Together Medical Officers Portal

14 March meeting update

Posted by Alex Scott on March 16, 2012

As mentioned in our previous blog, the Director-General’s surprising refusal to sign the QH proposed bargaining plan at this time led us to make enquires about the status of negotiations and the existence of Cabinet Budget Review Committee approval to commence bargaining.

Though specific questions were put to QH, the replies we received were vague. What was clear however was that QH was very keen for ‘discussions’ to continue. Rather than labour the technicalities any further, we advised QH we are working on the assumption there is no authority to bargain at this stage but we were happy to continue discussions and will await QH advice in coming weeks that they have full authority to engage in bargaining.

Why is it important whether negotiations have formally commenced or not? In previous negotiations, QH engaged in lengthy discussions without getting to detailed examination of issues until a very late stage. They then tried to rush agreement with the threat of loss of back pay if the matter was not finalized imminently and also withdrew offers previously put on the table. The argument was that the amount of time spent (rather than the matters comprehensively examined) was sufficient evidence of due process. Together has made it clear that we have committed to interest-bargaining of MOCA3 in good faith and expect the full interest-based bargaining process to be allowed to run, for there to be no pressure in the later stages to reach a premature agreement and for there to be no penalty for engaging in the full process e.g. loss of any back pay.

Together – the only union negotiating

This week Together was the only union present at the negotiations. Because it was ASMOFQ’s choice to prioritise other activities, and time is of the essence with MOCA2 expiring on 31 May, QH and Together made the difficult decision to press ahead with detailed discussions on private practice in ASMOFQ’s absence.

Private Practice

Private practice took up the whole agenda this week.  QH and Together agreed that a range of problems  with the current private practice arrangements put this item in all four interest categories for both parties, namely clarification simplification and interpretation, recruitment retention and equity, resolving longstanding problems, and delivery of safe quality and accessible efficient clinical services.  

Though not all SMOs experience significant problems with private practice in their day to day work, some do and those problems are serious. They arise from the lack of clarity of the legal and regulatory framework for billing, indemnity, contract terms and inconsistent policies as well as a lack of governance arrangements generally.

If one were setting out to design a private practice framework from scratch today, one would never come up with the current arrangements – a patchwork that is riddled with inconsistencies and does not meet organizational needs.  For example, one pressing need is to rectify an unintended  application  of the Option A contracts preventing doctors from retaining billings from private practice conducted out of ordinary hours (in and outside of QH facilities). This affects metro and non-metro employees but there is an urgent need to redefine entitlements to attract and retain medical practitioners – particularly in regional areas.

There is a commonly held view that the cobbled together suite of arrangements is better replaced than repaired to make it relevant to the needs of the public, SMOs and QH.

On a ‘without prejudice’ basis, QH and Together sketched out a number of criteria for the possible development of new private practice arrangements and are likely to recommend that MOCA3 include a clause outlining a project to be undertaken by a joint private practice review committee (currently chaired by Jenny Cannon of Together) to work up proposals to transform the private practice arrangements to be put out to extensive consultation with all stakeholders as early as possible but during the life of the agreement.

By way of assurance about any proposed change, from Together’s perspective two of the criteria for introduction of any new arrangements would be no disadvantage overall and mutual benefit for QH and Medical Officers. 

For your information, recently unions were asked to identify issues that demonstrate a need for change to private practice and the following is a dot point summary of Together’s submission.

Rationale for need for change to Private Practice arrangements

1.       The original intention of the right of private practice as negotiated by QH and the Union was as a recruitment and retention measure and was a salary supplement with no obligation for the SMO to recover any of the cost of Op A.

2.       Changes in the financial environment over time led to QH reinterpreting and modifying arrangements - often without negotiation – and there is currently a difference of opinion between the parties on the very the nature of the right of private practice in QH . Over time the parties have become further and further apart in terms of their interpretation of the right of private practice.

3.       There has been a long history of ad hoc variations to arrangements which have been illogical, not negotiated and /or not equitable (e.g. special deals for pathology and radiology and in 2006 changes  that introduced ED 25%, disturbed metro/non-metro differentials, greatly advantaged non-specialists as opposed to other groups  and did not advantage Op B).

4.       Regrettably in the past, non-representative bodies have been allowed to subvert the role of the registered industrial organizations adding to the patchwork nature of the current suite of options that do not have a sound industrial basis.

5.       Although QH and the Unions identified shared interests in 2005 in developing streamlined arrangements that are mutually beneficial this work was derailed due to intervention of AMAQ in 2006 .

6.       There have been recurrent disputes with the Unions on the content  of contracts, numerous operational issues , implementation of significant change (such as Acute Primary Care Clinics) without consultation and changes to policy which all  highlight the need for both employer and employee representatives to agree on mutually beneficial private practice arrangements as a priority.

7.       Retaining the current arrangements is not a viable option.

8.       It is not likely that tweaking or amending existing arrangements would satisfy the needs of the parties.

9.       As the number of contractual arrangements has grown, management of contracts has become an increasing administrative burden and simplification and rationalization of the arrangements has become desirable.

10.   A great deal of collaborative work has been done by the parities to develop a framework for a simplified equitable, mutually beneficial  private practice model that is capable of adaptation to future needs and has the potential to be to be supported by both QH and the Unions .

11.   With national health reform commencing this year it is desirable to adopt a uniform workable incentivized model  for MO employees across all LHHNs

 

We hope you continue to follow our blogs and give us your feedback as we go. The blog is an innovation to the union’s bargaining plan and represents an unprecedented opportunity for Medical Officers to participate in real-time in the negotiations by emailing your comments to jenny.cannon@together.org.au .  It is important too that you are talking to other members in your workplace about the negotiations and encouraging non-member colleagues to join. The more involvement from grass roots membership the better outcomes we will achieve together.