An incentive scheme designed to attract more health workers to rural NSW is causing animosity among staff as nurses push for an investigation into worsening bullying and harassment.
The NSW government's rural health workforce incentive scheme offers bonuses and rewards to people working in areas affected by critical staff shortages.
But the eligibility criteria inexplicably excludes some staff, NSW Nurses and Midwives' Association delegate and clinical nurse specialist Paul Haines told a parliamentary inquiry on Monday.
Mr Haines said one nurse might be eligible for a $5000 bonus, while another doing the same job missed out.
"All this has done is cause animosity between staff, anger towards the employer, and increase the likelihood of staff leaving our hospital," he said.
A parliamentary committee is investigating progress on some of the recommendations of the 2021-22 NSW health inquiry, which found country residents have worse health outcomes than their city peers.
NSW Health's written submission said a recent review showed most of the inquiry's 44 recommendations had been implemented or progressed but more work was required.
Deputy secretary of regional health Luke Sloane said local districts were working to make sure the incentive scheme was more equitable.
"It's not lost on us that it has affected people and it has caused, in some places, schisms within the workforce around why someone has received it and perhaps others not," he said.
The hearing was told 1566 new staff have been recruited into rural roles under the program and 9950 roles have been retained.
A "culture of fear" among some in the public system revealed during the 2022 inquiry persists 18 months on.
Nurses have reported increased levels of violence and aggression, along with bullying from their peers, the union's assistant general secretary Michael Whaites said.
Members had recently voted to push for an inquiry into worsening workplace culture.
Australian Paramedics Association NSW vice president Scott Beaton said there had been few improvements since the inquiry, with ambulances still regularly used as patient transport between rural towns.
"This takes the power of that emergency ambulance out of the small communities for two to three hours to take someone from a nursing home to get a CT scan or an X-ray," he told the inquiry.
Poor housing in country areas was also hampering recruitment efforts.
A government-owned house used by paramedics in Collarenebri, in the state's northwest, had not been refurbished for 18 years, Mr Beaton said.
"That house has now fallen into ruin, where it's uninhabitable," he said.
"That's unfortunate - we can't get these people."
Professor Megan Smith, from Charles Sturt University's faculty of science and health, said inadequate housing also limited students' practical placements.
"It can be really dire - to some extent people just don't go," Prof Smith said.
"Living in cars, couch-surfing and driving long distances backward and forwards is probably the other component of it."
The hearings continue.
