Dr Andrew Miller
Australian Medical Association WA
14 Stirling Highway
NEDLANDS WA 6009
Via email: email@example.com
Dear Dr Miller,
I refer to your article A Fair Go – and why we will fight for it published in the October 2020 edition of Medicus.
While acknowledging the Australian Medical Association (WA) Incorporated (AMA’s) position on the key issues raised, I wish to address some of your key claims and points contained within the article.
In doing so, I want to firstly acknowledge the WA health system’s on-going commitment to patient safety and delivering quality care. I recognise the extraordinary efforts and dedication of medical practitioners across the whole WA health system and thank them all for keeping the WA community safe, particularly over the last year in supporting WA’s health response to the COVID-19 pandemic.
I also want to acknowledge the professionalism of Mr Warren Edwardes, Dr Bennie Ng and Mr Paul Boyatzis in the way they have worked with the Department of Health (DoH) during negotiations for a replacement industrial agreement.
Since negotiations began between the DoH and the AMA in March 2019, DoH has made five offers, all of which have been rejected outright. Offers made have been in line with the State Government’s Public Sector Wages Policy Statement 2019 (Wages Policy). I note the AMA is seeking salary increases beyond Wages Policy.It is important to note the entire WA public sector, other than medical practitioners, have accepted increases of $1,000 per annum with no significant enhancements to conditions of employment since 2017. This includes the WA health system’s frontline workers – many of which are entering their third round of increases under the $1,000 Wages Policy.
Salaries and conditions for senior practitioners in WA Health remain very attractive when compared nationally and globally. WA Junior Doctor salaries are higher than most other Australian jurisdictions, with some junior classifications earning up to $25,000 more than their interstate counterparts.
Permanency for senior practitioners
The AMA has acknowledged permanency was traded away in 1996 for significant increases in pay, yet contends this trade-off is not a relevant consideration.
In the context of the WA public sector, senior medical practitioners are among the highest paid employees. With few exceptions, WA public sector employees employed on commensurate salaries, are also employed on fixed term contracts of employment for a maximum of five years’ duration, consistent with sections 45 and 53 of the Public Sector Management Act 1994 (WA).
I acknowledge the AMA has raised concerns about the use of fixed term contracts as a pseudo performance management tool and that the use of fixed term contracts leads to a culture of bullying and intimidation.
In this regard, I reiterate that WA Health has a zero tolerance for workplace bullying which is supported by a mandatory policy. The DoH along with the Health Service Providers (HSPS) encourage the AMA to call these instances out. Any allegations of bullying and intimidation should be brought to the attention of either the relevant Chief Executive of the HSP or myself at the earliest opportunity.
The DoH listened to the AMA’s feedback regarding this issue and proposed the inclusion of a statement in the Contract of Service provision (clause 20) to affirm “the WA health system recognises the importance of a culture of accountability and will not use contracts (as) a mechanism to manage a practitioner’s conduct or performance”. This however, was rejected by the AMA.
In addition, DoH offered to strengthen provisions around the issuing of subsequent contracts of employment to positively require 12 months’ notice of a decision to not offer a subsequent contract with failure triggering an automatic offering of a further 5-year contract. The proposed provisions also included the requirement to provide reasons for a decision to not offer subsequent contracts. This was also rejected by the AMA.
Portability and retention of leave entitlements for juniors
The DoH affirms that significant progress on this issue has been made in negotiations to date. The most recent DoH offer contained a suite of enhancements:
- Recognition of service with the following contracted state entities:
(i) Bunbury Health Campus;
(ii) Joondalup Health Campus;
(ii) Peel Health Campus; and
(iv) St John of God Midland Public and Private Hospitals.
- Recognition of service with the following contracted state entities:
for the purposes of qualifying service for paid parental leave, long service leave and recognition of sick leave accruals.
- Clarifying annual leave is portable between all HSPs.
- Strengthened access to special leave provisions.
If these provisions were agreed to, Western Australian Doctors in Training in the public sector would have generous portability provisions compared to other jurisdictions.
Revision of on-call and recall provisions
The DoH does not agree with the assertion that it has refused to engage on this issue.
The matter is before the Western Australian Industrial Relations Commission, with both DoH and the AMA discussing how to better define the terms in the context of the operations of the WA health system and the professional commitment of medical practitioners.
Both parties are currently engaged in an ongoing meaningful dialogue regarding on-call and recall issues, with a view to arriving at a common understanding outside the process of bargaining for a replacement agreement. This approach was agreed between the parties in negotiations.
Specialist recognition for all specialist registered doctors
The WA health system is committed to identifying a career pathway designed to attract and retain generalist practitioners with rural generalist qualifications to remote locations of WA.
General practitioners already have access to remuneration equivalent to Consultant Year 3 under the vocationally registered general practitioner and senior medical practitioner classification scales.
Sexual Assault Resource Centre (SARC) practitioners
Regarding the comments on SARC practitioners, the DoH has been steadfast in resolving this issue as a matter of priority. Contrary to how this issue has been portrayed in your article, the DoH has been working hard to find an appropriate way to remunerate these dedicated professionals.
On multiple occasions, I have met with the AMA where both parties clearly acknowledged that any Attraction and Retention Incentive (ARI), (which in this case applies to SARC practitioners), needed approval from State Government. To this end, the DoH has worked with the North Metropolitan Health Service to lodge a submission for an ARI to Public Sector Labor Relations (PSLR). The AMA understand ARIs now need approval by PSLR. Such approval does not reside with the DoH or within my authority as Director General.
Furthermore, the DoH has written to the Australian Medical Council to request that the SARC practitioners’ qualification (Fellowship of the Faculty of Clinical Forensic Medicine) be recognised as a specialist qualification, which would automatically allow them to be paid as paid as (sic) specialists.
Unfortunately, these facts were not reflected in your article.
In closing, I note the AMA has reinstated the entirety of its original claim. I trust the AMA will continue to bargain in good faith and review position on all the key issues.
For its part, the DoH remains committed to resolving negotiations amicably and reaching an agreement, not only in the interests of all medical professionals, but also for all patients across WA.
Dr D J Russell-Weisz
24 November 2020