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.’

The NZNO and negotiating team for the 20 District Health Boards entered mediation on January 31 after NZNO’s DHB nurses, midwives and health care assistants voted to reject the initial pay offer made in November.

The NZNO negotiating team said in an update that it presented the findings of its online member survey to last week’s mediation, including that members wanted an increased pay offer, safe staffing, a shorter term for the agreement (the original offer was for a 33 month term), and a firmer timeframe for pay equity.

“We were clear that any revised offer will require additional funding as trading off improvements from the previous offer would not be acceptable,” said the update to the about 27,000 members that will be covered by the new DHB/NZNO MECA (multi-employer collective agreement).

The original 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 – was widely viewed by nurses as too little too late. Members were also divided on how quickly the initial offer’s agreement to start negotiating a pay equity settlement would deliver results for nurses.

The NZNO negotiators said the DHBs were now “going to look at their ability to reconstruct an offer that addresses NZNO concerns”.  The DHBs were due to report back to NZNO by February 26 and members were to be updated on the outcome prior to a series of member meetings running from March 6 to March 23.

“Should DHBs agree to an improved offer the update will include the detail the offer for members to vote on at the meetings,” said the update.

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”.

Survey respondents were also found to be divided over what gains the the proposed pay equity process –due to start after the new contract is settled – would deliver and how quickly.

The online survey followed the New Zealand Nurses Organisation’s District Health Board members voting to reject the 20 DHB’s MECA (multi-employer collective agreement) offer with strong social media feedback that many felt the offer fell short of reflecting the skills and increasing workloads of nurses.

The union and employer negotiating teams were starting mediation today with the union not ruling out a vote on industrial action if a deal can’t be reached that members are ready to accept.

In a survey summary to members the NZNO negotiating team said safe staffing was also reiterated as a key issue by members concerned about continuing to work “under-staffed and under pressure”.

Other issues highlighted was that members felt back pay or a lump sum was important (the current agreement expired on July 31 last year), and most members favoured a two year term (the original offer was for a 33 month term).

The initial pay offer included an agreement to start negotiating a pay equity settlement and the survey found that 80 per cent of respondents backed a strategy to have pay parity with medical radiation technologists (MRTs) and allied health professionals.  The survey showed members were divided on whether the pay equity could deliver but survey respondents had indicated that a better base scale pay offer could increase their support of the proposed pay equity process.

A petition seeking public support for a better pay offer for district health board nurses had also reached nearly 13,800 signatures as mediation got underway today.

Health Minister David Clark says he understands nurses’ and other health workers’ hopes for better salaries under the new Government, but the reality is that “not everyone’s expectations will be met”.

He was responding to questions from Nursing Review and online health hub Health Central about New Zealand Nurses Organisation members rejecting the 20 district health boards’ pay offer of roughly two per cent a year, amidst expectations that the incoming Government may be more open to funding a more “respectful” offer.

Minister for Women Julie Anne Genter, who is also Associate Minister of Health (but in that capacity has no responsibility for wage settlements), says she is aware that nurses’ expectations are high and meeting everybody’s expectations poses “fiscal challenges” as there is a lot of investment that the new Government needs to catch up on.

Clark said he would not comment on the negotiations, which are due to go to mediation at the end of the month – with NZNO not ruling out industrial action if a better offer was not reached – or pre-empt the mediation outcomes.

“But I can understand firstly why those nurses might have hopes of better things.  This is a government that wants to see a more sustainable health sector. We don’t intend to run it down like our predecessors did. We want to ensure there are healthy workplaces and safe staffing and more sustainable funding over time.”

He said he needed to better understand why the NZNO negotiating team thought the initial pay offer would be accepted by members and why it was rejected.

“But the public also has an expectation based on the priorities outlined and the promises made that there will be more services delivered.”

“So the money that we pledged to put into healthcare won’t all go into salary raises,” said Clark. “Not everyone’s expectations will be met. I think that is the reality and I think we need to be upfront about that. But a Labour Government recognises the need to have a sustainably funded workforce and the need to make sure we have safe staffing and healthy workplaces.”

Nurses and midwives underpaid

Genter said as Minister for Women her number one priority was new pay equity legislation and working to close the gender pay gap in the public service.

“Female-dominated professions like midwives and nurses have structurally lower pay,” said Genter. “Those professions have been underpaid and undervalued because they are female-dominated.”

She said where there were MECAs (multi-employer collective agreements) for specialists or doctors the gender pay gap had disappeared, because so many more women were pursuing medicine and becoming specialists.

“But across the health workforce it is not necessarily the case and there is still more work to be done to rectify the pay gap.” She is aware of the NZNO’s pay equity claim for its DHB nurses, midwives and health care assistants. She said such pay equity claims are not her responsibility alone, but as Minister for Women she is working with other ministers on pay equity legislation to progress such claims (see below).

“Obviously this government is very supportive of closing the gender pay gap and lifting pay for the lowest paid workers, and valuing all of the professions that add so much to life in Aotearoa – we can’t do without them.”

Genter, in her role as Associate Minister of Health, spoke to Health Central about her two new delegations for health – population health (built environment) and climate change – along with women’s health, sexual health and disability services.

Next step to new pay equity legislation

This week Genter, in her role as Minister for Women, and Iain Lees-Galloway, the Minister for Workplace Relations and Safety, announced the reconvening of the Joint Working Group on Pay Equity Principles as the first step to new pay equity legislation.

The original group was set up in 2015 to develop principles to guide pay equity implementation, but Galloway said these principles had been ‘undermined’ by the pay equity bill introduced in July last year by the former government, which would have made pay equity claims tougher for women. The bill was scrapped by the incoming government in November.

The new working group has been charged with considering the issues around how to determine the merit of a pay equity claim and how to select appropriate male comparative professions/trades to compare the pay rates of women workers who lodge pay equity claims.

The group, facilitated by Traci Houpapa, meets today, January 24, and is due to make its recommendations to Ministers by the end of February. “Once we receive the recommendations, we will work to develop pay equity legislation which we expect to introduce mid-2018,” said Genter.

The tripartite partners include government representatives, unions (led by the New Zealand Council of Trade Unions) and employers (led by BusinessNZ and the Employers and Manufacturers Association).

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.

The DHBs’ offer – that had been endorsed by the New Zealand Nurses Organisation (NZNO) negotiating team – had been widely criticised in social media by some of the 27,000 nurses, midwives and health care assistant members of NZNO covered by the proposed deal.

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 –appeared to be seen as too little too late.  The offer also included a small lump sum of $350 and an agreement in principle by the 20 DHBs to progressing a pay equity claim with negotiations to begin in the year. (See details of the rejected offer here)

Harry acknowledged that the members rejection reflected their views that the offer “failed to respect nurses, midwives and health car assistants and the huge effort and value they bring to patients and our communities”. She said the next formal step was likely to be mediation between NZNO and the DHBs.  Nursing Review has sought comment from the DHBs’ negotiating team spokesperson but they had not responded at this point.

Nurses on social media had expressed disappointment and frustration that the DHBs’ offer was about or below inflation, it didn’t reflect growing pressures and responsibilities placed on nurses in the workplace and 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.

Harry also acknowledged that it appeared members did not have confidence that the agreement in principle by DHBs to start pay equity negotiations would see extra money in their pockets soon.

“I think members lost a lot of trust and confidence over the years of austerity,” said Harry. She said the negotiating team had supported the DHBs pay offer on the basis of the DHBs seeing merit in the pay equity claim and the new government’s support of pay equity.

“The negotiating team were certainly more optimistic (about the likelihood of getting a pay equity settlement) than the feedback we’ve got from members,” said Harry.  “And we will take the opportunity between now and we get to meet with our members next to fully inform them of what the pay equity process is.”

Harry would not disclose whether voters resoundingly or narrowly rejected the offer. But she did say it was pleased with the turnout at the 400 meetings held across DHBs in the past few weeks which was probably the highest turnout in more than a decade.

Posters on social media in the past few weeks – both for and against the offer – had called on nurses to turn up to meetings to be briefed on the details and make their voice count.

Harry said anecdotally it had a sense of what offer might be acceptable for members but it was first going to canvas members, via an electronic survey, so the negotiating team could be “absolutely confident” on what members would be prepared to ratify.  The aim was to post the survey before Christmas.

She said the timing of the mediation was not known yet but NZNO was setting up a series of member meetings in late February that would either be follow-up meetings to discuss next steps or “all going well” might have a ratifiable offer to put to members by then.

“Of course nurses and DHB employers will be doing their best to reach an employment agreement acceptable to both parties,” said Harry.

“Consideration of industrial action will only occur if NZNO and DHBs cannot achieve a resolution of the issues members have raised,”  Harry confirmed.

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.

It was revealed today that a new deal – a six per cent pay rise spread over just under three years – was offered by the DHBs on November 8 after, it is understood, successfully seeking sign-off from new Health Minister David Clark for additional funding.  The offer also includes an “agreement in principle” by the DHBs to the merit of NZNO’s separate pay equity claim with negotiations on pay equity due to begin in February.

The pay deal now on offer is for an initial two per cent increase, backdated to November 6, for the majority of nurses, midwives and healthcare assistants covered by the DHB/NZNO multi-employer collective agreement (MECA) and further two per cent pay rises in August 2018 and August 2019. In addition there is a lump sum payment of $350 for current NZN0 MECA members who are permanent DHB employees. Designated senior nurses and midwives are being offered a four per cent pay rise backdated from November 6 and then two per cent pay rises in August 2018 and August 2019.

The DHBs’ initial pay offer was made in mid-October, prior to the new Government being formed, and NZNO negotiators have now revealed that they recommended the 27,000 registered nurse, enrolled nurse, midwife and healthcare assistant members covered by the MECA to vote against that first offer in the series of ratification meetings due to start on November 22.

That initial offer had a six-month delay before the first pay increase and a 43-month term, rather than the 33-month term now being offered.

“But on November 8 NZNO was informed that the DHB CEOs were meeting with the Minister for approval to go beyond the financial parameter so that they could increase the offer and that the CEOs would manage/address the additional costs within their budgets,” said NZNO in a MECA bulletin update to its members, that was revised on November 17 to clarify what lead to the new offer.*

Lesley Harry, the NZNO’s industrial advisory, said it believed having a new Minister of Health had “provided the opportunity to push the parameters a little further” leading to the latest offer.

NZNO negotiators are telling members that they believe the latest offer is “a fair settlement that delivers on most key issues and providers processes with set timeframes to address others”.  It also noted that the overall cost of the offer was greater than other recent MECA settlements in the DHB sector.

Pay equity and safe staffing progress

When the MECA negotiations began in June the union also tabled an historic pay equity claim for nurses.

The negotiating team said the DHBs had now agreed in principle that the work of nurses, HCA and midwives is predominantly performed by women, and had been “historically undervalued and subject to systemic undervaluation”.

The union said it had also reached agreement on the process and timeframes for resolving pay equity issues with negotiations due to begin in February “with the goal of achieving an outcome later in 2018”.

A major plank of the negotiations was also safe staffing and the current slow implementation by DHBs of the Care Capacity Demand Management (CCDM) tools that use evidence-based data to calculate how many nurses need to be employed on a ward to deliver safe, quality patient care. (See recent Nursing Review story on DHB announcing nursing staff boost due to CCDM.)

The negotiators said the DHBs had now agreed to a package of changes that it believed would strengthen the DHBs obligations to deliver CCDM.

*Article updated at 12.45 on November 17 to reflect correction to NZNO MECA bulletin.

Safe staffing and other aspects of the proposed MECA offer:

• Full implementation of CCDM in all DHBs by 30 June 2021
• CCDM implementation plans will be agreed for each DHB within six months of ratification of the MECA (including DHBs that currently don’t have in place an evidence-based acuity tool required to implement the CCDM tools).
• CCDM implementation plans are to be part of DHB’s annual plans and accountability documents and will be included in the Ministry of Health operation policy framework.
• A re-evaluation of an agreed number of nurse practitioner role’s will be undertaken and completed by December 15 to help inform the pay equity process.
• A new Leadership Progression Pathway salary scale will be available for RNs and RMs who have been approved to be part of a DHB’s leadership programme.
• Designated RN prescribers who have been supported by the DHB will be placed on the Leadership Progression Pathway salary scale.
• PDRP allowances for ENs will increase from November 6 from $4000 to $4500 per year for EN Accomplished and from $2500 to $3000 per year for EN Proficient.
• The on-call rate will increase from $4.06 to $8 an hour from November 6 2017 and the public holiday on-call rate will increase to $10 an hour
• The escalation process for unsafe staffing has been revised to make it clearer and more user-friendly.
• Support for victims of domestic violence and an alternative dispute resolution process (consistent with NZNO’s commitment to Te Tiriti o Waitangi) will be explored jointly with other unions and DHBs during the term of the MECA.

NZNO claims not progressed:

• Improvements to professional development provisions
• Reductions to the numbers of hours staff can be required to work on-call
• An agreed interpretation on what ‘two full consecutive days off work each week’ consists of

The Minister for Workplace Relations and Safety Iain Lees-Galloway and the Minister for Women Julie Anne Genter today put out a statement reaffirmed the new Government’s pre-election commitment to halting the Employment (Pay Equity and Equal Pay) Bill currently before parliament.

“While both sides of the House seemed united in lauding the TerraNova decision in favour of care and support workers and Kristine Bartlett, the previous Government immediately introduced legislation that fundamentally changed the ability of anyone else to achieve the same result,” said Lees-Galloway.

Cee Payne, industrial services manager for the New Zealand Nurses Organisation said the flawed bill had put the onus on women to prove inequity and introduced extra barriers for women to be paid fairly.

“The Bill gave no opportunity for outstanding pay equity claims to be assessed the same way as Kristine Bartlett’s was,” she said. “Nurses haven’t established the best pay equity comparison for them yet but this Bill is off the mark as nurses deserve to establish this without having to jump through hoops.”

NZNO lodged a pay equity claim for district health board nurses and other NZNO members in the recent MECA negotiations (see previous story) and it is understood that alongside a new pay deal – to be voted on later this month – a possible pathway for pursuing the claim had also been progressed.

Glenn Barclay, national secretary of the Public Service Association, agreed the bill was flawed said there was much to celebrate in the decision to “dump” it.  “It was a short-sighted and unfair bill, and congratulations to this government for recognising that,” said Barclay.

He said unions, women’s groups and their allies had campaigned for equal pay for more than a century – and forty-five years after the Equal Pay Act, it was time to finish the job.

Lees-Galloway said while both sides of the House had seemed united in lauding the TerraNova decision in favour of care and support workers and Kristine Bartlett, the previous Government immediately introduced the bill that fundamentally changed the ability of anyone else to achieve the same result.  He said the new Government would start work on new legislation built on the principles of the Joint Working Group on Pay Equity.

Genter, who is also an associate minister for health said women in New Zealand should know the new Government was committed to valuing women in the workplace and valuing vocations that that have traditionally been women’s work; “the work that provides for others” and “cares for people who need care”.

“The existing Bill aimed to apply retrospectively, which would have been unfair to the up to eight groups of women currently making pay equity claims. We will do better by all women,” said Genter.

The government press release did not mention the fate of community mental health workers who were excluded from the $2 Billion care and support care workers pay equity settlement last year. Labour election policy was to make mental health workers a priority in pay equity negotiations.

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.