The independent panel recommendations will not solve the impasse it was intended to fix. But the recommendations, and the submission by NZNO did show that there is opportunity — let’s explain.

The NZNO DHB MECA is the name of the contract that covers over 27,000 nurses, midwives and Health Care Assistants (HCAs) across New Zealand. This District Health Board (DHB) Multi-Employer Collective Agreement (MECA) is between the New Zealand Nurses Organisation (NZNO) and the 20 DHBs across New Zealand. DHBs are responsible for the provision of public health services in New Zealand and are divided regionally across New Zealand. This contract expired in August of 2017. Since then, DHBs and NZNO negotiators have been trying to strike a deal. So far two offers have been rejected by NZNO members. In an effort to break this impasse — an independent panel was set up to resolve the issues between both parties. Both parties had an opportunity to submit positions. The outcome — which is not binding — was presented on the 24th of May 2018.

If you want to read through the whole submission then do so here. There is a lot to potentially cover — and this recommendation is only that… a recommendation. Members and health workers across the country will have to wait to see what is on the table and then vote on the offerings dished out.[1]

The panel recommendations

The two main points from the panel recommendation that we found interesting were:

1) That the recommendation was for 9% over 3 years or in other words a 3% increase every year till 2020. This — as people can see from previous HSWN statements — is not enough to match the aged-care sector pay deal, leaves workers with less than the living wage, leaves many people struggling with increasing living costs and fails to match backbench MP increases since the last significant pay increases in 2005. The obvious point is that this pay deal does not resolve this pay impasse.

2) The other point to make was around DHBs receiving funding “equal to 2% of the total national cost of the DHB employed nursing and midwifery workforce”. This could mean 2% more nurses/midwives. Using FTE figure from March 2018 this equates to 469 FTE across DHBs nationwide. Divided by relative FTE for regions — that means potentially 63 more nursing/midwifery staff for Auckland DHB, 59 more for Canterbury DHB, and so forth for each DHB. This calculation assumes that money given to DHBs will all go directly into staffing. The discussion by the panel highlights that this may not all go directly to staffing if DHBs have already “prioritised the investment in nursing resources needed to ensure patient and staff safety”. But irrespective, it is a step in the right direction for meeting the demand from demographic changes in health needs. This move also acknowledged that there is a need for more staff above current funding and that bargaining can achieve staffing increases. The question is whether 2% is enough?

2) The other point to make was around DHBs receiving funding “equal to 2% of the total national cost of the DHB employed nursing and midwifery workforce”. This could mean 2% more nurses/midwives. Using FTE figure from March 2018 this equates to 469 FTE across DHBs nationwide. Divided by relative FTE for regions — that means potentially 63 more nursing/midwifery staff for Auckland DHB, 59 more for Canterbury DHB, and so forth for each DHB. This calculation assumes that money given to DHBs will all go directly into staffing. The discussion by the panel highlights that this may not all go directly to staffing if DHBs have already “prioritised the investment in nursing resources needed to ensure patient and staff safety”. But irrespective, it is a step in the right direction for meeting the demand from demographic changes in health needs. This move also acknowledged that there is a need for more staff above current funding and that bargaining can achieve staffing increases. The question is whether 2% is enough?

The NZNO submission

The NZNO submission finally promoted a vision for members and health workers alike. While HSWN has some issue with features of the submission — the process of providing the submission gives people some definition of goals. The submission can be broken down into pay and staffing.

Pay

The NZNO submission finally created a vision for pay rates for nurses, midwives and HCAs in DHBs across New Zealand. The submission put forward by NZNO promoted increases to Registered Nurse (RN) and Enrolled Nurse (EN) rates from current salary figures of around 20% and HCAs with increases of up to 32%.[2] This is great! The submission states that there should be “additional steps in scale structure” and that “entry level adjustments and progress through the scales will be required to recognise post grad qualifications”. Excellent! It is not clear by when these increases should be expected — or were intended. For example the HCA figure of $56,300 is close to the aged-care settlement HCA Step 4 salary in 2021. It is unclear whether this figure is meant to be for 2018 or 2021.

The clear goal for pay increases is what has been lacking in the NZNO bargaining strategy so far. NZNO should follow this submission with a clearer goal for pay increases. What should members expect? This was the intention for the HSWN campaign around 18 in 18. A clear vision that is memorable, repeatable and raises expectations. We hope NZNO strategists can continue this new found trend.

Staffing

The submission by NZNO reiterated the expected — which is the continuation and full implementation of CCDM. There are many criticisms of CCDM as a programme to bring safe staffing — such as being time intensive, staffing below demand, among many others. Realistically the full implementation has been a long term goal following the 2006 Safe Staffing Healthy Workplaces Committee of Inquiry and the formation of the Safe Staffing Healthy Workplaces Unit. This programme was set up as a mechanism to capture staffing shortages and hopefully give leverage to change this. The new development of ‘escalation pathways’ has been pitched as a mechanism to respond to these staff shortages. The potential for this is yet to be seen or realised.

The substantial shortfall of the submission was the omission of minimum staffing ratios as an adjunctive mechanism for safe staffing. There is an international movement towards staffing ratios. This submission was an opportunity to add this mechanism to achieve safe staffing. HSWN believes that the data is already available to establish minimum staffing ratios for hospital and community based health work. HSWN believe that the only way forwards is mandated minimum staffing ratios which can include an acuity tool to index staffing to demand. This was a missed opportunity to introduce this tool to the table. New Zealand is leading the way in the wrong direction.

Where to from here?

There needs to be a movement towards realising the power that NZNO and the wider health sector workers have. The NZNO DHB MECA bargaining process is the benchmark for all other groups. This means that — in lieu of any strategy from other health sector unions at the moment (i.e. PSA) — this is a moment with opportunity for a health sector wide collective campaign for pay and conditions. Why is there no collective action where so many other groups benefit from this outcome? The recommendations — while in no way fixing the impasse — is showing that there is room to move for pay and increasing funding for staffing. The NZNO submission has shown there is “evidence” that there are “appropriate ranges” for salaries for nurses, midwives and health-care assistants. What must happen now is a strategy to reach these goals. Members, union officials, other health unions and health workers from across Aotearoa/New Zealand could be part of a strategy to bring change. Momentum can be built that makes the strikes on the 5th and 12th of July a moment in history. Let us organise. Let us build.

In solidarity,

Health Sector Workers Network

[1] The DHB offer has been released and is available here. HSWN will be responding to this offer in the near future.

[2] NZNO submission proposed that HCAs should sit between $44,500 and $56,300, an enrolled nurse should sit between $57,500 and $61,500, and a registered nurse or a midwife should sit between $64,300 and $80,000.