{"id":"nurse-and-midwife-to-patient-ratios-act-2025","name":"Nurse and Midwife to Patient Ratios Act 2025","slug":"nurse-and-midwife-to-patient-ratios-act-2025","collection":"act","jurisdiction":"sa","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":106145,"registerId":"sa-nurse-and-midwife-to-patient-ratios-act-2025-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Nurse and Midwife to Patient Ratios Act 2025","content":"South Australia\nNurse and Midwife to Patient Ratios Act 2025\nAn Act to establish nurse and midwife to patient ratios and other staffing requirements in incorporated hospitals, and for other purposes.\n\nContents\nPart 1—Preliminary\n1\tShort title\n2\tCommencement\n3\tInterpretation\n4\tObjects of Act\n5\tAct not to affect employment contracts\n6\tApplication of Fair Work Act 1994\nPart 2—Staffing requirements in incorporated hospitals\nDivision 1—Nurse and midwife to patient ratios\n7\tApplication of ratios\n8\tRatio for mixed wards\n9\tNo breach in circumstances of emergency\nDivision 2—Variations from ratios\n10\tQuality of care paramount\n11\tAgreement to vary a ratio\nDivision 3—Other staffing requirements\n12\tMinimum staffing requirements\nDivision 4—Effect of existing enterprise agreement\n13\tRelevant enterprise agreement of no effect\n14\tPreservation of existing higher staffing level requirements\nPart 3—Dispute resolution\n15\tLocal dispute resolution\n16\tDispute resolution by South Australian Employment Tribunal\nPart 4—Civil penalties\n17\tCivil penalty for breach of ratio or other staffing requirement\n18\tCivil penalty rules and procedure\n19\tCosts\nPart 5—Miscellaneous\n20\tCertain information to be included in annual report\n21\tRegulations\nSchedule 1—Staffing requirements at incorporated hospitals\nPart 1—Categories of incorporated hospital sites\n1\tCategory 1 hospital sites\n2\tCategory 2 hospital sites\n3\tCategory 3 hospital sites\n4\tCategory 4 hospital sites\nPart 2—Nurse and midwife to patient ratios\n5\tAcute stroke wards\n6\tAntenatal wards\n7\tBirthing suites\n8\tCoronary care units\n9\tGeneral medical and surgical wards\n10\tGeriatric evaluation and management units\n11\tHaematology wards\n12\tHigh dependency units\n13\tNeonatal intensive care units\n14\tOncology wards\n15\tPalliative care inpatient units\n16\tPostnatal wards\n17\tRehabilitation inpatient units\n18\tSpecial care nurseries\nPart 3—Minimum staffing requirements\n19\tSmall hospitals\n20\tState aged care\nSchedule 2—Related amendments and transitional provisions\nPart 1—Related amendment to Fair Work Act 1994\n1\tAmendment of section 79—Approval of enterprise agreement\nPart 2—Transitional provision\n2\tMoratorium on applications to SAET\nLegislative history\n\nThe Parliament of South Australia enacts as follows:\nPart 1—Preliminary\n1—Short title\nThis Act may be cited as the Nurse and Midwife to Patient Ratios Act 2025.\n2—Commencement\nThis Act comes into operation on a day to be fixed by proclamation.\n3—Interpretation\nIn this Act—\nbed includes cubicle, trolley, cot, treatment chair and birthing suite;\nCategory 1 hospital site means a hospital site specified in Schedule 1 clause 1 to be a Category 1 hospital site;\nCategory 2 hospital site means a hospital site specified in Schedule 1 clause 2 to be a Category 2 hospital site;\nCategory 3 hospital site means a hospital site specified in Schedule 1 clause 3 to be a Category 3 hospital site;\nCategory 4 hospital site means a hospital site specified in Schedule 1 clause 4 to be a Category 4 hospital site;\nChief Executive means the Chief Executive of the Department and includes a person for the time being acting in that position;\ncivil penalty order—see section 17;\ncivil penalty provision means section 7(1) and section 12;\nDepartment means the administrative unit of the Public Service that is responsible for assisting a Minister in the administration of this Act;\nemergency situation means either of the following situations:\n\t(a)\tan identified major incident, major emergency or disaster declared under the Emergency Management Act 2004;\n\t(b)\ta public health incident or a public health emergency declared under the South Australian Public Health Act 2011;\nenrolled nurse means a person registered under the Health Practitioner Regulation National Law—\n\t(a)\tto practice in the nursing profession as a nurse (other than as a student); and\n\t(b)\tin the enrolled nurses division of that profession;\nhospital site means a site at which activities of an incorporated hospital are undertaken;\nincorporated hospital has the same meaning as in the Health Care Act 2008;\nlocal dispute means a dispute initiated by way of a notification under section 15;\nmidwife means a person registered under the Health Practitioner Regulation National Law to practise in the midwifery profession as a midwife (other than as a student);\nmidwife in charge means a midwife who undertakes responsibilities of coordination of a ward or unit during a shift in addition to undertaking any midwifery duties, who must not be the same person as the midwife unit manager;\nmidwife unit manager means a midwife—\n\t(a)\twho provides pivotal coordination of patient/client care delivery in a defined patient care area; and\n\t(b)\twhose main focus is the line management, coordination and leadership of midwifery activities to achieve continuity and quality of patient/client care; and\n\t(c)\twho is accountable for the outcomes of midwifery practice in the specific practice setting;\nminimum staffing requirement means a staffing requirement set out in Schedule 1 Part 3;\nnominated mixed ward means a ward named in a notice published under section 8;\nnurse means registered nurse or enrolled nurse;\nnurse in charge means a registered nurse who undertakes responsibilities of coordination of a ward or unit during a shift in addition to undertaking any nursing duties, who must not be the same person as the nurse unit manager;\nnurse unit manager means a registered nurse—\n\t(a)\twho provides pivotal coordination of patient/client care delivery in a defined patient care area; and\n\t(b)\twhose main focus is the line management, coordination and leadership of nursing activities to achieve continuity and quality of patient/client care; and\n\t(c)\twho is accountable for the outcomes of nursing practice in the specific practice setting;\nratio means—\n\t(a)\ta staffing requirement set out in Schedule 1 Part 2; and\n\t(b)\ta staffing requirement that applies to a nominated mixed ward in accordance with section 8; and\n\t(c)\ta staffing requirement that applies under a ratio variation under section 11, subject to any terms of that variation;\nregistered nurse means a person registered under the Health Practitioner Regulation National Law—\n\t(a)\tto practice in the nursing profession as a nurse (other than as a student); and\n\t(b)\tin the registered nurses division of that profession;\nrelevant enterprise agreement means either of the following, as in force at the commencement of this Act:\n\t(a)\tthe Nursing/Midwifery (South Australian Public Sector) Enterprise Agreement 2022, approved by SAET under Chapter 3 Part 2 of the Fair Work Act 1994 on 1 December 2022;\n\t(b)\tif the enterprise agreement referred to in paragraph (a) is superseded by a subsequent enterprise agreement approved by SAET under Chapter 3 Part 2 of the Fair Work Act 1994 prior to the commencement of this Act—that subsequent enterprise agreement;\nrelevant union means an entity that represents or is entitled to represent a nurse or midwife in an incorporated hospital that is—\n\t(a)\tan employee organisation that is registered, or taken to be registered, under the Fair Work (Registered Organisations) Act 2009 of the Commonwealth; and\n\t(b)\tan association of employees registered under the Fair Work Act 1994;\nSAET means the South Australian Employment Tribunal established under the South Australian Employment Tribunal Act 2014;\nSouth Australian Employment Court means SAET (constituted as the South Australian Employment Court);\nward means a ward, unit, department or component of a hospital site managed by a nurse or midwife who is undertaking, whether temporarily or permanently, the role of—\n\t(a)\ta nurse unit manager or equivalent; or\n\t(b)\ta midwife unit manager or equivalent.\n4—Objects of Act\nThe objects of this Act are—\n\t(a)\tto establish requirements for a minimum number of nurses or midwives per patient in certain wards of incorporated hospitals; and\n\t(b)\tto establish other minimum staffing requirements at certain hospital sites or certain wards or for certain beds of incorporated hospitals; and\n\t(c)\tto protect nurses and midwives, recognising that nursing and midwifery workloads impact on the quality of patient care; and\n\t(d)\tto meet patient safety requirements in a way that optimises the use of nursing and midwifery resources; and\n\t(e)\tto further enhance the safety of, and optimise health outcomes for, patients.\n5—Act not to affect employment contracts\nNothing in this Act is intended to constitute a term of or to alter or vary, or authorise or require the alteration of, any employment contract.\n6—Application of Fair Work Act 1994\nAn enterprise agreement entered into in accordance with Chapter 3 Part 2 of the Fair Work Act 1994 after the commencement of this Act must not make provision for a minimum staffing level (whether expressed as a ratio or otherwise) applying in the same setting as a ratio or minimum staffing requirement imposed under this Act, and an agreement is void and of no effect to the extent to which it makes such a provision.\nPart 2—Staffing requirements in incorporated hospitals\nDivision 1—Nurse and midwife to patient ratios\n7—Application of ratios\n\t(1)\tAn incorporated hospital must ensure that each ward of the hospital to which a ratio applies is staffed in accordance with that ratio.\n\t(2)\tExcept as otherwise provided in this Act, the following apply to an incorporated hospital when staffing a ward in accordance with a ratio:\n\t(a)\ta ratio must be applied on the basis of the actual number of patients in each ward to which it applies;\n\t(b)\tif the actual number of patients in a ward is not divisible into a whole number following the application of the relevant ratio, an incorporated hospital must ensure that the ward is staffed with 1 additional nurse or midwife (as the case requires) in order to comply with the ratio;\n\t(c)\ta ratio may be applied in a flexible way in order to evenly distribute the workload, having regard to the level of care required by patients in a ward;\n\t(d)\ta nurse or midwife in charge required for the purposes of a ratio may be assigned a patient allocation provided that the total number of nurses or midwives meets the relevant ratio;\n\t(e)\ta ratio is a minimum requirement only and is not intended to prevent an incorporated hospital from staffing a ward with additional nurses or midwives beyond the number required by the ratio.\nExamples—\n\t1\tIn a ward with 20 patients and a 1:4 ratio, plus a required nurse or midwife in charge, a total of 6 nurses or midwives (as the case requires) are required for the shift to comply with the relevant ratio.\n\t2\tFor the purposes of paragraph (c), in a ward with 8 patients and a 1:4 ratio, if 3 patients require a higher level of care and 5 patients require a lower level of care then one nurse may be assigned to care for the 3 patients requiring the higher level of care and the other nurse to the other 5 patients.\n8—Ratio for mixed wards\n\t(1)\tAn incorporated hospital must, once in every period of 6 months—\n\t(a)\tnominate each mixed ward of the hospital as a nominated mixed ward for the following 6 month period, starting on a specified date; and \n\t(b)\tpublish on its website a notice of each nomination of a mixed ward which includes the following details:\n\t(i)\tthe name of the mixed ward;\n\t(ii)\tthe date on which the nomination is to take effect;\n\t(iii)\tthe total number of occupied beds in the mixed ward;\n\t(iv)\tthe relevant ratio for each portion of the ward;\n\t(v)\tthe expected number of occupied beds in each portion of the ward during the following 6 month period, determined in accordance with subsection (2);\n\t(vi)\tany other information prescribed by the regulations.\n\t(2)\tTo determine the expected number of occupied beds in each portion of the ward, the incorporated hospital must take into account—\n\t(a)\tthe portions in the ward and the number of occupied beds in each portion during the preceding 12 months; and\n\t(b)\tany known or anticipated factors during the following 6 month period (or the remainder of the 6 month period if re‑calculating the number of staff required in accordance with subsection (5)) which are likely to—\n\t(i)\tincrease or decrease the number of occupied beds; or\n\t(ii)\tchange the portions in the ward.\n\t(3)\tAn incorporated hospital must staff a nominated mixed ward in accordance with the following:\n\t(a)\tthe number of nurses or midwives (as the case requires) required to staff the ward is the number resulting when the actual number of patients is divided by the individualised mixed ward ratio;\n\t(b)\tif the resulting number under paragraph (a) is not divisible into a whole number, the incorporated hospital must ensure that the ward is staffed with 1 additional nurse or midwife (as the case requires) in order to comply with the ratio;\n\t(c)\tif any or all of the relevant ratios applying to a portion of the mixed ward require a nurse in charge or midwife in charge, only 1 nurse in charge or midwife in charge is required for the entire mixed ward.\n\t(4)\tIf an incorporated hospital fails to nominate a mixed ward as a nominated mixed ward in accordance with subsection (1), the mixed ward as a whole must be staffed in accordance with the relevant ratio applying to a portion of the ward that would require the highest number of nurses or midwives until the incorporated hospital nominates the mixed ward.\n\t(5)\tIf the configuration of a nominated mixed ward changes during a specified 6 month period, resulting in significantly different portions or significantly different numbers of occupied beds in its portions, an incorporated hospital must—\n\t(a)\tmake a new nomination in relation to the mixed ward for the remainder of the 6 month period; and\n\t(b)\tpublish on its website a notice of the nomination which includes the information required under subsection (1)(b)).\n\t(6)\tIn this section—\nindividualised mixed ward ratio means the ratio to be applied to a mixed ward, determined as follows:\n\t(a)\tdetermine the number of staff (excluding any nurse in charge or midwife in charge) required for each portion by applying the relevant ratio for that portion to the expected number of occupied beds published on the incorporated hospital's website in accordance with subsection (1)(b)(v);\n\t(b)\tadd the number of staff required for each portion together; \n\t(c)\tdivide the number of occupied beds, as determined in accordance with subsection (2), by the total number of staff determined in accordance with paragraph (b);\nmixed ward means a ward comprised of different portions of patients or beds;\nportion, in relation to a mixed ward, means a group—\n\t(a)\tof patients on the ward requiring a specific type of clinical service; or\n\t(b)\tof beds on the ward comprising a specific patient care area;\nrelevant ratio, in relation to a portion, means the ratio that would apply to the portion of the ward if it were itself a ward of the incorporated hospital.\n9—No breach in circumstances of emergency\n\t(1)\tAn incorporated hospital will not be in breach of section 7(1) by a failure to meet a required ratio on a ward if—\n\t(a)\tthe failure to meet the ratio occurred due to a need for increased patient numbers on the ward arising out of an emergency situation that could not reasonably have been anticipated; and\n\t(b)\tthe hospital has determined that the staffing level is safe and adequate to provide appropriate patient care.\n\t(2)\tAn incorporated hospital must notify any relevant union if a ward is not to be staffed in accordance with a ratio because of the application of subsection (1).\nDivision 2—Variations from ratios\n10—Quality of care paramount\nIn any proposal under this Division to vary a ratio—\n\t(a)\tthe primary consideration is the impact on the quality of patient care; and\n\t(b)\tany other considerations are as prescribed.\n11—Agreement to vary a ratio\n\t(1)\tThe Chief Executive and a relevant union may enter into an agreement to vary a ratio applying to a specified ward.\n\t(2)\tAn agreement under subsection (1) may only be implemented if the agreement is made in accordance with any prescribed procedures.\n\t(3)\tAn incorporated hospital that complies with an agreement under subsection (1) is taken to comply with the relevant ratio.\n\t(4)\tThe Chief Executive must, as soon as reasonably practicable after entering into an agreement to vary a ratio under this section, cause a statement of the ratio as varied to be published by notice in the Gazette.\nDivision 3—Other staffing requirements\n12—Minimum staffing requirements\nAn incorporated hospital must ensure that each hospital site of the incorporated hospital to which a minimum staffing requirement under Schedule 1 Part 3 applies is staffed in accordance with that requirement.\nDivision 4—Effect of existing enterprise agreement\n13—Relevant enterprise agreement of no effect\n\t(1)\tSubject to section 14, a relevant enterprise agreement has no force or effect for the purposes of this Act or any other Act or law to the extent that it provides for a minimum staffing level (whether expressed as a ratio or otherwise) applying in the same setting as a ratio or minimum staffing requirement imposed under this Act.\n\t(2)\tProceedings may not be commenced under the Fair Work Act 1994 in relation to any dispute arising out of the application or interpretation of a relevant enterprise agreement to the extent that it provides a minimum staffing level referred to in subsection (1).\n14—Preservation of existing higher staffing level requirements\n\t(1)\tIf a relevant enterprise agreement provides for a minimum staffing level that requires—\n\t(a)\ta higher number of nurses or midwives to patients than an applicable ratio for the same setting under this Act; or\n\t(b)\ta higher number of nurses or midwives than an applicable minimum staffing requirement for the same setting under this Act,\nthe minimum staffing level under the agreement applies instead of any ratio or minimum staffing requirement that would apply under this Act as if it were a ratio or minimum staffing requirement imposed by this Act.\n\t(2)\tA staffing requirement which applies in accordance with subsection (1) will continue to apply despite the expiry of a relevant enterprise agreement.\nPart 3—Dispute resolution\n15—Local dispute resolution\n\t(1)\tAn eligible nurse or eligible midwife who works at a hospital site of an incorporated hospital to which a ratio or minimum staffing requirement applies, or a relevant union as a representative of the nurse or midwife, may initiate a local dispute by notifying the incorporated hospital of a reportable matter.\n\t(2)\tA local dispute must be resolved in accordance with—\n\t(a)\tprocedures developed by the incorporated hospital for the resolution of a local dispute at the hospital; and\n\t(b)\tany policy or directive of the Chief Executive under the Health Care Act 2008; and\n\t(c)\tany prescribed procedures.\n\t(3)\tThe procedures, policies or directives referred to in subsection (2) must be determined with the approval of the relevant union.\n\t(4)\tThe parties to a local dispute must act in good faith and in a timely manner during the resolution of the dispute.\n\t(5)\tIf a party to a local dispute incurs costs in resolving that dispute, that party must bear their own costs.\n\t(6)\tIn this section—\neligible midwife means a midwife employed by an employing authority to work in an incorporated hospital under section 34 of the Health Care Act 2008;\neligible nurse means a nurse employed by an employing authority to work in an incorporated hospital under section 34 of the Health Care Act 2008;\nreportable matter means—\n\t(a)\tan alleged breach of a ratio or minimum staffing requirement at the hospital site; or\n\t(b)\ta dispute in relation to a determination by an incorporated hospital under section 9(1)(b) as to whether a staffing level is safe and adequate to provide appropriate patient care.\n16—Dispute resolution by South Australian Employment Tribunal\n\t(1)\tIf the parties to a local dispute are unable to resolve the dispute in accordance with section 15, a party to the dispute may apply to SAET (constituted as an industrial relations commission) for resolution of the matter.\n\t(2)\tSAET (constituted as an industrial relations commission) may deal with the dispute in any way it thinks fit for the prompt settlement of the dispute, including—\n\t(a)\tby means of mediation, conciliation or arbitration; or\n\t(b)\tby making a recommendation or expressing an opinion.\n\t(3)\tWithout limiting subsection (2), if SAET deals with the dispute by arbitration, SAET may make any order it considers appropriate for the prompt settlement of the dispute.\n\t(4)\tA person who makes an application under subsection (1) must notify the Chief Executive of that application as soon as practicable, and in any case not more than 7 days after the application is made.\nPart 4—Civil penalties\n17—Civil penalty for breach of ratio or other staffing requirement\n\t(1)\tIf, on application, the South Australian Employment Court is satisfied that—\n\t(a)\tan incorporated hospital has contravened a civil penalty provision; and\n\t(b)\tthe conduct constituting the contravention was deliberate and part of a systematic pattern of conduct,\nthe Court may make an order (a civil penalty order) that the hospital is to pay a civil penalty, not exceeding $10 000, that the Court considers is appropriate.\n\t(2)\tAn application under this section may only be made—\n\t(a)\twithin 12 months after the date of the alleged contravention; and\n\t(b)\tby—\n\t(i)\tan eligible nurse or eligible midwife who works at the hospital site of the incorporated hospital at which the contravention is alleged to have occurred; or\n\t(ii)\ta relevant union.\n\t(3)\tFor the purpose of subsection (1)(b), proof that the incorporated hospital expressly, tacitly, or impliedly authorised the conduct constituting the contravention will be taken to be proof that the employer's conduct constituting the contravention was deliberate.\n\t(4)\tFor the purpose of subsection (1)(b), in determining whether the incorporated hospital's conduct constituting the contravention was part of a systematic pattern of conduct—\n\t(a)\ta court may have regard to the following matters (without limitation):\n\t(i)\tthe number of contraventions committed by the hospital;\n\t(ii)\tthe period over which the contraventions occurred;\n\t(iii)\tthe number of wards affected by the contraventions;\n\t(iv)\tthe hospital's response, or failure to respond, to any complaints made about the contraventions; and\n\t(b)\tsubsection (5) does not apply.\n\t(5)\tTwo or more contraventions of a civil penalty provision are taken to constitute a single contravention if the contraventions were committed by the same incorporated hospital and arose out of a course of conduct by the hospital.\n\t(6)\tSubsection (5) does not apply to a contravention of a civil penalty provision that is committed by an incorporated hospital after the South Australian Employment Court has imposed a civil penalty on the hospital for an earlier contravention of the provision.\n\t(7)\tA civil penalty ordered by the South Australian Employment Court must be paid to the Treasurer and credited to the Consolidated Account.\n\t(8)\tThe civil penalty may be recovered as a debt due to the person to whom the penalty is payable.\n\t(9)\tIn this section—\neligible midwife has the same meaning as in section 15;\neligible nurse has the same meaning as in section 15.\n18—Civil penalty rules and procedure\n\t(1)\tThe contravention of a civil penalty provision is not an offence.\n\t(2)\tThe South Australian Employment Court must apply the rules of evidence and procedure for civil proceedings under the Fair Work Act 1994 when hearing proceedings for a civil penalty order.\n19—Costs\n\t(1)\tSubject to subsection (2), if a party to proceedings for a civil penalty order incurs costs, that party must bear their own costs. \n\t(2)\tA party to proceedings for a civil penalty order may be ordered to pay costs incurred by another party to the proceedings if the South Australian Employment Court is satisfied that the party—\n\t(a)\thas acted unreasonably—\n\t(i)\tin bringing the proceedings before the Court; or\n\t(ii)\tin relation to any other aspect of the conduct of the proceedings before the Court; or\n\t(b)\thas acted frivolously or vexatiously in bringing or in relation to the conduct of the proceedings before the Court.\nPart 5—Miscellaneous\n20—Certain information to be included in annual report\nAn incorporated hospital must include the following information in the hospital's annual report under section 37 of the Health Care Act 2008:\n\t(a)\ta summary of notifications made to the hospital under section 15(1);\n\t(b)\ta summary of any applications made to SAET under section 16(1);\n\t(c)\tdetails of any orders or recommendations made or opinions expressed by SAET under section 16 in relation to the incorporated hospital during the previous financial year;\n\t(d)\tthe action taken by the incorporated hospital during the previous financial year in response to an order, recommendation or opinion referred to in paragraph (c);\n\t(e)\ta summary of any applications made to the South Australian Employment Court under section 17;\n\t(f)\tdetails of any civil penalty orders made against the hospital under section 17.\n21—Regulations\n\t(1)\tThe Governor may make such regulations as are contemplated by, or as are necessary or expedient for the purposes of, this Act.\n\t(2)\tWithout limiting the generality of subsection (1), the regulations may—\n\t(a)\tamend Schedule 1 Part 1 to—\n\t(i)\tspecify additional sites of incorporated hospitals that are to be Category 1, 2, 3 or 4 hospital sites; or\n\t(ii)\tchange the category of an existing Category 1, 2, 3 or 4 hospital site; or\n\t(iii)\tremove a hospital site from a category; and\n\t(b)\tamend Schedule 1 Part 2 to—\n\t(i)\tinclude additional wards to which a ratio is to apply under section 7, and to specify the ratios that will apply in relation to such additional wards; or\n\t(ii)\tremove wards listed in that Part; and\n\t(c)\tmake any other amendment to Schedule 1 that is necessary for or consequential to an amendment made under a preceding paragraph.\n\t(3)\tThe regulations may—\n\t(a)\tbe of general or limited application; and\n\t(b)\tmake different provision according to the matters or circumstances to which they are expressed to apply; and\n\t(c)\trefer to or incorporate, wholly or partially and with or without modification, a standard or other document prepared or published by a prescribed body or person, either as in force at the time the regulations are made or as in force from time to time; and\n\t(d)\tmake provisions of a saving or transitional nature consequent on the enactment of this Act or on the commencement of specified provisions of this Act or on the making of regulations under this Act; and\n\t(e)\tprovide that a matter or thing in respect of which regulations may be made is to be determined according to the discretion of the Minister or any other specified person or body.\nSchedule 1—Staffing requirements at incorporated hospitals\nPart 1—Categories of incorporated hospital sites\n1—Category 1 hospital sites\nThe following hospital sites are Category 1 hospital sites:\n\t(a)\tFlinders Medical Centre;\n\t(b)\tLyell McEwin Hospital;\n\t(c)\tRoyal Adelaide Hospital;\n\t(d)\tWomen's and Children's Hospital.\n2—Category 2 hospital sites\nThe following hospital sites are Category 2 hospital sites:\n\t(a)\tModbury Hospital;\n\t(b)\tNoarlunga Hospital;\n\t(c)\tThe Queen Elizabeth Hospital.\n3—Category 3 hospital sites\nThe following hospital sites are Category 3 hospital sites:\n\t(a)\tRiverland General Hospital (Berri);\n\t(b)\tMount Gambier and Districts Health Service;\n\t(c)\tWhyalla Hospital and Health Service;\n\t(d)\tPort Lincoln Health Service;\n\t(e)\tGawler Health Service;\n\t(f)\tMount Barker District Soldiers' Memorial Hospital;\n\t(g)\tMurray Bridge Soldiers' Memorial Hospital;\n\t(h)\tPort Augusta Hospital and Regional Health Service;\n\t(i)\tPort Pirie Regional Health Service;\n\t(j)\tSouthern Fleurieu Health Service.\n4—Category 4 hospital sites\nThe following hospital sites are Category 4 hospital sites:\n\t(a)\tNaracoorte Health Service;\n\t(b)\tWallaroo Hospital and Health Service.\nPart 2—Nurse and midwife to patient ratios\n5—Acute stroke wards\n\t(1)\tThe staffing requirement at an incorporated hospital for an acute stroke ward is—\n\t(a)\t1 nurse for every 3 patients; and\n\t(b)\t1 nurse in charge.\n\t(2)\tIn this clause—\nacute stroke ward means a multi-day inpatient ward, or part of such a ward—\n\t(a)\tin which comprehensive care and monitoring of patients with strokes in the hyperacute or the acute phase is provided; and\n\t(b)\tthat has the capacity to provide thrombolysis.\n6—Antenatal wards\nThe staffing requirement at an incorporated hospital for an antenatal ward is as follows:\n\t(a)\ton the morning shift and the afternoon shift—\n\t(i)\t1 midwife for every 4 patients; and\n\t(ii)\t1 midwife in charge or nurse in charge;\n\t(b)\ton the night shift—1 midwife for every 6 patients.\n7—Birthing suites\n\t(1)\tThe staffing requirement for a birthing suite at an incorporated hospital for labour and birth is 1 midwife for every patient.\n\t(2)\tIn this clause—\npatient does not include a newborn infant.\n8—Coronary care units\n\t(1)\tThe staffing requirement at an incorporated hospital for a ward that is a coronary care unit is as follows:\n\t(a)\ton the morning shift and the afternoon shift—\n\t(i)\t1 nurse for every 2 patients; and\n\t(ii)\t1 nurse in charge;\n\t(b)\ton the night shift—1 nurse for every 3 patients.\n\t(2)\tIn this clause—\ncoronary care unit means a unit of specialised critical care beds dedicated to acute care, treatment and monitoring of patients with serious or unstable cardiac diseases.\n9—General medical and surgical wards\n\t(1)\tThe staffing requirement for a general medical and surgical ward at a Category 1 hospital site is as follows:\n\t(a)\ton the morning shift and the afternoon shift—\n\t(i)\t1 nurse for every 4 patients; and\n\t(ii)\t1 nurse in charge;\n\t(b)\ton the night shift—\n\t(i)\t1 nurse for every 8 patients; and\n\t(ii)\t1 nurse in charge.\n\t(2)\tThe staffing requirement for a general medical and surgical ward at a Category 2 hospital site is as follows:\n\t(a)\ton the morning shift—\n\t(i)\t1 nurse for every 4 patients; and\n\t(ii)\t1 nurse in charge;\n\t(b)\ton the afternoon shift—\n\t(i)\t1 nurse for every 5 patients; and\n\t(ii)\t1 nurse in charge;\n\t(c)\ton the night shift—\n\t(i)\t1 nurse for every 8 patients; and\n\t(ii)\t1 nurse in charge.\n\t(3)\tThe staffing requirement for a general medical and surgical ward at a Category 3 hospital site is as follows:\n\t(a)\ton the morning shift—\n\t(i)\t1 nurse for every 5 patients; and\n\t(ii)\t1 nurse in charge;\n\t(b)\ton the afternoon shift—\n\t(i)\t1 nurse for every 6 patients; and\n\t(ii)\t1 nurse in charge;\n\t(c)\ton the night shift—\n\t(i)\t1 nurse for every 10 patients; and\n\t(ii)\t1 nurse in charge.\n\t(4)\tThe staffing requirement for a general medical and surgical ward at a Category 4 hospital site is as follows:\n\t(a)\ton the morning shift—\n\t(i)\t1 nurse for every 6 patients; and\n\t(ii)\t1 nurse in charge;\n\t(b)\ton the afternoon shift—\n\t(i)\t1 nurse for every 7 patients; and\n\t(ii)\t1 nurse in charge;\n\t(c)\ton the night shift—1 nurse for every 10 patients.\n\t(5)\tIn this clause—\ngeneral medical and surgical ward means a multi‑day inpatient care area, including an acute ward, in which any of the following are cared for:\n\t(a)\tpatients with an acute or chronic illness or injury;\n\t(b)\tpatients waiting for surgery;\n\t(c)\tpatients recovering from surgery.\n10—Geriatric evaluation and management units\n\t(1)\tThe staffing requirement at an incorporated hospital for a ward that is a geriatric evaluation and management unit is as follows:\n\t(a)\ton the morning shift—\n\t(i)\t1 nurse for every 5 patients; and\n\t(ii)\t1 nurse in charge;\n\t(b)\ton the afternoon shift—\n\t(i)\t1 nurse for every 6 patients; and\n\t(ii)\t1 nurse in charge;\n\t(c)\ton the night shift—\n\t(i)\t1 nurse for every 10 patients; and\n\t(ii)\t1 nurse in charge.\n\t(2)\tIn this clause—\ngeriatric evaluation and management unit means a specialist patient care area providing restorative care for people with chronic or complex conditions associated with ageing, cognitive problems, chronic illness, and disability.\n11—Haematology wards\n\t(1)\tThe staffing requirement at an incorporated hospital for a haematology ward is as follows:\n\t(a)\ton the morning shift and the afternoon shift—\n\t(i)\t1 nurse for every 3 patients; and\n\t(ii)\t1 nurse in charge;\n\t(b)\ton the night shift—\n\t(i)\t1 nurse for every 5 patients; and\n\t(ii)\t1 nurse in charge.\n\t(2)\tIn this clause—\nhaematology ward means a multi-day inpatient ward, or part of such a ward, that is dedicated to the care of patients with blood cancers and related diseases primarily affecting bone marrow or blood cells and in which—\n\t(a)\ttreatment is provided involving complex and high dose chemotherapy regimens and stem cell transplants; and\n\t(b)\tsymptoms including, but not limited to, sepsis, febrile neutropenia, tumour lysis syndrome and disseminated intravascular coagulopathy are managed.\n12—High dependency units\n\t(1)\tThe staffing requirement for a high dependency unit at a Category 1 hospital site is as follows:\n\t(a)\ton the morning shift and the afternoon shift—\n\t(i)\t1 nurse for every 2 patients; and\n\t(ii)\t1 nurse in charge, unless the unit is co‑located with an intensive care unit;\n\t(b)\ton the night shift—1 nurse for every 2 patients.\n\t(2)\tThe staffing requirement for a high dependency unit at a Category 2 or Category 3 hospital site is 1 nurse for every 2 patients.\n13—Neonatal intensive care units\n\t(1)\tThe staffing requirement at an incorporated hospital for a ward that is a neonatal intensive care unit is as follows:\n\t(a)\t1 nurse for every 2 patients; and\n\t(b)\t1 nurse in charge.\n\t(2)\tIn this clause—\nneonatal intensive care unit means a specialist ward, or part of such a ward, that has the capacity to provide continuous life support and in which comprehensive multidisciplinary care is provided to newborn infants who are critically unwell.\n14—Oncology wards\n\t(1)\tThe staffing requirement at an incorporated hospital for an oncology ward is as follows:\n\t(a)\ton the morning shift and afternoon shift—\n\t(i)\t1 nurse for every 4 patients; and\n\t(ii)\t1 nurse in charge;\n\t(b)\ton the night shift—\n\t(i)\t1 nurse for every 8 patients; and\n\t(ii)\t1 nurse in charge.\n\t(2)\tIn this clause—\noncology ward means a multi-day inpatient ward, or part of such a ward—\n\t(a)\tdedicated to the care and non-surgical treatment of patients with cancer (other than those receiving treatment in a haematology ward); and\n\t(b)\tthat has the capacity to administer complex chemotherapy.\n15—Palliative care inpatient units\nThe staffing requirement at an incorporated hospital for a ward that is a palliative care inpatient unit is as follows:\n\t(a)\ton the morning shift and the afternoon shift—\n\t(i)\t1 nurse for every 4 patients; and\n\t(ii)\t1 nurse in charge;\n\t(b)\ton the night shift—\n\t(i)\t1 nurse for every 6 patients; and\n\t(ii)\t1 nurse in charge.\n16—Postnatal wards\n\t(1)\tThe staffing requirement at an incorporated hospital for a postnatal ward is as follows:\n\t(a)\ton the morning shift and the afternoon shift—\n\t(i)\t1 midwife or nurse for every 4 patients; and\n\t(ii)\t1 midwife in charge;\n\t(b)\ton the night shift—\n\t(i)\t1 midwife or nurse for every 6 patients; and\n\t(ii)\t1 midwife in charge.\n\t(2)\tIn this clause—\npatient does not include a newborn infant.\n17—Rehabilitation inpatient units\n\t(1)\tThe staffing requirement at an incorporated hospital for a ward that is a rehabilitation inpatient unit is as follows:\n\t(a)\ton the morning shift and the afternoon shift—\n\t(i)\t1 nurse for every 5 patients; and\n\t(ii)\t1 nurse in charge;\n\t(b)\ton the night shift—1 nurse for every 10 patients.\n\t(2)\tIn this clause—\nrehabilitation inpatient unit means a unit which provides reablement interventions to optimise function and reduce disability in individuals with health conditions, which operates in consideration of personal and environmental factors.\n18—Special care nurseries\n\t(1)\tThe staffing requirement at an incorporated hospital for a ward that is a special care nursery is as follows:\n\t(a)\t1 nurse or midwife for every 3 patients; and\n\t(b)\t1 nurse in charge or midwife in charge.\n\t(2)\tIn this clause—\nspecial care nursery means a ward in which care is provided solely to newborn infants who are unwell but who do not require the level of care and treatment provided to newborn infants in a neonatal intensive care unit, and includes—\n\t(a)\tspecial care baby units; and\n\t(b)\tspecial care high dependency units; and\n\t(c)\tconvalescent and low dependency units.\nPart 3—Minimum staffing requirements\n19—Small hospitals\n\t(1)\tA small hospital of an incorporated hospital must be staffed with at least 1 registered nurse and 1 other nurse or midwife on all shifts.\n\t(2)\tIn this clause—\nsmall hospital means a hospital site at which health services are provided that is not a Category 1, Category 2, Category 3 or Category 4 hospital site.\n20—State aged care\n\t(1)\tA State aged care bed at a hospital site (other than a Category 1 or Category 2 hospital site) of an incorporated hospital must be staffed in accordance with a staffing requirement imposed in relation to a Commonwealth aged care bed under the Commonwealth Act as if the State aged care bed was a Commonwealth aged care bed.\n\t(2)\tIn this clause—\nCommonwealth Act means the Aged Care Act 2024 of the Commonwealth;\nCommonwealth aged care bed means an aged care bed the provision of which is a funded aged care service under the Commonwealth Act;\nState aged care bed means an aged care bed other than a Commonwealth aged care bed.\nSchedule 2—Related amendments and transitional provisions\nPart 1—Related amendment to Fair Work Act 1994\n1—Amendment of section 79—Approval of enterprise agreement\nAfter subsection (2) insert:\n\t(2a)\tSAET must refuse to approve an enterprise agreement if the agreement makes provision for a minimum staffing level (whether expressed as a ratio or otherwise) applying in the same setting as a ratio or minimum staffing requirement imposed under the Nurse and Midwife to Patient Ratios Act 2025.\nPart 2—Transitional provision\n2—Moratorium on applications to SAET\n\t(1)\tA party to a local dispute under section 15 may not apply to SAET for resolution of a matter under section 16 during the moratorium period.\n\t(2)\tA person may not apply to the South Australian Employment Court for a civil penalty order under section 17 during the moratorium period.\n\t(3)\tSection 13 has no effect during the moratorium period.\n\t(4)\tAn incorporated hospital must act in good faith and take all reasonable measures to comply with a ratio or minimum staffing requirement during the moratorium period.\n\t(5)\tIn this clause—\nmoratorium period means a period of 2 years commencing from the day on which this Act is assented to by, or on behalf of, the Crown.\nLegislative history\nNotes\n\t•\tFor further information relating to the Act and subordinate legislation made under the Act see the Index of South Australian Statutes or www.legislation.sa.gov.au.\nPrincipal Act\nYear\nNo\nTitle\nAssent\nCommencement\n2025\n44\nNurse and Midwife to Patient Ratios Act 2025 \n5.11.2025\nuncommenced\n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"The legislation remains tightly focused on its original purpose: establishing nurse/midwife-to-patient ratios in public hospitals. While it includes necessary supporting machinery (dispute resolution, penalties, interaction with workplace law), these are ancillary to the core staffing mandate. The scope has not expanded beyond hospital staffing regulation."},"complexity_factors":["27 defined terms in section 3, including nested definitions for roles like 'midwife unit manager' vs 'midwife in charge'","Schedule 1 contains 18 separate ward-specific staffing formulas with variations by hospital category (1-4) and shift (morning/afternoon/night)","Complex calculation methodology for 'mixed wards' in section 8 requiring 6-monthly nominations, website publication, and mathematical derivation of 'individualised mixed ward ratios'","Conditional exceptions layered across sections: emergency exceptions (s.9), ratio variations by agreement (s.11), preservation of higher enterprise agreement terms (s.14)","Interaction with federal law: references to Commonwealth Aged Care Act 2024 and Fair Work Act 1994 (Cth), plus state Fair Work Act 1994","Dual dispute resolution pathways (local then SAET) with specific standing rules for who can bring claims","Civil penalty provisions with subjective thresholds ('deliberate', 'systematic pattern') and evidentiary presumptions (s.17(3)-(4))","Transitional provisions creating a 2-year moratorium with modified legal effects during that period"],"plain_english_summary":"**What this law does:**\n\nThis Act sets legally enforceable minimum staffing levels for nurses and midwives in South Australian public hospitals (called \"incorporated hospitals\"). It tells hospitals exactly how many nurses or midwives they must have on duty per patient in specific wards—like birthing suites, stroke wards, cancer wards, and general medical wards.\n\n**Who it affects:**\n\n- **Patients** in South Australian public hospitals—especially in wards with specific ratios like intensive care, maternity, and cancer treatment\n- **Nurses and midwives** working in these hospitals\n- **Hospital managers** who must ensure compliance\n- **Unions** representing nursing staff, who can initiate disputes if ratios aren't met\n\n**Key requirements:**\n\n- **Hard numbers**: For example, birthing suites need 1 midwife per patient; acute stroke wards need 1 nurse per 3 patients plus a nurse in charge; general wards vary by hospital size and shift (day vs night)\n- **Four hospital categories**: Big city hospitals (Royal Adelaide, Flinders, etc.) have stricter ratios than small regional hospitals\n- **Mixed wards**: Hospitals must calculate and publish staffing for wards that mix different types of patients (like medical and surgical)\n- **No excuses in emergencies**: Hospitals can temporarily breach ratios during declared emergencies (disasters, major incidents) but must notify unions and ensure care remains safe\n- **Civil penalties**: Hospitals face fines up to $10,000 for *deliberate, systematic* breaches—not one-off mistakes\n\n**Why it matters:**\n\nThis law puts patient safety into statute rather than leaving it to workplace agreements. It overrides existing enterprise agreements that had lower staffing levels, though it preserves any agreements that were *better* than these minimums. It creates a two-step dispute process—first local resolution, then the South Australian Employment Tribunal (SAET)—and allows nurses/midwives or their unions to take hospitals to court for systematic understaffing.\n\n**Important caveat**: There's a **2-year moratorium** (grace period) after the Act becomes law where penalties don't apply and disputes can't go to SAET, though hospitals must still try to comply in good faith."},"issue_detection":{"absurdities":[],"contradictions":[]},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"},"flash_summary":{"complexity_score":7,"scope_assessment":{"changed":true,"description":"This Act goes beyond simply setting nurse/midwife‑to‑patient ratios. In addition to prescribing numerical minima (the core purpose), it creates an enforcement and dispute architecture (civil penalties in the Employment Court, SAET dispute jurisdiction), modifies enterprise bargaining law (prevents new agreements from setting minima and adds a Fair Work Act amendment in Schedule 2 Part 1), and imposes a transitional moratorium on litigation for 2 years (Schedule 2 Part 2). It also empowers the executive to alter which hospitals and wards are covered and to change ratios via regulation (section 21). Those added features — enforcement thresholds, bargaining‑law overrides, regulatory amendment powers and a litigation moratorium — materially broaden the Act’s operational scope compared with a narrow statute that only prescribed staffing ratios."},"complexity_factors":["~24 defined terms in the Interpretation section (section 3) with several role‑specific definitions (nurse in charge, nurse unit manager, midwife unit manager, etc.)","Schedule 1 contains multiple hospital categories (4 categories, Schedule 1 Part 1) and many ward‑specific ratio entries (Schedule 1 Part 2 lists ~14 distinct ward types with shift‑specific ratios)","Mixed‑ward nomination and \"individualised mixed ward ratio\" calculation with multi‑step arithmetic and re‑nomination rules (section 8)","Multiple conditional exceptions and safeguards (emergency exception s9; quality‑of‑care primacy s10; preservation of higher enterprise agreement minima s14)","Cross‑legislative interaction: explicit modification of bargaining law (s6) and an amendment to the Fair Work Act in Schedule 2 Part 1","Two‑tiered dispute resolution with mandated local procedures plus SAET escalation and its civil/industrial constitutions (ss15–16)","Civil penalty regime with high evidentiary threshold (deliberate + systematic) and aggregation rules (s17)","Transitional moratorium preventing SAET/court applications for 2 years (Schedule 2 Part 2) adds conditional timing complexity","Regulations may amend core Schedules and delegate substantive determinations to executive discretion (s21), increasing conditionality and future variability","Interplay between preserved enterprise agreement minima and the Act’s minima (s13–14) creates priority and continuity rules that must be applied case‑by‑case"],"plain_english_summary":"**What this Act does (mechanics first)**\n\n- Establishes mandatory minimum nurse and midwife staffing levels (ratios) for specified wards and sites in incorporated hospitals in South Australia. Hospitals must staff each covered ward according to the ratio that applies (see section 7 and Schedule 1 Part 2).\n\n- Requires hospitals with mixed wards (wards that contain different patient groups) to nominate how the ward will be treated every six months, publish a notice on their website with the expected bed mix and the ratios that will apply, and staff the ward using an \"individualised mixed ward ratio\" calculation (section 8).\n\n- Allows the Chief Executive of the Department and a relevant union to agree to vary a ratio for a specified ward, subject to prescribed procedures; if implemented, compliance with that agreement counts as compliance with the Act (section 11).\n\n- Provides a limited emergency exception: a hospital will not be in breach if the staffing shortfall was caused by an unforeseeable emergency and the hospital has determined the staffing level is safe and adequate; the hospital must notify the relevant union if it relies on this (section 9).\n\n- Imposes other minimum staffing rules for small hospitals and for certain aged‑care beds at hospital sites (Schedule 1 Part 3, clauses 19–20).\n\n- Creates a two‑tier dispute process: local dispute resolution procedures at each hospital (section 15), and the ability to apply to the South Australian Employment Tribunal (SAET) for resolution if the local process fails (section 16).\n\n- Establishes a civil‑penalty enforcement route in the South Australian Employment Court where, on application and proof that conduct was deliberate and part of a systematic pattern, the Court may order a penalty up to $10,000 payable by the hospital (section 17). Only eligible nurses/midwives or a relevant union may apply, and applications must be made within 12 months of the alleged contravention (section 17(2)).\n\n- Prevents new enterprise agreements (after commencement) from including minimum staffing provisions that cover the same settings as this Act; if a pre‑existing enterprise agreement requires a higher staffing level than the Act, that higher requirement survives and overrides the Act in that setting (sections 6, 13–14; Schedule 2 Part 1 amends the Fair Work Act accordingly).\n\n- Imposes reporting obligations: hospitals must include summaries of staffing disputes, tribunal applications, orders and any civil penalties in their annual report (section 20).\n\n- Gives the Governor/regulations power to add or change which hospitals and wards the ratios apply to, and to update Schedule 1 (section 21).\n\n**Who it affects**\n\n- Incorporated hospitals in South Australia and their employing authorities: they must staff covered wards according to the ratios and publish required notices (sections 7–8, Schedule 1).\n\n- Nurses and midwives working in these hospitals: the Act prescribes how many nurses/midwives must be rostered per patient, defines who may start enforcement proceedings (eligible nurses/midwives) and provides protections for disputes (sections 3, 15–17).\n\n- Relevant unions: can represent employees in disputes, negotiate ratio variations with the Chief Executive, and bring applications (sections 11, 15, 17).\n\n- Parties to enterprise agreements: the Act removes the ability to bargain for minimum staffing levels in the same settings after commencement (section 6, Schedule 2 Part 1), but preserves higher pre‑existing minimums (section 14).\n\n**Why it matters (stated purpose, then practical trade‑offs and implementation points)**\n\n- The Act’s stated objects are to set minimum nurse/midwife numbers per patient and other staffing minimums, to protect nurses/midwives, and to meet patient safety requirements while optimising use of nursing resources (section 4).\n\n- Costs and who pays: hospitals bear the direct compliance costs — recruiting, rostering and paying additional nurses or midwives where the Act’s ratios exceed current staffing. Hospitals also face administrative costs (publishing nominations for mixed wards, annual report disclosures) and potential civil penalties where breaches are proven deliberate and systematic (sections 7–8, 17, 20).\n\n- Incentives and behaviour changes: hospitals are required to roster to firm numerical minima (Schedule 1). Where ward mixes change, hospitals must re‑nominate and potentially increase staff (section 8(5)). The preservation rule (section 14) gives an incentive to retain any higher minimums in existing enterprise agreements; by contrast, new enterprise agreements cannot reintroduce competing minimums (section 6).\n\n- Trade‑offs and substitution effects: the Act fixes headcount minima by ward-type and shift (Schedule 1). Hospitals may respond by changing how services are configured (e.g., changing ward classifications or patient flows), using the Chief Executive/union variation process instead of seeking enterprise agreement changes, or seeking regulatory changes (section 11; section 21 gives regulators power to alter Schedule 1 and hospital categories).\n\n- Enforcement design and thresholds: civil penalties are available only when a court is satisfied the contravention was deliberate and part of a systematic pattern, and are capped at $10,000 (section 17). This structure places a relatively high evidentiary threshold on punitive enforcement but still creates reputational and financial risk for hospitals.\n\n- Bureaucratic discretion and regulatory risk: the Chief Executive can enter ratio‑variation agreements with unions (section 11), and the Governor may make regulations changing which hospitals/wards are covered or the ratios themselves (section 21). Those powers concentrate implementation and amendment discretion in the executive and regulatory instruments.\n\n- Compliance burden and litigation timing: the Act creates mandatory internal dispute procedures and requires parties to try local resolution first (section 15). Separately, a two‑year moratorium (Schedule 2 Part 2) prevents SAET or court applications during the initial 2 years, while also requiring hospitals to ‘‘take all reasonable measures’’ to comply during that moratorium — a temporary constraint on judicial enforcement while the new regime bed‑downs.\n\n- Interaction with enterprise bargaining: the Act removes scope for new bargaining over minimums in covered settings (section 6), but preserves any higher minimums already in place (section 14). The Act also amends the Fair Work approval process via Schedule 2 so SAET must refuse approval of enterprise agreements that would duplicate the Act's minima.\n\n**Key operational points to watch in implementation**\n\n- How regulation is used to add or remove wards or hospital sites from Schedule 1 (section 21).\n- The specifics of the prescribed procedures for ratio variations and for local dispute resolution (sections 11, 15) — these are left to secondary instruments/policy.\n- How the mixed‑ward nomination process and the \"individualised mixed ward ratio\" calculation operate in practice, especially where bed occupancy fluctuates (section 8).\n- The effect of the two‑year moratorium on dispute volumes and whether compliance is verifiable during that period (Schedule 2 Part 2).\n\n(References: definitions and scope — section 3; primary duties and ratios — sections 7–12 and Schedule 1; dispute processes — sections 15–16; civil penalties — section 17; reporting and regulations — sections 20–21; transitional and Fair Work interactions — Schedule 2.)"},"summary":{"complexity_score":1,"scope_assessment":{"changed":false,"description":"Scope assessment is not possible as the legislation text was not retrievable. The submission contained only a 404 error page from the South Australian legislation website. No comparison between original intent and enacted provisions can be made."},"complexity_factors":["No actual legislative text was provided — only a website error page was submitted for analysis","Complexity cannot be meaningfully assessed without the substantive provisions of the Act","Score of 1 reflects the absence of analysable content, not simplicity of the underlying law"],"plain_english_summary":"The Nurse and Midwife to Patient Ratios Act 2025 (SA), by its title, appears intended to set minimum nurse and midwife-to-patient ratios in South Australian healthcare settings—affecting nurses, midwives, employers and patients to ensure adequate care and reduce unsafe workloads. \n\nThe source provided is a 404 page, so the actual text couldn’t be reviewed; no substantive analysis is possible until the Act’s published wording is located."}},"importantCases":[],"_links":{"self":"/api/acts/nurse-and-midwife-to-patient-ratios-act-2025","history":"/api/acts/nurse-and-midwife-to-patient-ratios-act-2025/history","analysis":"/api/acts/nurse-and-midwife-to-patient-ratios-act-2025/analysis","conflicts":"/api/acts/nurse-and-midwife-to-patient-ratios-act-2025/conflicts","importantCases":"/api/acts/nurse-and-midwife-to-patient-ratios-act-2025/important-cases","documents":"/api/acts/nurse-and-midwife-to-patient-ratios-act-2025/documents"}}