Qld hospital crisis averted as Govt delivers key contract concessions
The rancorous Queensland public hospital contracts dispute appears to be nearing resolution as senior medical staff consider a much-improved offer from the State Government.
In a major advance in the industrial confrontation that at one stage threatened to cripple Queensland’s public hospital system, doctors have agreed to consider substantially revised employment contracts and arrangements from Queensland Health, and the possibility of a mass walk-out by Senior Medical Officers has receded.
The breakthrough followed intensive negotiations in the week before Easter, during which Queensland Health Minister Lawrence Springborg and Queensland Health Director General Ian Maynard agreed to concessions and amendments to address serious concerns raised by the AMA, AMA Queensland, the Australian Salaried Medical Officers Federation, the Together union and the Senior Medical Officer Taskforce about the contracts.
Among the changes and concessions, the Minister agreed to incorporate the draft addendum (which, among things, removed the right of the Queensland Health Director-General to unilaterally alter contract terms) into the contracts, as well as removing references to “profitability” from the contracts, creating a Contracts Advisory Committee that included doctor representatives to guide future contract developments, and putting the development of key performance indictors in the hands of the State’s Clinical Senate.
In a further concession to help ease tensions, Mr Springborg has extended the deadline for doctors to sign the new contracts by a month, giving them until 31 May to decide whether or not to accept the revised offer.
AMA President Dr Steve Hambleton said it was up to each doctor individually to decide whether or not to sign the contracts, but the Queensland Government had “substantially delivered” on the changes that had been sought by the AMA and the other groups in the negotiations.
“We believe that the majority of doctors will have a contract that’s sufficiently balanced for them to consider signing and putting this behind them,” Dr Hambleton said. “We’re in a position to say that the contracts are in a far better position for the doctors to consider signing and to move on.”
Reflecting optimism that the dispute, which has caused great anxiety and distress for hundreds of senior public hospital medical staff, was nearing resolution, a meeting of around 300 doctors in Brisbane on 16 April accepted that the threat of mass resignations could be lifted.
“The vote was that the majority of individuals felt that the mass resignation strategy was no longer required,” Dr Hambleton said. “We had a substantial improvement in the contract. It wasn’t perfect. We’d certainly say it’s satisfactory, though.”
The new contracts, introduced to replace collective bargaining arrangements, are due to take effect from 4 August.
Mr Springborg hailed the new contracts as a “giant leap forward” for Queensland Health.
“These contracts protect the conditions of Senior and Visiting Medical Officers and facilitate new arrangements for the treatment of private patients in public hospitals, on terms fair to both private and public patients,” the Minister said.
The contracts were first mooted by the Newman Government in July last year following the release of a report by Queensland Auditor-General Andrew Greaves that found serious shortcomings in the operation of Queensland Health’s Right of Private Practice scheme.
The Auditor-General found that although the scheme had been effective in attracting and retaining senior medical staff to the State’s public hospital system, it had fallen well short of achieving its goal of cost-neutrality regarding the treatment of private patients in the public system.
Dr Hambleton said that, in their initial form, the contracts were unacceptable.
“[They] would have allowed unscrupulous managers to overrule clinical decisions. There was also an ability for a third party to change the contracts without reference to the person in the contract,” he said.
Mr Springborg said the contracts, in their revised form, would “facilitate closer working relationships between senior clinicians and the 16 Hospital and Health Boards that drive public patient health care under the devolved model introduced by the Newman Government in 2012”.
“These are lifetime contracts designed to improve the performance of our health system [and] also help to simplify our remuneration framework so that the lessons of the 2010 health payroll debacle are well learned,” he said.
An automated payroll system designed and introduced by IBM in 2010 was found to be badly flawed, with thousands of workers either overpaid, underpaid or not paid at all. It is estimated the system, originally expected to cost $6.2 million, could eventually cost taxpayers $1.2 billion.
Dr Hambleton said the bruising contracts dispute had badly undermined the trust between doctors and the Government and Queensland Health, and should never be repeated.
Talking of the way the Government initially went about introducing the contracts, he said “the wording and the process, the legislation changes, all coming at the same time, led a lot of people to believe that they were under significant attack”.
“This can never be allowed to happen again,” the AMA President warned. “This puts our patients at significant risk. There must always be an opportunity for clinicians at the frontline of care to choose the patient over the dollars, and I think we’ve delivered that with the contracts as they currently stand.”
He said there was a clear lesson to be learned about how to handle such planned changes in future.
“The right way to do this was to set up a system of engagement, to plan the roll-out of the contract changes, to work with the profession,” Dr Hambleton said. “If you want to make a change, you work in partnership.”
“If you work against us, we certainly are a very strong coalition that will form very, very quickly,” he warned. “The best way of doing this is together around a table. Let’s share the goals, let’s share the process, let’s work through this in an orderly way.”