Higher Salaries Commission model for health workers

July 15, 2008

Health professionals’ salaries could be set by a body like the Higher Salaries Commission  Professor Donald Evans, the director of Otago Bioethics Centre, says.

He was commenting on recent coverage of two complaints investigated by the health and disability commissioner Ron Paterson relating to treatment of two Dunedin hospital patients during the medical radiologists strikes in 2006.

Mr Paterson said one of the cases highlighted the incontrovertible fact patient safety was jeopardised during strikes by health professionals and he called for the Health Minister to consider what could be done to ensure better patient protection during strikes.

Prof Evans said while health professionals ensured strikes were organised so few people suffered ill effects and said patients were not harmed, that was not always the perspective of the patients.

“If I’m diagnosed with cancer and I need imaging to be treated, I regard even a day’s delay as a disaster.”

Taking the confrontation out of wage rounds by putting the decision-making in the hands of a salary awarding body would protect professionals’ integrity, he said.

A very good point, health professionals should not be faced with a conflict between their duty of care and industrial action.

He did not expect this would be favoured by the Government, however, because it would mean paying people what they were worth.

Paying people what they’re worth – that would be a scarey thought for a Finance Minister.

Politicians were sheltered from the sort of confrontation health workers faced over wages, Prof Evans said.

He’s right and there’s a strong case for health professionals to have the same protection.

A call last week from Otago District Health Board chief medical officer Richard Bunton to ban strikes by health workers has been described as unnecessary by the Public Service Association, which says systems are in place to protect patients during industrial action.

PSA national secretary Richard Wagstaff drew attention to the extensions in the life preserving service (LPS) arrangements during strikes since 2006 which now covered crisis intervention, therapeutic services and urgent diagnostic procedures in situations that could lead to permanent disability.

Mr Paterson was aware of extensions to the LPS provisions when he made his call for better protection as reference to them is made in footnotes in one of his complaints reports.

Unions Otago convener and New Zealand Nurses Organisation national industrial adviser Glenda Alexander said if people were paid what they were worth and there were balanced processes for getting a mutually satisfactory outcome then there might not be a need to strike, but that was not what happened.

She was in favour of the more positive interests- and issues-based approach used by the nurses union to negotiate its last collective agreement.

A change which protects workers’ rights and patient safety is needed, as is the political will to implement it.


Another call to make health workers’ strikes illegal

July 15, 2008

The Orthopaedic Society  has added its voice to calls to ban strikes for essential health workers.

Patients’ lives were at risk during strike action by essential health workers and such action should be made illegal, says the New Zealand Orthopaedic Society president, Dunedin specialist John Matheson.

He said the society, a professional body of 185 orthopaedic surgeons, was calling on the Minister of Health to make strike action illegal and to introduce compulsory arbitration for workers in essential health services.

Working during the 2006 medical radiologists’ strikes was the “most vulnerable” period of his career, Mr Matheson said.

“Working without X-rays for an orthopaedic surgeon is akin to working in a Third World country.

“We just feel that the public, and the people in the union and district health boards, and even the ministry, really have no idea what it is like when health professionals, particularly medical radiation technologists, go on strike, because no-one else can do that job.”

It was “extremely difficult” to diagnose and manage patients’ injuries and sudden illness without X-rays and other radiological investigations and patient care was similarly affected during strikes by junior doctors, Mr Matheson said.

Providing life preserving cover during strike action was not “cut and dried” and the society agreed with comments from Health and Disability Commissioner Ron Paterson it was an “incontrovertible fact” patient safety was jeopardised during strikes.

“We are not taking sides. It is just the whole process we are concerned about; [concerned] that it should get to strike action. There must be some better way of doing this, such as compulsory arbitration.”

Previous calls from the society to make strike action illegal had been rejected by past and present Ministers of Health and union leaders, he said.

“They must believe the rights of the public with serious needs are less important than the rights of health workers to strike.”

Police can’t strike for the sake of public safety, essential health workers should be prevented from striking for the sake of individuals’ safety.


Health Workers Should Lose Right to Strike

July 11, 2008

Otago District Health Board Chief Medical Officer Richard Bunton  says health workers, like police, should lose their right to strike.

He is commenting on the release of investigations by Health & DIsability Commissioner Ron Paterson into complaints over two deaths during the 20006 strike by medical radiation technologists, on which I blogged yesterday.

Mr Bunton said changing the system “has to happen” so that health service workers were covered by legislation, like police officers and not be allowed to strike.

He would expect the definition of health services to be fairly broad, covering any health work which was essential for delivering good patient care.  It would be a matter of “sitting down and working out a mechanism to settle salaries”.

I am sure this would have public support but at least one union isn’t keen.

Association of Salaried Medical Specialists executive director Ian Powell said Mr Bunton’s suggestion was ” throwing the baby out with the bath water”.

Mr Bunton said he accepted that his views would be controversial and would be met with an “interesting debate”.

It was rubbish to suggest strikes did not affect patient care.

No matter what words or niceties were used to explain what happened during strikes, there was no way that staff could deliver the same level of care when the usual processes and checks and balances were not there, he said.

They also cause extra work and put additional strain on alreay overstretched colleagues who aren’t on strike.

Mr Bunton said it was likely situations similar to those in Dunedin Hospital had occurred elsewhere. If Mr Paterson, the watchdog of patient rights, was making a strong statement about the risks to patients during strikes, the Government was obliged to “have a damn good look at it”.

Speaking from the United Kingdom, Mr Powell said Mr Bunton’s suggestion was not helpful. It would involve going “down to an arbitrationist system”, which he did not believe would be favoured by health workers.

Some perspective was needed about industrial action in the health sector. While there was a perception health was riddled with strikes, that was not the case.

 Mr Paterson was raising pertinent questions which should be considered by the health sector in general – not just the minister – but such consideration should not be a “knee-jerk” reaction, Mr Powell said.

The system doesn’t have to be riddled with strikes for striking to cause an unacceptable level of risk.


Should Medics Be Able To Strike?

July 10, 2008

A damning report  on two deaths which occurred because of delays to treatment during a medical radiation technologists’ strike raises the question of whether health professionals should be able to take that sort of industrial action.

A report into a complaint against the Otago District Health Board involving a Dunedin Hospital patient whose treatment was delayed because of strikes suggested “the wrong party is in the dock”.

The report is one of two by Health and Disability Commissioner Ron Paterson on two complaints against the board, arising out of medical radiation technologists (MRT) strikes in 2006.

It says although there is potential to breach an agreement with unions over life-preserving services, hospitals cannot allow patient safety to be jeopardised.

The reports draw attention to the risks to patients during health professionals’ strikes when clinicians are not able to carry out their usual practices, and calls for the Minister of Health to consider better protection for patients during strikes.

Strikes by any other workers may disrupt and annoy people, but those by health professionals have the potential to kill them.

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