The NSW Government has another health fight for wages on its hands as NSW public sector psychiatrists seek a 25% pay rise.

The problem is that, unlike the strike action that nurses and midwives take, public psychiatrists have resigned from their positions. That takes effect as of today.

Two thirds of the NSW public psychiatry sector workforce has resigned over pay and working conditions. Locally, the Nothern NSW Local Health District has seven (7) staff specialist psychiatrists; out of those, six (6) have tendered their resignation.

Dr Matt James is the Acting Director of Training for the Northern NSW Local Health District (NNSWLHD). He says that really does impact Lismore more than anywhere else.

"It actually affects our training. Our directors of training, our coordinators of training, me included, have tendered their resignation, so it will impact our trainees. But it is going to affect Lismore significantly in that our most senior inpatient psychiatrist and senior community psychiatrist have both tendered resignations.

Dr James says at the moment, the remuneration rates for specialists in the public health system in New South Wales pales in comparison to the equivalent job in other states.

"Generally between New South Wales and Queensland, and this has been pretty freely documented and released by the AMO, somewhere between 30% in Queensland and upwards of 40 to 50% in places like Western Australia and the Northern Territory. It is significant."

Similar to the nurses and midwives of northern NSW, our proximity to the border is causing a great deal of problems.

Dr James said the exodus began after 14 months of failed negotiations with the state government over a 25% pay rise. Psychiatrists argue their salaries are significantly lower than those in other states, making it difficult to attract and retain specialists.

"The system is struggling and at a breaking point. It came to a point last year where a whole bunch basically just said, 'Look, enough is enough, we can't go on.'"

"All we're asking for is the equivalent of what the emergency department doctors were provided 10 years ago. Which effectively equates to about a 25% increase. And I appreciate for a lot of people, that is a lot of money. For most psychiatrists, it's different because it depends on your level of expertise and your years of experience. That's probably somewhere between $60,000 to $90,000 per annum. And I appreciate that is a lot of money for a lot of people. But when our roles are otherwise being advertised at $3000 a day, my role, my current substantive role, is being advertised at $3000 a day."

Dr James highlighted the irony of the situation, noting that the government's reliance on locum psychiatrists, a more expensive alternative, further exacerbates the financial strain on the system. He emphasised that psychiatrists are seeking a pay increase not just for financial gain but to ensure the long-term viability of public mental health services in the region.

The situation is particularly acute in Lismore, which heavily relies on locum and visiting psychiatrists. This shortage directly impacts patient care, including reduced access to inpatient and community services.

"Already for someone on a middle to low income, accessing private services is limited. There are a limited number of private psychiatrists in the Northern Rivers. Those private psychiatrists do offer a valuable service that is needed, but for those that are on middle to low incomes, they generally reliant on the public service, and this is a service that we should be able to provide as a society," James said.

While discussions with the state government are ongoing, Dr James warned that the crisis could lead to the closure or at least a reduction of mental health beds and reduced access to vital psychiatric services for the Northern Rivers community.

"We're already struggling to fill our standard roles, let alone the ones that have tendered resignation. I would be very surprised if those roles are filled. I would say, and if a resolution is found, I would say that Lismore mental health, and this is treating for severe mental illness like schizophrenia, bipolar, severe suicidal alterations, those sorts of things, I'd say those beds are going to be closed, or at the very least, some of those beds are going to be closed.

"Those in the community are not going to have access to the see a psychiatrist that's full time in Lismore and Ballina, and this is incredibly sad for the community, especially when there's, as far as I see it, a cost mutual answer.

"It's sad for our patients. That is why I reached out to Janelle (Janelle Saffin, Member for Lismore). She's not my MP, but I reached out to her in this context because those suffering ongoing effects of trauma from floods, and those who aren't able to access other private services this is going to impact them significantly. And it's scary and incredibly sad," James said.

Minister for Mental Health Rose Jackson yesterday said that a 25% pay rise is too costly and the government plans to refer the matter to the state's Industrial Relations Commission.