‘NSW Health failure’: Pay delays leave NSW doctors feeling undervalued

Emergency department doctors in NSW have reported a decade-long pattern in delays in receiving their ‘on-call’ allowance entitlement as mandated by NSW Health, which makes up 25 per cent of their salaries.

Staff specialists in emergency departments at hospitals in Sydney’s west, such as Westmead, Nepean, and Blacktown, have called on NSW Health to address delays in allowance payments that account for a quarter of their take-home salaries.

A spokesperson from Western Sydney Local Health District told HR Leader: “We deeply value our doctors and apologise for the delays some emergency doctors have experienced in receiving their allowance pay.”

Under the Staff Specialists (State) Award and the Staff Specialists Determination 2015 award, doctors working in emergency departments are entitled to a 25 per cent allowance to compensate for shifts until midnight and on weekends.

This payment is made six-monthly in arrears for the periods ending 30 June and 31 December.

The Australian Salaried Medical Officers Federation (ASMOF) said the late payments stem from an approval process involving multiple signatories before final approval by the hospital’s CEO.

According to the allowance arrangement set out by NSW Health, “the allowance will be payable upon written confirmation, satisfactory to the chief executive by the director of the emergency department in respect of each physician in that department, and general manager or director of medical services (or the holder of an equivalent position) at the relevant facility in respect of each director of an emergency department”.

In a statement, the Western Sydney Local Health District spokesperson confirmed that all allowance pay for the period ending 31 December 2025 has been processed.

“The longest I’ve personally waited was around eight weeks, and it was only resolved after ASMOF escalated it,” Dr Danielle Unwin, emergency medicine specialist at Westmead Hospital, told HR Leader.

Unwin added that colleagues at other hospitals, including Nepean and Blacktown, face the same difficulties in resolving allowance payment delays.

ASMOF NSW president Dr Nicholas Spooner said: “If ASMOF did not step in and escalate these cases, these doctors would be forced to wait even longer to be paid the money they’ve earned, if they were to be paid at all.

“This is not a one-off failure. This has been going on for close to 10 years. It points to a dysfunctional NSW Health system that is completely incapable of performing even the most basic administrative functions.”

“We’re not asking for anything above and beyond what we’re entitled to. We should be valued as employees, and we shouldn’t have to feel that we have to beg for pay for the work that we do. It kind of feels like they don’t value us when this happens,” Unwin said.

"We are committed to ensuring all staff receive their pay on time and are currently implementing new processes to improve the timeliness of this moving forward,” the spokesperson concluded.

The allowance arrangement is scheduled for its routine review on 1 July 2026.