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A newsletter for NZNO members working in the primary health care sector

primary action

Summer 2013

Health Workforce NZ extends voluntary bonding scheme to primary care nursing This programme is an incentive-based payment scheme to reward medical, midwifery and nursing graduates who agree to work in hard-to-staff communities and/or specialities for no less than three years. In 2014 the applications have been extended to primary care including practice nurses, public health nurses, Well Child Tamariki Ora nurses, and district nurses. In order to receive payment (2014 - $2,833 net per year) graduates must register their interest in the scheme, be confirmed, and then stay on the scheme for a minimum of three years and a maximum of five years. The scheme is voluntary and individuals can withdraw at any time. There are limited places available and applicants must register their interest during the ‘Registration of Interest’ period . Information, including the application form is available at

Family Planning proposal for change to Senior/Medical Receptionist roles NZNO members say “No!” At the end of September Family Planning released a proposal for change to Medical Receptionist and Senior Medical Receptionist roles. The proposal expanded the position descriptions of the roles to include tasks such as: setting up for procedures; preparation and sterilisation of equipment; recording clinical measurements e.g. blood pressure; body mass index recording; and pregnancy testing. NZNO submitted that it was not appropriate to substitute unregulated staff for regulated health professionals. We do not support the introduction of an “advanced caregiver” role and do not support receptionists undertaking initial “data gathering” as a substitute for effective triage and assessment. We believe all actions involving direct client care must be under the direction and delegation of the NP/RN or GP, with this relationship explicitly clear and supported in position descriptions and employer policies. Fortunately Family Planning took the views of NZNO and members seriously and decided not to go ahead with the proposed changes.

Te Rau Kōkiri MECA achieved! Six years after the process first began the Te Rau Kōkiri journey has reached a significant destination – overwhelming ratification of the multi-employer collective agreement (MECA) for NZNO members in 14 Māori and iwi health providers. Those NZNO members voting strongly endorsed the “core conditions document” which sets standardised conditions such as hours of work, annual, sick, bereavement and long-service leave, employee rights clauses, management of change and professional development across the 14 providers. The MECA does not include pay rates. They have been agreed with each employer and recorded as a separate schedule to the MECA which expires on 30 June 2014. This is a stepping stone approach and our goal in the 2014 MECA will be to achieve fair standardised pay scales within the MECA. We are very pleased Te Rau Kōkiri has been ratified, albeit covering considerably fewer providers than began the journey. This MECA has begun to set positive standards in the sector. Now, with 14 providers signed up to TRK, we have a real opportunity to build on this foundation. But time is of the essence as the MECA expires midway through next year. We need to develop constructive relationships with these 14 employers and build member density and engagement at these sites. We also want to grow the MECA by bringing other employer parties on board and will look to target strategic worksites for this purpose. Some Māori providers are able to pay close to DHB rates; others simply cannot because their contracts don’t give them that leeway. Our members in these providers are entitled to the same pay and conditions as those employed by district health boards. We will continue to do all we can to achieve more money to fund pay parity. We will be looking to enact the commitment in the MECA to actively lobby the appropriate stakeholders alongside the employer parties for the extra funding required for pay parity. Ensuring the staff of Maori and iwi providers are properly paid is one contribution to improving Māori health outcomes. We acknowledge all staff and members who have contributed to this wonderful success.

National bargaining It has been a very busy five months in terms of national bargaining in Primary Health Care and we are pleased to report that we have successfully renegotiated the six collective agreements that were due to be renewed.

Prison nurses collective agreement The new collective agreement includes: ͙͙ A term to 30 June 2015; ͙͙ A 2% increase on wages and allowances effective from 1 January 2014 and a further 1% increase effective from 1 January 2015; ͙͙ Inclusion of Health Care Assistants in the CA including a new pay scale. During the term of the agreement the Department of Corrections will consult with NZNO over the development of progression criteria for Health Care Assistants; ͙͙ Wording in the CA providing shift leave for part time staff on a pro rata basis; ͙͙ Team Leaders. The parties agreed to work together during the term of this agreement to complete the work on the Team Leader job description. Following this an evaluation of the role will be carried out in consultation with NZNO, using the Department’s evaluation system. Any implications arising from the evaluation will be discussed with NZNO and should any changes be deemed necessary there is the ability to vary the CA accordingly. The Negotiation Team comprised NZNO staff Chris Wilson and Julie Governor and members Trish Carter, RN, Tongariro/Rangipo Prison, Jacqui O’Connell, RN, Christchurch Mens Prison and Queenie Komene, Team Leader, Northland Prison.

Healthcare NZ collective agreement The new collective agreement includes: ͙͙ Term of Collective Agreement,1 March 2013 to 28 February 2014; ͙͙ A 1.5% increase on wages backdated to 1 March 2013; ͙͙ Health Advisors now included in the CA; ͙͙ A No Pass-On Provision which indicates pay increases agreed by the parties will apply only to union members for a period of at least 3 months from the effective date of the increase; ͙͙ New clauses agreed for NZNO Access to the Workplace and NZNO Meetings; ͙͙ Agreement that the parties will meet during the term of the CA to discuss achieving a PDRP for Healthcare NZ that is endorsed by Nursing Council, is achievable by NZNO members and is appropriately remunerated; ͙͙ It is agreed the Healthy Workplace Forums will recommence; ͙͙ Commitment to investigating extending the coverage of the Collective Agreement to further include Senior Nurses in the next Collective Agreement. The Negotiation Team comprised NZNO staff Chris Wilson and Blair O’ Brien and members Marie Mockford and Annemarie Caister, Christchurch and Rhonda Ritchie Bay of Plenty.

Plunket negotiations protracted Negotiations for the two Plunket collective agreements were difficult and protracted this year due to the Ministry of Health funding not including any increase to Plunket for Consumer Price Index increases. Despite this constraint the NZNO negotiation teams worked hard to secure a 1% increase for a one year term. The main Plunket collective agreement was ratified by 88 percent of voting members and the Clinical Leaders, Clinical Advisors, Clinical Educators collective agreement was ratified by 83 percent of those voting members. The bargaining fee clause vote which balloted all employees was successful for both collective agreements. Many members expressed their disappointment that the settlement was less than what was needed to maintain pay parity with DHBs (now a 0.5% gap). We will be encouraging Plunket to actively seek improved MOH funding for the 2014/2015 year so it can meet its commitment to pay parity with DHB clinical roles. The Strategic Working Group will be the forum for NZNO and Plunket to discuss outstanding issues we did not manage to progress during our negotiations this year. Member feedback supported NZNO discussions around improved leave, and seeking coverage for B4 School check co-ordinators. Copies of the new collective agreements are now available from Plunket or your local NZNO office. Special thanks to the Plunket staff on the two NZNO negotiating teams – Angela Collie, Deborah Bee, Gail Sefton, Donna MacRae, Teri Ransfield, Merrianne Northcott, Delwyn Campi, Adrianne Kinsey, Allison Jamieson, Maria Van Der Plas and Vivienne Edwards for their commitment and input into the successful bargaining process.

Back Row: Teri Ransfield, Gail Sefton, Christine Gallagher, Angela Collie, Adrianne Kinsey, Allison Jamieson, Delwyn Campi, Donna MacRae Front Row: Laura Thomas, Merrianne Northcott, Vivienne Edwards, Maria Van Der Plas, Deborah Bee.

New Zealand Family Planning Collective Agreement 2013 Negotiations were held on 18 and 19 July 2013. The Negotiation Team was Chris Wilson NZNO, Mike Yeats NZNO, Vickie Aiken, RN, Dunedin, Daphna Whitmore, RN, Auckland, and Heather Perry, Health Promoter, Wanganui. An agreement was reached and ratified which included: ͙͙ A two year term; ͙͙ Wages nurses: increases to wages for nurses of 2%, 3.5% for Nurse Practitioners in the first year, in the second year an increase for both groups of 1.5%. Health Promoters: Increase of 2% in first year, 1.5% in the second year. Medical Receptionists/Clerical/Administrative Employees: increases of between 2.1% and 3.0% in the first year, 1.5% increase in the second year; ͙͙ An increase to transport expenses from 63 cents per kilometre to 70 cents per kilometre; ͙͙ A new weekend allowance of $2.00 per hour for those who work Saturday and/ or Sunday; ͙͙ An enhanced consultation clause; ͙͙ A new Union Delegate recognition clause; ͙͙ An agreement to continue to participate in joint Healthy Workplace forums in each region twice a year during the term of the agreement.

Back Row: Heather Perry, Daphna Whitmore, Mike Yeats Front Row: Chris Wilson, Vickie Aiken.

Primary Health Care MECA update The Primary Health Care Multi Employer Collective Agreement (MECA) now covers even more worksites with employers continuing to join – we have now over 550 employers covered! The wage scales in the MECA increased by 1.5% as of 1 September 2013 so you should have received this increase by now. If you are paid above the MECA wage scales then you should approach your employer and request the 1.5% increase in order to maintain the differential.

If you are covered by the Primary Health Care MECA you may be entitled to a merit payment! Clause 12.9 of the PHC MECA details the merit payments and criteria for Nurses, Midwives, Medical Receptionists and Administration Staff. The process is as follows: ͙͙ Consideration of the applicable merit level(s) is forwarded by the Registered Nurse, Enrolled Nurse or Medical Receptionist/Administration staff member (in writing if requested) to their employer detailing how they believe they meet the level criteria; ͙͙ The employer shall then respond to the request (in writing if requested by the employee) indicating either agreement to the requested level(s) or the reasons for declining the request. It is important to note: ͙͙ Each merit level can be awarded individually, with it not being necessary (eg) to attain merit level 1 prior to attaining merit level 2. The merit levels payments shall also be combined for those employees that meet criteria in both of the merit levels specified for their occupational group; ͙͙ The bullet point responsibilities within each of the merit levels in the MECA are not an exhaustive list; ͙͙ Awarding merit for the Registered Nurse/Practice Nurse/Midwife merit levels shall include the defined bullet points but is not restricted to those points only; ͙͙ For Enrolled Nurses and Medical Receptionist/Administration Staff awarding of merit may include the bullet points but is not restricted to those points only. We believe that if you produce evidence that supports the bullet points in the relevant merit level (or other as may be appropriate) and are performing at a consistently high level, or are performing tasks substantially outside the basic job description, then the appropriate Merit Level should be awarded. NZNO has worked hard to make these merit payments attainable and would like to see NZNO members taking up the opportunity. We know many of you are eligible to apply and we urge you to do so - you are worth it. Please contact your local NZNO Organiser for further advice if you do not believe the appropriate process (as detailed above) has been followed once you have submitted your application.

NZ Blood Service Another collective agreement bargaining process has been completed earlier this year and we were able to achieve an across the board pay increase of 1%, except for those on grandparented rates who will continue to be grandparented but will have access to PDRP payments. Also included was a one year term, agreement to the night rate allowance to commence from 7pm instead of 8pm and agreement to meet and discuss the result of the team leader scoping exercise. That meeting will take place in February 2014. Since ratification of the collective agreement, it has been agreed that a new role, Donor and Product Safety Services Coordinator will be included in the next collective agreement under the coverage of the CA. By the time of going to print, we saw the closure of the Napier and Nelson rooms. While we regret the closure of these sites despite the efforts of our members with NZNO support to oppose the closures, and we wish to say thank you to those Napier and Nelson NZBS members for their commitment and contributions to the NZNO membership. NZNO wishes you all well in your new endeavours whatever they may be.

Offering nursing services without a medical practitioner on site. Occasionally we receive enquiries from nurses in general practice and accident and medical centres about whether they have to continue to provide nursing services when there is no medical practitioner on site. There are several things that you can do when discussing this with your employer. ͙͙ Review the service contract (it could be with a PHO/NGO/DHB) to see whether the centre must provide nursing services; ͙͙ Review the service contract to see whether it must provide medical services within certain hours and how after hours or alternative arrangements such as telephone triage are to be met; ͙͙ Discuss with your employer, acknowledging consumer expectation, what level of service is available such as displaying notices at the entrance door and reception and in local papers that there is no doctor on site between X and Y hours and patients will be advised to make an appointment at another time or go to another provider for medical attention. The nurse herself must verbally convey this information to the clients who present; ͙͙ Discuss the referral process to another medical practitioner so everyone is clear about who, when and where you will be referring patients to; ͙͙ Discuss with your employer whether nursing triage will be offered during the times when there is no medical practitioner available. Do you have any specific training needs in triage assessment and referral? How can these training needs be met? ͙͙ Review any collaborative care that would normally happen in the evening and whether this will continue i.e. use of Standing Orders that require signing off at a later time/date, ACC care etc.

Primary Health Care leaders Your Primary Health Care National Delegates Committee (PHC NDC) met in Wellington on 19 November. This Committee meets face to face twice a year with the next meeting to be held in April 2014. There are 13 members on the Committee including representation from Primary Health Care MECA Practice Nurses, Accident and Medical Nurses and Medical Receptionists, Family Planning, Plunket, Prison Nurses, NZ Blood Service, Maori and iwi, College of Primary Health Care Nurses NZNO, Union Health Centres and Healthcare NZ The role of the Committee includes representing, advising, consulting and involving members in the constituent group they represent. The Committee acts as a reference group for all issues arising for members who are employed in the primary health care sector which includes commenting on policy documents and planning of future projects. They also provide leadership and are part of developing strategies to support the work of NZNO members across all health sectors. We had a very productive November meeting with NDC members, including sharing of work stream issues which informs our PHC sector work and strategy, and contributing to discussion on developing resources to ensure positive change occurs in the primary health care sector. One of the challenges we had identified a while ago was how to establish robust communication networks across such a diverse primary health care sector to ensure we represent members’ views.We have been discussing ways to mitigate this challenge and exploring ways to achieve same and have identified the number of delegates in the PHC sector with a view to starting up specific networks. So PHC delegates, be prepared! Your NDC network representative will contact you soon to begin the networking process including sharing and distributing information and finding out what your common issues are within groups and across the sector. Contact will take place over the coming months in time for NDC reps to be able to report back at the next NDC meeting in April 2014.

Back row; Maree Mockford, Angela Collie, Vicki Aiken, Marianne Lock, Trish Carter, Rhoena Davis Front row; Frances Franklyn, Yvonne Walmsley, Maire Christeller, Polly Marsters, Absent: Karen Smith

NZNO delegate, Yvonne Walmsley How long have you been an NZNO member? Since April 2012

Why did you join NZNO? My previous GP employer was great and I didn't see the need to join a union. She then sold her practice and I had some concerns about my new employer. I should have joined before I did, as my terms and conditions of employment and pay rate did not carry over.

What do you enjoy about your job? All of it! I enjoy the fact that every day is different, some more challenging than others. I work with a great team of receptionists, doctors and nurses. I was previously a midwife, working for a DHB, then the Ministry of Health, so it is interesting to see the healthcare system from another perspective.

What does being a member of NZNO mean to you? It's good to know that I can get advice and guidance on employment issues. Also I am kept informed of developments in the health service and provided with opportunities for meeting others working in GP practices.

You’re representing medical receptionists on NZNOs Primary Health Care National Delegates Committee – do you have any specific things you’d like to achieve in your role? That's a hard question to answer as I'm new to this! I would hope that all admin staff are seen as valuable members of a team, where ever they work, but I know this is not always the case. I would have to ask the medical receptionist members what they want me to achieve, and ask them to be patient with me!

Give us a break! During the last week of October, workers across New Zealand told the Government not to take away our right to regular meal and rest breaks. Primary Health Care members all around the country participated in ‘Give is a break’ activities. Everyone looks forward to having a break during the work day – having a cuppa, stepping outside for some fresh air, getting off our feet for a couple of minutes. If the proposed changes to our employment law goes ahead, workers might not have a break to look forward to. Changes to the ERA will take away the guaranteed minimum rest breaks which are currently in the law and replace them with a general obligation for your employer to give you “a reasonable opportunity” to get a break. If you and your employer can’t agree on what that “reasonable opportunity” means, guess who gets the final say? Your employer, of course. And if they think it’s not “reasonable” to give you a break at all? You could be working a very long shift without a single cup of tea or even a toilet stop!

NZNO Primary Health Care member, Leah Alforque

Meal and rest breaks are an essential part of having a healthy and safe workplace. Working long stretches without a break contributes hugely to errors and accidents. Yes, your employer will have to compensate you for the lack of breaks – but that’s going to be cold comfort when you’re totally worn out or even get injured on the job due to tiredness.

NZNO PHC delegate, Marianne Lock talks about lobbying MPs I think the proposed changes to the employment law look very similar to the Employment Contracts Act of the 1990s. Back then we had national collective agreements called national awards. The result of the Employment Contracts Act was that we lost our national awards and for many members that meant a significant slippage of wages and a loss of things like penal rates and other conditions. The situation was very bad and it was only with the introduction of the Employment Relations Act that things improved again for nurses. The changes that are on the table now will, if the Bill is passed, give a great deal more power to employers while at the same time eroding the rights of employees. Along with other union and NZNO members I have been meeting and lobbying MPs about the Bill. The first MP we met with was David Bennett. We all went and expressed our views which meant that we could lend weight to each other’s arguments and support each other. A couple of weeks later we also met with another local MP, Tim MacIndoe. I have met with MPs before; the first time was around 2005 or 2006 when I first became involved with the campaign to achieve a Primary Health Care MECA. It was very nerve racking initially but I didn’t go by myself and that really helped. Since then I have met with MPs several times and subsequently have become more confident. It’s just practice really. The more you do something, the more comfortable you become with it. If you are considering lobbying an MP I would say; ͙͙ Don’t go alone; surround yourself with like-minded people. This will give you confidence, and if you forget what you want to say, someone else will remember; ͙͙ Keep your message simple. Have two or three main points and stick to them don’t get side tracked you will often only have a short time; ͙͙ If you are feeling nervous remind yourself that you are a taxpayer and as such, are paying part of that MPs salary! (It really helps with my confidence!) ͙͙ MPs are just people the same as yourself and this is your opportunity to help keep them informed; ͙͙ Allocate someone to take notes so that you have a record of what was discussed; ͙͙ If you have some written information, you can leave that with the MP to remind them of your issue. I made an oral submission to the Transport and Industrial Relations Select Committee about the Employment Relations Act recently and it’s the same as lobbying an MP really. Keep your message succinct. Be prepared; I had what I wanted to say written down, and practiced saying it before hand. NZNO has some very good information on how to put together a submission and how to present it. I found this very useful and helpful. My main advice is “go for it!” Get help and support from NZNO, there is plenty of it out there, all you have to is express your interest and ask.

The New Zealand Nurses Organisation wishes you every happiness this holiday season and throughout the coming year.

Kua tae mai rā ngā hararei! He wā pai hei tūtakitaki whānau.

Level 3, Willbank Court, 57 Willis Street, Wellington 6011 PO Box 2128, Wellington 6140 Phone 0800 28 38 48

Primary Action - Summer 2013/14  

A newsletter for NZNO members working in primary health care in New Zealand.