A growing number of Victorian nurses have spoken out against St Vincent’s Hospital’s policy to prioritise Indigenous patients for treatment, warning it undermines public trust and places patient safety at risk.
Under the policy, introduced at St Vincent’s in 2024, all Indigenous patients are automatically classified as a minimum category three on arrival at the emergency department. This means they must be seen within 30 minutes, regardless of the urgency of their medical condition.
The initiative was developed in partnership with the Department of Health and intended to improve access to healthcare for Aboriginal and Torres Strait Islander people. But staff say the reality on the ground has been distressing and divisive.
A recent survey by the Nurses’ Professional Association of Victoria (NPAV) revealed that more than 90 per cent of nurses believe the policy poses a risk to public health. Many respondents said they felt pressured to act outside their professional and ethical obligations, and that prioritising patients based on race, rather than medical need, compromised clinical judgment.
Speaking to the Herald Sun, one nurse shared that “all Australians deserve to be treated equally, one person is not more important than another,” while another warned the policy “undermines public confidence” in the health system.
Kara Thomas, President of the NPAV, said the results highlight a growing crisis of confidence among frontline health workers. “Our members are dedicated to delivering culturally safe and equitable care,” she said. “But care must always be guided by clinical need and professional integrity, in line with the National Law and the Nursing and Midwifery Board of Australia’s Code of Conduct.”
Ms Thomas has written to Health Minister Mary-Anne Thomas, urging the government to urgently review the policy, citing serious concerns about its fairness and legality. She has also contacted the Australian Health Practitioner Regulation Agency (AHPRA), asking for clarity on whether nurses could face disciplinary action for refusing to comply with directions they believe breach ethical codes.
“We are seeking written assurance that no nurse will be coerced, directed or penalised for exercising professional judgment based on clinical need,” Ms Thomas said.
The backlash has been echoed by senior medical professionals, including Professor John Wilson, former president of the Royal Australasian College of Physicians, who has warned that the policy may breach medical ethics.
He said prioritising patients by race contradicts established triage principles, which are designed to ensure treatment is delivered based solely on urgency and severity.
A complaint about the policy is currently being assessed by the Victorian Equal Opportunity and Human Rights Commission.
Despite the mounting criticism, both St Vincent’s Hospital and Premier Jacinta Allan have defended the policy, describing it as part of a broader commitment to improving healthcare outcomes for Indigenous communities. The hospital has even been nominated for a Victorian Public Healthcare Award for its approach, with judges noting that “First Nations patients are now seen more promptly than non-Indigenous patients.”
However, for many on the frontline, the policy has created confusion and moral conflict. “Nurses are being forced to choose between following orders and following their code,” one staff member said. “That’s not fair on anyone, least of all the patients.”
How it compares to other codes
Category 1 – Immediate: Life-threatening.
Category 2 – Emergency: Could become life-threatening; requires assessment within 10 minutes.
Category 3 – Urgent: Not life-threatening, but requires treatment within 30 minutes.
Category 4 – Semi-urgent: Not life-threatening, requires assessment within 60 minutes.
Category 5 – Non-urgent: Needs treatment when time permits, typically within 120 minutes.
Aboriginals on code 3 will be attended to before a heart attack victim or burns victims. Also, serious head injuries and a whole list of other urgent matters, all because of their skin colour.
Who, on this earth can agree with that? In reality a decent Aboriginal with a bleeding cut/wound that has been dressed tempoary ro stop bleeding, perhaps by Paramedics., would decline the offer to be prioritized above Cat 1 or Cat 2, because they are brown skin, or in Victoria, mainly white skin, but Aboriginal history.
The Federal system and states have poured billions into Aboriginal medical centres and allied health. Where is that fitting into this?