Summary of Situation Confronting Queensland Emergency Department
SMO's
Queensland currently has an LNP dominated parliament with only 14 out of 89 MP's being
Non-LNP.
The State Government has announced it's intention to transition all SMO's to individual
contracts by May 2014.
These contracts will exist between the CEO of individual hospital's and the SMO's in that
hospital, and will be INDIVIDUALLY negotiated by each SMO.
There was no significant engagement with either of the two health unions in drafting the
new contract by Queensland Health. It has simply been a series of presentations in which
no notes were allowed to be taken and no draft contracts allowed to be removed from the
meeting room.
A draft contract was published to SMO's on 19th November, with a nine working day
consultation period for feedback to be provided on over 100 pages of material.
There has been no explanation from the government of the necessity to change all SMO's
to individual contracts, beyond that it is “the preferred method” of employment.
Queensland Health are unable to explain in what manner it will enhance patient care.
The contract incorporated:
1. Draconian Termination Clauses
2. No mechanism for appeal of dismissal, other than legal action (at an estimated cost
to the SMO of $50,000)
3. Replacement of award rates of pay and penalties with a single, annual payment
4. Removal of Medical Officer's Certified Agreement fatigue provisions
5. Provision of Professional Development Leave being subject to the requirements of
the hospital and Health Service District (HHS)
6. Clinical Support Time being at the discretion of the HHS
7. Significant leeway for CEO of HHS to unilaterally change contract after signature
8. Performance related pay with no guarantee that the individual SMO has any ability
to influence the KPI e.g. Pay based on NEAT achievement
9. Removal of the previous Medical Officers Certified Agreement fatigue provisions.
10. Relocation of the employee to other workplaces within Australia or overseas at the
discretion of the HHS
11. Performance KPI's to be determined AFTER signing the contract
12. No empowerment of the SMO to force renegotiation of contract, and therefore
remuneration, in the face of change to work practice, e.g. working extended hours
The State Government has used its majority to pass various “harmonisation” bills, which
have the effect of:
1. removing all pre-contract industrial instruments, agreements and awards
2. removing industrial relations commission power to void an unfair contract
3. removing all means of settling disputes
4. giving the Minister the power to issue a Health Service Directive, which can
retrospectively and unilaterally make any change to SMO contracts
A post “draft contract” poll of all SMO's by AMAQ revealed that:
1% believe the contract consultation process & information provided are adequate.
2% believe the contracts are acceptable.
84% will change their work for Queensland Health (resign, reduce hours or move away).
90% believe the contracts will reduce workforce retention, core services, student training,
and research capacity.
Subsequent negotiation under protest by Queensland Health has produced some minor
concessions, however, the contract remains extremely detrimental to ED SMO's in its
current form, especially around:
1. Lack of dispute resolution
2. Termination clauses that make medical staff vulnerable and therefore reduce their
capacity to advocate for patients
3. Lack of an extended hours clause
4. Lack of a fatigue management plan
5. PDL and CST at the discretion of the HHS
6. Ability of the HHS to unilaterally and retrospectively alter the SMO's contract
7. Definition and remuneration around KPI's
8. Lack of entitlement of new SMO's to be paid on a similar basis to current SMO's
9. Excision of traditional industrial representatives from the negotiation process
10. Absence of a “No Detriment” clause, meaning that there is nothing to stop a
hospital CEO from reducing an individual SMO's salary to the minimum wage with
the stroke of a pen. “No Detriment” clauses are standard in other senior executive
contracts for senior public servants, yet are uniquely absent in the SMO contract.
11. Ability of the hospital CEO to terminate an SMO's employment immediately if their
registration becomes not cancelled, but merely restricted. Reasons for restriction of
registration include physical and mental illness.
Emergency Medicine practitioners appear to be in particular danger in this process due to:
1. Their extended hours of work.
2. Their high work intensity whilst at work.
3. Their vulnerability to fatigue issues
ASEM is greatly concerned that the proposed contract will
1. Reduce patient care by reducing staffing, morale and quality and safety in ED’s
2. Totally remove our ability to act as advocates for our patients
3. Lead to mandated unsafe working practices
4. Decrease staff morale and subsequent recruitment and retention
5. Deter trainees from entering the speciality
6. Adversely affect training, education and research within our speciality
The current Queensland Health roadmap envisages the deadline for contract signature
being 30th April 2014.
Any SMO who declines to sign faces removal of their private practice allowance.
The draft contract for SMO’s may be viewed online here.
ASEM is particularly concerned that the government may, at any time, issue the contract to
all SMO’s and demand that each individual make a decision within one week. This will
leave little time for personal reflection and little or no time for discussion and organisation
between colleagues, across departments, HHS’s and craft groups. Without discussion,
prior thought and organisation within groups each individual will find themselves extremely
vulnerable and potentially forced to sign a contract which is not only not in the interest of
the doctor but also extremely dangerous for the people of Queensland. ASEM urges all
Emergency Department doctors to think deeply on these developments and their personal
response to it. Only by making decisions collectively do medical staff have any chance of
resisting this iniquitous and dangerous contract.