Following mediation in late January the New Zealand Nurses Organisation are waiting for the 20 DHBs to consider whether they can come back with a new offer by February 26.

The online petition was launched by NZNO in December after members voted to reject the DHBs’ initial multi-employer collective agreement (MECA).

NZNO Industrial Adviser Lesley Harry said nurses want to achieve pay rates and conditions that led to sustainable workforce and healthy workplaces.
She said any new offer needed to deliver improvements on the key issues – including a improved pay offer, safe staffing cand a firmer timeframe for pay equity – if it was to be accepted by members.

NZNO delegates Sarah Gilbertson and Karen Durham presented the petition to DHBs’ advocate Kevin McFadgen and said pay and conditions had to improve in order to sustain a quality health care service.

The pair said the issue was about recognising and rewarding a predominately female workforce. “The outcome of these negotiations is a reflection on our society and the value we place on health. Well supported health teams improve the health of all New Zealanders.”

NZNO has set up a series of MECA meetings between March 6-23 for its 27,000 registered nurse, enrolled nurse, midwife and health care assistant members covered by the NZNO/DHB MECA.

Prior to mediation the union indicated that it would not rule out using the March meetings to vote on industrial action, if a deal couldn’t be reached that it believed members would be ready to accept.

Late last month Health Minister David Clark told Nursing Review that he understood nurses’ and other health workers hopes for better salaries under the new Government but the was reality was that “not everyone’s expectations will be met”.

PETTION:
Dear District Health Board Chief Executives

‘Nurses, midwives and healthcare assistants are the heart of our public healthcare services. Their skills, hard work and compassion keep all New Zealanders happy, safe, and healthy. I support better pay and healthy workplaces in our public healthcare services for our precious nursing and midwifery teams. Please keep our local health services safe and sustainable by delivering our nurses a better deal.’

In mid-December the New Zealand Nurses Organisation (NZNO) announced that its nurse, midwife and healthcare assistant DHB members had voted to reject the proposed new DHB MECA (multi-employer collective agreement) during 400 meetings held across the country.

The pay offer – a two per cent increase, backdated to November 6, for the majority of nurses and midwives covered by the MECA, and further two per cent pay rise in August 2018 and August 2019 had been widely criticised in social media by some of the 27,000 NZNO members covered by the proposed deal as being too low and not adequately reflecting the pressure and stress they had worked under in recent years (see details of the rejected offer here).

In its update to members on December 13, the NZNO negotiating team said the rejection of the proposed MECA showed that DHB members believed a “better offer was worth the very serious consideration of possible industrial action”.

It said the team would “take every opportunity in front of us” to achieve a better offer through mediation (due to begin January 31) without resorting to industrial action. But it had scheduled a series of meetings starting in late February to update DHB members on the negotiation’s progress and those meetings could be used to hold a ballot on industrial action.

“Should industrial action occur, we will work with DHBs to provide essential services for people who need them,” said the MECA update. “We are aware of your professional commitment to your patients and although it hasn’t happened for a long time, we have experience of industrial action and balancing the two.”

A spokesperson for the DHBs’ negotiating team has yet to respond to Nursing Review’s request for comment.

NZNO industrial advisor Chris Wilson said participation is going well in its online survey of DHB members. The survey is being used to get formal confirmation from DHB members of the anecdotal feedback negotiators had received on what were the major issues that members wanted addressed when the negotiations go to mediation on January 31. The survey went online just before Christmas and is due to close at 4pm on Thursday, January 18.

Wilson said the survey did not include a question on whether to pursue industrial action if mediation failed to meet a resolution, and instead focused on getting formal feedback on what was needed to reach a MECA deal that members would accept.

She said the NZNO negotiators at this point were very much committed to the mediation process. “Obviously we will see what occurs on Jan 31.” A reserve day for mediation has also been set for early February.

“Industrial action does remain a possibility if we’re not able to secure an outcome through mediation that members are comfortable with,” said Wilson. But she said it was hopeful that once employers saw the issues highlighted by members in its online survey the negotiations “might make some grounds”.

The December 13 MECA update to NZNO DHB members said that it understood that the members key reasons for rejection were as follows:

• The two per cent pay increase was not enough to recognise the hours of unpaid overtime, missed breaks, stress and burnout that members had experienced as a result of the persistent health funding shortages over the last nine years.
• There wasn’t enough clarity about the amount and timing of any pay increases due to the planned pay equity process.
• Members were concerned that the nearly three-year MECA term meant that they would get left behind relative to other groups. Especially if the pay equity process didn’t deliver a quick result.
• The apparent lack of a guarantee of funding or staffing available to respond to the demand created by the implementation of the safe staffing process.

New Zealand Nurses Organisation negotiators have given the DHBs’ offer a thumbs-up after the change of government saw DHBs improving the initial deal. The DHBs have also agreed to commence separate pay equity talks with the union in February for the about 27,000 nurses, midwives and health care assistants NZNO members covered by the multi-employer collective agreement (MECA).

But the immediate MECA pay rise offer – a two per cent increase, backdated to November 6, for the majority of nurses and midwives covered by the MECA and further two per cent pay rise in August 2018 and August 2019 – has been given a thumbs-down by most of the nurses posting on NZNO Facebook pages.

Other nurses have called for members angry or uncertain about the offer to turn up, ask questions and vote at the ratification meetings that start on Wednesday, particularly as in 2015 only about 30 per cent of members voted in the first round of meetings and an “embarrassing” 15 per cent in the second round.

It is not known whether the Facebook posters reflect the mood of all DHB nurses but many posters are expressing disappointment that the pay offer is at about or below inflation, frustration that growing work pressures and responsibilities on nurses weren’t reflected by the two per cent increase and anger that it wouldn’t reinstate the pay relativity lost by this year’s $2 billion pay equity settlement to care and support workers in the aged care and disability sector.

In the MECA update bulletin posted this week the NZNO negotiators said the 20 DHBs agreeing in principle to start pay equity talks in the new year was the first big step in the process of gaining pay equity.

In a pay equity terms of reference document, tabled by the DHBs’ negotiators on October 11, the DHBs say they would like to work in partnership with NZNO to further explore the level of the current pay equity issue for DHB-employed nurses. The DHB said they were not in complete agreement over some statements in the NZNO equity claim, for example the relationship between the 2005 ‘pay jolt’ settlement and pay equity, but still saw benefit in exploring pay equity further.

The NZNO bulletin was optimistic of a pay equity settlement stating that “we now have a new Government fully committed to pay equity and our aim is to have resolution which will include further remuneration increases as soon as possible”, with the goal of achieving an outcome later in 2018.

“This is a real opportunity to deal with gender equity with a broader brush across a longer term rather than for example pursuing pay parity which would not necessarily deliver equity across all groups in a set of MECA negotiations,” said the negotiators in the NZNO bulletin.

But many nurses posting on Facebook said they were not willing to wait any longer. One commenter, who said she was an NZNO delegate, said she was unhappy with the offer and not happy that negotiators were recommending it. “Feel very conflicted as go home feeling very tired for a profession that I do love but is understaffed and this is a major issue which the DHBS have not addressed properly. I am sick of them playing hardball with our lives.”

Another nurse said gone were the days of considering nursing as a vocational career to help people and the pay should be reflecting not just the work nurses did but keeping up with the ever-growing cost of living.

“We as nurses are working under increasing pressures, we are seeing increasing volumes of patients through Emergency Departments, the ward staff under pressures to move patients on and out to make room. Being called in on days off to cover sickness and roster gaps. More is expected of us with little or no more time to do what is required.”

NZNO President Grant Brookes said he was unable to comment to the media on the social media backlash but in Facebook posts he pointed out that the pay rises in the DHBs’ offer did meet the projected consumer price index increases over the three-year term of the MECA.

When asked about his own pay rise, he pointed out that he had pledged when he stood for the full-time president’s role in 2015 to continue accepting only a DHB staff nurse salary.  “So, like the rest of you, I have not had a pay rise this year. My last increase was 2 per cent in July 2016.”

Lesley Harry, the NZNO industrial advisor and lead negotiator, posted on the official NZNO Facebook page that everyone was entitled to express their opinion but it was important that alternative views were also respected. “The negotiating team has worked hard on your behalf and now it’s up to members to decide.”

The DHBs’ negotiating team spokesperson has not returned Nursing Review calls this week.

Ratification meetings for DHB NZNO members begin on Wednesday November 22 and run until Friday December 8. A full schedule of the meetings can be viewed here.

This 1909 statement from Hester Maclean, our country’s first chief nurse, could probably take pride of place as Exhibit A when arguing the case that a nurse’s monetary worth has historically been undervalued because of the association with ‘womanly’ qualities.

Such evidence might be needed after the NZNO lodged a pay equity claim in June for nurses working in DHBs as part of its bargaining talks. Pay equity claims are said to have merit if the work is performed predominantly by women; there are ‘reasonable grounds’ to believe the work has been historically undervalued because it uses skills or qualities ‘generally associated with women’; and the work continues to be subject to gender-based undervaluation.

Nobody is expecting such a claim to be settled quickly, particularly as the shockwaves from the historic pay equity settlement for caregivers are still being worked through, particularly by nurses in the residential aged care sector who have lost pay relativity with their unregulated co-workers (see story last edition).

But NZNO sees the pay equity claim as the first page in the final chapter of closing the gender pay cap for its DHB nurses (and other members) and, eventually, nurses beyond the public health sector.

The union argues that, unlike the 2005 Fair Pay settlement, this time around the Kristine Bartlett vs TerraNova pay equity settlement is creating not only a legal precedent but also a legislative framework to pursue and settle pay equity claims (although unions are not happy with the current wording of the draft bill introducing that framework).

It is also acknowledged that the pay equity process will take time, with NZNO industrial services manager Cee Payne writing in Kai Tiaki recently that eliminating the gender pay gap would “most likely take the next decade to be fully realised”.

“Not for the sake of money-making”

Our formidable first matron-in-chief and chief nurse Hester Maclean’s belief that nurses should put caring before commerce set the culture for much of the first half of the 20th century.

Nursing shortages in World War II saw a revised salary scale negotiated and a salaries advisory committee for public hospitals set up in 1947, but as the country settled back into peacetime nurses lost industrial traction, with little salary movement for nearly two decades. Nursing was once again seen as a feminine vocation not to be marred by talk of money.

In 1957 the New Zealand Nurses Association (the forerunner of today’s NZNO) even withdrew from the Council for Equal Pay and Opportunity for fear that the professional organisation might become “too political”.

But times were changing and in 1962 international advice was sought by the association on better methods for negotiating pay and conditions, leading in 1965 to the introduction of overtime and weekend penal rates – the first real pay rise since 1950 – and the replacement of the salaries advisory committee with an arbitration mechanism in 1969.

The 1970s saw public hospital nursing unionised, but it wasn’t until 1985 with the ‘Nurses are worth more’ campaign that nurses really tried to use industrial clout and public opinion to seek fairer pay, including marching on parliament for the first time. In an even bigger first, in 1989 nurses took strike action for the first time, followed soon after by a decade of health restructuring and industrial reform that saw nursing go into survival mode for much of the 1990s.

Pay jolt and pay gaps between sectors

With the new millennium and the return of national bargaining, nurses were again ready to look at the issue of pay equity. On Suffrage Day 2003, NZNO launched its ‘Fair pay – because we’re worth it’ campaign to gain pay parity for DHB nurses with teachers and police.  After a hard-won campaign to get such a deal funded, a settlement was reached, leading to ratification in early 2005 of a national DHB multi-employer collective agreement (MECA) that introduced an up to 20 per cent pay jolt for nurses.

That pay jolt created a gap between DHB nurses and many of their non-DHB nursing colleagues. A decade later, that pay gap is nearly closed for nurses covered by MECAs in sectors such as primary health, family planning and prisons.

But the pay gap still remains for nurses with less industrial clout, including nurses in residential aged care, whose take-home pay is on average 23 per cent lower than their colleagues in public hospitals. And some nurses working for Māori and iwi providers are earning up to 20 per cent less than colleagues working for similar primary healthcare services. Those pay gaps are thrown into even starker relief by the realisation that the caregiver pay equity settlement could see the pay gap between nurses in those sectors and their unregulated colleague shrink or even disappear.

NZNO believes that the best step toward pay equity for all nurses is to begin by negotiating in the DHB sector, where it has the greatest numbers and influence. The State Services Commission and Combined Trade Unions (CTU) had also agreed that unions in the public sector could lodge pay equity claims through collective bargaining using the principles agreed by the tripartite Joint Working Group on Pay Equity late last year.

This led to NZNO lodging its claim when talks began in June, rather than waiting for the progress of the draft Employment (Pay Equity and Equal Pay) Bill, which NZNO and other unions oppose in its current form, saying it takes a backward step by placing new and “unreasonably onerous” requirements on women taking claims.

Meanwhile, once NZNO and the DHBs agree on terms of reference for pay equity talks, the task of assessing, with a gender-neutral eye, the value of nursing work in terms of skill, knowledge, responsibility, effort and working conditions will begin. Then comes selecting historically male-dominated occupations of equal value as comparators to back the claim that nurses are underpaid because of historic and ongoing gender inequity.

Hester Maclean might not approve, but it is probably about time that the value of a nurse “working for the good of her [his] fellow creatures” was calculated once and for all.

Lessons learnt from midwives’ pay equity case?

Community midwives lodged an historic pay equity claim under the Bill of Rights Act in 2015 and found that proving gender inequity was far from simple.

The College of Midwives’ claim for its self-employed lead maternity carers (LMC) led to mediation in 2016 with funder the Ministry of Health. In May this year it withdrew its court action after winning an interim pay increase and a legally binding agreement from the ministry that midwives would work with officials to design a new funding model for midwifery-led care that resolved the college’s longstanding concerns about pay equity and working conditions.

But in a report to members, the college said that after putting thousands of hours and dollars into researching and providing more than 3,000 documents for the case, it had proven easier to prove that midwifery pay was inequitable than it was to legally prove that inequity was due to gender.

LMC midwives had fought a case for equal pay for work of equal value in 1993 through the Maternity Benefits Tribunal and won, but there had been only two small increases since 2007, raising questions as to whether midwifery funding provided a sustainable income for the 24-hour, on-call service.

The midwifery case was unique because, as self-employed health professionals, community midwives were not covered by the Employment or Pay Equity Acts. But they too went through the process of looking at the historic discrimination of a female-dominated ‘caring profession’ and seeking out comparators in historically male-dominated professions. So are there lessons to share?

Alison Eddy, a midwifery advisor for the College of Midwives, says proving that a profession’s pay is inequitable because of gender is potentially difficult. She says it is easier to measure the clinical and technical skills and the professional accountability required of nurses and midwives than the so-called ‘soft skills’ that are also key to both female-dominated professions. The skills such as building relationships, working alongside people, and empowerment are all areas that can potentially be undervalued.

Commodifying those skills in order to match and compare pay with a comparator occupation in a field that has been historically male-dominated can also be challenging. Eddy says that after going through a lengthy process of using equitable job evaluation tools, the midwifery case had opted for pharmacists and GPs as two potential comparators and decided that midwifery fitted somewhere above the role of pharmacist and slightly below the role of GP.

Under the agreement with the ministry was the commissioning of an independent evaluation of the midwifery role and the provision of comparators and a market value for the role, using a gender-neutral lens, in readiness for a new funding model being in place by July 2018.

However, Eddy says that there are real concerns that the numbers now leaving the midwifery workforce due to feeling undervalued could impact on the sustainability of the service.