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Queensland Health contracts: radical, unfair, unhealthy

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The Queensland Government, based largely on the recommendations of a Commission of Audit led by Peter Costello, is implementing an outrageous policy of forcing Senior Medical Officers in the Queensland public health system onto individual contracts.

The policy, as outlined in the Queensland Health document Blueprint for better healthcare in Queensland. Broadly, will see Senior Medical Officers (SMOs) removed from award coverage, stripped of collective rights and denied access to the Queensland Industrial Relations Commission.

The whole proposal is being underpinned by legislative amendments being rushed through Parliament. It is, as far as I am aware, unprecedented in Australia, and is the result of absolutely no consultation with stakeholders.

The proposal, which has been identified as a priority by Queensland Government, is for existing conditions and protections embedded in awards and agreements to be removed by transferring senior medical staff on to contracts.

The AMA Council of Salaried Doctors has unanimously condemned the approach of the Queensland Government.

AMA Queensland has been working with the Australian Salaried Medical Officers Federation (ASMOF) (Qld) to analyse the proposal and respond to it. They have identified a range of concerns with the proposed contracts, which include:

  • the lack of a dispute resolution clause, which is unusual for an employment contract;
  • there denial of access to the Queensland Industrial Relations Commission;
  • the contract does not reference ASMOF or any union;
  • salary and tiered arrangements for payment are completely discretionary for the employer;
  • Rights of Private Practice will be removed. Private practice will only be allowed if agreed to by the employer;
  • rates and allowances will be set by a governance committee, with no guarantee of annual indexation;
  • individual contracts will reduce remuneration and rights, especially regarding overtime, on-call and hours of work provisions;
  • the employer can impose a roster on salaried and visiting medical officers without reasonable consideration being given to hours of work or fatigue; and
  • there is no means of collective renegotiation, or a mechanism to oversee the implementation of contracts.

These are just the issues specific to the contract itself.

Of course, more broadly, the concern is that the contracts diminish the collective bargaining rights of the doctors involved and create an imbalance in the power between the parties.

This is totally inconsistent with fair work practices, and leaves employees vulnerable, confused and with less time to devote to their core duty of patient care.

This duty of care will suffer even further as unpredictable rostering and overall dissatisfaction pervade the system.

What this means is that individuals will have to negotiate with the State, if indeed there is any room for negotiation at all. This is not only inefficient and daunting, but costly as well. Anyone who has negotiated with State entities will tell you that it can be a frustrating process.

ASMOFQ and AMAQ are currently considering their options in responding to the contract.

The Government wants the system to be implemented by mid-2014, leaving little time for doctors to consider their options, given the major cultural shift involved.

To date, there has been no meaningful engagement by the State Government with AMA Queensland or the ASMOFQ on the contracts, the enabling legislation or changes to private practice.

I cannot say it loudly or clearly enough: these contracts are unfair from a legal, industrial and health care point of view. They threaten the wellbeing of doctors in the public health system, as well as that of their patients.

I doubt whether the supposed short term gains will be sustainable or worthwhile, as many doctors are likely to leave the Queensland public health system when faced with a deal like this.

The Newman Government has an overwhelming majority in Parliament, and these proposals reflect what appears to be a take-it-or-leave-it approach which, unfortunately, is likely to damage the provision of health care in Queensland for years to come.