious or complex mental health needs,” the organisation said in a statement.
The organisation has called for urgent reform to what it calls the “fragile state of the state’s mental health infrastructure”.
“Access to psychiatry has been a major community concern for many years, with long waiting lists and escalating costs in the private sector driving people into already stretched public services,” the statement said.
The New South Wales Minister for Mental Health Rose Jackson held a press conference on 23 January and said as of that date 43 psychiatrists had resigned and that number was expected to increase.
“The good news is that we’ve engaged 23 locums to fill those roles and that there are another eight in the system being processed right now,” Ms Jackson said.
“As a consequence of that, we’re not seeing the significant disruption of mental health services at the local level.”
RANZCP does not blame the current state government for the current issues in mental health.
“This is not a new problem, and we understand that this is one that the current Minns Government has inherited after decades of neglect and underinvestment in NSW’s mental health system. But it is a problem that the sector is desperate to resolve with them,” RANZCP President Dr Elizabeth Moore said.
“Psychiatrists do not take decisions like these lightly. Our members are committed to providing the best care for their patients, but they can’t do that without enough people on the ground. If psychiatrists leave the system, it’s the people of NSW who will pay the highest price,” Dr Moore said.
The dispute is due to be heard in the state’s Industrial Relations Commission on 17 to 21 March. The Minister has indicated that, if ordered by the IRC that the 25% increase is fair, the government would pay it.
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Agree with @Louise Stone’s comment – thank you this is not about pay, it is about recruitment and retention – this is about a mental health system on the verge of collapse (well, some would quite reasonably argue that it has collapsed)
Interesting that NSW government is congratulating itself today for stopping the exodus of teachers by paying them more.
Also, they are willing to pay locums more than twice what salaried doctors are paid.
I applaud the public hospital psychiatrists for their courage in highlighting the severe inequity in pay (compared to other states), poor working conditions and inability to retain all levels of salaried doctors (interns to specialists) in NSW public hospitals.
If this continues, the public health sector will collapse in NSW and the inequity for patients will worsen. Many will not be able to afford much more expensive private health services.
If the NSW government actually cares about the health of the people of NSW, and NSW Health values its staff, it would put in place a plan to establish pay parity with other states for our salaried doctors now.
*** (societal cost) if this government’s failure to engage in finding meaningful solutions continues.
Dear MJA,
Please do not perpetuate the notion that this is about pay. 18months ago the NSW Branch RANZCP (again) requested active engagement from the Minns Labour Government in finding solutions to stop the trajectory of compounding attrition of NSW Public sector Staff Specialist Psychiatrists. All levers within scope had been exhausted (including locum recruitment from overseas) yet none could remedy the 30% vacancy rate. If the status quo were maintained without government intervention to address recruitment & retention; the untenable clinical working conditions arising from this enduring vacancy rate of 1/3 public psychiatrist workforce would only increase. Thus compounding the already unsustainable working pressures in a negative feedback loop. The Hon. Minister Jackson was questioned re plan to prevent further loss of SS Psychiatrists in NSW Question time in October. NSW Psychiatrists have sought government engagement to address the realities of their clinical conditions, the distress arising from not being able to provide necessary care with bed resources increasingly directed towards the next most unwell high risk patient. With no viable community public psychiatry services for the adult population (unless CTO/Depot Case managed) & erosion of capacity in community teams to manage distress via evidence-based intervention delivery, a revolving door of crisis admissions at great human cost for patients & society has sadly become what the Gov. continue to refer to as ‘high quality MH Care’. The Minns Gov. ‘offering’ a 6-month efficiency pilot to squeeze more from the remaining public psychiatrists was the proverbial straw on decades of under-resourcing & neglect. With a nationwide shortage of psychiatrists, multitude opportunities in the private sector, NSWHealth could not compete in recruiting permanent staff specialist psychiatrists. The compound effects are detrimental to the health & functioning not only of Psychiatrists in the system, the patients whose right it is to access necessary care in a universal healthcare system, but to the health of the entire public & private health system now & for the next generation (who require training by Psychiatrists in the public sector, medical students who require supervision to pass their psychiatry rotation & year of medical school). And with widespread effects across the education & criminal justice systems, to the detriment of societal health & productivity at large. The proposal of 25% to be closer to parity with our neighbouring states is relatively inexpensive when compared to the calculable costs of locums, setup of ‘MH Hub’ let alone the nearly incalculable costs across the system, society, let alone in human life. The Bondi Junction Inquest will cost between $20-30m, in the same ballpark as 25% proposal in an attempt to fill minimal necessary public psychiatrists to stabilise the public sector psychiatrist workforce. This is not about individual pay packets, it is about the societal cost.
The resigning psychiatrists are leaving primarily because of inadequate resourcing in the public system, not their own pay. (If they wanted money they’d just work in private, there’s heaps of work, and in private they can earn in 1-2 hours what a public staff psychiatrist makes in a day.) The 25% pay increase idea of theirs (which is all the general media seems to be reporting) was a suggestion to govt 16 months ago, with the primary aim being to recruit other psychiatrists, none of whom will currently work in the NSW public system because of dangerous conditions and it being the lowest pay a psych can make in Aus, back into the empty jobs nobody would take (1/3rd of NSW public psychiatrist jobs were chronically unfilled before the resignations). Govt responded with a 0% offer(!), and increased efficiency measures (telling drs who are covering multiple empty jobs to further increase their efficiency was so irritating it spurred 50 more resignations that week) so in total > 200 submitted resignations.
The inadequate resourcing is a huge deal, because not having a bed to admit suicidal and psychotic patients into, and not having inpatient and outpatient therapy programs, or enough staff (inadequate psychologists, social workers, and doctors), or safe community case management, means public psychiatrists end up carrying huge medicolegal risk and clinical discomfort when they care for patients without treating them with the evidence-based treatments that will work. Public psychiatry has become the govt stripping resources for 40 years, while the wider community and the legal system expect psychiatrists and their (denuded) team to prevent people suiciding or shooting up Bondi Westfield – public work has become all about risk management, with the psychiatrist in the end, when adverse events occur (and they often do), legally responsible for holding the risk all alone. Everyone has been jumping ship for 1-2 decades, the 290 psychs left in public last December (before 200 resigned) were already the last on the sinking ship.
Thank you for covering the crucial issue of the NSW Mental Health care system being constantly on the verge of collapse – and that a critical workforce shortage of psychiatrists must be addressed to fix this, noting that other changes are also needed but would not work without this. I would add that NSW public psychiatrists resigned in December 2024…it is that many gave substantial notice to maximise the chance of fixing the system, and some have further delayed their resignation (leaving) date as a compassionate measure to provide some psychiatric care while giving the IRC the opportunity to give the advice that the NSW Govt said they would follow to fix this: If the IRC finds that a 25% increase is needed, we will abide by that (to paraphrase our NSW Mental Health minister Rose Jackson.
The other issue is that the mental health workers are not adequately remunerated either – they have highly stressful jobs, see the most complicated children/teenagers that we have and yet are paid at minimal rates not equivalent to the work They are doing in Armidale./Hunter New England. repeatedly, we have those who are qualified, take on the job, realize how huge it is, realize that they are acting as independent practitioners but paid as juniors.
This is a really disappointing headline. I’m a GP, but my understanding is it isn’t the pay. It’s the lack of workforce, and the inability to recruit any of them BECAUSE of the pay. We really need to resist the temptation to buy into the narrative that these psychiatrists are “greedy”. They are concerned about the patient harms occurring through understaffing. And their own medicolegal risks when they are required to do the impossible.
Calling it a “Pay dispute” is a bit misleading, I think