{"id":"safe-patient-care-nurse-patient-and-midwife-patient-ratios-act-2015","name":"Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015","slug":"safe-patient-care-nurse-to-patient-and-midwife-to-patient-ratios-act-2015","collection":"act","jurisdiction":"vic","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":176450,"registerId":"vic-safe-patient-care-nurse-patient-and-midwife-patient-ratios-act-2015-current","compilationNumber":null,"startDate":"2026-04-05","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015","content":"Version No. 011\n\n**Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015**\n\n**No. 51 of 2015**\n\nVersion incorporating amendments as at  \n9 April 2025\n\n**TABLE OF PROVISIONS**\n\n*Section Page*\n\nPart 1—Preliminary 1\n\n1 Purposes 1\n\n2 Commencement 1\n\n3 Definitions 2\n\n4 Objective 8\n\n5 Change in name of hospital 9\n\n6 Crown bound 9\n\n7 Act not to affect employment contracts or workplace instruments 9\n\nPart 2—Nurse to patient and midwife to patient ratios 10\n\nDivision 1—General 10\n\n8 Ratio includes ratio variation 10\n\n9 Application of ratios 10\n\n10 Application of ratios in small hospitals 11\n\n11 Out of hours coordination of hospitals 12\n\n12 Rounding method 12\n\n12A Ratio for mixed wards 18\n\n13 Demand higher or lower than expected 23\n\n14 Skill mix 24\n\nDivision 2—Nurse to patient ratios 24\n\n15 Level 1 hospitals 24\n\n16 Level 2 hospitals 24\n\n17 Level 3 hospitals 25\n\n18 Level 4 hospitals 25\n\n19 Aged high care residential wards 26\n\n20 Emergency departments 26\n\n20A Intensive care units—level 1 hospitals 30\n\n20B Intensive care units—level 2 hospitals 32\n\n21 Coronary care units 33\n\n21A Acute stroke wards 34\n\n21B Oncology wards 34\n\n21C Haematology wards 34\n\n22 High dependency units 35\n\n23 Palliative care inpatient units 36\n\n24 Rehabilitation and geriatric evaluation management 37\n\n25 Operating theatres 37\n\n26 Post-anaesthetic recovery rooms 38\n\n27 Special care nurseries 38\n\n28 Neonatal intensive care units 41\n\nDivision 3—Midwife to patient ratios 42\n\n29 Meaning of *patient* 42\n\n30 Antenatal wards 42\n\n30A Antenatal wards—night shift 42\n\n31 Birthing suites 43\n\n31A Postnatal wards 45\n\n31B Postnatal wards—night shift 46\n\nDivision 4—Variations from ratios 47\n\n32 Quality of care paramount 47\n\n36 Local agreements to vary 48\n\nPart 3—Compliance and reporting 49\n\n37 Power to give safe patient care compliance direction 49\n\n38 Procedure for giving safe patient care compliance direction 49\n\n39 Effect of safe patient care compliance direction 50\n\n40 Obligation to report certain matters 50\n\nPart 4—Enforcement 52\n\n41 Local dispute resolution 52\n\n42 Referral to Magistrates' Court 53\n\n43 Civil penalty 54\n\n44 Notification requirements 55\n\nPart 5—General 56\n\n45 Regulations 56\n\nPart 6—Savings and transitional 58\n\n46 Meaning of *Agreement* 58\n\n47 Pre-existing higher staffing arrangements 58\n\n48 Pre-existing lower staffing arrangements 59\n\n49 Saving of pre-existing variations 59\n\n50 Saving of variations and redistributions—Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2019 60\n\nSchedule 1—Level 1, 2 and 3 hospitals 62\n\nSchedule 2—Hospitals not restricted in use of enrolled nurses 64\n\nSchedule 3—Categories of hospitals for emergency department ratios 68\n\n═══════════════\n\nEndnotes 70\n\n1 General information 70\n\n2 Table of Amendments 72\n\n3 Explanatory details 74\n\n**Version No.** **011**\n\n**Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015**\n\n**No. 51 of 2015**\n\nVersion incorporating amendments as at  \n9 April 2025\n\n**The Parliament of Victoria enacts:**\n\nPart 1—Preliminary\n\n\t1 Purposes\n\nThe purposes of this Act are to provide for—\n\n(a) requirements that the operators of certain publicly funded health facilities staff certain wards with a minimum number of nurses or midwives; and\n\n(b) the reporting of compliance with and enforcement of those requirements.\n\n\t2 Commencement\n\n(1) Subject to subsection (2), this Act comes into operation on a day or days to be proclaimed.\n\n(2) If a provision of this Act does not come into operation before 1 December 2017 it comes into operation on that day.\n\n\t3 Definitions\n\nIn this Act—\n\nS. 3 def. of *acute stroke ward* inserted by No. 1/2019 s. 21(1).\n\n***acute stroke ward*** means a multi-day inpatient ward, or part of such a ward—\n\n(a) in which comprehensive care and monitoring of patients with strokes in the hyperacute or the acute phase is provided; and\n\n(b) that has the capacity to provide thrombolysis;\n\nS. 3 def. of *acute ward* amended by No. 1/2019 s. 21(2).\n\n***acute ward*** means a multi-day inpatient ward in which any of the following are cared for—\n\n(a) patients who have an acute or chronic illness or an injury, other than those patients receiving care in an acute stroke ward;\n\n(b) patients recovering from surgery;\n\n***After Hours Coordinator*** means a registered nurse or a midwife who is responsible for overseeing the operations of the hospital when the Director of Nursing or Director of Midwifery is not on duty;\n\n***aged high care residential ward*** means a ward at a location—\n\n(a) the operator of which is an approved provider within the meaning of the Aged Care Act 1997 of the Commonwealth; and\n\n(b) that, as at 30 June 2014, had at least one place within the meaning of that Act that was high care allocated;\n\n***bed*** includes cubicle, trolley, treatment chair, cot and delivery suite;\n\nS. 3 def. of *below ratios distribution* substituted by No. 1/2019 s. 4(2).\n\n***below ratios distribution***  means a proposal made under section 34(1) before the repeal of that section by section 15 of the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2019**;\n\n***coronary 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;\n\nS. 3 def. of *Department* amended by No. 12/2025 s. 15.\n\n***Department*** means the Department of Health;\n\n***enrolled nurse*** means a person registered in Division 2 of the Register of Nurses kept by the Nursing and Midwifery Board of Australia under the Health Practitioner Regulation National Law, other than as a student;\n\nS. 3 def. of *general medical or surgical ward* amended by No. 36/2020 s. 4(1).\n\n***general medical or surgical ward*** means—\n\n(a) a multi-day inpatient ward in which either of the following are cared for—\n\n(i) patients with an acute or chronic illness or an injury;\n\n(ii) patients recovering from surgery; or\n\n(b) a short stay observation area;\n\nS. 3 def. of *haematology ward* inserted by No. 1/2019 s. 21(1).\n\n***haematology 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\n(a) treatment is provided involving complex and high dose chemotherapy regimens and stem cell transplants; and\n\n(b) symptoms including, but not limited to, sepsis, febrile neutropenia, tumour lysis syndrome and disseminated intravascular coagulopathy are managed;\n\n***high care beds*** do not include—\n\n(a) aged person mental health beds for which supplementary funding is provided by the Department in accordance with the Victorian health policy and funding guidelines published by the Department from time to time; or\n\n(b) low care allocated places as at 30 June 2014;\n\n***hospital*** means—\n\n(a) a level 1 hospital, a level 2 hospital, a level 3 hospital or a level 4 hospital; or\n\n(b) the following—\n\n(i) Darlingford Upper Goulburn Nursing Home Inc.;\n\n(ii) Indigo North Health Inc.;\n\n(iii) Lyndoch Living Inc.;\n\n(iv) Red Cliffs and Community Aged Care Services Inc.;\n\nS. 3 def. of *intensive care unit* inserted by No. 12/2025 s. 4.\n\n***intensive care unit*** means a unit (other than a neonatal intensive care unit), or part of such a unit, dedicated to the identification, monitoring and treatment of patients who are critically ill through the initial and sustained support of vital organ functions;\n\n***level 1 hospital*** means a hospital specified in Part 1 of Schedule 1;\n\n***level 2 hospital*** means a hospital specified in Part 2 of Schedule 1;\n\n***level 3 hospital*** means a hospital specified in Part 3 of Schedule 1;\n\n***level 4 hospital*** means a campus of any public hospital, denominational hospital, multi purpose service or public health service within the meaning of the **Health Services Act 1988** other than a public hospital, denominational hospital, multi purpose service or public health service that is a level 1 hospital, level 2 hospital or level 3 hospital;\n\n***local dispute*** means a dispute between a nurse or midwife and the operator of a hospital initiated by way of a notification under section 41(1);\n\n***midwife*** means a person registered in the Register of Midwives kept by the Nursing and Midwifery Board of Australia under the Health Practitioner Regulation National Law, other than as a student;\n\n***midwife in charge*** means a midwife who is undertaking, whether temporarily or permanently, the role of—\n\n(a) a midwifery unit manager or equivalent; or\n\n(b) an associate midwifery unit manager or equivalent;\n\nS. 3 def. of *neonatal intensive care unit* inserted by No. 1/2019 s. 4(1).\n\n***neonatal 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;\n\nS. 3 def. of *nominated mixed ward* inserted by No. 1/2019 s. 4(1).\n\n***nominated mixed ward*** means a ward named in a notice published under section 12A;\n\nS. 3 def. of *normal care nursery* repealed by No. 1/2019 s. 4(5)(a).\n\n* * * * *\n\n***nurse*** means registered nurse or enrolled nurse;\n\n***nurse in charge*** means a registered nurse who is undertaking, whether temporarily or permanently, the role of—\n\n(a) a nurse unit manager or equivalent; or\n\n(b) an associate nurse unit manager or equivalent;\n\n***occupied*** includes available to be occupied;\n\nS. 3 def. of *oncology ward* inserted by No. 1/2019 s. 21(1).\n\n***oncology ward*** means a multi-day inpatient ward, or part of such a ward—\n\n(a) dedicated to the care and non-surgical treatment of patients with cancer (other than those receiving treatment in a haematology ward); and\n\n(b) that has the capacity to administer complex chemotherapy;\n\n***operator***, in relation to a hospital, means the entity that has day-to-day responsibility for managing and operating the hospital;\n\nS. 3 def. of *ratio* amended by No. 1/2019 s. 4(3).\n\n***ratio*** means a staffing requirement set out in a provision of Part 2;\n\n***ratio variation*** means a variation to a ratio implemented under Division 4 of Part 2;\n\nS. 3 def. of *redistribution principles* repealed by No. 1/2019 s. 4(5)(b).\n\n ** * * * **\n\n***registered nurse*** means a person registered in Division 1 of the Register of Nurses kept by the Nursing and Midwifery Board of Australia under the Health Practitioner Regulation National Law, other than as a student;\n\n***relevant union*** means an organisation within the meaning of the Fair Work (Registered Organisations) Act 2009 of the Commonwealth that represents or is entitled to represent a nurse or midwife in a ward;\n\nS. 3 def. of *resuscitation bed* inserted by No. 1/2019 s. 26.\n\n***resuscitation bed*** means a bed in an emergency department that is allocated for the assessment, resuscitation and treatment of patients with critical conditions and that is being used for that purpose;\n\n***safe patient care compliance direction*** means a direction given under section 37(1);\n\n***Secretary*** means the Department Head (within the meaning of the **Public Administration Act 2004**) of the Department;\n\nS. 3 def. of *short stay observation area* inserted by No. 36/2020 s. 4(2).\n\n***short stay observation area*** means an area of a hospital into which patients admitted to the emergency department are transferred for the provision of short-term treatment, observation, assessment or reassessment when they no longer require emergency care;\n\nS. 3 def. of *special care nursery* substituted by No. 1/2019 s. 4(4).\n\n***special care nursery*** means a ward, or part of such 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;\n\n***ward*** means a ward, unit, department or component of a hospital managed by a nurse or midwife who is undertaking, whether temporarily or permanently, the role of—\n\n(a) a nurse unit manager or equivalent; or\n\n(b) a midwifery unit manager or equivalent.\n\n\t4 Objective\n\n(1) The objective of this Act is to provide for safe patient care in hospitals by establishing requirements for a minimum number of nurses or midwives per number of patients in specified wards or beds, recognising that nursing workloads impact on the quality of patient care.\n\n(2) In meeting the objective of this Act, the operator of a hospital may apply the ratios in a flexible manner having regard to the following—\n\n(a) variations in the number of patients who occupy or are expected to occupy beds;\n\n(b) variations in patient numbers that may lead to a period of peak demand.\n\n\t5 Change in name of hospital\n\nIf the name of a hospital changes, the requirements of this Act continue to apply to that hospital after the change of name despite the change of name.\n\n\t6 Crown bound\n\nThis Act binds the Crown in right of Victoria and, to the extent that the legislative power of the Parliament permits, the Crown in all its other capacities.\n\n\t7 Act not to affect employment contracts or workplace instruments\n\nNothing in this Act is intended to constitute a term of or to alter or vary, or authorise or require the alteration or variation of—\n\n(a) any employment contract; or\n\n(b) any workplace instrument within the meaning of the Fair Work Act 2009 of the Commonwealth.\n\nPart 2—Nurse to patient and midwife to patient ratios\n\nDivision 1—General\n\n\t8 Ratio includes ratio variation\n\nIn this Division, ***ratio*** includes a staffing requirement that applies under a ratio variation, subject to any terms of that variation.\n\n\t9 Application of ratios\n\n(1) Except as otherwise provided—\n\n(a) a ratio applies to every ward in each hospital to which it is specified to apply; and\n\n(b) a ratio must be applied on the basis of the actual number of patients in each ward to which it applies; and\n\n(c) a ratio is a minimum requirement only and is not intended to prevent the operator of a hospital from staffing a ward with additional nurses or midwives beyond the number required by the ratio; and\n\n(d) a 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\n**Examples**\n\n1 For subsection (1)(b), in a ward with 30 beds where only 26 beds are usually occupied, the operator of the hospital must not use the other 4 beds unless additional staff are available to meet the ratio requirements.\n\n2 For subsection (1)(d), 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.\n\nS. 9(2)  amended by No. 39/2022 s. 860.\n\n(2) Despite anything to the contrary in this Act, a ratio does not apply in respect of any ward that is being predominantly utilised for the care of persons being treated for a mental illness within the meaning of the **Mental Health and Wellbeing Act 2022**.\n\n\t10 Application of ratios in small hospitals\n\n(1) Despite anything to the contrary in a ratio applying to a level 4 hospital with one ward, the operator of the hospital must staff that ward with—\n\n(a) one registered nurse on all shifts; and\n\nS. 10(1)(b)  amended by No. 36/2020 s. 5(1).\n\n(b) one After Hours Coordinator or equivalent position (who, unless subsection (3) applies, is not supernumerary) during all off-duty periods of the Director of Nursing or Director of Midwifery.\n\nS. 10(2)  substituted by No. 36/2020 s. 5(2).\n\n(2) Despite anything to the contrary in a ratio applying to a level 4 hospital with only 2 wards, the operator of a hospital with only 2 wards must staff the hospital with one After Hours Coordinator or equivalent position (who, unless subsection (3) applies, is not supernumerary) during all off-duty periods of the Director of Nursing or Director of Midwifery.\n\nS. 10(3)  inserted by No. 36/2020 s. 5(2).\n\n(3) Despite anything to the contrary in a ratio applying to a level 4 hospital with one or 2 wards, the operator of a hospital with one or 2 wards must count the After Hours Coordinator in addition to any ratio that applies if the hospital has either or both of the following—\n\n(a) an emergency department that has had at least 2500 annual presentations in the 12 months immediately preceding the day on which the ratio is being applied;\n\n(b) a nominated birthing suite within the meaning of section 31.\n\n\t11 Out of hours coordination of hospitals\n\nThe operator of a hospital with 3 wards or more must staff the hospital with one After Hours Coordinator during all off-duty periods of the Director of Nursing or Director of Midwifery, in addition to any ratio that applies.\n\n\t12 Rounding method\n\nS. 12(1)  substituted by No. 1/2019 s. 5(1).\n\n(1) If the actual or expected number of patients in a ward or the number of beds of one of the following categories is not divisible into a whole number following the application of the relevant ratio, the operator of the hospital must ensure that the ward or number of beds is staffed with one additional nurse or midwife (as the case requires) in order to comply with the ratio—\n\n(a) on and from the day on which Part 2 of the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2019** comes into operation—\n\n(i) on all shifts in level 1 hospitals and level 2 hospitals—\n\n(A) a general medical or surgical ward;\n\n(B) a coronary care unit;\n\n(C) a high dependency unit;\n\n(D) an operating theatre;\n\n(E) a post-anaesthetic recovery room;\n\n(ii) on all shifts in an emergency department in hospitals specified in Part 1 of Schedule 3;\n\n(iii) on the night shift in—\n\n(A) an emergency department in hospitals specified in Part 2 or 3 of Schedule 3;\n\n(B) an emergency department to which section 20(5) applies;\n\n(iv) on the night shift in level 3 hospitals—\n\n(A) a general medical or surgical ward;\n\n(B) a coronary care unit;\n\n(C) a high dependency unit;\n\n(D) an operating theatre;\n\n(E) a post-anaesthetic recovery room;\n\n(v) on the night shift in level 4 hospitals—\n\n(A) an acute ward;\n\n(B) a coronary care unit;\n\n(C) a high dependency unit;\n\n(D) an operating theatre;\n\n(E) a post-anaesthetic recovery room;\n\n(vi) on the night shift in an aged high care residential ward in all hospitals;\n\n(b) on and from 1 March 2020—\n\n(i) on the morning shift in level 3 hospitals—\n\n(A) a general medical or surgical ward;\n\n(B) a coronary care unit;\n\n(C) a high dependency unit;\n\n(D) an operating theatre;\n\n(E) a post-anaesthetic recovery room;\n\n(ii) on the morning shift in level 4 hospitals—\n\n(A) an acute ward;\n\n(B) a coronary care unit;\n\n(C) a high dependency unit;\n\n(D) an operating theatre;\n\n(E) a post-anaesthetic recovery room;\n\n(iii) on the morning shift in—\n\n(A) an emergency department in hospitals specified in Part 2 or 3 of Schedule 3;\n\n(B) an emergency department to which section 20(5) applies;\n\n(iv) on the night shift in all hospitals—\n\n(A) a palliative care inpatient unit;\n\n(B) a geriatric evaluation management bed;\n\n(c) on and from 1 March 2021—\n\n(i) on the morning shift in all hospitals—\n\n(A) a palliative care inpatient unit;\n\n(B) a geriatric evaluation management bed;\n\n(C) a rehabilitation bed;\n\nS. 12(1)(c)(i)(D)  inserted by No. 36/2020 s. 6(1).\n\n(D) an acute stroke ward;\n\nS. 12(1)(c)(i)(E)  inserted by No. 36/2020 s. 6(1).\n\n(E) a haematology ward;\n\nS. 12(1)(c)(i)(F)  inserted by No. 36/2020 s. 6(1).\n\n(F) an oncology ward;\n\nS. 12(1)(c)(ia)  inserted by No. 36/2020 s. 6(2).\n\n(ia) on the afternoon shift in all hospitals—\n\n(A) an acute stroke ward;\n\n(B) a haematology ward;\n\n(C) an oncology ward;\n\n(ii) on the afternoon shift in level 3 hospitals—\n\n(A) a general medical or surgical ward;\n\n(B) a coronary care unit;\n\n(C) a high dependency unit;\n\n(D) an operating theatre;\n\n(E) a post-anaesthetic recovery room;\n\n(iii) on the afternoon shift in level 4 hospitals—\n\n(A) an acute ward;\n\n(B) a coronary care unit;\n\n(C) a high dependency unit;\n\n(D) an operating theatre;\n\n(E) a post-anaesthetic recovery room;\n\n(iv) on the afternoon shift in—\n\n(A) an emergency department in hospitals specified in Part 2 or 3 of Schedule 3;\n\n(B) an emergency department to which section 20(5) applies;\n\n(v) on the night shift in all hospitals—\n\n(A) a special care nursery;\n\n(B) a neonatal intensive care unit;\n\n(C) an antenatal ward;\n\n(D) a postnatal ward;\n\n(E) a birthing suite;\n\nS. 12(1)(c)(v)(F)  inserted by No. 36/2020 s. 6(3).\n\n(F) an acute stroke ward;\n\nS. 12(1)(c)(v)(G)  inserted by No. 36/2020 s. 6(3).\n\n(G) a haematology ward;\n\nS. 12(1)(c)(v)(H)  inserted by No. 36/2020 s. 6(3).\n\n(H) an oncology ward;\n\n(d) on and from 1 March 2022—\n\n(i) on the morning shift in all hospitals—\n\n(A) a special care nursery;\n\n(B) a neonatal intensive care unit;\n\n(C) an antenatal ward;\n\n(D) a postnatal ward;\n\n(E) a birthing suite;\n\n(ii) on the afternoon shift in all hospitals—\n\n(A) a palliative care inpatient unit;\n\n(B) a geriatric evaluation management bed;\n\n(C) a rehabilitation bed;\n\nS. 12(1)(da)  inserted by No. 36/2020 s. 6(4).\n\n(da) on and from 1 July 2022—\n\n(i) on the afternoon shift in an aged high care residential ward in all hospitals;\n\n(ii) on the night shift in a rehabilitation bed in all hospitals;\n\n(e) on and from 1 March 2023, on the afternoon shift in all hospitals—\n\n(i) a special care nursery;\n\n(ii) a neonatal intensive care unit;\n\n(iii) an antenatal ward;\n\n(iv) a postnatal ward;\n\nS. 12(1)(e)(v)  amended by No. 36/2020 s. 6(5).\n\n(v) a birthing suite;\n\nS. 12(1)(f)  inserted by No. 36/2020 s. 6(6), amended by No. 12/2025 s. 5(1).\n\n(f) on and from 1 July 2023, on the morning shift in an aged high care residential ward in all hospitals;\n\nS. 12(1)(g)  inserted by No. 12/2025 s. 5(2).\n\n(g) on and from the day on which the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2025** comes into operation, on all shifts in a ward that is an intensive care unit in level 1 hospitals and level 2 hospitals.\n\nS. 12(2)  substituted by No. 1/2019 s. 5(1).\n\n(2) If on a date in relation to which a ward (other than a nominated mixed ward) or a number of beds is staffed to comply with a ratio for a particular category of ward or bed subsection (1) does not apply to that particular category, the operator is not required to ensure that the ward or number of beds is staffed with an additional nurse or midwife in order to comply with the relevant ratio unless—\n\n(a) safe patient care may be compromised if the ward or number of beds is not staffed with the additional nurse or midwife; and\n\n(b) the actual or expected number of patients in the ward or the number of beds requires more than 50 per cent of one additional nurse or midwife in order to comply with the ratio.\n\n(3) In addition to any requirement under subsection (2), the operator of a hospital may assign a nurse or midwife to care for patients—\n\n(a) across multiple wards at night; or\n\n(b) in the case of a nurse, across multiple beds in aged high care residential wards on any shift.\n\nS. 12(4)  repealed by No. 1/2019 s. 5(2).\n\n* * * * *\n\nS. 12A inserted by No. 1/2019 s. 6.\n\n\t12A Ratio for mixed wards\n\n(1) In February and August each year, the operator of a hospital—\n\n(a) must nominate a ward as a mixed ward for the following 6 month period starting on 1 March or 1 September of that year (as the case requires) if—\n\n(i) the operator has specifically configured the ward to provide, in the course of its ordinary operation, a mixture of clinical services; and\n\n(ii) there is more than one portion of the ward and, accordingly, more than one ratio would apply when determining staff numbers for the entire ward but for subsection (3); and\n\n(b) must publish a notice of the nomination of the ward as a mixed ward on the hospital's Internet site including the following details—\n\n(i) the name of the mixed ward;\n\n(ii) the total number of occupied beds in the mixed ward;\n\n(iii) the different ratios that would apply but for subsection (3);\n\n(iv) the expected number of occupied beds in each portion of the ward during the following 6 month period determined in accordance with subsection (2).\n\n(2) For the purpose of determining the expected number of occupied beds in each portion of the ward, the operator must take into account—\n\n(a) the portions in the ward and the number of occupied beds in each portion during the preceding 12 months; and\n\n(b) any factors during the following 6 month period (or the remainder of the 6 month period if subsection (8) applies) which are likely—\n\n(i) to increase or decrease the number of occupied beds; or\n\n(ii) to change the portions in the ward.\n\n(3) Subject to subsections (4), (5) and (6), the operator of a hospital must staff a nominated mixed ward in accordance with a ratio determined as follows for the relevant 6 month period—\n\n(a) determine the number of staff (excluding any nurse in charge or midwife in charge) for each portion by applying the relevant ratio for that portion;\n\n(b) add the number of staff for each portion;\n\n(c) determine the nominated mixed ward ratio by dividing the total number of occupied beds in the nominated mixed ward by the total number of staff ascertained in paragraph (b).\n\n(4) For the purposes of subsection (3)(a), if the number of occupied beds in a portion is not divisible into a whole number following the application of the relevant ratio for that portion, the number of staff for that portion may be rounded down to the nearest whole number if at least one (but not all) of the portions of the nominated mixed ward is a portion to which section 12(2) would apply if the portion were a ward.\n\n(5) If the number of occupied beds in the nominated mixed ward is not divisible into a whole number following the application of the ratio determined under subsection (3)(c), the operator of the hospital must ensure that the ward is staffed with an additional nurse or midwife (as the case requires) in order to comply with that ratio unless—\n\n(a) section 12(2) would apply to each portion of the nominated mixed ward if each portion were a ward; and\n\n(b) safe patient care would not be compromised if the nominated mixed ward were not staffed with the additional nurse or midwife; and\n\n(c) the number of occupied beds in the nominated mixed ward requires less than or equal to 50 per cent of one additional nurse or midwife in order to comply with that ratio.\n\n(6) If the ratio applying to a portion of a nominated mixed ward requires a nurse in charge or a midwife in charge for that portion, only one nurse in charge or one midwife in charge (as the case requires) is required for the entire nominated mixed ward.\n\nS. 12A(6A) inserted by No. 36/2020 s. 7.\n\n(6A) Subsections (6) and (7)(b) do not apply, in relation to night shifts, to a short stay observation area if—\n\n(a) the short stay observation area is co‑located with an emergency department in a hospital specified in Part 1 of Schedule 3; and\n\n(b) the total number of occupied beds in the short stay observation area and emergency department is 30 or more.\n\n(7) If the operator of a hospital fails to nominate a ward as a mixed ward in accordance with subsection (1)—\n\n(a) the ratio otherwise applying to a portion of the ward that is the highest nurse to patient, or midwife to patient, ratio of the ratios otherwise applying to the portions of the ward is to be applied to the mixed ward as a whole until the operator nominates the mixed ward; and\n\n**Example**\n\nA mixed ward that the operator has failed to nominate consists of 2 portions. The ratio of one nurse for every 3 patients applies to Portion A. The ratio of one nurse for every 6 patients applies to Portion B. The ratio that applies to the entire ward is one nurse for every 3 patients because this ratio is the higher of the 2 ratios.\n\n(b) if any ratio otherwise applying to a portion of a nominated mixed ward would but for this section require a nurse in charge or a midwife in charge for that portion, only one nurse in charge or one midwife in charge (as the case requires) is required for the entire ward.\n\n**Example**\n\nA mixed ward that the operator has failed to nominate consists of 2 portions. A nurse in charge is required for Portion A. A nurse in charge is required for Portion B. Despite each portion requiring a nurse in charge, the operator is not required to staff the mixed ward with 2 nurses in charge. One nurse in charge is sufficient.\n\n(8) If 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, the operator of a hospital—\n\n(a) must make a new nomination in relation to the mixed ward for the remainder of the 6 month period; and\n\n(b) must publish a notice of the new nomination on the hospital's Internet site including the following details—\n\n(i) the name of the mixed ward;\n\n(ii) the total number of occupied beds in the mixed ward;\n\n(iii) the different ratios that would apply but for subsection (3);\n\n(iv) the expected number of occupied beds in each portion of the ward during the remainder of the 6 month period determined in accordance with subsection (2); and\n\n(c) must staff the nominated mixed ward for the remainder of the 6 month period in accordance with a new ratio determined in accordance with subsection (3).\n\n(9) This section does not apply to—\n\n(a) a special care nursery with 8 or more occupied cots; or\n\n(b) a ward with 6 or more birthing suites.\n\n(10) In this section—\n\n***portion***, in relation to a mixed ward, means the category of those patients or beds in the ward to which a particular ratio applies.\n\n**Example**\n\nA mixed ward may have 3 portions: a portion of general medical or surgical beds, a portion of palliative care beds and a portion of coronary care beds.\n\n\t13 Demand higher or lower than expected\n\n(1) Beds in addition to the beds that have been staffed under a ratio may only be occupied if nurses or midwives are available to comply with the ratio.\n\n(2) If the actual or expected number of patients on a particular day falls below the number of patients for which a ward is staffed in accordance with a ratio, the number of nurses or midwives may be adjusted down before the commencement of a shift.\n\n**Note**\n\nSee also section 7.\n\n\t14 Skill mix\n\nThe operator of a hospital, other than a hospital specified in Schedule 2, may use no more than 20 per cent enrolled nurses in meeting ratios in an acute ward or a general medical or surgical ward.\n\nDivision 2—Nurse to patient ratios\n\n\t15 Level 1 hospitals\n\nThe operator of a level 1 hospital must staff a general medical or surgical ward as follows—\n\n(a) on the morning shift or the afternoon shift—\n\n(i) one nurse for every 4 patients; and\n\n(ii) one nurse in charge;\n\nS. 15(b) substituted by No. 36/2020 s. 8.\n\n(b) on the night shift—\n\n(i) one nurse for every 8 patients; and\n\n(ii) on and from 1 July 2021, one nurse in charge.\n\n\t16 Level 2 hospitals\n\nThe operator of a level 2 hospital must staff a general medical or surgical ward as follows—\n\n(a) on the morning shift—\n\n(i) one nurse for every 4 patients; and\n\n(ii) one nurse in charge;\n\n(b) on the afternoon shift—\n\n(i) one nurse for every 5 patients; and\n\n(ii) one nurse in charge;\n\nS. 16(c) substituted by No. 36/2020 s. 9.\n\n(c) on the night shift—\n\n(i) one nurse for every 8 patients; and\n\n(ii) on and from 1 July 2022, one nurse in charge.\n\n\t17 Level 3 hospitals\n\nThe operator of a level 3 hospital must staff a general medical or surgical ward as follows—\n\n(a) on the morning shift—\n\n(i) one nurse for every 5 patients; and\n\n(ii) one nurse in charge;\n\n(b) on the afternoon shift—\n\n(i) one nurse for every 6 patients; and\n\n(ii) one nurse in charge;\n\nS. 17(c) substituted by No. 36/2020 s. 10.\n\n(c) on the night shift—\n\n(i) one nurse for every 10 patients; and\n\n(ii) on and from 1 July 2023, one nurse in charge.\n\n\t18 Level 4 hospitals\n\n(1) The operator of a level 4 hospital must staff an acute ward as follows—\n\n(a) on the morning shift—\n\n(i) one nurse for every 6 patients; and\n\n(ii) one nurse in charge;\n\n(b) on the afternoon shift—\n\n(i) one nurse for every 7 patients; and\n\n(ii) one nurse in charge;\n\n(c) on the night shift, one nurse for every 10 patients.\n\nS. 18(2)  repealed by No. 1/2019 s. 7.\n\n* * * * *\n\n\t19 Aged high care residential wards\n\nThe operator of a hospital must ensure that the high care beds in an aged high care residential ward are staffed as follows—\n\n(a) on the morning shift—\n\n(i) one nurse for every 7 residents; and\n\n(ii) one nurse in charge;\n\n(b) on the afternoon shift—\n\n(i) one nurse for every 8 residents; and\n\n(ii) one nurse in charge;\n\n(c) on the night shift, one nurse for every 15 residents.\n\n\t20 Emergency departments\n\n(1) The operator of a hospital specified in Part 1 of Schedule 3 must staff a ward that is an emergency department as follows—\n\n(a) on the morning shift—\n\nS. 20(1)(a)(i)  amended by No. 1/2019 s. 27(1), substituted by No. 12/2025 s. 6(2).[[1]](#endnote-1)\n\n(i) one nurse for every 3 beds (not including any resuscitation bed);  \nand\n\nS. 20(1)(a)(ia)  inserted by No. 12/2025 s. 6(2).\n\n(ia) one nurse for each resuscitation bed; and\n\n(ii) one nurse in charge; and\n\n(iii) one triage nurse;\n\n(b) on the afternoon shift—\n\nS. 20(1)(b)(i)  amended by No. 1/2019 s. 27(2)(a).\n\n(i) one nurse for every 3 beds (not including any resuscitation bed); and\n\nS. 20(1)(b)(ia)  inserted by No. 1/2019 s. 27(2)(b).\n\n(ia) one nurse for each resuscitation bed; and\n\n(ii) one nurse in charge; and\n\n(iii) 2 triage nurses;\n\n(c) on the night shift—\n\nS. 20(1)(c)(i)  amended by No. 1/2019 ss 8(1), 27(3)(a).\n\n(i) one nurse for every 3 beds (not including any resuscitation bed); and\n\nS. 20(1)(c)(ia)  inserted by No. 1/2019 s. 27(3)(b).\n\n(ia) one nurse for each resuscitation bed; and\n\n(ii) one nurse in charge; and\n\n(iii) one triage nurse.\n\nS. 20(2)  repealed by No. 1/2019 s. 8(2), new s. 20(2) inserted by No. 12/2025 s. 6(3).\n\n(2) The operator of a hospital referred to in subsection (1) must meet the following—\n\n(a) on and from the day on which the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2025** comes into operation—25 per cent of the additional staffing requirement set out in subsection (1)(a)(i) and (ia) in each 28 day period;\n\n(b) on and from 1 December 2025—75 per cent of the additional staffing requirement set out in subsection (1)(a)(i) and (ia) in each 28 day period;\n\n(c) on and from 1 July 2026—the additional staffing requirement set out in subsection (1)(a)(i) and (ia).\n\n(3) The operator of a hospital specified in Part 2 of Schedule 3 must staff a ward that is an emergency department as follows on all shifts—\n\n(a) one nurse for every 3 beds; and\n\n(b) one nurse in charge; and\n\n(c) one triage nurse.\n\n(4) The operator of a hospital specified in Part 3 of Schedule 3 must staff a ward that is an emergency department as follows—\n\n(a) on the morning shift or the afternoon shift—\n\n(i) one nurse for every 3 beds; and\n\n(ii) one nurse in charge; and\n\n(iii) one triage nurse;\n\n(b) on the night shift—\n\n(i) one nurse for every 3 beds; and\n\n(ii) one nurse in charge.\n\n(5) The operator of a hospital, the emergency department of which has had more than 7000 annual presentations (other than a hospital specified in Schedule 3), must staff the ward that is the emergency department as follows on all shifts—\n\n(a) one nurse for every 3 beds; and\n\n(b) one nurse in charge; and\n\n(c) in the case of an emergency department that had a regularly rostered triage nurse on one or more shifts immediately before the commencement of this section, one triage nurse for that shift or each of those shifts in that ward.\n\n(6) The operator of a hospital, the emergency department of which has had between 5000 and 7000 annual presentations (both inclusive) (other than a hospital specified in Schedule 3), must staff the emergency department with 2 registered nurses on all shifts.\n\n(7) The 2 nurses referred to in subsection (6) may be assigned to meet the ratios in other wards of the hospital if they are free to return to the emergency department immediately when required.\n\n(8) The operator of a hospital the emergency department of which has had fewer than 5000 annual presentations must staff the hospital with—\n\n(a) if the hospital has only one or 2 wards—\n\n(i) 2 registered nurses on all shifts; and\n\n(ii) an additional nurse who is available to assess and care for patients within the emergency department when required; and\n\n(b) if the hospital has 3 or more wards—\n\n(i) 2 registered nurses on all shifts; and\n\n(ii) an additional nurse who is supernumerary and available to assess and care for patients within the emergency department when required.\n\n(9) If an emergency department to which this section applies experiences a seasonal fluctuation in the number of presentations such that a ratio required by a different subsection of this section would otherwise apply during the period of that fluctuation (if taken on an annualised basis) but for the operation of this section and the operator of the hospital determines to implement staffing changes based on the seasonal fluctuation, the operator of the hospital must staff the emergency department ward with the number of nurses, triage nurses and nurses in charge that would be required by that other subsection during the period of the fluctuation.\n\n(10) In this section—\n\n***annual presentations*** means presentations in the 12 months immediately preceding the day on which the ratio is being applied;\n\n***presentations*** means persons who present to the emergency department for assessment.\n\n**Note**\n\nA local agreement may vary the application of these ratios and other ratios in this Division. See section 36.\n\nS. 20A  inserted by No. 12/2025 s. 7.\n\n\t20A Intensive care units—level 1 hospitals\n\n(1) Subject to subsections (2) and (3), the operator of a level 1 hospital must staff a ward that is an intensive care unit as follows—\n\n(a) on the morning shift—\n\n(i) one ICU liaison nurse for every 15 occupied beds; and\n\n(ii) one team leader for every 10 occupied beds; and\n\n(iii) one nurse for each occupied bed; and\n\n(iv) one nurse in charge;\n\n(b) on the afternoon shift—\n\n(i) one ICU liaison nurse for every 15 occupied beds; and\n\n(ii) one team leader for every 10 occupied beds; and\n\n(iii) one nurse for each occupied bed; and\n\n(iv) one nurse in charge;\n\n(c) on the night shift—\n\n(i) one ICU liaison nurse for every 30 occupied beds; and\n\n(ii) one team leader for every 10 occupied beds; and\n\n(iii) one nurse for each occupied bed; and\n\n(iv) one nurse in charge.\n\n(2) The operator of a level 1 hospital does not contravene the ratio set out in subsection (1)(a)(iii), (b)(iii) or (c)(iii) if a nurse assigned to an intensive care unit provides care to up to 2 patients who—\n\n(a) are not critically ill; or\n\n(b) do not require the sustained support of vital organ functions.\n\n(3) The operator of a hospital referred to in subsection (1) must meet the following—\n\n(a) on and from the day on which the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2025** comes into operation—25 per cent of the additional staffing requirement set out in subsection (1) in each 28 day period;\n\n(b) on and from 1 December 2025—75 per cent of the additional staffing requirement set out in subsection (1) in each 28 day period;\n\n(c) on and from 1 July 2026—the additional staffing requirement set out in subsection (1).\n\nS. 20B  inserted by No. 12/2025 s. 7.\n\n\t20B Intensive care units—level 2 hospitals\n\n(1) Subject to subsections (2) and (3), the operator of a level 2 hospital must staff a ward that is an intensive care unit as follows—\n\n(a) on the morning shift—\n\n(i) one ICU liaison nurse; and\n\n(ii) one team leader for every 12 occupied beds; and\n\n(iii) one nurse for each occupied bed; and\n\n(iv) one nurse in charge;\n\n(b) on the afternoon shift—\n\n(i) one ICU liaison nurse; and\n\n(ii) one team leader for every 12 occupied beds; and\n\n(iii) one nurse for each occupied bed; and\n\n(iv) one nurse in charge;\n\n(c) on the night shift—\n\n(i) one team leader; and\n\n(ii) one nurse for each occupied bed; and\n\n(iii) one nurse in charge.\n\n(2) The operator of a level 2 hospital does not contravene the ratio set out in subsection (1)(a)(iii), (b)(iii) or (c)(ii) if a nurse assigned to an intensive care unit provides care to up to 2 patients who—\n\n(a) are not critically ill; or\n\n(b) do not require the sustained support of vital organ functions.\n\n(3) The operator of a hospital referred to in subsection (1) must meet the following—\n\n(a) on and from the day on which the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2025** comes into operation—25 per cent of the additional staffing requirement set out in subsection (1) in each 28 day period;\n\n(b) on and from 1 December 2025—75 per cent of the additional staffing requirement set out in subsection (1) in each 28 day period;\n\n(c) on and from 1 July 2026—the additional staffing requirement set out in subsection (1).\n\nS. 21  amended by No. 12/2025 s. 8(2) (ILA s. 39B(1)).\n\n\t21 Coronary care units\n\n(1) The operator of a hospital must staff a ward that is a coronary care unit as follows—\n\n(a) on the morning shift or the afternoon shift—\n\n(i) one nurse for every 2 patients; and\n\n(ii) one nurse in charge;\n\nS. 21(1)(b)  substituted by No. 12/2025 s. 8(1).\n\n(b) on the night shift—\n\n(i) one nurse for every 3 patients; and\n\n(ii) subject to subsection (2), one nurse in charge.\n\nS. 21(2)  inserted by No. 12/2025 s. 8(2).\n\n(2) The operator of a hospital referred to in subsection (1) must meet the following—\n\n(a) on and from the day on which the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2025** comes into operation—25 per cent of the additional staffing requirement set out in subsection (1)(b)(ii) in each 28 day period;\n\n(b) on and from 1 December 2025—75 per cent of the additional staffing requirement set out in subsection (1)(b)(ii) in each 28 day period;\n\n(c) on and from 1 July 2026—the additional staffing requirement set out in subsection (1)(b)(ii).\n\nS. 21A  inserted by No. 1/2019 s. 22.\n\n\t21A Acute stroke wards\n\nThe operator of a hospital must staff a ward that is an acute stroke ward on all shifts with—\n\n(a) one nurse for every 3 patients; and\n\n(b) one nurse in charge.\n\nS. 21B  inserted by No. 1/2019 s. 22.\n\n\t21B Oncology wards\n\nThe operator of a hospital must staff a ward that is an oncology ward as follows—\n\n(a) on the morning shift or the afternoon shift—\n\n(i) one nurse for every 4 patients; and\n\n(ii) one nurse in charge;\n\n(b) on the night shift—\n\n(i) one nurse for every 8 patients; and\n\n(ii) one nurse in charge.\n\nS. 21C  inserted by No. 1/2019 s. 22.\n\n\t21C Haematology wards\n\nThe operator of a level 1 hospital must staff a ward that is a haematology ward as follows—\n\n(a) on the morning shift or the afternoon shift—\n\n(i) one nurse for every 3 patients; and\n\n(ii) one nurse in charge;\n\n(b) on the night shift—\n\n(i) one nurse for every 5 patients; and\n\n(ii) one nurse in charge.\n\n\t22 High dependency units\n\n(1) The operator of a level 1 hospital must staff a ward that is a stand alone high dependency unit as follows—\n\n(a) on the morning shift or the afternoon shift—\n\n(i) one nurse for every 2 patients; and\n\n(ii) unless the unit is co-located with an intensive care unit, one nurse in charge;\n\nS. 22(1)(b)  substituted by No. 12/2025 s. 9(1).\n\n(b) on the night shift—\n\n(i) one nurse for every 2 patients; and\n\n(ii) subject to subsection (1A), one nurse in charge unless the unit is co-located with an intensive care unit.\n\nS. 22(1A)  inserted by No. 12/2025 s. 9(2).\n\n(1A) The operator of a hospital referred to in subsection (1) must meet the following—\n\n(a) on and from the day on which the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2025** comes into operation—25 per cent of the additional staffing requirement set out in subsection (1)(b)(ii) in each 28 day period;\n\n(b) on and from 1 December 2025—75 per cent of the additional staffing requirement set out in subsection (1)(b)(ii) in each 28 day period;\n\n(c) on and from 1 July 2026—the additional staffing requirement set out in subsection (1)(b)(ii).\n\nS. 22(2)  amended by No. 12/2025 s. 16.\n\n(2) The operator of Central Gippsland Health Service (Sale campus), West Gippsland Hospital, Grampians Health (Wimmera Base Hospital) and Warrnambool Base Hospital must staff a ward that is a high dependency unit as follows—\n\n(a) on the morning shift—\n\n(i) one nurse for every 2 patients; and\n\n(ii) one nurse in charge;\n\n(b) on the afternoon shift or the night shift, one nurse for every 2 patients.\n\n(3) The operator of Angliss Hospital, Bairnsdale Regional Health Service, Echuca Regional Health and Portland District Health must staff beds in a high dependency unit with one nurse for every 3 beds on all shifts.\n\n(4) The operator of Swan Hill District Health and Williamstown Hospital must staff beds in a high dependency unit with one nurse for every 4 beds on all shifts.\n\n\t23 Palliative care inpatient units\n\nThe operator of a hospital must staff a ward that is a palliative care inpatient unit as follows—\n\n(a) on the morning shift—\n\n(i) one nurse for every 4 patients; and\n\n(ii) one nurse in charge;\n\n(b) on the afternoon shift—\n\nS. 23(b)(i) amended by No. 1/2019 s. 23(1).\n\n(i) one nurse for every 4 patients; and\n\n(ii) one nurse in charge;\n\nS. 23(c) substituted by No. 1/2019 s. 23(2).\n\n(c) on the night shift—\n\n(i) one nurse for every 6 patients; and\n\n(ii) one nurse in charge.\n\n\t24 Rehabilitation and geriatric evaluation management\n\n(1) The operator of a hospital must staff rehabilitation beds as follows—\n\n(a) on the morning shift or the afternoon shift—\n\n(i) one nurse for every 5 patients; and\n\n(ii) one nurse in charge;\n\n(b) on the night shift, one nurse for every 10 patients.\n\n(2) The operator of a hospital must staff geriatric evaluation management beds as follows—\n\n(a) on the morning shift—\n\n(i) one nurse for every 5 patients; and\n\n(ii) one nurse in charge;\n\n(b) on the afternoon shift—\n\n(i) one nurse for every 6 patients; and\n\n(ii) one nurse in charge;\n\nS. 24(2)(c) substituted by No. 36/2020 s. 11.\n\n(c) on the night shift—\n\n(i) one nurse for every 10 patients; and\n\n(ii) on and from 1 July 2023, one nurse in charge.\n\nS. 24(3)(4)  repealed by No. 1/2019 s. 9.\n\n* * * * *\n\n\t25 Operating theatres\n\n(1) The operator of a hospital must staff an operating theatre with the following—\n\n(a) one instrument nurse;\n\n(b) one circulating nurse;\n\n(c) one anaesthetic nurse.\n\n(2) The operator of a hospital may reduce or increase the number of nurses with whom an operating theatre is staffed in accordance with the prescribed criteria.\n\n**Note**\n\nSee also section 7.\n\n(3) The operator of a hospital that complies with subsection (2) is taken to comply with the ratio in subsection (1).\n\n(4) In this section, ***operating theatre*** means an operating theatre that is being utilised to perform a surgical procedure.\n\n\t26 Post-anaesthetic recovery rooms\n\nThe operator of a hospital must staff a post‑anaesthetic recovery room with one nurse for each unconscious patient on all shifts.\n\nS. 27 substituted by No. 1/2019 s. 10.\n\n\t27 Special care nurseries\n\nS. 27(1) substituted by No. 1/2019 s. 24.\n\n(1) The operator of a hospital must staff a ward that is a special care nursery as follows—\n\n(a) in the case of 7 or fewer occupied cots, on all shifts—\n\n(i) one nurse or midwife; and\n\n(ii) for every 4 additional occupied cots beyond 4, one person, being either a nurse or a midwife;\n\n**Note**\n\nSee subsection (2) in relation to requirements for 6 occupied cots.\n\n(b) in the case of 8 or 9 occupied cots—\n\n(i) on the morning shift or the afternoon shift—\n\n(A) one nurse or midwife; and\n\n(B) for every 4 additional occupied cots beyond 4, one person, being either a nurse or a midwife; and\n\n(C) a nurse in charge or a midwife in charge; and\n\n(ii) on the night shift—\n\n(A) one nurse or midwife; and\n\nS. 27(1) (b)(ii)(B) amended by No. 36/2020 s. 12(1)(a).\n\n(B) for every 4 additional occupied cots beyond 4, one person, being either a nurse or a midwife; and\n\nS. 27(1) (b)(ii)(C) inserted by No. 36/2020 s. 12(1)(b).\n\n(C) a nurse in charge or a midwife in charge;\n\n(c) in the case of 10 occupied cots—\n\n(i) on the morning shift or the afternoon shift—\n\n(A) 3 persons, each being either a nurse or a midwife; and\n\n(B) a nurse in charge or a midwife in charge; and\n\nS. 27(1)(c)(ii) substituted by No. 36/2020 s. 12(2).\n\n(ii) on the night shift—\n\n(A) 3 persons, each being either a nurse or a midwife; and\n\n(B) a nurse in charge or a midwife in charge;\n\n(d) in the case of 11 or more occupied cots—\n\n(i) on the morning shift or the afternoon shift—\n\n(A) 4 persons, each being either a nurse or a midwife; and\n\n(B) for every 3 additional occupied cots beyond 11, one person, being either a nurse or a midwife; and\n\n(C) a nurse in charge or a midwife in charge; and\n\n(ii) on the night shift—\n\n(A) 4 persons, each being either a nurse or a midwife; and\n\nS. 27(1) (d)(ii)(B) amended by No. 36/2020 s. 12(3)(a).\n\n(B) for every 3 additional occupied cots beyond 11, one person, being either a nurse or a midwife; and\n\nS. 27(1) (d)(ii)(C) inserted by No. 36/2020 s. 12(3)(b).\n\n(C) a nurse in charge or a midwife in charge.\n\n(2) Despite section 12, the operator of a hospital must staff a special care nursery with 6 occupied cots, on all shifts, with 2 persons, each being either a nurse or a midwife.\n\n(3) A nurse or midwife with whom the operator of a hospital staffs a special care nursery for the purpose of complying with this section must have completed—\n\n(a) the equivalent of at least 64 hours' employment per fortnight as a nurse or a midwife during a 12 month period; or\n\n(b) a total of 64 hours' placement in a special care nursery.\n\n**Note**\n\nThe 64 hours' placement in a special care nursery is supernumerary to the relevant ratio.\n\n(4) For the purpose of ensuring that appropriate care and treatment of infants in a special care nursery is provided, the operator of the hospital—\n\n(a) must take into account the prescribed criteria; and\n\n(b) in accordance with the prescribed criteria, may staff the special care nursery with nurses or midwives in addition to the number required as a minimum under subsection (1).\n\nS. 28 amended by No. 1/2019 s. 11(1)(2)(ILA s. 39B(1)).\n\n\t28 Neonatal intensive care units\n\n(1) The operator of a hospital must staff a ward that is a neonatal intensive care unit as follows on all shifts—\n\n(a) one nurse for every 2 occupied cots; and\n\n(b) one nurse in charge.\n\nS. 28(2) inserted by No. 1/2019 s. 11(2).\n\n(2) For the purposes of ensuring that appropriate care and treatment of infants in a neonatal intensive care unit is provided, the operator of a hospital—\n\n(a) must take into account the prescribed criteria; and\n\n(b) in accordance with the prescribed criteria, may staff the neonatal intensive care unit with nurses in addition to the number required as a minimum under subsection (1).\n\nDivision 3—Midwife to patient ratios\n\n\t29 Meaning of *patient*\n\nIn this Division, ***patient*** does not include a newborn infant.\n\nS. 30 (Heading) amended by No. 1/2019 s. 12(1).\n\n\t30 Antenatal wards\n\nS. 30(1) amended by No. 1/2019 s. 12(2).\n\n(1) The operator of a hospital must staff an antenatal ward with the following—\n\n(a) on the morning shift or the afternoon shift—\n\n(i) one midwife for every 4 patients; and\n\n(ii) one midwife in charge or nurse in charge;\n\nS. 30(1)(b) amended by No. 12/2025 s. 10.\n\n(b) subject to section 30A, on the night shift, one midwife for every 6 patients.\n\nS. 30(2) amended by No. 1/2019 s. 12(3).\n\n(2) A midwife or nurse assigned to an antenatal ward at night may assist in a nursery other than a neonatal intensive care unit, if the hospital layout and workload permits, without the operator of the hospital being in contravention of the requirement set out in subsection (1)(b).\n\nS. 30A inserted by No. 12/2025 s. 11.\n\n\t30A Antenatal wards—night shift\n\n(1) Subject to subsection (2), the operator of a prescribed hospital must staff an antenatal ward on the night shift with one midwife for every 4 patients.\n\n(2) The operator of a hospital referred to in subsection (1) must meet the following—\n\n(a) on and from the day on which the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2025** comes into operation, in each 28 day period—\n\n(i) the ratio set out in section 30(1)(b); and\n\n(ii) 25 per cent of the additional staffing requirement set out in subsection (1);\n\n(b) on and from 1 December 2025, in each 28 day period—\n\n(i) the ratio set out in section 30(1)(b); and\n\n(ii) 75 per cent of the additional staffing requirement set out in subsection (1);\n\n(c) on and from 1 July 2026—the additional staffing requirement set out in subsection (1).\n\nS. 31 (Heading) amended by No. 1/2019 s. 13(1).\n\n\t31 Birthing suites\n\nS. 31(1) substituted by No. 1/2019 ss 13(2), 25.\n\n(1) Subject to subsection (2), the operator of a level 1 hospital, a level 2 hospital or a level 3 hospital must ensure that—\n\n(a) 2 midwives for every 3 nominated birthing suites are provided on all shifts; and\n\nS. 31(1)(b) substituted by No. 36/2020 s. 13.\n\n(b) in the case of a hospital with 6 or more nominated birthing suites—\n\n(i) on the morning shift, a midwife in charge is provided; and\n\n(ii) on and from 1 July 2023, a midwife in charge is provided on the afternoon shift; and\n\n(iii) a midwife in charge is provided on the night shift.\n\nS. 31(2) amended by No. 1/2019 s. 13(3).\n\n(2) The operator of a hospital referred to in subsection (1) that has had fewer than 730 births in the 12 months immediately preceding the relevant day must staff the nominated birthing suites with one midwife on all shifts.\n\n(3) A midwife rostered on under subsection (2) may be rostered to be on call for the hospital.\n\nS. 31(4) amended by No. 1/2019 s. 13(4).\n\n(4) A midwife rostered to a birthing suite may be redeployed to assist in another ward in addition to the ratio for that ward if not required in the birthing suite.\n\nS. 31(5) amended by No. 1/2019 s. 13(4).\n\n(5) If a midwife is redeployed from a birthing suite in accordance with subsection (4), the operator of the hospital is taken to comply with the ratio for the birthing suite.\n\nS. 31(6) substituted by No. 1/2019 s. 13(5).\n\n(6) In February and August each year, the operator of a hospital—\n\n(a) must determine the number of occupied birthing suites in the hospital for the following 6 month period starting on 1 March or 1 September of that year (as the case requires); and\n\n(b) must publish the determination referred to in paragraph (a) on the hospital's Internet site.\n\nS. 31(7) inserted by No. 1/2019 s. 13(5).\n\n(7) For the purpose of determining the number of occupied birthing suites under subsection (6), the operator of a hospital must take into account—\n\n(a) the number of birthing suites used for birthing or midwifery assessments during the preceding 12 months; and\n\n(b) any factors which are likely to increase or decrease the number of birthing suites to be used for birthing or midwifery assessments during the following 6 month period.\n\nS. 31(8) inserted by No. 1/2019 s. 13(5).\n\n(8) Despite anything to the contrary in subsection (7), if the operator of a hospital determines that fewer birthing suites were used during the preceding 12 months on Saturdays and Sundays, the operator may determine the number of occupied birthing suites in the hospital that—\n\n(a) is applicable only on Saturdays and Sundays for the relevant 6 month period; and\n\n(b) is lower than the number determined under subsection (6).\n\nS. 31(9) inserted by No. 1/2019 s. 13(5).\n\n(9) As soon as practicable after receiving a request from the relevant union for the information used by the operator to make a determination under subsection (6) or (8), the operator of a hospital must provide the relevant union with the information.\n\nS. 31(10) inserted by No. 1/2019 s. 13(5).\n\n(10) In this section—\n\n***midwifery assessment*** is an assessment of an outpatient by a midwife in a birthing suite for the purposes of assessing the outpatient in relation to the outpatient's pregnancy;\n\n***nominated birthing suite*** means a birthing suite that is one of a number of birthing suites determined to be occupied under this section.\n\nS. 31A inserted by No. 1/2019 s. 14.\n\n\t31A Postnatal wards\n\n(1) Subject to subsection (2), the operator of a hospital must staff a postnatal ward with the following—\n\n(a) on the morning shift or the afternoon shift—\n\n(i) one midwife or nurse for every 4 patients; and\n\n(ii) one midwife in charge or nurse in charge;\n\nS. 31A(1)(b) substituted by No. 36/2020 s. 14, amended by No. 12/2025 s. 12.\n\n(b) subject to section 31B, on the night shift—\n\n(i) one midwife or nurse for every 6 patients; and\n\n(ii) on and from 1 July 2022, one midwife in charge or nurse in charge.\n\n(2) The operator of a hospital  must ensure that, of the persons referred to in subsection (1)(a)(i) or (b) and with whom the operator staffs a postnatal ward for the purpose of complying with the ratio—\n\n(a) at least one is a midwife; and\n\n(b) not more than one is a nurse.\n\n(3) A nurse with whom the operator of a hospital staffs a postnatal ward for the purpose of complying with the ratio—\n\n(a) must have completed a total of 48 hours' placement in a postnatal ward; and\n\n**Note**\n\nThe 48 hours' placement in a postnatal ward is supernumerary to the relevant ratio.\n\n(b) must be undertaking a postgraduate midwifery program in the course of the nurse's employment by the hospital; and\n\n(c) must satisfy the prescribed requirements.\n\nS. 31B inserted by No. 12/2025 s. 13.\n\n\t31B Postnatal wards—night shift\n\n(1) The operator of a prescribed hospital must staff a postnatal ward on the night shift with—\n\n(a) subject to subsection (2), one midwife or nurse for every 4 patients; and\n\n(b) one midwife in charge or nurse in charge.\n\n(2) The operator of a hospital referred to in subsection (1) must meet the following—\n\n(a) on and from the day on which the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2025** comes into operation, in each 28 day period—\n\n(i) the ratio set out in section 31A(1)(b)(i); and\n\n(ii) 25 per cent of the additional staffing requirement set out in subsection (1)(a);\n\n(b) on and from 1 December 2025, in each 28 day period—\n\n(i) the ratio set out in section 31A(1)(b)(i); and\n\n(ii) 75 per cent of the additional staffing requirement set out in subsection (1)(a);\n\n(c) on and from 1 July 2026—the additional staffing requirement set out in subsection (1)(a).\n\nDivision 4—Variations from ratios\n\n\t32 Quality of care paramount\n\nIn any proposal under this Division to vary a ratio—\n\n(a) the primary consideration is the impact on the quality of patient care; and\n\n(b) any other considerations are as prescribed.\n\nSs 33–35 repealed by No. 1/2019 s. 15.\n\n* * * * *\n\n\t36 Local agreements to vary\n\n(1) The operator of a hospital and a relevant union may enter into an agreement to vary—\n\n(a) a ratio; or\n\n(b) the application of a rounding method under section 12.\n\n(2) An agreement under subsection (1) may only be implemented if the agreement is made in accordance with any prescribed procedures.\n\n(3) The operator of a hospital that complies with an agreement under subsection (1) is taken to comply with the relevant ratio or the requirement of section 12, as the case may be.\n\nPart 3—Compliance and reporting\n\n\t37 Power to give safe patient care compliance direction\n\n(1) The Secretary, for the purposes of giving effect to the objective of this Act, may give a written direction to the operator of a hospital in relation to the following matters—\n\n(a) a requirement that the operator comply with a ratio or a ratio variation, including a requirement arising out of a declaration made or injunction granted under section 42(1);\n\n(b) any other matter or thing necessary or appropriate to be directed in order to give effect to that objective.\n\n**Note**\n\nThe objective of this Act is set out in section 4.\n\n(2) The Secretary must give a copy of a safe patient care compliance direction to a member of the public on request.\n\n(3) The Secretary must give a copy of a safe patient care compliance direction to any relevant union within a reasonable period after giving the direction.\n\n\t38 Procedure for giving safe patient care compliance direction\n\n(1) At least 48 hours before giving a safe patient care compliance direction, the Secretary must—\n\n(a) give a copy of the proposed direction to the operator of the hospital; and\n\n(b) indicate when the Secretary intends to give the direction.\n\n(2) The operator of a hospital given a proposed direction under subsection (1) may give the Secretary written comments in relation to the proposed direction before the time at which the Secretary intends to give the direction.\n\n(3) The Secretary must take into account any comments given in accordance with subsection (2)—\n\n(a) in deciding whether to give the direction; and\n\n(b) if the Secretary decides to give the direction, in determining the content of the direction.\n\n\t39 Effect of safe patient care compliance direction\n\n(1) The operator of a hospital to which a safe patient care compliance direction applies must comply with that direction.\n\n(2) A safe patient care compliance direction has effect despite anything to the contrary in either of the following having effect in relation to the hospital to which the safe patient care compliance direction applies—\n\n(a) a health service agreement within the meaning of the **Health Services Act 1988**; or\n\n(b) an interim funding statement within the meaning of that Act.\n\n\t40 Obligation to report certain matters\n\nThe operator of a hospital to which any of the following applies must report that matter in its report of operations for a financial year under Part 7 of the **Financial Management Act 1994**—\n\n(a) any finding by the Magistrates' Court under section 42(1)(a) during that year that the operator did not comply with any of the following—\n\n(i) a ratio;\n\n(ii) a ratio variation;\n\n(iii) a requirement by or under Division 4 of Part 2 to undertake consultation in good faith with respect to the making of a ratio variation;\n\n(b) whether any injunction has been granted by the Magistrates' Court under section 42(1)(b) during that year in respect of the operator;\n\n(c) whether any civil penalty has been imposed on the operator by the Magistrates' Court under section 43 during that year and, if so, the amount of that penalty;\n\n(d) whether the operator has been issued with a safe patient care compliance direction during that year;\n\n(e) the action taken during that year by the operator subsequent to any finding referred to in paragraph (a).\n\nPart 4—Enforcement\n\n\t41 Local dispute resolution\n\n(1) A nurse or midwife who works at a hospital covered by a ratio or a relevant union (as representative of the nurse or midwife) may notify the operator of the hospital of an alleged breach of the ratio or a ratio variation.\n\n(2) A local dispute must be resolved in accordance with any prescribed resolution procedures.\n\n(3) The parties to a local dispute must act in good faith during the resolution of that dispute under subsection (2).\n\n(4) If a party to a local dispute incurs costs in resolving that dispute, that party must bear the party's own costs.\n\nS. 41(5) inserted by No. 1/2019 s. 16.\n\n(5) This section does not apply to breaches that—\n\n(a) are alleged to have occurred during the period commencing on the day on which Part 2 of the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2019** comes into operation and ending 180 days after that day; and\n\n(b) are in relation to staffing requirements which are in operation consequent to amendments made by that Part.\n\nS. 41(6) inserted by No. 12/2025 s. 14.\n\n(6) This section does not apply to a breach of an additional staffing requirement—\n\n(a) set out in section 20(2)(a), 20A(3)(a), 20B(3)(a), 21(2)(a), 22(1A)(a), 30A(2)(a)(ii) or 31B(2)(a)(ii); and\n\n(b) that is alleged to have occurred during the period commencing on the day on which the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2025** comes into operation and ending on 30 November 2025.\n\nS. 41(7) inserted by No. 12/2025 s. 14.\n\n(7) This section does not apply to a breach of an additional staffing requirement—\n\n(a) set out in section 20(2)(b), 20A(3)(b), 20B(3)(b), 21(2)(b), 22(1A)(b), 30A(2)(b)(ii) or 31B(2)(b)(ii); and\n\n(b) that is alleged to have occurred during the period commencing on 1 December 2025 and ending on 30 June 2026.\n\n\t42 Referral to Magistrates' Court\n\n(1) If the parties to a local dispute are not able to resolve the dispute in accordance with section 41, the Magistrates' Court, on an application by a party, may do any or all of the following—\n\n(a) make a declaration that the operator of the hospital complied with or did not comply with any or all of the following—\n\n(i) a ratio;\n\n(ii) a ratio variation;\n\n(iii) a requirement by or under Division 4 of Part 2 to undertake consultation in good faith with respect to the making of a ratio variation;\n\n(b) grant an injunction restraining the operator of the hospital from contravening or continuing to contravene any or all of the following—\n\n(i) a ratio;\n\n(ii) a ratio variation;\n\n(iii) a requirement by or under Division 4 of Part 2 to undertake consultation in good faith with respect to the making of a ratio variation.\n\n(2) Subsection (1) applies despite section 100(2)(a) of the **Magistrates' Court Act 1989**.\n\n(3) If an application is made under subsection (1), the Magistrates' Court may grant an interim injunction in respect of that application restraining the operator of the hospital from engaging in or continuing the course of conduct the subject of the application pending the determination of the application.\n\n(4) An interim injunction has effect until either of the following occurs—\n\n(a) the application under subsection (1) is determined;\n\n(b) the interim injunction is revoked by a court.\n\n(5) If the Magistrates' Court grants an interim injunction, the Magistrates' Court must determine the substantive application as a matter of urgency.\n\n(6) In deciding whether to make a declaration or grant an injunction under this section, the Magistrates' Court must not consider the clinical aspects of the matter the subject of the dispute.\n\n\t43 Civil penalty\n\n(1) If the Magistrates' Court makes a declaration under section 42(1)(a) that the operator of a hospital did not comply with a ratio or a ratio variation, the Magistrates' Court may make an order imposing a penalty not exceeding 60 penalty units on the operator.\n\n(2) The Magistrates' Court may impose a penalty on the operator only if satisfied that the non‑compliance was wilful and serious.\n\n(3) A penalty imposed under this section is to be paid into the Consolidated Fund.\n\n(4) An order imposing a penalty under this section is taken, for the purposes of enforcement, to be an order made in a civil proceeding.\n\n(5) Nothing in this section is to be taken as creating an offence for non-compliance with a ratio or a ratio variation.\n\n\t44 Notification requirements\n\n(1) A person who makes an application to the Magistrates' Court under section 42(1) must notify the Secretary of that application as soon as practicable, but in any case not more than 7 days after the application is made.\n\n(2) If the Magistrates' Court makes a declaration or grants an injunction under section 42, the principal registrar within the meaning of the **Magistrates' Court Act 1989** must notify the Secretary of the making of that declaration or the granting of that injunction within 7 days.\n\nPart 5—General\n\n\t45 Regulations\n\n(1) The Governor in Council may make regulations for or with respect to any matter or thing required or permitted by this Act to be prescribed or necessary to be prescribed to give effect to this Act.\n\n(2) The regulations—\n\n(a) may be of general or limited application;\n\n(b) may differ according to differences in time, place or circumstances;\n\n(c) may require matters affected by the regulations to be—\n\n(i) in accordance with specified standards or specified requirements; or\n\n(ii) approved by or to the satisfaction of a specified person or body or a specified class of persons or bodies; or\n\n(iii) as specified in both subparagraphs (i) and (ii);\n\n(d) may leave any matter or thing to be from time to time determined, applied, dispensed with or regulated by a specified person;\n\n(e) may provide in a specified case or class of cases for the exemption of persons or things or a class of persons or things from any of the provisions of the regulations—\n\n(i) whether unconditionally or on specified conditions; and\n\n(ii) either wholly or to such an extent as is specified.\n\nPt 5A (Headings and  \nss 45A–45F) inserted by No. 11/2020 s. 59, repealed by No. 51/2015 s. 45F.\n\n* * * * *\n\nPart 6—Savings and transitional\n\n\t46 Meaning of *Agreement*\n\nIn this Part—\n\n***Agreement*** means the Nurses and Midwives (Victorian Public Sector) (Single Interest Employers) Enterprise Agreement 2012–2016 [2012] FWAA 5560 made under the Fair Work Act 2009 of the Commonwealth;\n\n***CWMA*** has the meaning given by clause 4(f) of the Agreement, but including any variations made in accordance with clause 42 of the Agreement.\n\n\t47 Pre-existing higher staffing arrangements\n\n(1) If an above ratio CWMA is in effect immediately before the commencement of this section, a staffing requirement provided for in that CWMA—\n\n(a) applies for the purposes of this Act as if it were a ratio, instead of or in addition to (as applicable) any ratio that would apply under this Act; and\n\n(b) is taken to be a ratio for the purposes of Division 4 of Part 2.\n\n(2) In subsection (1), ***above ratio CWMA*** means a CWMA that—\n\n(a) requires the operator of a hospital to staff a ward with a higher number of nurses or midwives than otherwise required under a ratio; and\n\n(b) is the subject of a formal written agreement with a person who or body that is entitled to make that agreement; and\n\n(c) except in the case of an agreement at hospital level to provide equivalent full-time nurses or midwives with no additional recurrent funding, is funded by a person who or body that has responsibility to provide that funding.\n\n\t48 Pre-existing lower staffing arrangements\n\n(1) If a below ratio CWMA is in effect immediately before the commencement of this section, a staffing requirement provided for in that CWMA applies for the purposes of this Act as if it were a ratio, instead of the ratio that would otherwise apply under this Act, until that CWMA is terminated or otherwise ceases to have effect.\n\n(2) A below ratio CWMA applying as if it were a ratio under subsection (1) terminates and ceases to have effect on the first anniversary of the commencement of this section.\n\n(3) In this section, ***below ratio CWMA*** means a CWMA that permits the operator of a hospital to staff a ward with a lower number of nurses or midwives than required under a ratio.\n\n\t49 Saving of pre-existing variations\n\n(1) A redistribution of nursing or midwifery hours under clause 42.2 of the Agreement that permits a hospital to staff a ward with a lower number of nurses or midwives than required under a ratio, and as in effect immediately before the commencement of this subsection, is taken to be a redistribution under section 33(1).\n\n(2) A distribution under clause 42.3 of the Agreement that permits a hospital to staff a ward with a lower number of nurses or midwives than required under a ratio, and as in effect immediately before the commencement of this subsection, is taken to be a below ratios distribution.\n\n(3) An alternative staffing model under clause 42.4 of the Agreement that permits a hospital to staff a ward with a lower number of nurses or midwives than required under a ratio, and as in effect immediately before the commencement of this subsection, is taken to be a trial under section 35(1).\n\n(4) Any arrangement other than that specified in subsection (1), (2) or (3) made under the Agreement to reduce the number of nurses or midwives in a ward to a level that is lower than that required by any ratio and as in effect immediately before the commencement of this subsection is taken to be an agreement under section 36(1).\n\nS. 50 inserted by No. 1/2019 s. 17.\n\n\t50 Saving of variations and redistributions—Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2019\n\n(1) Despite the repeal of section 33 as in force immediately before the commencement of section 15 of the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2019**, an operator of a hospital that complies with—\n\n(a) a redistribution proposal made and implemented in accordance with section 33 before that repeal; or\n\n(b) a redistribution of nursing or midwifery hours taken under section 49(1) before that repeal to be a redistribution under section 33(1)—\n\nis taken to comply with the relevant ratio during the relevant specified period.\n\n(2) Despite the repeal of section 34 as in force immediately before the commencement of section 15 of the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2019**, an operator of a hospital that implements—\n\n(a) a below ratios distribution that is in effect immediately before that repeal; or\n\n(b) a distribution of nursing or midwifery hours taken under section 49(2) before that repeal to be a below ratios distribution—\n\nis taken to comply with the relevant ratio during the relevant specified period.\n\n(3) Despite the repeal of section 35 as in force immediately before the commencement of section 15 of the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2019**, an operator of a hospital that applies—\n\n(a) an alternative staffing model in accordance with section 35(2) or (3) immediately before that repeal; or\n\n(b) an alternative staffing model taken under section 49(3) before that repeal to be a trial under section 35(1)—\n\nis taken to comply with the relevant ratio for the duration of the application of that model.\n\nSch. 1 amended by Nos 1/2019 ss 18, 19, 36/2020 s. 15, 12/2025 s. 17.\n\nSchedule 1—Level 1, 2 and 3 hospitals\n\nPart 1—Level 1 hospitals\n\nAlfred Hospital\n\nAustin Hospital\n\nBox Hill Hospital\n\nCasey Hospital\n\nDandenong Hospital\n\nFootscray Hospital\n\nFrankston Hospital\n\nHeidelberg Repatriation Hospital\n\nMonash Children's Hospital\n\nMonash Medical Centre (Clayton)\n\nNorthern Hospital\n\nPeter MacCallum Cancer Centre\n\nSt Vincent's Hospital\n\nSunshine Hospital\n\nThe Royal Children's Hospital\n\nThe Royal Melbourne Hospital\n\nUniversity Hospital Geelong\n\nPart 2—Level 2 hospitals\n\nBendigo Hospital\n\nGoulburn Valley Health\n\nGrampians Health (Ballarat Base Hospital)\n\nLatrobe Regional Hospital\n\nMaroondah Hospital\n\nMercy Hospital for Women\n\nMildura Base Public Hospital\n\nNortheast Health Wangaratta\n\nThe Royal Women's Hospital\n\nWarrnambool Base Hospital\n\nWerribee Mercy Hospital\n\nPart 3—Level 3 hospitals\n\nAlbury Wodonga Health (Wodonga campus)\n\nAngliss Hospital\n\nBairnsdale Regional Health Service\n\nCentral Gippsland Health Service (Sale campus)\n\nDhelkaya Health (Castlemaine campus)\n\nEchuca Regional Health\n\nGrampians Health (Wimmera Base Hospital)\n\nHamilton Base Hospital\n\nMonash Medical Centre (Moorabbin)\n\nPortland District Health\n\nRosebud Hospital\n\nSandringham Hospital\n\nSwan Hill District Health\n\nThe Royal Victorian Eye and Ear Hospital\n\nWest Gippsland Hospital\n\nWilliamstown Hospital\n\nSch. 2 amended by Nos 1/2019 s. 20, 12/2025 s. 18.\n\nSchedule 2—Hospitals not restricted in use of enrolled nurses\n\nAlbury Wodonga Health (Wodonga campus)\n\nAlexandra District Hospital\n\nAlpine Health (Bright campus)\n\nAlpine Health (Mt Beauty campus)\n\nAlpine Health (Myrtleford campus)\n\nAngliss Hospital\n\nArarat Hospital\n\nBacchus Marsh Hospital\n\nBairnsdale Regional Health Service\n\nBeaufort and Skipton Health Service\n\nBeechworth Health Service\n\nBenalla Health\n\nBoort District Health\n\nCalvary Health Care Bethlehem Limited\n\nCasterton Memorial Hospital\n\nCaulfield Hospital\n\nCentral Gippsland Health Service (Heyfield campus)\n\nCentral Gippsland Health Service (Maffra campus)\n\nCentral Gippsland Health Service (Sale campus)\n\nCentral Highlands Rural Health (Creswick campus)\n\nCentral Highlands Rural Health (Daylesford campus)\n\nCohuna District Hospital\n\nColac Area Health\n\nDhelkaya Health (Castlemaine campus)\n\nDhelkaya Health (Maldon Hospital)\n\nDunmunkle Health Services\n\nEastern Health (Peter James Centre)\n\nEastern Health (Yarra Ranges Health)\n\nEast Grampians Health Services (Ararat Services)\n\nEast Wimmera Health Service (Birchip campus)\n\nEast Wimmera Health Service (Charlton campus)\n\nEast Wimmera Health Service (Donald campus)\n\nEast Wimmera Health Service (St Arnaud campus)\n\nEast Wimmera Health Service (Wycheproof campus)\n\nEchuca Regional Health\n\nGoulburn Valley Health (Tatura campus)\n\nGoulburn Valley Health (Waranga campus)\n\nGrampians Health (Dimboola District Hospital)\n\nGrampians Health (Edenhope and District Memorial Hospital)\n\nGrampians Health (Stawell Regional Health)\n\nGrampians Health (Wimmera Base Hospital)\n\nGreat Ocean Road Health (Lorne Community Hospital)\n\nGreat Ocean Road Health (Otway campus)\n\nHamilton Base Hospital\n\nHeathcote Health\n\nHesse Rural Health\n\nHeywood Rural Health\n\nHopetoun Hospital\n\nInglewood and Districts Health Service\n\nJeparit Hospital\n\nKaniva Hospital\n\nKerang District Health\n\nKilmore and District Hospital\n\nKooweerup Regional Health Service\n\nKorumburra Hospital\n\nKyabram and District Health Services\n\nKyneton District Health Service\n\nLeongatha Hospital\n\nMallee Track Health and Community Service\n\nMansfield District Hospital\n\nMaryborough District Health Service\n\nMonash Health (Monash Health Community)\n\nMoorabbin Hospital\n\nMoyne Health Services\n\nNCN Health (Cobram campus)\n\nNCN Health (Nathalia District Hospital)\n\nNCN Health (Numurkah campus)\n\nNhill Hospital\n\nOmeo District Health\n\nOrbost Regional Health\n\nPenshurst and District Health\n\nPortland District Health\n\nQueen Elizabeth Centre\n\nRainbow Hospital\n\nRobinvale District Health Services (Manangatang campus)\n\nRobinvale District Health Services (Robinvale campus)\n\nRochester and Elmore District Health Service\n\nRosebud Hospital\n\nRural Northwest Health (Warracknabeal campus)\n\nSt Vincent's Palliative Care Services (Kew)\n\nSandringham Hospital\n\nSeymour Health\n\nSouth Gippsland Hospital\n\nSouth West Healthcare\n\nSwan Hill District Health\n\nTallangatta Health Service\n\nTerang and Mortlake Health Services\n\nThe Royal Victorian Eye and Ear Hospital\n\nTimboon and District Healthcare Service\n\nUpper Murray Health and Community Services\n\nWest Gippsland Hospital\n\nWest Wimmera Health Service (Natimuk Centre)\n\nWestern District Health Service (Coleraine campus)\n\nWilliamstown Hospital\n\nWonthaggi Hospital\n\nYarram and District Health Service\n\nYarrawonga Health\n\nYea and District Memorial Hospital\n\nSch. 3 amended by No. 12/2025 s. 19.\n\nSchedule 3—Categories of hospitals for emergency department ratios\n\nPart 1\n\nAlfred Hospital\n\nAngliss Hospital\n\nAustin Hospital\n\nBendigo Hospital\n\nBox Hill Hospital\n\nCasey Hospital\n\nDandenong Hospital\n\nFootscray Hospital\n\nFrankston Hospital\n\nGoulburn Valley Health (Shepparton campus)\n\nGrampians Health (Ballarat Base Hospital)\n\nLatrobe Regional Hospital\n\nMaroondah Hospital\n\nMildura Base Public Hospital\n\nMonash Medical Centre (Clayton)\n\nNorthern Hospital\n\nSt Vincent's Hospital\n\nSunshine Hospital\n\nThe Royal Children's Hospital\n\nThe Royal Melbourne Hospital (City campus)\n\nUniversity Hospital Geelong\n\nWerribee Mercy Hospital\n\nPart 2\n\nAlbury Wodonga Health (Wodonga campus)\n\nBairnsdale Regional Health Service\n\nGrampians Health (Wimmera Base Hospital)\n\nRosebud Hospital\n\nSandringham Hospital\n\nWarrnambool Base Hospital\n\nWilliamstown Hospital\n\nPart 3\n\nCentral Gippsland Health Service (Sale campus)\n\nEchuca Regional Health\n\nNortheast Health Wangaratta\n\nSwan Hill District Health\n\nThe Royal Victorian Eye and Ear Hospital\n\nThe Royal Women's Hospital\n\nWest Gippsland Hospital\n\n═══════════════\n\nEndnotes\n\n1 General information\n\nSee [www.legislation.vic.gov.au](http://www.legislation.vic.gov.au) for Victorian Bills, Acts and current Versions of legislation and up-to-date legislative information.\n\n*Minister's second reading speech—*\n\nLegislative Assembly: 2 September 2015\n\nLegislative Council: 17 September 2015\n\nThe long title for the Bill for this Act was \"A Bill for an Act to specify requirements that the operators of certain publicly funded health facilities staff certain wards with a minimum number of nurses or midwives, to provide for the reporting of compliance with, and enforcement of, those requirements and for other purposes.\"\n\nThe **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015** was assented to on 13 October 2015 and came into operation on 23 December 2015: Special Gazette (No. 426) 22.12.15 p. 2.\n\nINTERPRETATION OF LEGISLATION ACT 1984 (ILA)\n\nStyle changes\n\nSection 54A of the ILA authorises the making of the style changes set out in Schedule 1 to that Act.\n\nReferences to ILA s. 39B\n\nSidenotes which cite ILA s. 39B refer to section 39B of the ILA which provides that where an undivided section or clause of a Schedule is amended by the insertion of one or more subsections or subclauses, the original section or clause becomes subsection or subclause (1) and is amended by the insertion of the expression \"(1)\" at the beginning of the original section or clause.\n\nInterpretation\n\nAs from 1 January 2001, amendments to section 36 of the ILA have the following effects:\n\n• Headings\n\nAll headings included in an Act which is passed on or after 1 January 2001 form part of that Act. Any heading inserted in an Act which was passed before 1 January 2001, by an Act passed on or after 1 January 2001, forms part of that Act. This includes headings to Parts, Divisions or Subdivisions in a Schedule; sections; clauses; items; tables; columns; examples; diagrams; notes or forms. See section 36(1A)(2A).\n\n• Examples, diagrams or notes\n\nAll examples, diagrams or notes included in an Act which is passed on or after 1 January 2001 form part of that Act. Any examples, diagrams or notes inserted in an Act which was passed before 1 January 2001, by an Act passed on or after 1 January 2001, form part of that Act. See section 36(3A).\n\n• Punctuation\n\nAll punctuation included in an Act which is passed on or after 1 January 2001 forms part of that Act. Any punctuation inserted in an Act which was passed before 1 January 2001, by an Act passed on or after 1 January 2001, forms part of that Act. See section 36(3B).\n\n• Provision numbers\n\nAll provision numbers included in an Act form part of that Act, whether inserted in the Act before, on or after 1 January 2001. Provision numbers include section numbers, subsection numbers, paragraphs and subparagraphs. See section 36(3C).\n\n• Location of \"legislative items\"\n\nA \"legislative item\" is a penalty, an example or a note. As from 13 October 2004, a legislative item relating to a provision of an Act is taken to be at the foot of that provision even if it is preceded or followed by another legislative item that relates to that provision. For example, if a penalty at the foot of a provision is followed by a note, both of these legislative items will be regarded as being at the foot of that provision. See section 36B.\n\n• Other material\n\nAny explanatory memorandum, table of provisions, endnotes, index and other material printed after the Endnotes does not form part of an Act.  \nSee section 36(3)(3D)(3E).\n\n2 Table of Amendments\n\nThis publication incorporates amendments made to the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015** by Acts and subordinate instruments.\n\n–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––\n\n**Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015, No. 51/2015**\n\n| Assent Date: | 13.10.15 |\n| --- | --- |\n| Commencement Date: | S. 45F inserted on 25.4.20 by No. 11/2020 s. 59: s. 2 |\n| Note: | S. 45F repealed Pt 5A (ss 45A–45F) on 25.10.20 |\n| Current State: | This information relates only to the provision/s amending the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015** |\n\n\n**Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2019, No. 1/2019**\n\n| *Assent Date:* | 26.2.19 |\n| --- | --- |\n| *Commencement Date:* | Ss 4–20 on 1.3.19: s. 2(1); ss 21–25 on 1.3.20: s. 2(2); ss 26, 27 on 1.3.21: s. 2(3) |\n| *Current State:* | This information relates only to the provision/s amending the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015** |\n\n\n**COVID-19 Omnibus (Emergency Measures) Act 2020, No. 11/2020**\n\n| Assent Date: | 24.4.20 |\n| --- | --- |\n| Commencement Date: | S. 59 on 25.4.20: s. 2 |\n| Current State: | This information relates only to the provision/s amending the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015** |\n\n\n**Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2020, No. 36/2020**\n\n| Assent Date: | 17.11.20 |\n| --- | --- |\n| Commencement Date: | Ss 8–11, 14 on 18.11.20: s. 2(2); s. 6 on 1.3.21: s. 2(3); ss 4, 5, 7, 12, 13, 15 on 1.7.22: s. 2(4) |\n| Current State: | This information relates only to the provision/s amending the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015** |\n\n\n**Mental Health and Wellbeing Act 2022, No. 39/2022**\n\n| Assent Date: | 6.9.22 |\n| --- | --- |\n| Commencement Date: | S. 860 on 1.9.23: s. 2(2) |\n| Current State: | This information relates only to the provision/s amending the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015** |\n\n\n**Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2025, No. 12/2025**\n\n| Assent Date: | 8.4.25 |\n| --- | --- |\n| Commencement Date: | Ss 4–19 on 9.4.25: s. 2 |\n| Current State: | This information relates only to the provision/s amending the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015** |\n\n\n–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––\n\n3 Explanatory details\n\n1. S. 20(1)(a)(i): The amendment proposed by section 6(1) of the **Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Act 2025**, No. 12/2025 is not included in this publication as the words \"on the\" do not appear in section 20(1)(a)(i).\n\n  Section 6(1) reads as follows:\n\n  6 Emergency departments\n\n  (1) In section 20(1)(a)(i) of the Principal Act, for \"on the\" **substitute** \"subject to subsection (2), on the\". [↑](#endnote-ref-1)","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":8,"scope_assessment":{"changed":true,"description":"The legislation has grown significantly beyond its original 2015 scope. The original Act covered basic nurse-to-patient ratios in general wards, emergency departments and some specialty units. Through amendments in 2019, 2020 and 2025, it now encompasses: intensive care units (new sections 20A-20B), acute stroke wards (21A), oncology and haematology wards (21B-21C), neonatal intensive care (expanded), special care nurseries (completely rewritten), antenatal/postnatal night shift ratios (30A, 31B), and complex phased implementation of additional staffing requirements. The 2025 amendments alone added staged compliance (25%/75%/100%) for multiple new staffing categories. The rounding rules (section 12) have expanded from a simple provision to a labyrinthine schedule of 20+ ward/shift/date combinations. What began as a framework for general ward staffing has become a comprehensive, granular prescription of staffing minima across virtually every clinical area in Victorian public hospitals."},"complexity_factors":["Multiple overlapping classification systems: hospitals classified into 4 levels (Level 1-4), wards classified into 20+ distinct types (acute stroke, haematology, neonatal intensive care, etc.), and emergency departments split across 3 schedule categories","Phased implementation with 15+ different commencement dates scattered from 2015 through to 2026, with some provisions staged at 25%, 75% and 100% compliance thresholds","Extensive cross-referencing between sections, schedules and external documents (e.g., enterprise agreements, the Aged Care Act 1997, Health Services Act 1988)","47+ defined terms in section 3, many with nested definitions and exceptions (e.g., 'bed' includes cubicles, trolleys, treatment chairs, cots and delivery suites; 'high care beds' excludes specific mental health beds)","Complex conditional logic in section 12 (rounding method) with 6 sub-paragraphs (a)-(g) containing multiple sub-sub-paragraphs, each triggering at different dates and applying to different ward/shift combinations","Nested exceptions and savings provisions in Part 6 preserving pre-2015 enterprise agreement arrangements, below-ratio distributions, and transitional arrangements from multiple amendment Acts","Mixed ward calculations (section 12A) requiring 6-monthly nominations, internet publication, mathematical aggregation of partial ratios, and fallback rules if nominations fail","Birthing suite occupancy determinations (section 31) requiring annualised calculations, weekend variations, and union notification obligations","Skill mix restrictions (section 14) limiting enrolled nurses to 20% in acute wards, with Schedule 2 listing 80+ exempt hospitals","Multiple enforcement pathways with grace periods: sections 41(5)-(7) create temporary immunity periods for breaches during staged implementation phases"],"plain_english_summary":"**What this law does:**\n\nThis Act sets **minimum staffing rules** for nurses and midwives in Victorian public hospitals and certain other publicly funded health facilities. It tells hospital operators exactly how many nurses or midwives must be on duty for each patient, depending on the type of ward, the time of day, and the size of the hospital.\n\n**Who it affects:**\n\n- **Hospital operators** (the organisations running public hospitals) — they must meet these minimum ratios or face penalties.\n- **Nurses and midwives** — the law protects their workloads and gives them a way to complain if ratios aren't met.\n- **Patients** — the law aims to ensure safe care by preventing dangerously low staffing levels.\n\n**Key things the law covers:**\n\n- **Different ratios for different wards:** General wards, emergency departments, intensive care units, birthing suites, special care nurseries, and many other specialised wards each have specific nurse-to-patient or midwife-to-patient ratios.\n- **Different rules for different hospital sizes:** Hospitals are classified into four levels (Level 1 being the largest, Level 4 the smallest), with stricter ratios for bigger hospitals.\n- **Shift-by-shift requirements:** Ratios vary between morning, afternoon and night shifts — generally requiring more staff during the day.\n- **Rounding up:** In many wards, if the maths doesn't work out to a whole number of staff, hospitals must round up and add an extra nurse or midwife.\n- **Mixed wards:** Special rules apply when one ward contains different types of patients (e.g., general medical and palliative care beds together).\n- **Enforcement:** Nurses, midwives or their unions can report breaches. Disputes go to local resolution first, then to the Magistrates' Court if unresolved. The Court can issue injunctions and impose civil penalties (fines up to 60 penalty units) for wilful, serious breaches.\n- **No cutting existing conditions:** The law doesn't override employment contracts or workplace agreements — it sets a floor, not a ceiling. Hospitals can always staff above the minimum.\n\n**Why it matters:**\n\nThis is one of the most prescriptive staffing laws in Australian healthcare. It removes discretion from hospital managers about minimum nurse and midwife numbers, aiming to reduce patient deaths, medical errors and staff burnout. The detailed schedules name specific hospitals and spell out exactly how staffing must work in each location."},"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"},"summary":{"complexity_score":6,"scope_assessment":{"changed":false,"description":"Based on the available metadata, the Act appears to remain focused on its original purpose: mandating minimum nurse-to-patient and midwife-to-patient ratios in Victorian public health settings. The version history indicates amendments have been made since the original 2015 enactment, but there is insufficient text provided to determine whether those amendments materially expanded or contracted the scope of the legislation."},"complexity_factors":["Multiple ward-type-specific ratio schedules requiring interpretation across different clinical settings","Interaction between state legislation and federal healthcare funding and regulation frameworks","Definitions of 'nurse', 'midwife', and 'patient' that may have precise technical legal meanings affecting coverage","Enforcement mechanisms and penalty provisions requiring understanding of both civil and regulatory law","Exemption or variation provisions that may allow departures from standard ratios in defined circumstances","Potential interaction with enterprise agreements (workplace contracts) and industrial relations law","Version history suggests the Act has been amended, meaning the current operative law may differ from the original — readers must confirm which version applies","Limited legislative text was provided, making full assessment of complexity factors incomplete"],"plain_english_summary":"This Victorian law creates legally binding minimum nurse-to-patient and midwife-to-patient ratios in public hospitals and health services. It gives patients a right to a baseline level of nursing attention and prevents employers from rostering staff below those limits.\n\nIt affects public hospital patients, nurses and midwives, and health service operators, and matters because it turns evidence linking lower ratios to better outcomes into an enforceable staffing obligation."},"issue_detection":{"absurdities":[],"contradictions":[]},"flash_summary":{"complexity_score":8,"scope_assessment":{"changed":true,"description":"Since enactment the Act's scope has been broadened and made more granular by later amendments: new ward categories and units (eg. acute stroke, haematology, oncology, intensive care units) and additional staffing items (eg. resuscitation bed nurses, ICU liaison/team leaders) were added (see s 21A, s 21B, ss 20A–20B, s 20(1)(a)(ia)). The amendments also introduced phased implementation schedules for extra staffing (eg. s 20(2); s 20A(3); s 20B(3); ss 21(2), 22(1A), 30A(2), 31B(2)), expanded rounding and timing rules (s 12), and new mixed‑ward nomination procedures (s 12A). Schedules and multiple amendment Acts (2019, 2020, 2025) materially expanded who and what wards are covered, and added transitional arrangements (Part 6)."},"complexity_factors":["Numerous ward‑ and shift‑specific ratios spread across Division 2 and Division 3 (ss 15–31B) and multiple hospital categories in Schedules 1–3","Phased implementation and staged ramp‑ups for additional staffing requirements introduced by amendment Acts (see s 12 timing clauses; ss 20(2), 20A(3), 20B(3), 21(2), 22(1A), 30A(2), 31B(2))","Detailed rounding and mixed‑ward calculation rules affecting rostering arithmetic (ss 12, 12A)","Local variation mechanism requiring operator‑union agreements and prescribed procedures (s 36) which can alter application of ratios","Enforcement architecture combining local dispute procedures, Magistrates' Court declarations/injunctions and civil penalties (ss 41–43) plus notification/reporting duties (ss 37–40, 44)","Skill‑mix and exclusion rules limiting use of enrolled nurses and excluding certain mental health wards (s 14; s 9(2))","Transitional and savings provisions preserving pre‑existing enterprise agreement arrangements (Part 6, ss 47–50)","Broad delegated regulation‑making power that can vary application by time, place or class (s 45)","Multiple amendments across 2019, 2020 and 2025 that add new ward categories (eg. acute stroke, haematology, oncology, ICU) and alter operation—raising interpretive and implementation complexity (Table of Amendments & endnotes)"],"plain_english_summary":"Mechanically, the Act prescribes minimum nurse‑to‑patient and midwife‑to‑patient staffing ratios for named public hospitals and ward types, requires operators to roster staff to those minima, report compliance and permits Secretary directions and court orders to enforce them. Its stated purpose is to provide safe patient care by recognising nursing workloads; practically, hospital operators carry the staffing and funding obligations, relevant unions can negotiate local variations, and technical rules (rounding, mixed‑ward nominations, skill‑mix caps, phased roll‑outs) shape rostering and costs."}},"importantCases":[],"_links":{"self":"/api/acts/safe-patient-care-nurse-to-patient-and-midwife-to-patient-ratios-act-2015","history":"/api/acts/safe-patient-care-nurse-to-patient-and-midwife-to-patient-ratios-act-2015/history","analysis":"/api/acts/safe-patient-care-nurse-to-patient-and-midwife-to-patient-ratios-act-2015/analysis","conflicts":"/api/acts/safe-patient-care-nurse-to-patient-and-midwife-to-patient-ratios-act-2015/conflicts","importantCases":"/api/acts/safe-patient-care-nurse-to-patient-and-midwife-to-patient-ratios-act-2015/important-cases","documents":"/api/acts/safe-patient-care-nurse-to-patient-and-midwife-to-patient-ratios-act-2015/documents"}}