Nurses assisting with gender-affirming surgeries at Tasmania’s Royal Hobart Hospital are set to receive double-time pay, while those working on emergency surgeries at the same facility reportedly earn 25 percent less for similar weekend shifts. The arrangement has drawn criticism from some hospital insiders amid concerns about resource allocation and its potential impact on other surgical services.
An internal email dated October 14, obtained by a news outlet, invited staff to express interest in supporting gender-affirming surgery lists scheduled for four Saturdays between November and March. The email—sent by an associate nurse unit manager in the hospital’s Post Anaesthetic Recovery Unit—explained that the procedures are being transitioned from Hobart Private Hospital, which ceased providing these surgeries after being acquired by the not-for-profit Catholic provider Calvary. Calvary’s ethical guidelines prohibit gender-affirming surgeries at its facilities.
The Tasmanian government stepped in to ensure the continuation of privately funded gender-affirming surgeries at Royal Hobart, the state’s largest public hospital. According to the email, each operating list will involve two patients undergoing procedures lasting three to four hours under general anesthesia, requiring staff to commit to the full day. To acknowledge this, nurses working these shifts will receive double-time pay for approximately 9½-hour shifts.
A hospital staff member, speaking anonymously, said the double-time pay was unusual compared to weekend shifts for other surgeries, which typically receive time and a half. The source described the situation as creating “a two-tiered system,” noting that weekend operations are normally limited to urgent and emergency procedures, with only one or two of the hospital’s 13 theaters in use on Saturdays. In contrast, the gender-affirming surgeries require an additional operating theater staffed by multiple personnel, including scrub and anesthetic nurses, anesthetists, and surgeons.
Health Minister Bridget Archer and the Department of Health have denied that the introduction of gender-affirming procedures at Royal Hobart has impacted emergency or other essential surgeries. Minister Archer stated that the government was meeting its commitment to continue gender-affirming services without affecting the public health system. A department spokeswoman said claims that these procedures were prioritized over emergency surgeries or public elective cases were incorrect, although she did not specifically address the details of the surgeries.
The controversy has drawn criticism from Women Speak Tasmania, a sex-based rights advocacy group. Spokeswoman Elizabeth Caballero raised concerns about staff allocation and resource use amid ongoing staff shortages, arguing that prioritizing non-essential gender-affirming surgeries while patients wait long periods for essential and life-saving procedures “is totally unacceptable.” She also criticized the use of double-time pay as an inducement for staff participation.
Currently, only 56 percent of public elective surgery patients in Tasmania receive treatment within clinically recommended timeframes, fueling debate over the hospital’s resource management and surgical priorities.