The drive up to Sydney is bit like how enterprise bargaining is going for hospital doctors; it’s now September and we’ve reached our “Are we there yet?” moment. For those of you keeping tabs, the ACT Government formally initiated enterprise bargaining way back in December 2016. We submitted our log of claims on 28 April 2017, had our first meeting with ACT Health on 5 May and have since met on 21 July, 11 August, 7 September and 18 September.
From 6 October we expect to be in a bargaining meeting every fortnight.
So, are we there yet?
The simple answer is NO, we’re not.
While bargaining inevitably has its stops and starts, the first half of 2017 was full of inactivity and meeting cancellations. Since then, our meetings with ACT Health and the ACT Government have given us some encouragement from their willingness to review some parts of the current agreement that are no longer fit for purpose.
The AMA (ACT) believes that now is the time to tackle several long-standing industrial issues that are detrimental to hospital doctors, their families and their patients. The message we’re getting from our members is that they’re not interested in ‘kicking the can’ down the road for four more years and believe that a small jurisdiction, such as ours, should be able to tackle some of the big issues and come up with an agreement that’s innovative, industry leading and mutually beneficial.
A few of the major items we’ve put on the table include:
With the Federal AMA leading the way, AMA branches around Australia have been working tirelessly to promote the case for fundamental change in how public hospitals roster doctors. From interns to consultants, we believe public hospitals need to do a better job of ensuring their rostering practices aren’t contributing to fatigue and burnout let alone negatively impacting on patient safety.
Here in the ACT, we’ve proposed that rosters should be released a minimum 28 days before they are due to commence and should be inclusive of overtime and on-call/re-call. The often quoted ‘true and verified emergent situation’ need to be appropriately defined, particularly when we hear from our members that administrators rely on this to justify last minute roster changes.
AMA (ACT) has also proposed the introduction of a hospital-wide ‘graduated rest period’ for doctors who work consecutive nights. A similar arrangement is already in operation in local Emergency Departments where doctors work 7 nights on followed by 7 days off. Our proposal seeks to introduce a similar arrangement generally, meaning that if a doctor works 4 nights they should get a minimum of 48 hours rest from all duties (5 nights = 72 hours, 6 nights = 96 hours and 7 nights = 120).
Finally, and perhaps most importantly, we’ve proposed that a set of rostering principles be developed across the ACT Health network and that the principles be developed with the direct input of the doctors who work on the hospital floor, the AMA and department heads. The principles should be developed with fatigue and burnout in mind and they should provide each department, and every doctor working in that department, a better balance between work and adequate rest.
Access to leave
Another area that AMA (ACT) has identified as a problem for hospital doctors is access to annual leave. Our enterprise bargaining survey revealed that, in 2016 many hospital doctors did not get reasonable access to annual leave. Over the course of this year, we continue to hear about the difficulty our members are experiencing in accessing annual leave - even when applications have been made well in advance.
Given that hospital doctors are expected to work long hours, often including nights and weekends, be on-call and be recalled, find time to study and time with family and friends, we believe that annual leave applications should be considered in light of:
- The amount of annual leave accrued;
- The last time annual leave was taken;
- The length of notice given to the employer;
- The amount of leave requested; and
- Operational requirements.
Finally, we’ve also asked for an additional week of leave for those who work 10 Saturdays or Sundays (currently it is available only where 10 Sundays are worked). Since other health professions who work similar hours receive a minimum 5 weeks per annum, we believe this is a very reasonable proposal.
Splitting of agreements
The last round of bargaining saw the Fair Work Commission rule against splitting the current single agreement into two agreements – one for Staff Specialists and one for all other hospital doctors. The unsuccessful action was brought on by two, separate groups of staff specialists and opposed by ASMOF. In this round of bargaining, ASMOF itself is pursuing a claim for separate agreements that are also proposed to cover Staff Specialists in one and all other hospital doctors in the other.
When AMA (ACT) canvassed the issue with our members earlier this year, the feedback was that we should continue to have a single agreement but with distinct parts covering the different groups. While separate agreements exist in the larger states, at the present time, there don’t seem to be compelling reasons to have two agreements covering hospital doctors in the ACT.
Given the outcome from the last case before the FWC on the issue and ACT Health’s likely opposition to two agreements, we think the issue may be more of a hindrance than a help in the current negotiations.
Protected teaching time
Another issue identified in our enterprise bargaining survey concerned access to protected teaching time. Doctors told us that it was difficult to access teaching time away from all clinical duties and all too frequently they were required to attend teaching sessions both after hours and on an unpaid basis.
The current hospital doctors’ agreement does not provide for protected teaching time and, on that issue, is lagging other jurisdictions, such as Victoria, where doctors have a guaranteed five hours of paid, protected teaching time each week. To ensure that the ACT Health remains an attractive place to work and to learn, we’ve proposed that hospital doctors here have an identical arrangement to that in Victoria.
Regular meetings have now been scheduled and so, hopefully, we will get to the end of our bargaining road in the not-too-far distant future.
-Anish Prasad (Hospital Organiser)