Contracts risk leaving healthy system to just crumble away #qldpol #smoqld #keepourdoctors
THE dispute between Queensland’s doctors and the Newman Government is unnecessary and needs to be settled before irreparable harm is done to the public health system.
Our senior doctors love their work and regard it as a privilege to advocate and care for their patients. We work in modern hospitals, which are well staffed and equipped and provide world-class care.
Our training programs for younger doctors are the envy of the world and some of Australia’s leading research takes place in Queensland’s teaching hospitals.
All this is now within weeks of being decimated.
Doctors are happy to engage with government to evolve ways to optimise cost benefits in health. We are not happy to be placed under iron-fisted dictates by non-clinical managers, driven by the unfettered desire to cut costs oblivious of outcomes.
Under the proposed contracts, if I disobey a “legal and reasonable” direction or take action which causes “risk to the profitability of the service”, I can be dismissed without notice and, because I earn more than $129k per annum, I have been deprived of my right of appeal to the Queensland Industrial Relations Commission.
Moreover, my contract can be altered after I sign it and without my consent. I can be sent to work in a place, or at times, to which I have not agreed. What sort of a contract is that?
The director-general of Health has, to his credit, attempted to compensate for these deficiencies by adding an addendum to the contract. But it is poorly drafted, does not meet the concerns of senior doctors and will be difficult to implement.
These contracts have been subjected to detailed analysis by several sets of lawyers and industrial experts, who pronounce them to be “draconian”.
Doctors have been advised not to sign them by the April 30 deadline.
If I do not sign, my income will be reduced by about one third due to the withdrawal of my private practice rights from July 2014; from July 2015 I will be out of a job.
This raises a second issue, namely the two recent reports by the Queensland Audit Office into private practice in public hospitals.
While these reports suggest, among other things, that eight doctors of 88 audited were identified as having engaged in improper billing practices it cannot be assumed this was widespread.
The reports detail examples of systemic maladministration and poor handling of paperwork by hospitals. Most doctors would be perfectly happy to see these defects corrected.
The audit also reports details of an aspect of the private practice scheme known as “option A”, in which doctors with little or no access to private practice in public hospitals are compensated by a salary supplement.
This scheme, in operation since 1992, has been successful in recruiting and retaining doctors who might otherwise have opted to practise in the private sector. But it has been subject to deliberate misinterpretation by government, including the allegation that doctors have deprived the taxpayer of $800 million over nine years.
A rudimentary read of the audit report reveals that $725 million of this $800 million was the `option A’ salary supplement referred to above and all the doctors had done was bank their fortnightly salary cheque!
Such implied accusations of widespread improper actions are outrageous and have contributed to the despair which many doctors find so intolerable that they feel resignation is their only choice.
As a servant of Queensland Health for over 25 years, I have watched the unit I direct at the Royal Brisbane and Women’s Hospital grow and flourish. It is profoundly distressing to contemplate it crumbling away as colleagues discuss with me their options.
I have written individually to all 74 LNP Members of Parliament with these concerns. Their silence in response has been deafening, with only my own member Bruce Flegg and assistant health minister Chris Davis (both doctors) indicating any understanding of where all this could lead.
This could become a catastrophe for health services in Queensland. Without urgent action, some essential services will be available only in the private sector, as clinics and emergency departments close and surgical waiting lists blow out.
Perhaps even more serious is the effect this will have on future services, as training programs are disaccredited and junior doctors are forced to seek training elsewhere.
Where to from here? I am an eternal optimist and am hoping that a scrap of goodwill and trust can be kindled from the embers. The Government needs to abandon its plans for imposition of ridiculous contracts or, at least, place an adequate moratorium on implementing them until they can be properly negotiated and agreed.
We already have a certified employment agreement valid until June 30, 2015, so deferring changes to the private practice arrangements and implementation of contracts until then would make a lot of sense.
The name calling and misrepresentation of facts must stop. Perhaps we should consider recruiting an experienced, impartial mediator.
Doctors are not opposed to contracts per se, as long as they are fair and balanced, and we have no objection to accountability.
Dr Stephen Morrison is vice-president of the Australian Salaried Medical Officers’ Federation (Queensland), head of the Thoracic Medicine unit at the Royal Brisbane and Women’s Hospital, and an associate professor at the University of Queensland.
Source: Courier Mail