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The Budget and the MECA

scalpel12This past week has been a busy one. Thursday 21 May was Budget Day. It’s a day we are always on the edge of our seats, hoping for a plan for health that delivers for our members and all New Zealanders.

And the day after that we held our final meetings about the offer from DHBs for our multi-employer collective agreement. The results of those meetings did not surprise us but what we didn’t expect was the extent to which NZNO members working in DHBs rejected the DHBs’ offer. Over 82 per cent voted no.

This years’ Budget does not provide enough funding to meet the health needs of New Zealanders. In order to meet the costs of rising prices, an increasing population, an ageing population, an ageing health workforce, long overdue decent wage increases, new services etc etc, we estimate the funding allocated is at least $260 million short.

District Health Boards (DHBs) are short-changed by at least $121 million. And we know almost all of them are already struggling to manage massive deficits, meaningless health targets and the continuing push from government to “centralise” services at any cost.

How are DHBs going to deal with the likely flow-on impacts on safe staffing, workplaces that are healthy for staff and patients and quality care?

Nurses, midwives, caregivers and other health care workers are telling us they are already stretched to the limit. Some are having to sacrifice tea and lunch breaks and are working unpaid overtime just to keep up with the care they need to give to ensure needs of patients are met. Support for training and development is decreasing. Stress levels are rising and morale is low.

And it’s not only DHBs that are bearing the brunt of reduced spending. Efforts to reduce poverty related illness are not being tackled in a “joined-up” way.

Health workforce planning is proceeding at a snail’s pace. New graduate nurses are still looking for jobs that aren’t there. Older nurses are still being pressured to work night shifts.

Health workers need a fair deal to cope with the increasing demands that are being placed on them.

And this means we need to stand together to make progress in our bargaining with the DHBs for our multi-employer collective agreement.

NZNO members working in DHBs don’t feel valued. They instructed the negotiating team to retain what’s already in the MECA, secure a decent pay increase, improve access and support for professional development and advance safe staffing and healthy workplaces.

The DHBs’ offer clearly didn’t cut it. They need to do better for their largest group of workers.

We’re heading back into bargaining on Thursday with a clear mandate: the offer must be improved. Nurses can no longer continue to take up the slack for a sick health system.

We can’t do all the work here! DHBs need to take some responsibility for advocating for the funding that provides appropriately for every member of staff and every patient. New Zealanders won’t settle for anything less.


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Patients’ rights, nurses’ rights

stress-feature01NZNO delegate, Erin Kennedy asks an important question: “Is unsafe staffing a breach of the Code of Health and Disability Services Consumers’ Rights?”

Like most nurses, I am not easily shockable, but I found myself almost speechless last week on learning that three nurses had been forced into the position of caring for 40 patients overnight on a heavy orthopaedic ward. (A pool nurse also came to help for part of the shift.)

NZNO organisers and delegates have argued strongly for safe staffing for years now, but unfortunately, the level of permanent and pool staffing means that staffing levels including skill mix are often unsafe, with sick staff unable to be replaced. The constant push to avoid financial penalty when the 6-hour Emergency Department rule is breached also leads to patients being moved from the Emergency Department to areas where there are simply not enough nurses to care for all the patients safely.

Under the Code of Health and Disability Services Consumers’ Rights, patients have a number of rights, including the right to co-operation amongst providers to ensure quality and continuity of services, and the right to informed consent. The right to be fully informed means information must be conveyed to the patient in a way that enables the patient to understand the treatment or advice. Right 6 of the code states that every consumer has ‘the right to the information that a reasonable consumer, in that consumer’s circumstances, would expect to receive’. Specifically, it states that patients are entitled to an explanation of his or her condition and an explanation of the options available, including an assessment of the expected risks, side effects, benefits, and costs of each option.

Given the unsafe staffing levels at some of our DHBs, it is high time that explanations around surgery, for example, go further than simply outlining the procedure and its risks and benefits. Patients should ask, and should be told, whether their post operative care will be safe. A “reasonable consumer” clearly has the right to know whether their recovery might be hampered because of unsafe staffing. Certainly, if I have surgery any time soon, I will be asking whether there are enough nurses rostered on to provide all of the care I and other patients require. Will there be enough staff to ensure that I can obtain analgesia or other medications on time? Will the nurses be able to check my vital signs often enough to notice if I am bleeding, or have arrested or need medical intervention? If I need help mobilising to the toilet, will there be someone to help me or will I risk a fall and further injury? Will there be someone to answer my call bell if I need help?

Nurses do not like being forced to ration care, but until all DHBs accept that in many instances staffing levels are unsafe (for both patients and nurses), it is a fact of life and one which can seriously impact patients’ wellbeing and recovery. Not warning patients that their post-operative care may not be optimal, and could be downright dangerous, is, in my opinion a breach of the code.

 

 

 


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Employment law changes – the long answer

ERA changesA couple of days ago, on Facebook, a member asked what NZNO were actually going to do about the changes to employment law, apart from posting stuff on Facebook.

Well, good question. The short answer is lots! The long answer is… longer – I’ll make a start here and see how far I get today.

The first thing I want to stress is that NZNO is its members. We are a member-run organisation. That means staff are essentially employed by members, through their membership fees. The strength of our organisation comes entirely from how many members there are, and how willing those members are to get involved in the work of the organisation.

Thousands of NZNO members are workplace delegates, thousands belong to Colleges and Sections. Thousands are active sharing information and having discussion about our issues on social media. Many inform themselves and their colleagues by reading our monthly publication Kai Tiaki Nursing NZ. We have a Board of Directors and a Rūnanga elected by NZNO members. You can be as involved as you want to be.

NZNO is as strong as its membership. 

So – the next bit of the answer is about the changes to employment law. They are wide ranging changes that have been touted by the Government as fair, reasonable and just “tweaking” things. If only!

These changes have the potential to drive wages down, increase poverty and tip the balance of power between workers and employers firmly into employers’ hands.

We have been fighting these changes for a long time. In 2013 over a thousand NZNO members wrote submissions against the Employment Relations Amendment Bill to the Transport and Industrial Relations Select Committee. Over 10,000 submissions were received by the committee. I can’t remember the exact numbers but something like 98% of the submissions received were against the changes being proposed.

The Government didn’t have the numbers to pass the legislation last year, but it was first on their agenda after the Election.

We have been working hard along with the Council of Trade Unions and other health unions over the last 18 months to mitigate some of the worst changes of this new employment legislation.

Our risk assessment when the changes were first signaled showed us that our vulnerabilities were most focused around three key areas of the Act:

The 30 day rule is repealed

This means that new employees who are not union members will not be covered by the collective agreement even if their job comes within the coverage clause. Until last week, new employees were covered by the collective agreement in their workplace for the first 30 days. This protection is now stripped away so a new employee can be they can be paid less than the collective agreement right from the start. Over time this will reduce everyone’s pay and conditions.

Employers opting out of MECA bargaining

Employers will be able to opt out of multi-employer collective agreement (MECA) bargaining. An employer who seeks to opt out of MECA bargaining must give written notice to all intended parties to the bargaining within ten days of receiving the initiation notice. This could dismantle MECAs that have brought steady improvements in pay and conditions for NZNO members over the years.

Removing the duty to conclude bargaining

It is no longer a breach of the duty of good faith to fail to enter into a collective agreement.

Employers are now able to apply to the Employment Relations Authority to declare bargaining is over. Once that happens:

  • employers will be able to put pressure on individuals to agree to lesser pay and conditions
  • industrial action will be unlawful for two months

Here are a few examples of what we have been doing and will continue to do to address these attacks on workers fundamental employment rights.

We have been implementing our strategy to address both the 30 days and the conclusion of bargaining issues with new clauses in our collective agreement bargaining over the last 12 months and this work is ongoing as collective agreements reach the end of their terms.

We have been including in bargaining clauses to address the issues around conclusion of bargaining.

We will be back around the computer making sure initiation of bargaining for collective agreements is undertaken at the soonest opportunity and that conversations happen with employers around this matter to ensure coverage of collective agreements remains as it is currently.

Our sector groups (DHB, Aged care, Primary health and Private hospitals and hospices) have been identifying strategies for each particular sector.

We have developed resources for organisers to discuss with delegate the process for new employees.

We have been able to initiate all our MECA bargaining prior to the Act coming into force and maintaining collaborative relationships with as many employers as possible to secure our future MECAs and national collective agreements.

We have been participating in conversations with the CTU around the Code of Good Faith.

We have been educating our delegates and members through the Bad Medicine Campaign, delegate training and other processes.

We are strong, growing and ready for the future. We need to maintain the upmost vigilance with our employers who we have collective agreements with – we have learnt from the 1990s that our aged care employers pose the greatest risk in this type of industrial relations environment. We have been here before and thrived.

Kia kaha. We will build power through our unity.

Talk to your NZNO delegate or organiser if you’d like to become more involved.

 


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All the way for fairness, justice, value and equal pay

Film-Colour-160Yesterday the Government announced that on 1 April the minimum wage will increase by 50 cents to $14.75 an hour.

A 50 cent increase in the minimum wage is a shame on our whole society. As the Council of Trade Unions says, we are now in a situation where the minimum wage is also the maximum wage for hundreds of thousands of workers.

Workers in aged care, who are underpaid because the work they do is seen as “women’s work”, are being unfairly impacted by this poverty-wage. Caregiver roles are physically and emotionally exhausting with many caregivers going above and beyond what is required.

There is a huge injustice happening here. Aged care workers are bearing the brunt of unfair gender-based pay rates, and a Government minimum wage rate that seems designed to increase poverty and hardship.

Aged care workers are providing care to residents that is worth much, much more than they are getting paid. The residents benefit, the employers benefit and the workers don’t.

Oh, I am sure they are “valued” for what they do. Every time I hear a Government Minister or Rest home owner talking about the aged care workforce they talk about the incredibly important and valuable work aged care workers do. To their shame, it’s a value that is not being reciprocated with an appropriate pay rate.

NZNO and SFWU members have been working for justice for aged care workers and others in low-paid jobs for many years. We have negotiated collective agreement, lobbied successive Governments, and worked together with other groups and organisations who care deeply about fairness and equality, like we do.

A big leap forward in our struggle came at the end of last year when union member Kristine Bartlett won her equal pay court case. The next step is for the employment court to decide what the monetary value of equal pay is. When that happens we expect aged care workers around the country to benefit enormously.

We’re going All the way for equal pay and we’re going to win. This pathetic increase in the minimum wage won’t slow us down – every injustice just strengthens our resolve. Watch this space.

 

 


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A demand to be taken seriously

dilbert-ceo-payNZNO delegate Ady Piesse is an activist for fairness at work and an advocate for collective action. This blog post has previously been published as a comment on Facebook. 

I’m a thinker….I think a lot. Sometimes I’m accused of over thinking, but generally my thinking usually provides me with ideas or helps me problem solve.

So, a couple of weeks ago, I got to thinking – what do I do in my job that is so different from my CEO’s that justifies our salaries?

At the start of every shift I check my equipment so if that cardiac arrest, acute SOB, trauma or the blue floppy baby arrives unannounced, I have the confidence that myself and my colleagues will be able to use that equipment to potentially save a life.

My CEO makes sure his lap top ‘on’ button works.

I monitor numerous pieces of equipment attached to my patients, checking for those spiralling trends so I can intervene early if I need to.

My CEO monitors computer screens that check to make sure my patients are meeting the six hour targets.

I do ‘end-of-bed-o-grammes’ all day every day, with new patients, existing patients, other nurses’ patients, to monitor change, deterioration or improvement.

My CEO looks at spread sheets to see how hard I’m working or how much harder I can be made to work.

I hold in my hand medication that has the potential to kill or to cure.

My CEO holds a pen, an iPhone.

I sit holding a patient’s hand while a doctor tells her and her family her condition is terminal. I hold a child’s hand. I hold the hand of a terrified patient who can’t breathe. I hug people I only met today and know won’t be here tomorrow.

I don’t know if my CEO has ever held a hand or given a stranger a hug.

Every day I take home people’s stories; for some it will be the worst day of their lives. These people have faces and I know some will never leave my memory.

My CEO takes home statistics.

Some days I leave wondering if I have it in me to keep doing what I’m doing – less is not more in my job – but my CEO seems to think so.

I know it’s all more complex than that.

I use my knowledge and observation skills to think ahead and intervene early to avoid a failure to rescue situation, my CEO uses their knowledge and observations to think strategically, for example.

What I’m thinking doesn’t take away from the important role my CEO plays in the day to day running of my organisation, but thinking simply – that’s about the bones of it.

Then some more thinking. I play a damned important role in this organisation too, so how is it I only get paid maybe a quarter of what my CEO earns?

And why should I feel guilty or scared of standing up and asking for more? So I’ve decided I owe nobody an apology for feeling the way I do.

More thought. Stand up and be counted, get as many colleagues on board as I can to speak out and say enough is enough!

I’ve become quite vocal in the past couple of weeks –I’ve decided to stand up for myself. I’ve realised that complaining to colleagues is not going anywhere. We need to be the very visual faces behind our MECA.

I’m guilty like many of having not gone to meetings in the past, been so apathetic to expect Government and the Boards to realise my worth and support me accordingly – I’ve been ridiculously naive! I know there are many colleagues feeling the same way and I’m hoping my ranting will given colleagues the confidence to stand up too and speak out for change!

MECA representatives at these current negotiations can only push the “we’re serious about this…” boat so far – we need to make ourselves visible to Government and our Boards and not just ask, but demand to be taken seriously,  otherwise we have another long three years of the same and more than likely, a lot worse to come.

So, be at those MECA meetings that are coming up and come with ideas! It’s time we got tough!

 

 


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A Living Wage

poster_2Kieran Monaghan is a primary health care nurse and NZNO member who works at Evolve Youth Service. Kieran is an activist for health and social justice. 

NZNO CEO Memo Musa adds an update from NZNO at the end of Kieran’s blog.

I was recently invited to attend a four-day training workshop on the organising strategies of the Living Wage campaign. The following is a report on my experience, and my reflections between the Living Wage, the Declaration of Alma-Ata and NZNO.

What is the Living Wage?

The principle of the Living Wage is simply that the labour a person provides is acknowledged by a wage that provides them with the ability to live with dignity and without poverty. The Living Wage differs from the idea of a minimum or poverty wage, which for any worker is inadequate, and may require a second or third job with accounts of people working 70-80+ hours a week, to meet the basic costs of provisions and living.

The Living Wage campaign in New Zealand is supported by over 200 unions, faith and community groups across the country. Commitments to proactively work on developing grassroots community connections to advocate for a Living Wage are currently being established. Following the hui, we have set up our own local hub in Newtown Wellington.

The current rate for the Living Wage is set at $18.80 an hour and is reviewed and adjusted annually.

Impact of the Living Wage in action.

At the hui we heard stories about the difficulty of life of low wages, including the impacts on education and health.  We also heard the success of nearly 500 workers employed at Wellington City Council, who had their pay rates increased by at least $4 an hour in response to the Living Wage campaign. The WCC parking wardens reported a significant reduction in the work hours needed to earn a sufficient amount to cover the basic costs of living. In addition many now have increased time at home with family. Other workers have reported that moving to the Living Wage has enabled them to dedicate more time on studying towards further qualifications to increase future employment opportunities, so the potential for a better life once again becomes a reality. This is in stark contrast to the workers’ previous experiences where these realities appeared almost impossible to access.

Connections from a nursing perspective

As advocates for health and continued well-being, I wonder if nursing could, and maybe should, stand at the front of this campaign in the spirit of partnership, protection, and participation? Health is much more than Health services. From a Primary Health perspective the ten points defined in the Declaration of Alma-Ata outline that providing the most equitable, affordable, accessible care, in a timely and culturally appropriate manner is critical to the health of both the individual and wider community. These foundational tenets of Primary Health Care are an essential part of a systemic strategy to reducing the widening health disparities we are currently witnessing.

In Aotearoa we are see growing inequalities and disparities in many areas:

  • Minimal low cost housing precipitates overcrowded living conditions, leading to increases in skin infections and rheumatic fever.
  • Healthy food options are significantly more expensive than inadequate options, negatively influencing diabetes and CVD outcomes.
  • Increased prescription charges impact on the ability to buy food and pay bills, the negotiation of budgeting for essentials can lead to less effective treatment for preventable and easily treated conditions.

Many of the illnesses we see in Primary Care, and the more expensive option of Emergency Departments presentations, are conditions of poverty and many are entirely avoidable. The now familiar term of the Working Poor represents many of these people. In February 2013 NZNO published a press release advocating for the Living Wage, stating “Poverty is the root cause of much ill health and inequality in this country. Those who are struggling to survive on incredibly low wages are also the people who face barriers to accessing health care, education and other social services when and where they need them.”.

NZNO is a member organisation of Living Wage Movement Aotearoa NZ. For NZNO to become an accredited  Living Wage employer, ensuring all employees, from the cleaners up, have access to a quality of living free from poverty, would send a strong statement of commitment to the Living Wage kaupapa.

What can we do together?

The implementation of a Living Wage is a strategic intervention that could have significant and long term positive benefits to the health and well being of family and whānau in Aotearoa New Zealand.

A number of primary health organisations have not only joined the Living Wage movement by signing up as member organisations, but have also become accredited Living Wage employers, paying all staff, including their cleaners, the Living Wage.

Here are some things that we can do as a nursing community:

  • Find out if our own workplaces support the Living Wage campaign and introduce them to the idea if it is new to them
  • Encourage health advocacy organisations to sign on as member organisations of the Living Wage movement
  • NZNO to become an accredited Living Wage organisation for all its employees, including contractors, so that it models a healthy standard of quality employment conditions by refusing to pay what amounts to a poverty wage.
  • Find out if there is a Living Wage campaign branch in your local area and offer to get involved and help spread the word.
  • Read more about the Living Wage campaign and share the stories with others.

It is inspiring to see unions such at the SFWU, CTU and EPMU among other accredited Living Wage employers and hopefully the NZNO soon will join with them to make a concrete contribution to reducing inequality in Aotearoa New Zealand.

NZNO update

NZNO is fully committed to the Living Wage campaign and as such has made a financial commitment to be a member of the Living Wage Movement Aotearoa NZ and priority was first to ensure this support for the movement was up front and can be afforded. All staff employed by NZNO are paid above the Living Wage amount currently set at $18.80 per hour.

Contracted staff are not employees, however. So, before we seek Living Wage accredited employer status there are some formal processes and obligations that we have to work through to ensure it is the contracted staff who receive the Living Wage, not the owners of the businesses.

 


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Control vs power

People powerAmendments to the Employment Relations Act are due to come into law on 6 March next year.

Over the last year many of us have been trying to stop the changes. Thousand of nurses, midwives, caregivers and kaimahi hauora made submissions to the Select Committee considering the amendments – and NZNO is really proud that every single one of those submissions were written by members, no tick-box form submissions for us!

Thousands of us protested, attended rallies, participated in the “Give us a break” workplace actions, talked to our families and friends about the issues, used social media and much more. We did it to stand up for decent working rights for nurses, health workers and the rights of all workers in Aotearoa.

The Government didn’t listen.

This legislation gives employers the right to remove tea breaks, withdraw from collective bargaining, trample on new employees rights to equitable working conditions with their colleagues and to refuse to collectively bargain with other employers

But one thing the legislation doesn’t do is give employers power – what it’s giving them is control.

It’s control of the ugliest kind. The kind of control that can legally demand employees work with no breaks or strip loyal staff of paid hours of work and pit employees against one another.

What we have is power! Power is about strength, sharing that strength with others and growing stronger as a result. It’s about standing beside our colleagues, our whānau, and our community so we all have the strength to stand together for what is right and just.

As a fledgling union in the 1990s when the Employment Contracts Act was introduced – our members and other union members lost significant pay and conditions.

Over the last decade and a half we have demonstrated what real power is.

We have worked together to rebuild national and multi-employer collective agreements.

We took up the fight for pay equity through the Fair Pay campaign.

We supported settlements that extended fair pay across the primary health, aged care and private hospital sectors.

We stand with Kristine Bartlett and the Service and Food Workers Union Ngā Ringa Tota in support of pay equity for caregivers.

Our engagement and participation builds real power – our strength in standing together can’t be taken away by the stroke of a pen or the drying ink on legislation.

Governments may make laws that give employers more control; but we hold the power – people power!