Dr. Ali thanks for the question.

As I am currently not on the Board I do not have the full facts at my disposal to answer your first question and only a qualified answer to your second question. Yes, it seems reasonable for a 1% wage rise but I don\'t know the impact this would have on the finite budget the WDHB has signed off with the MOH/Govt.

One of my son\'s is a GP in New Zealand and I am aware of the temptation for our trained people to earn significantly bigger money offshore. If this was an easy problem to fix with all the brain power in health it would have been fixed by now. It is not a problem that WDHB can fix by itself. Govt. monetary and fiscal policies over time and the public response thereto has a lot to contribute to bringing equilibrium to international/NZ wage rates. What we can do at WDHB is to make it a place were people want to work because it is the best health provider in the country - we need to work on this. Also, we strive to be and have a reputation of being a fair and good employer in comparison to other DHB\'s in NZ.

With regard to supporting a strike whilst I may have sympathy I would not be able to support it. Individual members of a Board have to stand by the decision of the board irrespective of their personal opinion - a cabinet approach.

I believe that patients have to be the number one priority of any DHB... So where does that fit in with industrial disputes between the DHB and healthcare workers? Well in order to acheive the necessary focus on the patient, we need to look after our staff. Without  staff being adequately resourced, supported, and remunerated we are exposing both patients and staff to unneccessay risk.

Being a healthcare professional, I reckon I have a pretty good understanding of where resident doctors are coming from at the moment. The possible industrial action from the RDA isn\'t just about money, in point of fact this is probably the least of junior doctors concerns... it\'s about safe and reasonable working conditions.

But this isn\'t just a long-winded rant designed to garner support from the disenfranchised and long-suffering staff, this is entrenched in law... Employers have a duty of care under the Health and Safety in Employment Act 1992 and its subsequent amendments to provide a safe workplace and take \"all practicable steps\" to manage hazards and avoid exposing employees to unneccessary risk of injury to physical or psychological health.

I think RMOs are justified in asking for the status quo to be maintained and at the very least a 1% pay increase! I dont believe the the DHBs are justified in trying to claw back your entitlements and the working conditions that you currently possess.

I believe the solutions for retaining RMO\'s, specialist doctors, nurses, and other health care professionals can be achieved through better working conditions and pay. This said, creative thinking and retention schemes such as a broader bonding scheme (not just for hard to staff areas) and better tax and student loan right-off incentives where the longer you stay in NZ the better off you are, may go some way to keeping health care professionals in NZ.

Would I support RMO\'s if they were to strike? Well, having spoken to some of you out there, I know this would not be a decision that would be taken lightly, and with this in mind, I would have to say yes I would support you... But I hope it doesn\'t come to that.

The issue of attracting and retaining staff is of great concern to me.  However, I would not be able to make an informed decision on your questions until, as a board member, I have access to all the facts.

Awaiting response

Dear Dr Imran

As a candidate, and not a sitting member of the Board, I do not have  background information  to your current dispute or negotiations with the DHB. 

Citizens and Ratepayers Health Policy is to focus on \"strengthening and retaining the health workforce\" and gauge progress in \"workforce retention rates.\"

Please be assured of my support for those goals.

Kind regards

June Kearney

Dear Dr Imran

As a Health Board candidate of course I wish I could offer a solution.  Our inability to pay our doctors sufficiently well

to retain their skills within New Zealand is becoming a huge problem for medical services. 

But it is entirely impossible for me to develop the level of knowledge required to suggest solutions unless I am

elected to the Board and can then be privy to the sort of detailed information I would need to work with other on this issue.

But having said that, yes you are justsified asking for a 1% pay rise.  And forgive my bluntness in saying that it\'s not

the asking that\'s the problem, it\'s the Health Boards being able to find the funding to meet the request.

If I\'m elected I\'m fully aware the job will be a huge challenge - we need smarter decisions in health.  I hope

my experience and qualifications suit me to meet the challenge. 

Hello Imran,

Thank very much for your questions.  I think that it is absurd to claw-back on Resident doctors entitlements in the face of continuing, and increasing shortages in junior doctors. I believe junior doctors would be justified in asking for more than a 1% pay increase but recognise that in such times of economic hardship and in the face of the potential loss of conditions that the RDA has worked for 25 years for it is best to ask for a 1% increase and to keep the current MECA otherwise as it is at present.

The ideal solution to keeping doctors in NZ would be to improve working hours and conditions. Unfortunately there are not enough doctors (probably in the world) to achieve this in most countries let alone NZ, so the bottom line is that the only way at the present time that I believe doctors could be retained is to pay them more money.  This is pretty unpalatable to politicians and the public at the present time, but if NZ wishes to maintain a first world public health system I\'m afraid that in the free-market where doctors are very mobile commodities the only way to keep them here is to at least make an attempt to improve pay and bring us more into line with Australian salaries.  We should change to an industrial pay system which includes 1.25 time, 1.5 time, and double time. To encourage employers to minimise doctors working more than 40 hours per week, hours beyond 40/week could be paid at double time, much like in Australia. The current industrial solution offered by the DHBs, as I understand it, does not contain double time, and only goes up to 1.5 time, despite all other healthcare workers I know of on an industrial model having double time as part of their agreement.  Specialist doctors would certainly be more likely to stay in NZ if they didn\'t have to work extra hours covering junior doctors that have left the country...

The frank answer to your final question, \"would you support RMOs if we did strike?\".  I am afraid that the one thing that I have to be careful involving myself in, if elected, would be the current debate. As I am an RMO in the resident doctors association this would be a clear conflict of interest.

It would be sad, very sad, if strike action had to occur again (it would have happened every two years since 2006 I believe) but if that is what it takes then that is what had to be done. I do not subscribe to the paternalistic/moralistic view that doctors or other health-care workers should not be allowed to strike for moral reasons, and understand where the negotiations are at. What else can a union do but strike if the employer is trying to reduce working conditions in the face of a depleted workforce which continues to contract and negotiations are going nowhere ?

I hope that has answered your questions,

Cheers,

James

Workforce is a huge for WDHB. Staff is the organisations most valuable asset. I don\'t have a full knowledge of the background and issues in the current dispute. It would not be right of me to give a definitive answer without knowing all the facts. I will however give some opinions.

I have been party to worker negtiations on both sides as a union representative and from an employer perspective during my carreer in health. Goodwill is an important part of any negotiation and I trust that both parties have that and that both parties have the patients needs in mind. It is important for both sides to listen to each other and try to understand each other perspective. It is important to pay workers more but we are operating with limitations of tight budgets which must be factored in.

Retention is an issue and my personal feeling is that it is more than just money although it is an important part. We also need to consider working conditions to ensure that we staff, Doctors, Specialists find WDHB and New Zealand the place they want to work.

I hope that strike action can be avoided as the patients will be affected.

Dear Dr Ali,

Thank you for your message and for your commitment to the public health system in New Zealand.

First, I am very sorry that there is a dispute between resident doctors and the DHBs. It seems evident that one area for improvement that can be achieved by the soon-to-be elected health board is improved staff-management relationships. It seems as if management is not collaborative in its approach.

Second, doctors will stay in New Zealand for a number of reasons, but one will be if their employer demonstrates excellent human resource management. For example, supporting career development, being open and honest in communciations and leading by example. Again, this is not the stauts quo.

Third, since I may soon be in a governance position it would not be sensible for me to give a commitment to a position without knowing all the facts. However, I understand that the DHBs have not granted the 1% raise now that has been requested by the RMA. To me that shows bad faith and should be remedied.

Forth, all staff should have at least every other weekend off to have a work-life balance and work effectively. I am concerned that there may be safety implications to the disputed contract changes.

You are welcome to e-mail me if you wish to correspond further.

Kind regards,

Neil Miller

neiljamesmiller@yahoo.com

Whi- le I do not have both sides of the argument Generally I would not support the clawing back of conditions and entitlements.

You are justified in seeking to retain current conditions and a 1% increase seems hardly likely to btreak the bank!

While I do not have solutions for retaining doctors in NZ I certainly believe this a a significant priority for the health servvice.

I do not support full out strikes in essentisl services - but I acknowledge that go mslow or partrial strikes maybe acceptable provided that lives are not put at riak.

David Thornton