4 minute read
Back and forth
In May I described the DHBs’ convoluted approach to the MECA negotiations as a siege mentality. The last ever DHB MECA was signed by the employers on the 30th of June, three months after its stated term began which was, in turn, actually a whole year after the previous MECA had expired.
Dr Julian Vyas | ASMS President
The next day Te Whatu Ora and Te Aka Whai Ora came into existence. The transitional provisions of the Pae Ora legislation moved our District Health Board members from working for 20 DHBs to having just one employer. With that came hope of an integrated, more equitable public health system, including more fair and equitable employment practises towards our members.
But, along with this optimism, was a realisation about the extreme complexity of integrating 20 DHBs into one organisation. As an example, across the DHBs’ financial systems, Te Whatu Ora identified 3.7 million unique cost codes that need consolidating.
For us, on the front line, decision-making that had happened locally in the past (however sub-optimally at times), became bogged down in disagreement about whether that authority now resided nationally, regionally or locally.
Again, the new national context helped us reach a nationally agreed winter rate for added SMO duties. Regrettably, the legacy of the DHB mindset meant that application of these rates at a local level was, at best, inconsistent. At its worst, some districts tried to pass the buck and/or skip out of their contractual obligations under the MECA entirely.
So, what of 2023?
When I emailed members before the indicative vote on the MECA this year I said we had “unfinished business.” For me that included two things in particular. The first is to make progress on fair and equitable shift work arrangements. Members will recall that the DHBs refused to even consider this in the MECA negotiations. ASMS has pursued - and achieved - pay improvement in several EDs. This work is still ongoing for other departments.
The second is to find a way to get out from under the Government’s unfair and provocative public sector pay restraint policy. Currently, we are some way from knowing if this will still be in place by the time we start bargaining. Electoral prospects and the wider political landscape will undoubtedly have an influence here too.
More broadly we must continue to work alongside Te Whatu Ora to help them “unlearn” the poor practises of the DHB era, and to develop an organisational culture that enables them to be a better, more engaged employer. In November, I attended the first National JCC with Te Whatu Ora. I believe their national leadership team are genuinely looking for ways to make the system work better. At that meeting, we made it clear that long term recruitment strategies are important - but people “on the ground” are exhausted now. So we need Te Whatu Ora to find solutions now – not just offer tea and sympathy for how hard things are, and say “help is coming.”
All districts have now had their first local JCC under the new system as well. Our plan is for at least two JCCs at a local level each year, and to then have interim “catch-up” meetings between a core group of industrial staff and local senior management. ASMS is consciously trying to change the tenor of the meetings to focus more on specific undertakings from local management, and to hold them to account for those commitments.
Lastly, as alluded to above, there will be a general election in 2023. The health system will undoubtedly be an election issue. A recent Ipsos poll found 33 per cent of New Zealanders think healthcare is one of the three most important issues currently facing the country. Only cost of living and housing were named more often.
What we really need from politicians is transparency about how much importance they really place on our public health system, including its workforce. That transparency is the foundation for a shared vision about how good our public health system can be. From that we can understand just what we can do to best help all our patients.
