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15 Apr 2014

Substantial progress is being made toward resolution of the damaging Queensland public hospital contracts dispute following significant concessions and changes from Health Minister Lawrence Springborg.

In a development that has fuelled hopes the industrial feud is nearing settlement, all parties to the dispute – including representatives from the AMA, Government, the Australian Salaried Medical Officers Federation and the Together union – were late last week engaged in face-to-face discussions on the fine details of a revised offer from Mr Springborg.

AMA President Dr Steve Hambleton, whose efforts to keep open lines of communication during the depths of the industrial battle have been instrumental in achieving the recent progress, said the Minister’s “significantly revised offer” presented a “real chance to settle this dispute”.

“With good will from all sides, we are in a good position to resolve this dispute to the satisfaction of all parties,” Dr Hambleton said.

On 8 April, Mr Springborg unveiled a series of concessions and changes he said should resolve outstanding concerns about the contracts.

Among the changes, 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.

He also announced references to “profitability” would be removed from clause 25(5) of the core contract; that an advisory committee that included doctor representatives would be formed to guide future contract developments; and that devising key performance indictors would be put in the hands of the State’s Clinical Senate.

Under the terms of the Government’s offer, public hospital Senior Medical Officers have until 30 April to sign the contracts without incurring a penalty, and they are due to come into effect from 7 July.

“These changes remove the remaining doubts,” Mr Springborg said. “They provide reassurance that any continuation of the damaging campaign by unions is unnecessary.”

But Dr Hambleton cautioned that, while in principle the revisions appeared to address outstanding concerns, the detail of the changes would need to be examined and thrashed out before doctors could feel confident.

“The new offer has the potential to rule out the need for mass resignations by disaffected doctors across the State,” the AMA President said. “However, both sides still need to work cooperatively over the finer details of the contracts to ensure everything is in order. The devil will be in the detail, which we now need to get right.”

The original contracts offered by Queensland Health were met with outrage by senior hospital staff, who were particularly concerned by provisions that stripped away basic employment rights and protections including fatigue provisions, rest breaks, limits on hours, and unfair dismissal and dispute resolution procedures, as well as allowing managers to unilaterally alter shifts and reallocate doctors to different hospitals without consultation.

As the dispute escalated, hundreds of doctors warned they might be forced to resign from the Queensland public hospital system, creating an enormous vacuum of skills and expertise that the Government would find extremely difficult to fill.

Dr Hambleton said the revised offer from the Government did appear to address the key issues and concerns raised by the AMA and others.

Many doctors had been concerned about a reference to profitability in a section of the contract relating to termination of employment.

Mr Springborg said the intention in including the phrase had been to “promote respect for, and the protection of, public health resources”.

“But I recognise that phraseology has caused concern among some doctors and, following a review of other provisions in the contract, the Government has agreed to delete any such reference,” the Minister said.

Another point of contention had been the lack of opportunity for input from the medical profession in the future development of contracts.

Mr Springborg said that, following consultation with doctor representatives including the AMA, Queensland Health Director General Ian Maynard would establish a nine-member Contracts Advisory Committee – including an independent chair, four doctor representatives elected by secret ballot, three Hospital and Health Services representatives, and a Queensland Health representative.

The Minister said that, to address doctor concerns, the development of key performance indicators (to come into effect from 2016) would be put in the hands of the State’s Clinical Senate, which comprises representatives from all clinical specialties and is chaired by Dr David Rosengren.

Mr Springborg said the change would help ensure that KPIs worked to advance clinical practice, and to build cooperation between hospitals, health services and local clinicians.

Adrian Rollins

 


Published: 15 Apr 2014