TRANSCRIPT OF PROCEEDINGS
Fair Work Act 2009
VICE PRESIDENT WATSON
B2011/3940
s.242 - Application for a low-paid authorisation
Application by Australian Nurses Federation
(B2011/3940)
Melbourne
10.05AM, THURSDAY, 13 DECEMBER 2012
Continued from 23/11/2012
1035339-1
PN8417
THE VICE PRESIDENT: Mr Ritchie.
PN8418
MR RITCHIE: Good morning, your Honour.
PN8419
THE VICE PRESIDENT: Warrnambool is back on the map, I gather.
PN8420
MR RITCHIE: Pardon?
PN8421
THE VICE PRESIDENT: Warrnambool is back on the map.
PN8422
MR RITCHIE: It is. It is. We managed to get Mr Bishop this morning, which is
good. Your Honour, I have a few witnesses who I won't be relying on for
cross-examination. Can I suggest that perhaps I get through Mr Bishop and my
remaining witness and then I will go through those at the conclusion of our
evidence if that suits.
PN8423
THE VICE PRESIDENT: Yes.
PN8424
MR RITCHIE: So we call our next witness, Damien Bishop.
<DAMIEN BISHOP, AFFIRMED
[10.06AM]
<EXAMINATION-IN-CHIEF BY MR RITCHIE
[10.06AM]
PN8425
MR RITCHIE: Mr Bishop, can you please restate your name, work address and
occupation for the transcript, please?---Damien Bishop; shop 2, 70-80 Hopkins
Highway, Warrnambool, Jamieson Medical Clinic; practice manager.
PN8426
Have you prepared a witness statement in this matter, Mr Bishop?---Yes.
PN8427
Do you have a copy of that with you here today?---I do.
PN8428
Can you take a moment to flick through that. Is that witness statement still
current as when you made it on 14 May or is there anything updated or you'd like
to change?---No, I think that's pretty well as it is now.
PN8429
So do you stand by that statement as being true and correct in every particular?
---Yes.
PN8430
I tender that, your Honour.
PN8431
THE VICE PRESIDENT: That will be exhibit R16, subject to the usual
reservations from Mr Dowling.
PN8432
MR DOWLING: Yes, your Honour. There's an objection to the second sentence
in the first paragraph. I'm content for it to be treated in the same way the other
objections to the statements have been treated.
PN8433
THE VICE PRESIDENT: Yes, that's noted. Thank you, Mr Dowling.
PN8434
MR DOWLING: Thank you, your Honour.
EXHIBIT #R16 WITNESS STATEMENT OF DAMIEN BISHOP
PN8435
****
DAMIEN BISHOP
XN MR RITCHIE
MR RITCHIE: Mr Bishop, I'm just going to ask you a few questions based on
your statement. How long have you been with the Jamieson Medical Clinic?
---Seven years, coming into my eight year.
PN8436
And can you briefly explain the operations of the clinic and what it is the clinic
does?---Yes, the clinic provides general practice facilities for patients. It's a
10-doctor clinic with five nurses. We look after the Warrnambool area. We've
also got subbranches in Koroit and Mortlake.
PN8437
What hours of work do those five nurses work?---Sorry, what hours of work?
PN8438
Yes?---Anywhere between 8.30 to 5.00 is what they cover, yes, Monday to
Friday.
PN8439
Do they ever work weekends?---No.
PN8440
Do they regularly work overtime?---Overtime would be if there was a staff
meeting or a clinic meeting that was scheduled after-hours. That would be the
only example of overtime that I could think of.
PN8441
So how many times in a year would you estimate?---For overtime?
PN8442
Yes?---Staff meetings, probably once every three months or something like that once every two months, maybe. Yes, that would be the only time. They're
probably usually scheduled conveniently from 6 o'clock at night.
PN8443
Do your nurses regularly work nights?---What was that, sorry?
PN8444
Do your nurses regularly work nights?---No.
PN8445
****
DAMIEN BISHOP
XN MR RITCHIE
I'm going to take you to a witness statement from one of the witnesses who has
given evidence in this matter so far. I appreciate you won't have that in front of
you but I will read it out and I want you to respond to it?---Yes.
PN8446
It's the witness Leonie Kelly - D18 for the parties. At point 10 Ms Kelly says, "I
refer to the statements made in relation to Jamieson Medical Clinic Warrnambool
by Mr Damien Bishop and Ms Carolyn Fleming. The hourly rate of pay is not
specified in either statement. Mr Bishop in his statement indicates the clinic
provides five weeks' annual leave per year and paid time off for professional
development. He also indicates that the clinic always provides a wage increase,
even though nurses are paid above award. I'm informed by the responses to the
ANF survey that the pay increase in 2011 was only 1 per cent and that the higher
hourly rate is in lieu of overtime, shift loadings and weekend penalties. I also
understand that the nurses only receive four weeks' annual leave, so the
five weeks must have been provided quite recently." What do you say in response
to Ms Kelly about the annual leave?---The annual leave has been five weeks and it
has been that case since I've taken over the actual payroll type thing, which would
be the last three or four years I would imagine, yes.
PN8447
What about Ms Kelly's statement where she says that your hourly rate is in lieu of
overtime, shift loadings and weekend penalties? What do you say to that?---No,
that's not correct. We would be a very - being a country town, it's not hard to
work out what other general clinic nurses are being paid. So we're probably in
line with one of the other clinics that we associate closely with. I'm not sure what
the other clinics do but we - no, in lieu of overtime that's got nothing to do with it.
PN8448
Ms Kelly seems to base her view on the ANF survey response where she contends
you only pay four weeks. Is it your view that the ANF survey is in error then if
you haven't provided four weeks?---I believe so, yes.
PN8449
****
DAMIEN BISHOP
XN MR RITCHIE
Are you aware of your nurses' classifications under the Nurses Award?---Yes.
What I class them is a registered nurse level 2.
PN8450
What are your nurses currently paid?---Well, they've just undergone the generally all of them are paid $32.65 an hour and one who is paid just slightly
more, $33.73, mainly because she does the bulk of the rostering.
PN8451
How long have they been on that rate?---Actually that rate they've only been on
since last week, that was when we finished our staff appraisals. Before that I
think the rest of the nurses would have been on about, from memory, about
$31.50 and that one nurse who does the rostering would have been on about
$32.30, or something like that, just off the top of my head.
PN8452
You refer I believe to that process at point 3 of your statement, "We perform an
annual staff review of our nurses' entitlements, performance and conditions." Is
that the staff appraisal you mentioned occurred last week?---Yes, we started
about three weeks ago but as you can see, when you've got part-time staff and
that, yes, we just finished them last week. That also includes receptionists and
that as well.
PN8453
Do you have knowledge of the public sector hospital working environment?---My
wife works up the local hospital here, yes, not as a nurse but, yes, she's involved
in that environment.
PN8454
In your view, are the work patterns in your clinic comparable with that of the
hospital?---No, I wouldn't have thought so. I would like my wife to be able to
work from 9.00 till 3 o'clock.
PN8455
I'll take you to another witness statement of a witness who's given evidence in this
matter and it's by the name of Ms Caldwell, and I'll read it out for you - statement
in reply, D13 for the parties, at point 20 - Ms Caldwell is responding to a question
in a survey completed by VECCI and is referring to that question and says, "If the
implication" - I will read the full paragraph - "I note that in the VECCI survey
there is a question concerning the average nurse-patient ratio at the top of page 6.
I do not understand this question. If the implication is that the role is less
demanding because the number of patients seen at any one time is fewer, then this
is an unrealistic assessment. The skills and knowledge required to provide care
assessment of a single patient may be significantly higher than those required to
manage multiple patients due to the specialist nature of the care provided." Do
you have view as to the nature of seeing single patients at your clinic as opposed
to multiple patients at the hospital and whether they are comparable or one would
be more demanding than the other?
****
DAMIEN BISHOP
XN MR RITCHIE
PN8456
MR DOWLING: I'm really not sure this witness is qualified to answer this
question. He's given evidence that he doesn't work in a hospital. His only
connection is with his wife who works there, who doesn't work as a nurse.
PN8457
THE VICE PRESIDENT: There might be a limited utility but I will allow the
question.
PN8458
MR DOWLING: Thank you, your Honour.
PN8459
MR RITCHIE: Do you want me to - - -?---As far as nurse bookings, I suppose at
a particular time, like a 10-minute slot, 15-minute slot, in a GP-type clinic they're
only looking after that one particular patient at that one particular time. If that's
either or harder than a hospital environment, I couldn't actually really say.
PN8460
THE VICE PRESIDENT: Mr Bishop, can I just ask you to move the microphone
a little bit away from your mouth?---Okay.
PN8461
We're getting a little bit of distortion?---Yes, no worries. Do you want me to
repeat that or - - PN8462
MR RITCHIE: No.
PN8463
THE VICE PRESIDENT: No, that's fine.
PN8464
MR RITCHIE: That's fine, thank you. At point 2 of your statement, Mr Bishop,
you state your nurses receive paid professional development and paid time off for
attendance. Can you elaborate on how that's organised in your clinic?---Yes, we
provide them to attend workshops or whatever, which is most of the time
scheduled during the week. Just in the last two years we've provided nurses to
attend Pap smear courses, nurse immunisations, triaging, CPR courses. There's
also a weekend annual conference which they are allowed to attend and some
have attended in the last couple of years and we do provide for that as well.
****
DAMIEN BISHOP
XN MR RITCHIE
PN8465
That witness statement I just read from, Ms Caldwell, at point 30 there's another
statement that I'd like you to respond to and it's referring to turnover of staff and
Ms Caldwell says, referring to a survey of APNA, "49 per cent of respondents
indicated they were either looking for new employment or may start looking in
the next six months. Clearly high staff turnover is a major disruption to practise
productivity and continuity of patient care." What's your experience with staff
turnover at the Jamieson Medical Clinic?---We've had one nurse - our main nurse
who's on that higher hourly rate, she's been there for 10 years. We've had another
nurse who has been there for four years I think - I'd say four to five years. We've
had another nurse who was with us, who went to the hospital system but has now
returned to us in the last 12 months, and there's two other nurses that have
probably been with us in the last two years, been with us for two years. Yes, so
that's it.
PN8466
So Ms Caldwell's statement that, "clearly high staff turnover is a major disruption
to practise productivity and continuity of patient care", what would you say to
that?---Not in our case.
PN8467
In your - I think it was your evidence - seven and a half or coming up to
eight years or so in Jamieson Street Medical Clinic, how often has the ANF
attended your workplace to try and bargain for an EBA?---I actually asked the
nurse yesterday just to get a bit of a heads up because I couldn't remember them
ever attending and she'd been there longer than me obviously but, no, she couldn't
say she's ever seen them and she - yes. So - - PN8468
So just focusing on your knowledge in your almost eight years, has there been
anything you can recollect, any visits?---No. No, not that I can recall.
PN8469
And has the ANF ever got in touch with you, maybe a phone call or an email or
asked to try and bargain for an EBA in some way?---No.
****
DAMIEN BISHOP
XN MR RITCHIE
PN8470
At point 3 of your statement you state the you negotiate terms and conditions with
your nurses. Can you elaborate on how that works, that negotiation?---Well,
okay, for one thing a couple of years ago we decided to drop back from full-time
to four days a week. One nurse decided that she could only commit to school
hours, which we allowed because we didn't want to lose her. So she works from
9.00 till quarter past 3. One nurse wanted to change her days from Thursday to
Friday to Monday to Tuesday. We allowed that. The nurse who was with us who
went to the hospital system and has now come back, she could only come back if
she was allowed to work Wednesday, Thursday, Fridays, and we were able to
allow that to happen.
PN8471
Then lastly, Mr Bishop, at point 1 of your statement you state you do not support
the ANF's application and indicate you don't consider your nurses do either. Can
you elaborate on that point, as to why you don't support the application?---Well, I
think us as an employer would like to be able to negotiate with our nurses, as we
have been doing, on a one-on-one basis or whatever, and I think - although I can't
speak for them - I get the impression they like that way as well, to be able to
negotiate with us directly.
PN8472
Nothing further, your Honour.
<CROSS-EXAMINATION BY MR DOWLING
[10.23AM]
PN8473
MR DOWLING: Mr Bishop, when you described the experience of your nurses
you identified I think on my count five nurses. So are there five nurses employed
by your practice?---Yes.
PN8474
And your evidence was that in terms of pay rates and classifications you indicated
that you classify your nurses at a registered nurse level 2. Is that the case for all
five of them, is it?---Yes.
****
DAMIEN BISHOP
XXN MR DOWLING
PN8475
You gave some evidence about those nurses being required to attend staff or clinic
meetings and that that will happen from 6 pm. Do you pay those five nurses
overtime for attending those staff and clinic meetings in addition to their normal
rate?---Yes, they get paid time and a half.
PN8476
You gave some evidence about staff appraisals and what you described as a
one-on-one negotiation. Do I understand the process to be that there's a review of
their performance and that review is done on a one-on-one basis? Is that right?
---Yes, it's done on a one-on-one basis with another independent person who
comes in as well.
PN8477
And do you - - -?---They're contracted by the clinic to perform that role.
PN8478
Is it your evidence that as part of those one-on-one discussions, that's when the
question of pay and conditions is to be raised? Is that correct?---All going well,
yes.
PN8479
So that's also done on the one-on-one basis, in the same way?---Yes.
PN8480
Is that correct?---Yes, and also followed up - I probably (indistinct) with the five
associates of the GP clinic as to the - yes, but mainly one on one for the actual
nurses.
PN8481
Do you recall the process that resulted in some of the nurses employed at your
clinic receiving a pay rise in late 2011?---Can I recall?
PN8482
Yes?---No, I can't, sorry.
PN8483
Can I suggest to you that it occurred this way in 2011: that nurses were sent a
letter identifying that they would receive an increase in their hourly rate. Does
that sound right to the best of your recollection?---I don't know if they were sent a
letter.
****
DAMIEN BISHOP
XXN MR DOWLING
PN8484
What I'm suggesting to you is that is how it occurred, a nurse received a letter
indicating that her pay hourly pay rate was going to increase and it was going to
increase from $31.50 to $31.70, and she received that information in a letter.
Does that accord with your recollection?---Honestly, I can't recall. I honestly
can't recall. I'm sorry if I'm vague on that one but I can't actually recall.
PN8485
Can you not recall the process last year that resulted in a wage increase in your
practice and you are the practice manager?---Yes, last year was an unusual year
for us; we moved clinics. So I probably had a bit on my plate.
PN8486
I suggest to you that that is how it occurred: a letter was written and that there
was no advance warning or notice to any nurse that they would receive such a
letter. Is that consistent with your recollection or not, or you can't recall?---That's
your suggestion.
PN8487
Yes. Can you recall or not?---No, I honestly can't recall.
PN8488
What I suggest to you is that the registered nurses who received that letter were
informed that their pay rate was to increase from $31.50 to $31.70. Can you
recall whether that's correct?---Well, to me, 20 cents doesn't seem like much of a
pay increase.
PN8489
I'm not asking you whether it's much of a pay increase. I'm asking whether you
can recall whether that happened?---No, I can't recall.
PN8490
That's a pay increase of about point 6 per cent. I'm putting to you that's what
happened in 2011?---I don't think that's correct.
PN8491
And I also put to you that there was no pay increase at all in 2010. Do you recall
whether that's correct?---No, I can't recall.
****
DAMIEN BISHOP
XXN MR DOWLING
PN8492
Is it possible that - - -?---I'm sorry, I can't recall.
PN8493
Is it possible that it is in fact correct, there was no pay increase at all in 2010?
---Yes, that might have been the case.
PN8494
And is it equally possible that in fact the pay increase for 2011 was point
6 per cent?---No, I don't think that is the case.
PN8495
I think your evidence earlier was that the rates that the nurses are currently paid
was increased in the last week and that prior to it becoming the current rate, it was
$31.50?---Yes, that was just - yes, from what I could - yes, I think we decided the
pay rates to increase by about 3 per cent. So, yes, take - - PN8496
Does that assist your memory of your evidence that the previous rate was $31.50?
What I'm suggesting to you is the previous rate was in fact $31.70 and that there
hadn't been an increase in the year before that. Does that assist your memory?---I
can't recall whether there was a pay rise in the year before, if you're talking 2010.
PN8497
Is it possible there was no increase in 2011 or 2010?---I don't think it would have
been.
PN8498
You can't recall?---No, I can't recall.
PN8499
You've given some evidence that you paid five weeks' annual leave?---Mm.
PN8500
Are you aware how long there has been an obligation to pay five weeks' annual
leave at your practice?---No, I don't know. We've been paying for about the last
four or five years I think.
PN8501
****
DAMIEN BISHOP
XXN MR DOWLING
If I tell you that the obligation only arose on 1 January of 2010, does that assist
your recollection as to how long you've been paying it? Prior to that time, it was
four weeks?---Yes. If that's the case, yes. Like (indistinct) probably, yes. I
would say that's how long we've been paying it. Sorry, I might have just
overestimated it but, yes, they've been getting paid five weeks from the time that
they're supposed to have been paid. Don't worry, nurses are pretty quick on that
sort of thing.
PN8502
The five nurses that are employed in your practice, is there any reason they were
not able to give evidence in this matter?---Well, generally because none of them
knew anything about it until I approached them about it. The senior nurse at the
time - - PN8503
Sorry to interrupt you, Mr Bishop. Perhaps I will make my question a bit more
specific. Is there anything that prevented them from attending in this hearing to
give evidence?---Yes, I think I just answered the question.
PN8504
That's the question?---None of them knew anything about it when (indistinct)
information about the witness statement, so therefore they didn't actually feel
comfortable with doing anything about it, apart from the one who did but then got
cold feet when she realised there was a court appearance required.
PN8505
Can I talk to you about the duties of your nurses. Is it correct to say that they all
are involved in chronic disease management?---Yes, they are - no, not all of them
are. It's just something we're in the midst of actually rejigging our chronic disease
management at the moment. We've had a - yes, we're actually in the process of
rejigging the whole structure of the (indistinct) how we do that. But at the
moment not all of them are.
PN8506
How many of the five are involved in chronic disease management?---Probably
three - yes, I would say four.
****
DAMIEN BISHOP
XXN MR DOWLING
PN8507
Four of the five. Is it correct that they all are involved in the preparation of
mental health care plans?---Yes.
PN8508
Is it correct that they are all involved in the preparation of CMAs or
comprehensive medical assessments?---Yes, we've got one nurse who does the
majority of the CMAs.
PN8509
And the others do it from time to time. Is that correct?---It would be very, very
occasionally.
PN8510
And the nurse that does the majority of those, is it correct that she attends local
nursing homes to carry out that comprehensive medical assessment?---Yes.
PN8511
She does that not accompanied by a general practitioner?---Not at that time.
PN8512
When she attends the nursing home to carry out the CMA, she's not accompanied
whilst she's preparing it by a general practitioner. Is that - - -?---I would say she's
not.
PN8513
Are you aware there's an obligation for a general practitioner to be present when
the comprehensive medical assessment is being carried out?---I wasn't aware of
that.
PN8514
Nothing further, your Honour.
<RE-EXAMINATION BY MR RITCHIE
[10.36AM]
PN8515
MR RITCHIE: Mr Bishop, I've just got a few more questions for you and then
we're done. My friend Mr Dowling took you through your recollection of the
history of wage increases in your negotiation with your nurses. What would
happen if one of your nurses was dissatisfied with her pay rate, what would
happen there?---If she was dissatisfied, I would think she would be able to come
and talk to me about it and that we would go through I suppose the whys and the
why nots of why she's on that rate, why she didn't get a higher rate, or why she
can't, or what she has to do to get a higher rate. But I've never had that happen to
me.
****
DAMIEN BISHOP
RXN MR RITCHIE
PN8516
And my friend also took you through specific duties of your nurses. Are your
nurses involved in staff selection at all?---In the staff selection?
PN8517
Do they interview and recruit other nurses for other positions?---Occasionally
when I have interviewed for nurses occasionally I've had the man nurse who I
keep referring to, occasionally she'd opt in the interview, yes.
PN8518
And would they make the call as to who is employed and who is not?---No, they
don't make the final call.
PN8519
What about policy development, are they involved in that extensively at your
clinic?---Policy and procedures? Yes, they have a bit of an input, especially for
accreditation every three years.
PN8520
What about, say, development of policy around health or public policy, et cetera?
---I'm sorry, what was that, Mark, the last bit?
PN8521
What about, say, participating in policy discussions or helping shape health policy
for the industry?---Yes, they would be involved in some discussion in that.
PN8522
Do you consider that your nurses should be classified as a nurse manager?---No,
not really. I think they all do a pretty even role. There's only one who might just
do a bit of the rostering.
PN8523
Are you familiar with the classification definitions in the Nurses Award?---Yes, I
believe so.
PN8524
Having looked at those, is it possible that your nurses should be classified as a
level 3 as opposed to a level 2 in your view?---No, I'm of the belief it's level 2.
****
DAMIEN BISHOP
RXN MR RITCHIE
PN8525
Thank you, Mr Bishop. I've nothing further.
PN8526
THE VICE PRESIDENT: Thank you for your evidence, Mr Bishop. You are
now excused from further attendance?---Thank you.
<THE WITNESS WITHDREW
[10.40AM]
PN8527
MR RITCHIE: Thank you, your Honour. Our next witness, Margaret Geary, has
come up this morning from Bendigo. She was organised to be here at 10.15 but
my colleague can't track her down. If I might ask for a very brief adjournment say, 10 minutes - we can track down Ms Geary and then resume.
PN8528
THE VICE PRESIDENT: Yes, very well. We will adjourn for a short time.
<SHORT ADJOURNMENT
[10.40AM]
<RESUMED
[10.52AM]
PN8529
THE VICE PRESIDENT: Mr Ritchie?
PN8530
MR RITCHIE: Thank you for that, your Honour (indistinct) and I call my next
witness Margaret Geary.
PN8531
THE VICE PRESIDENT: Ms Geary, if you can come to the witness box, please.
<MARGARET GEARY, SWORN
[10.53AM]
PN8532
THE VICE PRESIDENT: Thank you, Ms Geary, please be seated.
<EXAMINATION-IN-CHIEF BY MR RITCHIE
[10.53AM]
PN8533
MR RITCHIE: Ms Geary, could you again give us your name, work address and
occupation for the transcript, please?---Margaret Geary, (address supplied), and I
am finance and administration manager.
PN8534
Have you prepared a witness statement in this matter?---Yes, I have.
PN8535
Do you have a copy of that with you here today?---Yes, I do.
PN8536
Could you just take a moment to look through that. Is your statement still true
and correct in every particular or are there any changes or updates you'd like to
make since you prepared it in May?---No, it's still true and correct.
PN8537
You stand by that statement as being true and correct in every particular in this
matter?---Yes, I do.
PN8538
I tender that, your Honour.
PN8539
THE VICE PRESIDENT: The witness statement of Margaret Geary will be
exhibit R17.
EXHIBIT #R17 WITNESS STATEMENT OF MARGARET
GEARY
PN8540
MR RITCHIE: Your Honour, can I note a hearsay objection to the second
paragraph under the heading numbered 1.
PN8541
THE VICE PRESIDENT: Yes, thank you.
****
MARGARET GEARY
XN MR RITCHIE
PN8542
MR RITCHIE: Ms Geary, how long have you worked at the Strathfield Primary
Health Service?---Three years.
PN8543
How many practice nurses do you currently employ?---We have three.
PN8544
You state in your statement that all three practice nurses are paid above award
wages. Is that still correct?---It is correct.
PN8545
Since May 2012 when you prepared this statement, are those wage rates the same
or have they changed?---They are still currently the same.
PN8546
How does - what is the process for wage increases for your nurses?---We do
annual reviews on all the nurses which are completed by myself, the practice
manager and also the principal doctor at the practice. So that's done annually, and
also we review the wages on 1 July with the increase of award.
PN8547
You review them in line with the award, did you say?---Yes.
PN8548
Why is that?---Just to make sure that they're not falling below the level in between
reviews.
PN8549
Do your practice nurses regularly work overtime?---Not a lot of overtime, no. We
have worked a little bit of overtime recently with accreditation, which the nurses
were heavily involved in, but on a regular basis, not a lot of overtime.
PN8550
When they do work that overtime, how are they paid?---They have an option.
They can take it as overtime or they can take it as time in lieu.
PN8551
Do practice nurses work weekends?---No, they don't.
****
MARGARET GEARY
XN MR RITCHIE
PN8552
Do they work afternoon or night shifts?---No, they don't.
PN8553
How many weeks of annual leave do the nurses receive?---They're currently
receiving five weeks annual leave a year.
PN8554
Are you aware of the classifications in the Nurses Award?---Yes.
PN8555
What have you classified those nurses as under that award?---We have two nurses
classified at level 2 and one at level 3.
PN8556
In your statement at 4, you state, "Strathfield say Primary Health actively
encourages all nurses to participate in professional development opportunities.
Any costs associated with professional development are covered by the company
and is regularly utilised by the nursing staff." Can you elaborate on how that
process goes of which training is selected and how the nurses are able to
participate?---Our primary nurse at the practice constantly reviews the nurse and
their education. If they want to go and do a course, they submit an application to
her which she reviews and if that's approved, they head off and do that course.
But we're heavily into education, so usually any opportunity that comes along, the
nurses will try and participate in that and we always pay the full costs involved
with that.
PN8557
Since June 2010 - sorry. For the last three years, you've said you've worked at
Strathfield (indistinct) how often has the ANF attended your workplace in an
attempt to bargain for an EBA?---To my knowledge, they've never been to the
workplace.
PN8558
Have they ever got in touch with you maybe by email or even a phone call just to
try and discuss an EBA?---Not that I'm aware of, no.
****
MARGARET GEARY
XN MR RITCHIE
PN8559
You state in your statement, "We believe we provide an open environment where
staff feel comfortable approaching us should they wish to discuss any matters."
Can you elaborate to his Honour how that negotiation or discussion occurs?
---Yes. Our primary nurse, she negotiates with the nurses on a regular basis.
She's in charge of their training. So as well as being a nurse herself and practising
a the practice, she also does - is fully participating in the staff reviews. She also
reviews their wages along with myself and the principal doctor at the practice, so
we have a really heavy involvement of the nurses with input. If they don't feel
comfortable coming directly to myself or the principal doctor then they do feel
comfortable talking amongst themselves, and then those thoughts are usually put
forward through that particular nurse, which we've implied we're more than happy
to review at any time.
PN8560
At 1 in your statement, you state you do not support the above action as being
taken. You say, "This has been discussed with our practice nurses who have
advised that they are happy to continue to negotiate their individual terms and
conditions of employment with us without the assistance of a third party to
negotiate on their behalf." Can you elaborate on why you don't support this
application?---I don't support it because of the fact that I think the nurses are well
looked after within our practice. We have a very open relationship and any time
that they have concerns, whether it be payroll, whether it be employment, whether
it be medical, physical - whatever they're going through - we have a very open,
two-way policy, and I think it's important that we look after our nurses and the
nurses in return usually are very responding to that. So I find that because we
have such a good system already in place and that it's working well, they're happy,
we're happy. I just feel that if you've got a third party coming in upsetting that
that it can cause a little bit of (indistinct) in the practice.
PN8561
Nothing further.
****
MARGARET GEARY
XN MR RITCHIE
PN8562
THE VICE PRESIDENT: Mr Dowling?
<CROSS-EXAMINATION BY MR DOWLING
[11.01AM]
PN8563
MR DOWLING: Thank you, your Honour. Ms Geary, you've given some
evidence about the nurse - you say you employ three practice nurses, one of
whom you've described in your evidence as "the primary nurse"?---That's correct.
PN8564
The classifications that you've described in your statement are an RN level 3, pay
point 4 and RN level 2, pay point 4, and the third nurse, an RN level 2, pay
point 1. Should we understand that the RN level 3, pay point 4 is the primary
nurse?---That's correct, yes.
PN8565
You've given some evidence that if the nurses work overtime, they have a choice
between payment as overtime or time in lieu?---Correct.
PN8566
Should we understand that when they elect to take the option of time in lieu, they
get one and a half times the time they have worked as time in lieu?---That's
correct.
PN8567
You gave some evidence that they receive five weeks annual leave currently?
---Yes.
PN8568
Has that changed recently?---No, that one has been in probably about - just over
12 months they've been getting the five weeks annual leave. It was previously
four but it's now five.
PN8569
Are you aware that you've had an obligation to pay five weeks annual leave since
1 January 2010?---Yes, and they were back dated for that, so their annual leave
was adjusted.
****
MARGARET GEARY
XXN MR DOWLING
PN8570
Why is it that they weren't being paid the five weeks annual leave from 1 January
2010?---I didn't have the books at that stage and I did a full review when I joined
up with VECCI, and we went through the awards and updated all the awards and
updated all the management of that. So that adjustment was made when we
picked that up. The nurses also picked that up and as soon as they mentioned it, it
was addressed and corrected.
PN8571
In relation to the three nurses that you identify, the second of those you identify as
a casual nurse, and you describe her base rate of pay, in your words, as $40 an
hour. Is it correct that that $40 includes the 25 per cent casual loading?---Yes,
that's correct.
PN8572
So if we work backwards, in fact her base rate of pay is $32 per hour. Is that
correct?---That's correct.
PN8573
The third nurse that you have described as the registered nurse level 2, pay
point 1, are you able to say how long that nurse has been qualified as a nurse?---I
couldn't give you her actual date of registration as a nurse, no.
PN8574
Are you able to say approximately; is it five years experience or is it 10 or is
it - - -?---No, I couldn't tell you.
PN8575
You have no idea how long she's been a nurse?---I know she's a fully registered
nurse, but I'm not sure and I'm not prepared to have a guess at when she was a
registered nurse.
PN8576
How long has she been employed at the practice?---10 and a half months.
PN8577
Do you know where she was employed prior to that?---No, I don't know where
she was employed prior to that. I did not employ her.
****
MARGARET GEARY
XXN MR DOWLING
PN8578
You've given some evidence about a review process. Should we understand that
that review process is conducted on a one-on-one basis?---The initial review is
done by the principal doctor.
PN8579
So that's the nurse with the doctor?---Nurse with the doctor, who is the principal
owner of the practice after, usually, consultation with the managing nurse. So
they usually sit and have a discussion. A form is given out initially to the nurse or
any staff member in our practice about three weeks before the actual review date,
where they can write everything that they have concerns about, write what they're
happy about, write what they're not happy about. That then comes back for the
practice nurse or the head nurse and the principal doctor to review. Then they get
together and actually go over that review, and - - PN8580
Sorry to interrupt you. When you say, "They get together", are you talking about
the nurses or the doctors?---The practice nurse and the principal doctor, the
principal of the practice. They will just sit and discuss it. They'll come up with a
set of final decisions, whether that be more training, pay rise, whatever that may
be. Then once they are both in agreeance with that, they will sign off against it.
PN8581
Should we understand that if there are to be queries raised about the rate of pay by
the practice nurse that that process is the opportunity for the practice nurse to raise
it?---We're open to review rates paid any time; not just at review. But yes, they
definitely discuss it at that time.
PN8582
With the principal doctor, I think, is your evidence. Is that right?---Yes.
PN8583
One of the things you say about your practice is that there's a relationship between
the nurses and the doctors. Do you understand that this application seeks an order
that there be bargaining between those respondents and the ANF representing its
members?---I do understand that, yes.
****
MARGARET GEARY
XXN MR DOWLING
PN8584
That that agreement - any agreement that might be negotiated will represent the
minimum terms and conditions that the practice will have to pay to its nurses at
that practice?---Yes.
PN8585
That that will not prevent any policy development of that practice, any
relationship or approach to the relationship between the doctors and the nurses or
the practice managers and the nurses at that practice?---Yes.
PN8586
Do you also understand that - have you seen the ANF's evidence filed in this
matter?---Not that I'm aware of, no.
PN8587
Well, I can tell you that the ANF have given evidence that they are prepared to
consider and respond reasonably to claims or responses to claims that may be
made by particular employers if they want to bargain for their own agreement. So
if a particular employer says, "We have a particular set of circumstances. We'd
like our own agreement. We don't want one that applies to everybody else", the
ANF have said they're prepared to sit down and bargain with that employer and
they can describe their particular circumstances and they will be reasonably
responded to. Do you understand that proposition?---I do understand it, yes.
PN8588
Is there anything preventing your practice from entering into those sort of
negotiations with the ANF?---I don't believe that at this stage we need to actually
do that, but if we had a nurse that had specifically requested this action be taken
against it, I would be happy to discuss that further, but I don't believe at this stage
that our nurses are happy to go there.
PN8589
So if a nurse requests the entering into those negotiations, is it your evidence that
you will enter into those negotiations?---Sorry, too many "entries" there. Sorry,
can you reword that.
****
MARGARET GEARY
XXN MR DOWLING
PN8590
If a nurse requests that your practice enter into those negotiations with the ANF, is
it your evidence that you will enter into those negotiations?---If we had a nurse
that came to us and said they were going to to go to the ANF because they were
unhappy of their pay conditions and that they were going to approach the ANF
and request the ANF to contact us to negotiate on their behalf, we would
definitely take that very seriously, but it's not something we would chase up
individually ourselves, no.
PN8591
I'm not saying whether you would take it seriously; I'm asking whether you would
commence the negotiations?---If it was requested, we would consider
commencing that. But we're not going to commence it ourselves.
PN8592
I'm not asking whether you'd consider it; I'm asking you whether you'd do it?
---No.
PN8593
Is it correct that until approximately 12 months ago, you employed a registered
nurse by the name of Pamela Nicholson?---That wasn't at - correction: she was
working one day at Strathfield (indistinct) Primary Health, and previously at
Heathcoate Primary Health.
PN8594
For that one day, she was employed by Strathfield (indistinct) is that correct?
---Yes, correct.
PN8595
Her duties included immunisations?---Yes, I believe she was doing immunisations
under the instruction of a doctor. Yes.
PN8596
Pap smears?---Pap smears, yes.
PN8597
Care plans?---Correct.
****
MARGARET GEARY
PN8598
Dressings?---Correct.
XXN MR DOWLING
PN8599
ECGs?---I don't believe she was doing ECGs at Strathfield (indistinct) because
our ECGs are completed by (indistinct)
PN8600
Do you recall the level at which she was classified?---No, I did not look at her
records before I come down to verify her classification pay.
PN8601
Do you accept that a nurse in her position in the position she was carrying out at
least pap smears and care plans is doing the work of a registered nurse level 3?---I
don't believe she's a registered nurse of level 3.
PN8602
I'm not asking you whether you classified her as such; I'm putting to you that a
nurse carrying out pap smears and care plans as she did at (indistinct) is doing the
work of a registered nurse level 3?---I don't believe she was under that category.
I'm not saying what she was paid. I don't believe that that's the category that she
should have been paid under.
PN8603
Perhaps if you listen to my question, it's a little different, and I'm sorry if I wasn't
clear enough. I'm suggesting to you that a nurse working at Strathfield (indistinct)
carrying out care plans and carrying out pap smears should properly be classified
as an RN level 3. Do you agree or disagree with that proposition?---Disagree.
PN8604
Nothing further, your Honour.
PN8605
THE VICE PRESIDENT: Mr Ritchie?
<RE-EXAMINATION BY MR RITCHIE
[11.12AM]
PN8606
MR RITCHIE: Just one question. You mentioned, Ms Geary, about - you spoke
about a situation in which - regarding the five weeks annual leave, I think it was
your evidence that the nurses raised this as an issue and then the employer
addressed that and fixed it and made the five weeks. Has that happened with
other issues? Have nurses come to you and had that discussion and (indistinct)?
****
MARGARET GEARY
RXN MR RITCHIE
---Yes, definitely.
PN8607
What sort of issues?---Travel allowance and the various ways that travel
allowance can be paid. We were paying them under one system and one of the
nurses came back and had been suggested by her accountant that she be paid
under a different system, and when we looked into it, it was more beneficial for
those nurses to be paid the other way. So we changed that and they now get paid
the secondary way.
PN8608
That sounds like a fairly informal but effective system that you have?---Yes, very
much so.
PN8609
Nothing further.
PN8610
THE VICE PRESIDENT: Thank you for your evidence, Ms Geary. You can
step down.
<THE WITNESS WITHDREW
[11.13AM]
PN8611
MR RITCHIE: Your Honour, we have one remaining witness, Krystyna Gruba.
I've indicated to my friend - I think also to the tribunal - that there's a number of
our remaining witnesses that we've locked off as a result of travel or difficulties in
attending today and tomorrow. Ms Gruba has double-booked herself for
tomorrow and we've indicated that tomorrow would suit the parties better than
today. I think this afternoon might be quite full for Ms - so if I may, I might
advise the tribunal later today on whether Ms Gruba will be attending tomorrow
or is a late (indistinct) at which point I can conclude VECCI's evidence. But I'm
just reluctant to do it right this minute just in case her double booking resolves
itself. Then of course I can inform the tribunal formally of which witness
statements we might be relying on. Is that a course of action that - - PN8612
THE VICE PRESIDENT: Yes, that would appear to be the best way forward in
the circumstances. So, Mr Harmer- so you haven't got any other witnesses to call
now?
PN8613
MR RITCHIE: Not now, no. Perhaps Ms Gruba tomorrow, but my
understanding is handing over to Mr Harmer for his witnesses today and
tomorrow.
PN8614
THE VICE PRESIDENT: Yes. Mr Harmer, are you ready to commence your
witnesses?
PN8615
MR HARMER: Yes, your Honour, subject to - if I could I'll just raise some
minor housekeeping issues. But our witnesses are ready to go, if the tribunal
pleases.
PN8616
THE VICE PRESIDENT: There are some minor housekeeping issues?
PN8617
MR HARMER: Look, I just wanted to note one or two issues, your Honour. The
first is that on the last occasion, we had indicated that we still intended to
cross-examine one ANF witness who unfortunately was indisposed with parental
leave, Ms Elizabeth Robinson. We've had discussions with the ANF and I
understand she's still on parental leave and we no longer press to cross-examine
that witness, if I could just clarify that. Secondly, we have had some
correspondence with the ANF and some discussion over production of documents.
Those discussions are continuing subject to the tribunal's discretion. If we can't
resolve the issue today, there might be some minor argument over that tomorrow,
but we're trying to resolve that issue.
PN8618
Thirdly, with witnesses for the AMA and VECCI on the last occasion, there was a
confidentiality regime put in place for questions around profitability and other
commercially sensitive material. We have liaised with the ANF and, as I
understand it, there's consent for that same regime applying to our witnesses
today. If the tribunal pleases, we have prepared a draft order, which is just
modified to suit more our witnesses, and I might just provide that now and just
give a copy to the parties. If the tribunal pleases, we do not have an
understanding from the ANF as to which witnesses questions around profitability
will be put, and as I understand it, the union is at large to put questions to any of
our three witnesses.
PN8619
The regime that we've requested I think attempts to replicate what was previously
granted by the tribunal other than for point 1(b), and I just wanted to clarify with
the drafting there that we're not seeking to have any greater scope than
profitability covered yet, but we'd like to reserve the discretion to seek a further
direction should any other issue arise from cross-examination. So
notwithstanding the way that's drafted, if I could just clarify that that's the intent.
I otherwise thought it might be appropriate to get that regime in place before our
witnesses arrive, if the tribunal pleases.
PN8620
THE VICE PRESIDENT: Yes, thank you, Mr Harmer. It may be appropriate to
raise it, but it might not be appropriate to finalise it until we know what evidence
is given.
PN8621
MR HARMER: Yes, thank you, your Honour. Other than those minor points,
unless there's anything arising from that, we have three witnesses to present to the
tribunal today, the first of which is Ms Nikkie Salagiannis. I request to call
Ms Salagiannis.
PN8622
MR DOWLING: Your Honour, whilst Ms Salagiannis is on her way, for
completeness and arising from what my friend Mr Harmer has said, I wonder if I
can tender the statement of Ms Robinson, which is a statement of 34 paragraphs
dated 29 February 2012. I think it is annexures A through to F.
PN8623
THE VICE PRESIDENT: That statement with the annexures will be
exhibit D46.
EXHIBIT #D46 WITNESS STATEMENT OF ELIZABETH
ROBINSON
PN8624
MR DOWLING: Thank you, your Honour.
<NIKKIE SALAGIANNIS, SWORN
[11.19AM]
PN8625
THE VICE PRESIDENT: Thank you, Ms Salagiannis, please be seated?
---Thank you.
PN8626
Mr Harmer.
<EXAMINATION-IN-CHIEF BY MR HARMER
[11.19AM]
PN8627
MR HARMER: Ms Salagiannis, you're a fair distance away there. Just let me
know if you can't hear me at all. Could you please state to the tribunal your full
name?---Nikkie Salagiannis.
PN8628
Your current residential address?---(address supplied.)
PN8629
Your occupation?---State manager for New South Wales.
PN8630
For the purpose of these proceedings, have you prepared two statements?---Yes, I
have.
PN8631
Do you have copies of those statements with you?---Yes, I have.
PN8632
Is the first statement dated 17 July 2012?
PN8633
I think if you go to page 17, it was dated at the point then you signed it?---Yes, it
is.
PN8634
Is that statement of 17 July 2012 true and correct in every respect?---Yes, it is.
PN8635
If the tribunal pleases, could I first seek to tender the statement of Ms Salagiannis
of 17 July 2012.
PN8636
THE VICE PRESIDENT: That will be exhibit H10.
****
NIKKIE SALAGIANNIS
XN MR HARMER
EXHIBIT #H10 WITNESS STATEMENT OF NIKKIE
SALAGIANNIS OF 17/07/2012
PN8637
MR HARMER: If it please the tribunal. Ms Salagiannis, have you also prepared
a second statement dated 4 December 2012?---Yes, I did.
PN8638
Could I just take you to paragraph 58 of that statement. Do you have anything
that you wish to clarify in relation to that paragraph of your statement?---Just
clarifying - regarding the PNIP funding, that it was dependent on the registered
nurse, enrolled nurse as well as the SWPE number of the centre, as well as doctors
employed in the practice. So that was a standard whole patient equivalent of the
centre. So that's also a factor considering your PNIP payments in a medical
centre.
PN8639
So you're referring to the text about eight lines down where you list the amount of
funding received is dependent upon the number of registered nurses, enrolled
nurses and doctors, and you also want to refer to the SWPE?---Correct, yes.
PN8640
Could I just take you to the annexure marked SN2 to that statement at page 6?
---Yes.
PN8641
Under the heading, "Calculation of payments", and the subheading, "Calculation
of full-time GP" at the top of that page, there's a reference to the standardised
whole patient equivalent, SWPE, value. The next line - it says that one full-time
GP is equivalent to an SWPE value of 1000. Is that what you wanted to refer to at
paragraph 58?---Yes, I did.
PN8642
Other than that change to paragraph 58, is that statement of 4 December 2012 true
and correct in every respect?---Yes, it is.
PN8643
I seek to tender that statement, if the tribunal pleases.
****
NIKKIE SALAGIANNIS
XN MR HARMER
PN8644
THE VICE PRESIDENT: Exhibit H11.
EXHIBIT #H11 WITNESS STATEMENT OF NIKKIE
SALAGIANNIS OF 04/12/2012
PN8645
MR HARMER: If it please the tribunal. Thank you, your Honour, I have no
further questions.
PN8646
THE VICE PRESIDENT: Mr Dowling?
<CROSS-EXAMINATION BY MR DOWLING
[11.23AM]
PN8647
MR DOWLING: Thank you, your Honour. Ms Salagiannis, you are, no doubt in
your position, aware of the classification structure under the Nurses Award 2010?
---Yes.
PN8648
You are aware that that classification structure provides for a position described as
"nurse manager"?---In, sorry, the 2010 award?
PN8649
Yes?---Can you tell me what page?
PN8650
You have a copy of the 2010 award, do you?---I do have the award in front of me.
PN8651
If you can turn to schedule B that sets out the classification definitions?---What
page is that on, sorry?
PN8652
It's on page 34 of my copy but, I'm sorry, I can't promise you that your copy is
numbered in the same way?---So schedule B, classification definitions?
PN8653
Yes?---It's got "nurse assistant" on top, B1, the page?
PN8654
It does, yes. If you can turn over the page to where it commences B5. You see
there "registered nurses"?---Yes, level 1.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8655
Under that heading, it commences "registered nurse level 1"?---Yes.
PN8656
It follows with "registered nurse level 2"?---Yes.
PN8657
The next entry under B5 point 3 is "registered nurse level 3"?---Correct, yes.
PN8658
Then there are, under paragraph 3, three descriptions of what my included as a
registered nurse level 3. The first is a clinical nurse consultant?---Mm'hm.
PN8659
The second is a nurse manager?---Yes.
PN8660
The third is a nurse educator?---Yes.
PN8661
Are you aware of that position described as a nurse manager under the heading
"registered nurse level 3"?---I am, but I would need to recap it if that's what you
mean.
PN8662
I don't need to ask you any questions about it at the moment; I just need to know
whether you're aware of that classification and that title?---Yes.
PN8663
Have you seen the statements filed by IPN by Mr Beckett and Mr Beattie?---No.
PN8664
If I can hand to you a copy of the statement of Mr Beckett filed in this
proceeding?---Thank you.
PN8665
Mr Beckett, as part of the evidence he will give, attaches at the end of his
statement - so commencing after his page 4 - a series of schedules.
PN8666
Have you seen those schedules before?---I've seen these for New South Wales
centres where, when I need to ask a question, HR or payroll will actually give
them to me for the particular staff member I might be asking about. So from more
from a dependent individual nurse, I have, yes.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8667
Have you seen these schedules attached to Mr Beckett's statement?---No.
PN8668
The very ones that are attached to Mr Beckett's statement?---No.
PN8669
You've not seen those before?---No.
PN8670
He says they were prepared at his request. You don't have any reason to doubt
that that was so?---No, they would have come from, I presume, our payroll
department.
PN8671
If I can ask you to turn, in those schedules, to the one that's headed B4?---What
page would that be on, sorry?
PN8672
It's on page 18?---Of B4, yes.
PN8673
The page numbering appears in the bottom right-hand corner as you're looking at
the document in a landscape way?---Yes.
PN8674
Now, this is a schedule that deals with Queensland, and I appreciate you're the
state manager for New South Wales, so I'm only going to ask you to do the best
you can. You will see that that indicates the various classifications of the enrolled
nurses and the registered nurses that are employed throughout the state of
Queensland. Do you see that?---I'm just trying to see if there's Queensland, but I
can see that, yes, they're employees.
PN8675
I'm happy to - you don't need to take my word for it. Mr Beckett describes this
schedule as applying with respect to Queensland and if you look in the top
right-hand corner, it says, "B4 (QLD) brackets". There's a bit more of a - to it
being Queensland, but I'm happy to take you, in respect to that, where he
describes it that way. But take my word for it at the moment at the moment.
What it does is list all of the nurses employed in the state of Queensland and you'll
see in the fourth column - one column has been blanked out, so don't include that under a heading "gen desc 1", it identifies whether the nurse is an enrolled nurse
or a registered nurse, and then identifies the level at which they are paid or, sorry,
the level at which they are classified. Can you see that?---Yes, I can.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8676
I can tell you - and I'm happy for you to go through it personally, but the list
identifies 54 permanent registered nurses and 47 of those or 87 per cent are
"registered nurse level 1". There are 136 nurses in total, and you can see that if
you look in the top right-hand corner there's a box, and if you follow the columns
along the top, you'll see that the seventh column along has "total" in it at the top?
---Yes.
PN8677
At the very bottom, the bottom box in that column says 136. That's meant to
represent the total number of nurses in that state?---Yes.
PN8678
So there are 136 nurses in Queensland. 33 of them are enrolled nurses, 93 of them
are level 1 nurses and nine of them are level 2 nurses, and I can tell you - but I'm
happy for you to look yourself - there are no level 3 nurses employed in the state
of Queensland at all, according to the evidence that will be given by Mr Beckett.
Do you agree with that from the document that's in front of you; can you find a
level 3 nurse in that list?---No, I can't find a nurse of level 3.
PN8679
So from that evidence - - -?---Sorry, this is Queensland only. So 18 onwards, I'm
sorry. No, I can't see a level 3 nurse.
PN8680
So from the evidence of Mr Beckett should we assume that there is no nurse
manager employed in the state of Queensland?---That's not my state, but from
what I understand, there is a nurse manager who runs Queensland. But I think
that she might be a salary person, so it's a different schedule, I think. I'm not quite
sure.
PN8681
You're unable to say how Queensland operates?---No, I'm aware that there is a
state nurse coordinator in Queensland; yes, an equivalent to what we have in New
South Wales. Some nurses that are of a manager level are salaried as I was a few
years ago, so the salary is a different component; it's not part of the award. It
exceeds the value, so it doesn't come up as a level on the actual paperwork. It's a
salaried employee.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8682
So those nurses are listed along with the managerial employees of IPN rather than
listed with the nurses of IPN. Is that as you understand things?---I understand it
that some state nurse coordinators can be salaried workers, yes, because I know
that the one that we have at the moment is a salaried worker, and they don't come
under these levels because it's a percentage above a particular amount of the
award that they actually salaried. There's one salaried one that I'm aware of that
doesn't fall under the levels, and they've negotiated the agreement, these particular
nurses that we have.
PN8683
Those nurses that fall into that managerial category, they don't actually work in
the clinics?---They do.
PN8684
They do?---They might do a day a - example: New South Wales, our state nurse
coordinator works a day a week in the practice.
PN8685
Are you not able to say, in having a look at that schedule, what happens in
Queensland?---No, I'm not.
PN8686
In respect of the state nurse coordinator that you're aware of in the state of New
South Wales, are you able to say how many there are?---There is one state
coordinator in New South Wales.
PN8687
If I can ask you to turn to the previous schedule, which is B3 and deals with South
Australia. Again, if you're unable to say because it doesn't deal with the state of
New South Wales, please do so. South Australia is a little more easy to deal with.
All of the nurses employed are set out there on one page, on page 17?---Thank
you.
PN8688
Do you have that page?---Yes, I have that.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8689
You can see from the top right-hand corner the same "total" column that I took
you to in respect of Queensland?---Yes.
PN8690
It identifies that there are 44 nurses employed in the state of South Australia?
---Mm'hm.
PN8691
If you consider, as you look at that schedule, only those that are full-time and
exclude the part-timers, the evidence of Mr Beckett will be that there are no
level 2 and level 3 nurses at all that fall into the full-time or casual categories. Do
you see that?---Yes, excluding part-time you said; exclude the part-time nurses?
PN8692
Yes?---Yes, sir.
PN8693
Is it a safe assumption that a part-time nurse couldn't be present at all the time that
the full-time nurses are present?---But the numbers vary. If you have two -
sometimes when we do employ nurses, we might put two part-time nurses to
make up one full-time position. It just depends on the need, and that way they can
help with sick leave and annual leave and things like that, and some are mums. It
just depends on how it fits in to the centre.
PN8694
You're not able to say how it is that there's no level 2 and level 3 nurses amongst
the full-timers and casuals in the state of South Australia?---No, I'm not.
PN8695
You referred a moment ago to the state nurse coordinator and you say it may be
that that person is not included in these schedules. If that person was to be
classified under the award, can I suggest to you that that person would be
classified at an RN level 4 or RN level 5. It would be - I think it would be an RN
level 3 or a 4.
PN8696
Can I suggest to you that a nurse manager that I identified before in level 3 is
typically a nurse managing a unit or a ward. Do you agree with that, from your
experience?---Yes.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8697
That that's something of considerably less responsibility than the nurse in your
description who's responsible for all of the nurses throughout the entire state; do
you agree with that proposition?---I just have to go back to the B award, sorry.
PN8698
Perhaps if you just consider the question first, and I'm happy for you to look at the
classifications schedule thereafter, but do you accept that the position of the state
nurse coordinator is one of considerably more responsibility than a level 3 nurse
manager who might be managing a unit or a ward within a hospital?---The state
nurse coordinators that we have don't financially manage the centres, if that makes
sense. What it is is there's a business manager who oversees the centre's
financials and rosters, as well as the manager in the centre. So the state nurse
coordinator doesn't oversee the - when it comes to financials and rostering, the
actual practice manager does that. So it's more clinically making sure that the
appropriate policies and procedures are being followed at a centre level by the
nurses, and they do assist in, if there is any discussions, from a clinical issue
perspective with the nurse. But they don't work from a managing roster financial
perspective; more of a managerial role. That's more the business manager who is
the area manager of the centre who takes in the admin and the nursing hours into
account.
PN8699
Well, for the moment, my question is just focussed on the difference between a
nurse manager level 3 that I took you to some time ago in the award classification
and the state nurse coordinator. What I'm suggesting is that the RN level 3 nurse
manager is typically a nurse manager in charge of a unit or a ward in a hospital. If
we stop there for the moment, does that accord with your recollection of things or
your understanding of the operation of a nurse manager in that classification?
---As a clinical nurse consultant in that clinic. The department - that's how I look
at it to be: from a clinical skill perspective.
PN8700
Now, what I'm suggesting to you is that the role of state nurse coordinator is
considerably more senior to the role of nurse manager identified in level 3 of that
classification and that they would be at 4 or 5. Is that something you agree with
or disagree with?---I think I just need to read the 4 and 5 if - I seem to disagree
because it's more clinical and clinical consultant more so than what it would be
the management and admin and financials. That's how I look at it, but I can read
through it again if you like, just to - - ****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8701
Well, I'm happy for you to - I think your evidence so far is that that state nurse
coordinator would be a 3 or a 4. I'm simply putting to you it's a 4 or a 5. Now, is
that something you agree with or disagree with?---I'd say it would be a 3 or a 4.
PN8702
Now, if I can ask you to turn ahead in the schedules - if you return to those
schedules - to page 21. This schedule deals with the state of New South Wales?
---Mm'hm.
PN8703
You'll see - again, if you go to the top right-hand box - the "total" column. There
are 175 nurses employed in the state of New South Wales. The chart only
describes one full-time level 3 nurse. I'm happy for you to look through it. I
suggest to you that there is only one registered nurse level 3 full-time of those
175 nurses set out in that schedule. Does that accord with your understanding of
the distribution of level 3 full-time nurses in the state of New South Wales?
---That there's only one?
PN8704
Yes?---The most recent figures that I saw probably about six months ago - I don't
know how old these are, but level 3 nurses, I think there's about three of them
because when we acquired practices six months ago, probably read them - there's
three, I think. I can find that out for you - - PN8705
Full-time?---Full-time, sorry. Then - I think they're part-time. So that's probably
right.
PN8706
Should we assume that that one full-timer and possibly, on your evidence,
two part-timers are the nurse managers responsible for supervising the balance of
172 nurses?---No, there's about seven part-time level 3s as well on this list, I
think, but what happens in a practice setting is there is the nurses work closely
with the clinicians, and the nurses at a level 1 and pay point 8 - because there's
also pay points, pay point 1 to 8. If you've been nursing in general practice at
level 1 for seven or eight years and thereafter then they're the pay points that
you're paid against as well.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8707
You automatically a pay point each year?---Each year, correct. So the nurses do
have the doctors that actually assist them in supervision because it's general
nursing.
PN8708
Well, if we can focus for the moment on the supervision by nurses. Is it - and,
sorry, just to finish on what you say, it's your evidence, is it, that whilst there
might not always be a senior nurse available, the doctor is available to provide a
level of supervision. Is that your position?---The doctor is on-hand in the practice
if the nurse requires anything or any clarification of what the doctor has asked the
nurse to conduct or what treatment the doctor has asked the nurse to conduct.
PN8709
But the doctor doesn't actively supervise the work as it's being done by the nurse,
does he or she?---The doctor doesn't sit in the treatment room with the nurse, no.
PN8710
The doctor directs the nurse as to what they should or shouldn't do. That's correct,
isn't it?---After they've seen the patient, correct.
PN8711
They don't supervise the work as it's being done, do they?---Not directly in - no,
but nor does the supervising nurses. If you have any questions or concerns, you
can either see the doctor that's at hand, the doctor that asks you to conduct that
procedure, or they can call their state nurse coordinator, or they can contact some
centre that has a larger nurse number, which isn't many. There may be a team
leader that they can contact or the chief medical officer, or their state nurse
coordinator by phone if there is a pressing issue. But they will see that that doctor
- like, they would buzz that doctor straight away.
PN8712
Are you aware of the Australian Nursing and Midwifery Council?---Yes.
PN8713
Are you aware that they publish a document called the Decision-making
Framework"?---No.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8714
Are you aware they have a set of national competency standards?---I'm aware that
there are competency standards, yes.
PN8715
Are you aware that the Decision-making Framework provides that the national
competency standards for the registered nurse currently reserve decision-making
about the planning and coordination of nursing care to registered nurses?---Sorry,
can you repeat that again for me.
PN8716
The national competency standards for the registered nurse currently reserve
decision-making about the planning and coordination of nursing care to registered
nurses?---Yes, what that means is if a doctor asks for a nurse to conduct a
dressing, the doctor will say, "Can you dress that for me. This is what you - I
would like this particular dressing."
PN8717
Then ultimately - - -?---The nurse has the skill, sorry, in general practice to
prepare for that wound dressing. But the nurse is not going to make the call as to
what dressing type they will put on that dressing. If there's exodus, if there's a
particular dressing that is required, the doctor will actually, in general practice - so
the nurse will prepare as per the doctor's instructions, which is your - - PN8718
There's a difference between the doctor directing a nurse as to what to do and the
doctor supervising a nurse in the duties that she carries out. You agree with that
as a general proposition?---Sorry, repeat that so I can hear it again.
PN8719
There's a difference between the doctor directing the nurse as to the tasks she is to
carry out and a doctor supervising the nurse as to the manner in which she is to
carry it out?---She's a registered nurse, so once she's received the directive of what
she needs to do, then that's all part of her general practice training in nursing to
carry out that procedure or what the doctor has asked her to do. The nurse
wouldn't have somebody overseeing them. Even a supervising nurse wouldn't
oversee them if it's part of their general work.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8720
It's the exercise of that nurse's discretion as to how she carries it out. That's
what - - -?---From her training as a general practice nurse.
PN8721
If she's an enrolled nurse being supervised or a graduate nurse being supervised
by fellow and more senior registered nurse, the senior nurse might be there
overseeing the way the task is carried out?---It depends. Some of our - well,
New South Wales centres don't have - you're talking enrolled nurses as an
example. We also - you can have technicians that can carry out ECG spirometry
audios. They don't need supervision because it's a machine and they're trained on
how to use that machine, and I'm not downgrading what nurses do or - I'm a nurse
as well. But particular things you wouldn't being supervised - like, if you want to
plan an ECG, the doctor has asked you to conduct an ECG, so the planning is the
same for everybody: you tell the patient to get ready. "This is what the process
is. Is your name" - it's the same process, and enrolled nurses wouldn't need a
supervising nurse to watch them or an RN to watch them to carry out that process.
PN8722
What I'm suggesting to you is there's a difference between the direction from a
doctor and the supervision from a doctor, and it's your evidence from your
statement that doctors do not actually watch an IPN nurse performing a treatment
on a patient. That's right?---That's correct.
PN8723
They're not directing them - they're not supervising them in the way they carry out
their duties. That's what I'm putting to you. They - - -?---They don't watch them,
no; they direct them in what they would like done, completed for that patient.
PN8724
They're not supervising them in the way they carry out the task that has been
assigned to them. Would you agree with that proposition?---They're not watching
them in the same room, correct. If the nurse has any issues, the nurse will buzz a
doctor to come and check because sometimes a doctor will say, "Look, once
you've done that, can you give me a call. I just want to come back and check
that." But that's at the doctor's discretion.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8725
If I can ask you to turn back to Mr Beckett's statement and the schedules
contained as an attachment to his statement, and if I can ask you to turn to the
first schedule, schedule A. That identifies, we are told, the nurses employed by
IPN Australia-wide and that lists 19 level 3 nurses and 380 level 1 nurses. Should
we assume that the 19 are responsible for supervising the 380?---No.
PN8726
Should we assume that, amongst the 380 level 1s, some of them are supervising
themselves?---Why would they need supervision? I'm just trying to understand.
PN8727
Do you say nurses don't need supervision in your clinics; is that your evidence?
---They have the doctors who will direct them to carry out a necessary procedure.
PN8728
Because they have doctors that are available in the practice, they don't need senior
nurses to supervise them. Is that your evidence?---No, they have a state nurse
coordinator. If it is a larger centre, that's when they have a team leader as well in
the practice as a nurse.
PN8729
The state nurse coordinator is certainly not going to be - there's one of them in the
state?---Correct.
PN8730
So there's only a limited amount of supervision that one can do for the
380 level 1s, I assume?---There are policies and procedures that guide all of our
registered nurses, all of our nurses - enrolled nurses or registered nurses - in the
way that they carry out their procedures, as well as what they are able to complete
when they see a patient, so - - PN8731
I'm not asking about the policies and procedures; I'm asking about supervision,
and - - -?---I'm just trying to answer that in a way of guidance because I think
supervision also falls in the banner of guidance and support network.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8732
So is it your evidence that because you have policies and procedures and because
you have a doctor and because you have a state coordinator, they don't need
someone to supervise them at the practice level?---If they require supervision,
there is a policy and procedure that states that nurses are able to contact their state
coordinator, and if they're uncomfortable - because I remember writing it - with
any type of procedure or request by a doctor, they're allowed to say, "Look, I'm
not familiar with that procedure. I need to get more guidance on that", and then
we make sure that that is provided to them.
PN8733
So the place they go for their supervision is the policy, the place they go is to the
state nurse coordinator. Is that - - -?---They actually go their practice manager in
the practice, who does support them if they need anything for - - PN8734
Who might or might not be a nurse?---They will make sure they have the
appropriate information that they need.
PN8735
Who might or might not be a nurse. Is that correct?---May or may not, correct.
They might not be a nurse, no. But not that they're - - PN8736
So if they're looking for supervision from a nurse and their practice manager isn't
one, you say they go to the policy and then they go to the state nurse coordinator.
Is that your evidence?---No, what my evidence is is that there is a support network
there for them and they can contact their practice nurse coordinator if they feel
that they need to, as well as the doctor that's on site.
PN8737
If I can ask you to look at schedule B7, which commences on page 26. We're told
by Mr Beckett that this schedule lists the all of the nurses employed by Allied.
Do you know what I mean when I say Allied: that's the short-hand used by
Mr Beckett to replace the Allied Medical Group Holdings Pty Ltd. So he tells us
in his statement that B7 lists all of those nurses employed by that entity, Allied
Medical Group Holdings Pty Ltd. Do you have any reason to suspect that he's not
accurate?---No, if it came from head office, I wouldn't think so.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8738
I can tell you that there are 170 nurses - again you can go to the top right-hand
box in the column headed "total" and at the very bottom, you'll see 170 nurses. I
can tell you that, of those 170, there are only 12 registered nurses?---Mm'hm.
PN8739
That the balance of 158 are enrolled nurses. Do you have any reason to expect
that that's not reliable?---No, I wouldn't expect that.
PN8740
That there are, amongst the places where those nurses are said to practise,
approximately 20 locations identified. I'm happy for you to not take me at my
word?---It's okay, yes.
PN8741
There are eight of those 20 where there are at least one registered nurse, but there
are at least 12 locations where there are no registered nurses at all. Does that
accord with your understanding of operations?---If it's on here, then yes.
PN8742
So should we correctly understand then that at those 12 locations, all of the
enrolled nurses receive no supervision from a registered nurse?---It would depend
on the centre. I don't have that information in front of me of what procedures they
carry out, but if they're predominantly ECG, spirometry, wound management, no
S8s, no S4s - which means injectables and things like that - because some centres
can run - we've got - some particular centres will only run maybe with enrolled
nurses or assistants in nursing because there's non-invasive therapies occurring in
that practice. So it just depends on what type of centre it is and what procedures
they're carrying out because in some centres, doctors give their own injectables,
some doctors don't. If you have - ENs are now medication-trained as well, so if
there are particular injectables that can be given by the EN, then they'll give them
out. It just depends on the centre and what the need is.
PN8743
But I think we have to assume, don't we, from that schedule, regardless of the
needs of a particular centre, there are at least 12 that employ ENs that employ no
RN?---If that's what it is then - - ****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8744
Should we understand that all of those centres would have made application under
the Practice Nurse Incentive Program?---Yes, obviously the Practice Nurse
Incentive Program is less for enrolled nursing - hiring enrolled nurses - than what
it is for hiring registered nurses.
PN8745
You've given some information in your evidence about the Practice Nurse
Incentive Program. Perhaps you can turn to that document. It's NS2 to your
second statement. If you turn to paragraph 19 - sorry, my apologies - page 19 of
that document, you'll see three-quarters of the way down the page, there's a
heading that reads, "Supervision of the enrolled nurse". You'll see it reads
underneath that, "The enrolled nurse is legally required to be supervised by a
registered nurse and is accountable and responsible for all aspects of delegated
care." Are you able to explain how it is that the enrolled nurses at those 12
locations could possibly be supervised by a registered nurse when they don't
employ one?---We have the state nurse coordinator, and there are other - if it's a
cluster of centres and there is a registered nurse in that area and there is an
assistance or help - clarification for something, the nurse can pick up the phone
and call that RN. It's not physically to be on site supervising the enrolled nurse.
PN8746
No, the document provides for direct supervision and indirect supervision. So is it
your evidence that, at those 12 locations, those ENs are being indirectly
supervised by an RN?---They can be, as well as the doctor, indirectly.
PN8747
Well, let's leave the doctor to one side for a moment because you have read that
the enrolled nurse is legally required to be supervised by a registered nurse. Do
you see that in the first line under the heading that I took you to?---Yes.
PN8748
So let's concentrate on the registered nurses. Is it your evidence that the registered
nurses in some way indirectly supervise those enrolled nurses at those 12
centres?---I'm not sure about that particular state. So maybe they haven't applied
for the PNIP. I'm not sure to be honest, so I'm just rattling off the way that I
would normally do it, but it could be different with Allied.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8749
Are you aware of any processes being in place for the direction, guidance, support
and monitoring of the ENs' activities, as required by the guidelines?---No, I'm not
aware.
PN8750
Of the ENs that are listed as being employed by Allied, only 15 of the 158 of them
are at pay point 5. Are you able to explain how it is that - should we assume that
all of those 158 have worked less than five years or should we assume that some
have been incorrectly classified or are you unable to say?---I couldn't assume, no.
I'm not their manager, so I couldn't make that decision.
PN8751
What I'm suggesting to you is that it is a regular occurrence at IPN clinics
throughout the country that ENs do not have access to supervision by a registered
nurse. Are you able to say or not?---There's enrolled nurses and there's endorsed
enrolled nurses. There's a difference between enrolled and endorsed enrolled
nurse. An enrolled nurse has finished their training but they're not
medication-endorsed. Then there's endorsed enrolled nurses that are enrolled
nurses that are medication-endorsed nurses. I can only speak for New South
Wales, so we have enrolled nurses who are medication-endorsed nurses, if that
makes - so there's a different spectrum there, and they receive six months extra
training to become medication-endorsed.
PN8752
They still require, under a PNIP, the supervision of a registered nurse, whether
they're medication-endorsed or not. Do you agree with that or do you not know?
---I'm not sure.
PN8753
I'm also putting to you that it is a regular occurrence that registered nurses do not
always have the access to an appropriately more senior registered nurse for
supervision throughout the country with respect to IPN clinics. Are you able to
say or not say?---For New South Wales, what I can say is I've never had an issue
where one of our nurses felt that they weren't assisted as they required it from our
state nurse coordinator our time leader nurses.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8754
So you gauge, as a guide to whether they have got the appropriate level of
supervision, whether someone has come to you with a problem, and if they
haven't come to you with a problem, you think it's all fine, they're being
appropriately supervised. Is that your evidence?---No, I don't agree. What it is that is one factor that I would take into account, as well as any issues the doctors
might have or any complaints or concerns from the centre.
PN8755
Are you aware of the Nursing and Midwifery Board of Australia?---Yes, I am
aware of it.
PN8756
Being a nurse yourself, you will understand that that provides for the registration
of nurses and the licensing for them to practice. Do you accept that that licensing
and registration does not differentiate in any way based on the nurse setting?
---The registration?
PN8757
Yes?---No, that's correct.
PN8758
There's no limit or restriction on the authority to practice based on the setting that
the nurse might be going into. That's correct, isn't it?---I'm not sure, sorry. I don't
have anything in front of me to - I'm basing it on myself, so it depends on which
setting you want to go and work in and if you have - - PN8759
I'm suggesting to you it doesn't depend on the setting at all. In fact the registration
and licensing you receive from the Nursing and Midwifery Board of Australia will
not change dependant on the setting, whether it be a clinic, a hospital or
community health centre. Do you agree with that proposition?---I do, yes.
PN8760
That follows because a nurse may be called upon in any setting to exercise the full
scope, competencies and functions that they are experienced to utilise?---I
couldn't go and work in a hospital today; just to walk in the door and say, "I'm
here. Can I work as a hospital nurse." Is that what you mean?
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8761
No?---Because I don't have that experience. I mean, to go back in a particular
specialty. I might be registered, but to go in and work in a skin clinic in a hospital
or to go and work in emergency care in a hospital - is that what you're - - PN8762
What I'm suggesting to you is you receive registration, licence to practice that's
not dependant upon where you go, and there's a very good reason for that, and that
is you are required, wherever you may be, to exercise the full degree of your
abilities and competencies. Do you agree with that?---As a division 1 nurse. Is
that what you mean? Because it's - - -
PN8763
As a registered nurse or as an enrolled nurse?---Yes, but I couldn't go and work yes, my registration. But not that I could go and work anywhere in any industry
or any - depending on my experiences.
PN8764
Ms Salagiannis, you give some evidence about primary and secondary care and I
just want to put to you my instructions about those matters. I suggest to you that
primary care can properly be described as coordinating care and practising
preventative nursing practice or the first contact for symptom management, which
can take place in any practice setting. Do you agree or disagree with that
proposition?---Primary care, yes.
PN8765
That secondary care encompasses direct patient care, can also require the client
being referred by a primary care provider to a specialist such as a cardiologist or
nurse practitioner for example, but secondary care can also include nursing care
provided to clients in the community. Do you agree with that proposition?---The
secondary care that I wrote more in my statement was reflecting more as the next
step after coming into primary care - would be then in more of a hospital setting;
that's how I envisioned it more. Then from there, then they would go probably
back into the community and they would receive community care after the fact,
depending on the (indistinct) management or what the requirement is.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8766
You accept that there are nurses employed by IPN and its related companies that
provide secondary care?---In my statement, what I meant was - the way that I
meant it was that once they come into our centre with whatever the primary
complaint is or the symptom is, then they - if it is serious, then it's taken back to
the hospital or they see a specialist. But, no, I'm thinking of it more as a primary
practice.
PN8767
Can I suggest to you that secondary care engaged in at IPN clinics would include
such things as IV infusions, cannulation, blood collection in emergencies,
post-injection care and observation; it's correct to describe that as secondary care,
isn't it?---The nurses don't go - usually, IV - in our medical centres, they don't IV
cannulate unless there's a particular specialty nurse which - we have, I think, one
in Manly that's a separate but we don't - our nurses do not infuse. When we have
an emergency and we need to cannulate somebody, the doctor will always
cannulate. The doctor will take emergency bloods - - PN8768
There's - I'm sorry to interrupt you?---No.
PN8769
Let's deal with one at a time. I suggest to you that nurses at all of your clinics are
involved in post-injection care and observations. Is that correct?---Post-injection
care and observations, yes.
PN8770
That that is properly secondary care?---I call it primary care because if a patient
comes in and they're vomiting or something like that, then the doctor will ask the
nurse to give the injection, so I took it as primary care for that particular - that's
how I meant it in my statement.
PN8771
Having accepted the definitions of primary care and secondary care that I've
described to you, do you want to amend your statement?
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8772
MR HARMER: Your Honour, could I just object to that question briefly. I don't
understand there to have been any acceptance of the definition of secondary care
as put. I understand the witness to have clarified that she had specific intended
definitions of primary and second care that she utilised in her statement. I don't
think there's a meeting of minds on what my friend is putting and what the witness
is dealing, if the tribunal pleases.
PN8773
THE VICE PRESIDENT: Why can't the witness deal with that question?
PN8774
MR HARMER: I think what's being put is that she has already accepted
two definitions put by the ANF and that's not my understanding of what has
occurred with this witness, if the tribunal pleases.
PN8775
MR DOWLING: Your Honour, my recollection is a little different, but perhaps
I'll - I don't think there's any doubt she accepted the definition of primary care.
My friend can say otherwise if his notes suggest otherwise, but I didn't think there
was any doubt about that, so perhaps I'll put it one at a time.
PN8776
THE VICE PRESIDENT: Yes.
PN8777
MR DOWLING: Having accepted the description that I gave of primary care, do
you want to amend the statement that you've provided in respect of primary and
secondary care?---I don't know about the definition of secondary care. I always the way that I was explaining it in my statement was more a serious incident or a
serious condition - I always took it as the primary care - so secondary care - so the
patient will need to go to a hospital and seek further medical assistance, whereas
if we can deal with something at the centre level then I call that primary care. So
maybe I need to amend that part of secondary care.
PN8778
That's the way you've approached those two concepts?---That's how I - yes.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8779
You give some evidence about ratios and the way in which there might be a
difference in ratios between a clinic and a hospital. Do you accept that a
registered nurse or enrolled nurse will practise with the same level of attention
and skill when providing nursing care to the client, regardless of the number of
clients treated in any time frame?---Sorry, can you repeat that. So - - PN8780
Do you accept that a nurse will practise with the same level of attention and skill
when providing nursing care to the client, regardless of the number of clients
treated in any time frame?---I think it depends on the setting you're in and the
management of care that you're providing and what area you're in, to be honest.
PN8781
So you say, do you, that sometimes a nurse might give a lowers standard of care,
depending on the - - -?---Standard, no, sorry. I thought as in time. So no.
PN8782
So they will give the same level of attention and skill to any patient, regardless of
the number of patients treated at any one time or the ratio of the patient's
treatment. You agree with that as a proposition?---There's also time limits. So
that would be very difficult if you have quite a lot of patients at a particular time
interval. So - - PN8783
Do you have time limits on the treatment of your patients?---No, we don't have
time limits.
PN8784
Do you understand that hospitals have time limits on the treatment of their
patients?---No, they don't.
PN8785
Now, you've given some evidence about career pathways within IPN, and I
wondered if you could turn to your first statement, please, and annexure K to that
statement, and you'll see there that's a document annexed by you described as
"operations career paths". Do you see that?---Yes.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8786
You have there the position of state nurse coordinator, four boxes from the left in
the top row. I think your evidence is that there's one of those per state?---Yes.
PN8787
If we move further to the right, the business manager, how many of those are
there?---We have - it varies in different states. For New South Wales, I have
six area managers.
PN8788
The state manager - should we assume that there's one of those in each state?
---Correct, yes.
PN8789
I assume there's one chief operating officer?---There's two chief operation officers
across Australia. One has four states and the other one has two states.
PN8790
If we take a registered nurse who enters what you describe as the career path, we
can ignore the medical assistant and enrolled nurse. She's past that point, she or
he, and they enter as a registered nurse. Your evidence is that their career
progression should be to state nurse coordinator, business manager, state manager
and chief operating officer. Is that right?---In my statement 2, I - because there's
also a level which isn't in here, but it's not directed in every centre. If you have like, in our Penrith centre, we have three nurses that could work at one time.
There is actually a nurse team leader, an RN, who is a team leader there. It
doesn't happen in all centres, so in, I think, maybe about four centres we do have
actually a nurse leader in a practice.
PN8791
Is that four centres in Australia or four centres in New South Wales?---No,
New South Wales - that we have a team leader that's in a practice or three. I'm not
quite sure of the numbers.
PN8792
So - - -?---But, yes, I mean, that's - there is, sort of, in between that in some
centres a team leader, and then - but in - some registered nurses might want to
apply - is a practice manager. It just depends on the centre. If that position is
available, they have that option. That's why they can - - ****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8793
Is it fair to say that this is largely a progression to managerial position?---From
registered nurse to a state nurse coordinator?
PN8794
Yes?---It's clinically related more so. The business manager and the practice
manager oversee a lot more of the admin and financials and performance
management with the assistance of the state nurse coordinator from a clinical
aspect.
PN8795
So if we differentiate the managerial from the clinical, is it the state nurse
coordinator that has the clinical responsibilities and the business manager and
state manager and chief operating officers that have more of a - - -?---And the
practice manager assisting the management of the financials as well, and rostering
and the operational rostering of a practice.
PN8796
So if my registered nurse who enters your career path in fact wants to remain in
clinical practice, doesn't want to follow a managerial path, the only step for her in
terms of remaining clinical is to step to the state nurse coordinator. Is that what
you say?---Not really. I mean, in some instances, if a nurse were - I was a
manager RN, so I managed the treatment room but I was a manager of a centre
many years ago. So if you find the right person for the job in a current centre -
like, we have a centre now that there's a job available, and I've actually said to the
nurse if she wanted to apply, she'll still work in the treatment room the hours we'd replace her with other nurses as well because then she can also manage the
practice. It could be that she works in the afternoon in the treatment room and
manages in the morning. So there's a variety. So it doesn't mean that they give up
their clinical practice, no. If that's something they aspire to, then they can still
work admin and - if it's not the state nurse coordinator (indistinct) clinical then
they can work.
PN8797
This career path that you've annexed to your statement, it doesn't have a clinical
career progression within the role of registered nurse identified on it. You agree
with that proposition?---State nurse coordinator - exempt the state nurse
coordinator, do you mean?
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8798
Well, there's one of those in the state, so our nurse wants to remain as a registered
nurse and she wants to remain clinical. Putting aside the state nurse coordinator,
there's nothing identified on your career path for that nurse?---Unless they work in
a centre that has a team of nurses, then not in this particular career path, no.
PN8799
Is this the only career path document that IPN have produced?---There is a newer
one than this, but it's along the same lines, but that's the same our admin staff. I
mean, some admin staff are very career-focussed, and then they move on to
somewhere else where, when a position does come up somewhere, they do apply
for a position somewhere else because they want to be in more management if
there isn't a job available within our - we're not very top-heavy in management, to
be honest.
PN8800
You give some evidence about a review process that takes place in your
first statement, and is it correct that the conducting of performance reviews will be
done one-on-one with the nurse and the relevant doctor in that particular
practice?---This particular format has only been out for a year, to be honest. Prior
- there was a different format to that, but a performance appraisal that I would
conduct or that their manager will conduct with our nursing staff - is that what
you're - nursing or admin - - PN8801
Yes?---With nursing staff. It would also be with - the doctor won't be in the room.
It will be discussion with the doctors of how they feel their nurses are going and
their need. But also with the state nurse coordinator - because our nurse
coordinator tries to get out to every centre every quarter at least or every few
months to see the nurses. Then the manager will conduct the appraisal with the
nurse involved one-on-one, collecting that information and then delivering it to
them - - -
PN8802
So on the managerial side, there might have been some discussion with the doctor
and the state nurse coordinator. But in the practice of it, the nurse is sitting there
with the practice manager?---When a performance appraisal is conducted, then
you collect the - as per any employee, if you look at how they're working within
that team, if there's anything they will need to train on refine on - that's why you
put it together: to, sort of, move forward with, "This is how you're doing", and it
will be no surprises. Our staff - and this is how I work in the state of New South
Wales. If you're sitting in a performance appraisal, there's never a surprise. As
things come up or any issues or extra training or you're doing really well in
something but you might need training a little bit more on something else, the
discussion does occur during that year, and in the performance appraisal, you sit
down with them and just talk to them about how they've gone, any extra training
that they might need moving forward because the doctor might want to conduct
more pre-employment medicals or things like that. So it's more a discussion; it's
not a performance management tool as a review.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8803
I think it's your evidence, is it, that that appraisal, as I understand it, between the
practice manager and the nurse is the occasion when there will be a decision about
whether there's a pay rise?---The discussion - it's not a pay review, but a
discussion can occur or it might not occur, depending on how the performance
review is going as well.
PN8804
So subject to performance, if there's to a pay rise - - -?---As well as the ward.
PN8805
- - - it's in that conversation between the nurse and the practice manager?---It can
happen. It might not. It depends. Example: we might have a nurse that
three months out or four months out - we're looking at a care plan. Then we have
a discussion. So it could be in that year. The review may have already occurred
prior. It just depends on the circumstances, but that could be the forum that it
could be brought up, correct.
PN8806
I think your evidence about Ms Burrell is that that was the process - any pay
review was to be considered at her performance review but in her case - sorry, I
withdraw that, your Honour. But in respect of performance reviews, pay rises will
only be received if they're warranted after the review. Is that a fair statement of
the position?---Ms Burrell - - PN8807
Let's leave Ms Burrell aside?---Okay, because she's my employee, yes.
PN8808
Let's talk about it more generally first?---Yes.
PN8809
A pay rise will only be given after review if it's warranted, I think, in your
words?---No, that's not the right way to say it, sorry.
PN8810
They're your words, so I'm not - - -?---No, I hear you. That's where the discussion
occurs or can occur in a pay review. It depends on historically how they have
performed. It depends if they've received an increase in pay during that year.
There's a whole lot of - they're always above award, our nurses, if not (indistinct)
they're above award. So the discussion is always how well they've performed. If
we're looking at extra duties, then we can discuss an increase. If it's the same
duties, then we look at the percentage of increase that did occur in the award and
we try and keep that gap at the same level as what they originally had.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8811
Are you suggesting that where you say at paragraph 53, "IPN nurses only receive
pay rises at such reviews if it is warranted" - do you want to change that evidence
or is that evidence - - -?---No, sorry, can I just get - what paragraph was that?
PN8812
53?---But that's relating to Mrs Burrell.
PN8813
But you say Ms Burrell's wage rate was not increased as a result of the
performance review, "As IPN nurses only receive pay rises at such reviews if it is
warranted." You're talking about all IPN nurses?---Warranted, being - warranted
meaning if she's received something in the year, it, sort of, sounds - yes.
PN8814
But you're talking about all IPN nurses there, aren't you?---Not the ones that - I
mean, "if it's warranted" meaning that if they've received a pay increase in the past
year, yes, we review and we see whether it is warranted over the year. If there
was an increase in the year, then it wouldn't be warranted to give them one when
we see them again if it was only four months ago, five months ago or - - PN8815
Well, if you can have a look at Ms Burrell's performance review form, which is
annexure A to your statement, and if you can go to the third page of it - and that's
where it lists, under item 5, "General service levels". Do you see that?---Yes.
PN8816
PN8817
Beneath the columns marked "meets expectations" and "exceeds expectations" are
a series of ticks. Should we understand from the way that's been completed that
Ms Burrell either met expectations or exceeded them in every single item that's
listed under "general service levels"?---That's what the manager has ticked.
PN8818
If you go back to the first page, Ms Burrell is given an overall rating, and her
overall performance rating is that she fulfils expectations?---Yes.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8819
But your evidence is that a pay rise was not warranted in her case. Is it your
evidence that someone with a review of that sort where they are fulfilling
expectations does not, as a matter of course, get a pay rise?---This isn't my - I
didn't directly deal with this employee. I did speak with their manager, and there
were other concerns based on performance that weren't documented there, but
there is a letter in here regarding her performance in the practice.
PN8820
So we shouldn't accept this appraisal at its face?---No, it's there, so we should
accept it.
PN8821
It's there she meets expectations or exceeds them and on all general service levels,
her manager gives her an overall performance rating of fulfilling expectations, but
it's your evidence that someone in that position, a pay rise is not warranted?---If
that's what it says, that's not my employee, so I can't really elaborate on that.
PN8822
You've annexed it to your statement. You give some evidence in your statement
about training and the way IPN deals with its training requirements?---What page
is that on, sorry?
PN8823
I don't need you to turn to the statement for the moment. Well, I'm happy for you
to do so. If you turn to page 11 of your first statement?---Yes.
PN8824
At the top of page 11, you give some evidence about Ms Crawford and in
paragraph 77, you say that at the relevant time, the nurses in Australia were not
required to acquire CNE points, continuing nurse education and because that
training was not required, it was not mandatory for Ms Crawford to attend those
training sessions, and I think the suggestion is that that's one of the reasons she's
not paid for those training sessions. Is that the position of IPN?---We did pay for
some of the courses. The ones that were centre-related, practice-related we did.
But once they weren't practice-related, we didn't.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8825
But is there a suggestion that the ones that are not mandatory for her CNE
requirements are not going to be paid for; is that the policy?---No, what we do is in our centres, if it's relating to the practice in the centre when it comes to ear
irrigation - if a nurse would like to go and do a course in - or they might be
midwifery-trained and they want to do a further midwifery course to keep them
midwife-registered, we don't need that in our practices, so we ask our nurses that
if it is to do with, example, diabetes management or wound management or audio
training or if we plaster patients in the centre and they want to do a plaster course,
by all means. So as long as it's relating to the general practice, then we're happy
to pay if it's relevant to the clinic.
PN8826
Is one of the advantages that IPN has over other - I think your evidence is one of
the advantages it has over other small practices is it has the resources and
processes of a larger human resources department and human resources
professionals. Is that your evidence?---Yes.
PN8827
You say though in your evidence that IPN doesn't have a study leave policy?
---No, we don't. Not that I'm aware of. It's case by case.
PN8828
Is there any reason that all of those human resources resources couldn't have
compiled a study leave policy?---Well, what we did do is, with the nurses, we
tried to find a better package for our nurses because we did do a road show in
2003, 2004. Nurses - it was very difficult, you know, at the time to look and see
what the nurses needed. So a couple of years ago, we decided to enrol with
APNA, and that way - we fully pay our nurses registration with APNA. They do
receive online resources there for their CNE assistance that they need. If there is a
course that they - and when we're talking about discussion is - if a nurse did come
to me - and I'm talking about me in New South Wales - and said, "Look, I really
want to go and do this diabetes management care plan course, but it's on from
Thursday lunch time until 5 o'clock", more than likely, actually I would, and the
centre requires that the doctors really would like that nurse to be trained on care
plans for diabetic nurses. I would pay for that and we would - so it's a
case-by-case negotiation with a nurse.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8829
But is any of that a reason - - -?---It's not a written guide, but I mean - - PN8830
Is any of that a reason why IPN is not in a position to develop a proper study leave
policy?---I'm unsure about that - from that end of a study leave policy. I know
we've discussed it and at the moment, we're concentrating on renegotiating the
APNA registrations to allow for more online training for the nurses as well at no
fee for the nurse because we're paying for that - the company is paying for that.
But, no, we've concentrated on resourcing that way for the moment, but I don't
know about the study leave; I'm not sure.
PN8831
Do you think the study leave policy would be a good idea, provided it left some
discretion at each practice as to how they approved or didn't approve the particular
course that was being sought?---I think you have to look at the funding and just
see where you would direct funding. At the moment, we're directing it with the
registration of the nurses and helping them in that way. I just think that it's a
discussion to be had probably with the nurses as well. But for the moment, you
would have to look at what funding we have, and you would have to make a
decision on that, whether that's more appropriate or do we work with APNA
registration? We send nurses to the conference as well, so it just depends.
PN8832
Isn't it in the interests of an organisation like yours that there be a policy on an
issue like this; are you saying that an ad hoc basis is a proper basis for something
like this to be implemented?---I call it a negotiation - not really an ad hob basis of the need of the centre
PN8833
You give some evidence about what you describe in your first statement as a
dedicated support system and that's from - so that you can look at your statement
if you need to - paragraph 116 of your first statement. One of the things that you
describe as part of that system is the grievance procedure. Is it your evidence that
that grievance procedure should be used or could be used to raise issues about pay
and conditions?---As a grievance, yes. If that's a grievance - if - yes.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8834
Has anyone ever raised a grievance under this grievance procedure policy with
you about pay?---In writing?
PN8835
Yes?---No, I've had phone calls or a discussion with staff where - it's been more,
actually, flexibility of time to be honest. A lot more of it has been more, "Can I
do the school pick-up at 3 o'clock, Nikkie, and then come back to work?" I've
been - - PN8836
I'm talking about pay for the moment?---Okay, sorry, yes. So if a discussion
occurs, we do negotiate if the - but not on a - - PN8837
I'm not asking you whether you negotiate?---Not on the form, no. I - - PN8838
I'm asking you - - -?---To date - - PN8839
Perhaps just listen to my question. I'm asking you whether the grievance
procedure policy has been used to raise a grievance with pay rate?---I have not
received one in writing.
PN8840
You describe also the role of the chief medical officer and I suggest to you that no
nurse has raised a dispute with the chief medical officer about pay rates. Do you
have any knowledge of that?---Not that I'm aware of.
PN8841
I put to you that no nurse has raised a dispute about pay rates with the national
SNC committee?---I'm part of that committee, but if a nurse - there has been
nurses that have asked me about pay review or about pay increases - - PN8842
I'm putting to you, as part of the business of that committee - no nurses raised a
pay dispute with that committee. Is that correct or not correct?---There would
have been. I'm just trying to think. I can't remember, sorry. I'd need to - - -
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8843
Are they minuted, those meetings?---Yes, they are, and if you need that - I can
access that if you do need that.
PN8844
You can provide us the minutes of SNC committee, can you?---Yes.
PN8845
Can you provide those for the last 12 months?---12 months, yes.
PN8846
I would formally call on those, your Honour. You have also, in respect of this
same matter, attached a log, you say, of issues raised, log of queries and
grievances, and you annexe that as annexure N to your statement?---This has
come from our HR department, yes.
PN8847
Is it correct that, of all the entries raised in that log, none of them identify pay
rates?---I think so, yes. Correct.
PN8848
Now, you're aware that as part of this proceeding, the ANF has sought to negotiate
with IPN and its related companies?
PN8849
Do you accept that the medicine practice at IPN centres across the country is
exactly the same as medicine practised in non-IPN centres?---The doctor-nurse
relationship maybe. Is that what you mean? Like, the doctor-nurse relationship?
PN8850
I'm talking about the medicine practised. I'm suggesting to you that the medicine
practised at IPN centres across the country is exactly the same as the medicine
practised in non-IPN centres. Do you agree with that proposition?---Non-IPN
general practice, yes.
PN8851
That there's no reason that you could not participate in negotiations to deal with
the terms and conditions of practice nurses to apply throughout Australia?---I
don't see the reason why - I've been around for almost 18 years and, again, I'm
speaking on behalf of New South Wales, I've not had an issue that I haven't been
able to deal with with a nurse regarding flexibility, regarding their working hours.
I've never had an issue. So I don't think that I would require that assistance.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8852
Do you understand that, as a nurse, creating a floor of standards is an important
thing for the industry?---Do we not have a standard? The award is a standard,
yes, so - - -
PN8853
I suggest to you that the Nurses Award 2010 is clearly not designed with general
practice nurses in mind. Do you agree with that as a general proposition?---No.
PN8854
Can you see the word "general practice nurse" anywhere in that award?---When
they talk about level 1, they talk about general practice.
PN8855
Is it your evidence that Nurses Modern Award 2010 is specifically designed or in
some way designed to cater for practice nurses employed in Australia?---Yes.
PN8856
How do you come to that conclusion?---Well, when I look at it - and I'll flick to it
to just explain - it talks about "general nurse duties", and when you read the
components of it, it actually does general practice, and then you have, like,
specific clinic nurses. So we have a mental health nurse that works in one of our
centres.
PN8857
But is it your suggestion where it refers to "general nurses duties", that that's in
some way a reference to general practice?---No, general nursing duties are usually
what our nurses perform in general practice.
PN8858
What I'm suggesting to you is this Nurses Award is deliberately and broadly
designed to pick up nurses in all industries: hospitals, community health centres,
general practice, local government, all of those things. It's designed to cover all of
those things. Do you agree with that?---I agree that it's designed to cover - I
believe that it does cover our general practice nurses in our centres. I'd need to
see what the other job descriptions are and how they work, but it's - - ****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8859
What I'm suggesting to you is it would be beneficial for the practice nurses
generally and the industry of practice nurses if they had an agreement targeted
specifically to the way they work in practice, and for IPN to the way it particularly
works. Do you agree that that would be advantageous for the industry of practice
nursing?---No, I don't - for me, I don't. In the industry that I work in, in general
practice, I don't have an issue with that award.
PN8860
Do you accept that the ANF is willing to consider any peculiarities about the way
IPN operates and to negotiate with them about any peculiarities that they have?
---What type of peculiarities?
PN8861
Well, is it your evidence that IPN operates in a different way or IPN has a peculiar
operation that, "If we were to have an agreement, we don't want to go in with
everybody else. We've got some differences, so if we were to have an agreement,
we'd like our own"; what I'm suggesting to you is the ANF are quite prepared to
sit and listen to any particular requirements that the IPN have. Do you accept all
of that?---But we don't have any - we manage to deal with our centres and our
nursing staff and our admin staff according to the awards that we currently have,
and I haven't seen an issue with that from New South Wales where I come from
with my nurses.
PN8862
So if an order were to be made, you are happy to go to be - in the general range of
the way practice nurses are dealt with, you don't want anything peculiar for IPN?
---No, I'm happy with this current award that we have in our centres.
PN8863
I'm suggesting to you something slightly different. If an order were made in this
proceeding that IPN were required to negotiate, you are happy for IPN to be part
of the negotiations more broadly and you wouldn't want them broken off to have
their own separate agreement?---Sorry, repeat that again. So you're saying that if
there's another broad award that's put into place - is that what you mean? Or - - ****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8864
Yes. If there's an agreement specific for general practice nurses, you're happy that
IPN could fit within a broad agreement dealing with general practice nurses and
would not need its own peculiar agreement?---No, what I mean is that it would
depend on - also, there's a lot of factors that I'd have to look into as well. It's also
different pay rates, the funding that I receive or that we receive in the centre. It's
not just one thing that I have to - it is a number of factors that we'd have to look at
as well. At the moment, the current model - the way that it does work - works
well in our centres, and I don't have any issues with it at the moment. But if
there's something else to come out in the future, then that's something that I'd have
to look at to see whether it would function well in our centres from a financial
standpoint, from an individual centre as well.
PN8865
Perhaps I'll ask the question again. If there is an order made in this proceeding
and the tribunal orders that the parties commence negotiation for an agreement to
apply to practice nurses - so take that much for the purposes of my question?
---Okay, yes. So it's been agreed, yes.
PN8866
Are you suggesting that IPN would be happy to negotiate such an agreement with
all of the other medical centres throughout Australia and it wouldn't seek to have
its own peculiar agreement?---That wouldn't be a decision that I would have to
make; it wouldn't be my decision. But if there's a decision that's been made
obviously then we'd follow with whatever the decision that's been made, but then
we'd have to look at whether we can function from a financial standpoint. It
depends on what it is that - the changes are to be made, and that's something that I can't really make a decision on that. It would be obviously at the higher
managers than myself.
PN8867
Now, you're aware that Ms Burrell, of course, has provided some evidence in this
proceeding. She's provided two statements and you've read those. Is that
correct?---I have read them, yes. I don't have them in front of me though.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8868
In her first statement - and I don't think you need to go to it, but if you are
concerned, I'm happy to provide it to you - she provides a position description for
the position of registered nurse. Do you recall that attachment?
PN8869
It's a document said to be owned by HRNOD. Can you explain to the tribunal
what that acronym stands for?---That's Human Resources and - OD - I can't
remember what OD means, but it's human resources department.
PN8870
It's said to be dated May 2011. To the best of your knowledge, is that the present
position description that applies to registered nurses employed by IPN?---Can I
quickly look it, sorry, because I know that we were reviewing them just recently
with the committee.
PN8871
It's exhibit D8, your Honour. I'm not sure whether we might be able to get a copy
quicker than your Honour's associate.
PN8872
MR HARMER: If the tribunal pleases, I'm happy to provide my copy, if that
helps.
PN8873
MR DOWLING: You'll see there it's the first of the attachments. It's marked in
the top right-hand corner as attachment A. Do you see that?---Yes.
PN8874
A third of the way down the page on the left, it says, "Position description:
registered nurse". Do you see that?---Yes.
PN8875
I referred you to do a date, on my date, on the second page, almost cut off, but
down the bottom left-hand corner, you can see, "May 2011"?---Yes.
PN8876
That's where you can see "document owner: HRNOD"?---Yes.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8877
Can you confirm whether this is the present position description for registered
nurses employed by IPN?---I think a new draft has been put together but it hasn't
been finalised, so I think that is the most current one.
PN8878
So this is the current position description?---I think so, yes.
PN8879
Now, Ms Burrell, in paragraph 6 of her statement, sets out her broad
responsibilities. You've not taken any issue with those in your statement. She
also sets out, at paragraph 3, her nursing qualifications. She says she's been a
nurse for 30 years. You accept that's accurate?---If she's saying that, yes.
PN8880
She sets out her nursing qualifications: bachelor of health sciences, postgraduate
degree in perioperative services, certificate IV workplace training and, at that
point, was currently studying for a certificate IV in occupational health and
safety?---Mm'hm.
PN8881
You accept that all of that is accurate?---Yes, if she's written that.
PN8882
I expect it follows, does it, that there will be nurses employed by IPN with
considerably less experience and qualifications than Ms Burrell?---Yes, we have a
variety of different nurses with different qualifications.
PN8883
So from those at one end of the spectrum, it might be one year or two years with
no postgraduate qualifications, but for Ms Burrell at 30 years and - - -?---Probably
two years or three years, yes.
PN8884
So from two years to three years - does that mean you don't employ one years?
---We - some of the nurses that are one year go through a postgrad course. I think
that's more Queensland, WA. Not so much New South Wales.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8885
So we've got a range of two to three years with possibly no postgraduate
qualifications up to someone like Ms Burrell of 30 years and the nursing
qualifications that she describes. The same position description will apply to
those two nurses at either end of that spectrum. Is that right?---Yes.
PN8886
It may be - is it correct - that because of that significant variation in their
experience and qualifications, there might be a variation in the complexity of the
work that those nurses do. Is that correct?---The nurses - when they're employed,
they go through more of a checklist with their state nurse coordinator. So what
we normally do is in our meeting in New South Wales, we have a Friday morning
meeting with all of our business managers and our state nurse coordinator, and a
discussion occurs about any new nurses that are joining a practice, and a training like, a meet and greet is also booked in with the state nurse coordinator and also a
training - to see where the competency levels are depending on what that centre's
requirements are. So that state nurse manager will go out and see how that nurse
works, if she needs training or guidance or anything like that so that that
assessment is made as well, so we have a guide of how well they're working. So
in some instances, they might not be carrying out some particular parts of the
work. It just depends on the nurse's training and assessment when the state nurse
coordinator conducts that.
PN8887
So should we conclude from that that there is a variation in qualifications and
experience?---Yes.
PN8888
There's a variation in the complexity of the work they do as a result of what might
have been an assessment of their competencies?---To a degree.
PN8889
Is it correct that that same position applies in respect of enrolled nurses?---If an
enrolled nurse that hasn't worked in general practice before, do you mean, or - - ****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8890
No, the same - - -?---You're comparing ENs and ENs now?
PN8891
Yes?---Yes, sorry.
PN8892
Is there a position description that is peculiar to enrolled nurses in the same way
that this position description is peculiar to registered nurses?---There is an
enrolled nursing position, an RN position. Yes, the different job descriptions.
PN8893
Are you able to produce to the tribunal the current position description that
applies with respect to enrolled nurses?---Yes, I can access it and give it to
Michael. Yes.
PN8894
Is there a separate position description that applies with respect to assistants in
nursing?---I think so, yes.
PN8895
Can you also produce a copy of that position description; should we assume that
there is one for registered nurses, one for enrolled nurses and one for assistants?
---Yes, and there's one for state nurse coordinator and one for a registered nurse
leader, in the larger sentence.
PN8896
Perhaps if you can provide to the tribunal, so that we're confident we've got the
proper registered nurse one, the registered nurse, the enrolled nurse and the
assistant in nursing?---Yes, I can do that.
PN8897
Your Honour, I'm conscious of the time. I'm happy to keep going but I am also
confident, with the balance of witnesses, that we will get through them in the
afternoon.
PN8898
THE VICE PRESIDENT: Yes. We'll adjourn until 2 pm.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
<LUNCHEON ADJOURNMENT
<RESUMED
[12.52PM]
[2.02PM]
PN8899
MR DOWLING: Ms Salagiannis, if I could ask you some questions about the
clinics operated by IPN in New South Wales. Can you firstly tell the tribunal how
many clinics there are operated by IPN in New South Wales?---There's 39.
There's a couple opening but 39 in - yes.
PN8900
I think your evidence before lunch was that there were three team leaders engaged
amongst those 39. Is that right?---I think there's five centres, sorry, that have
them.
PN8901
And one state nurse coordinator?---Yes, one state nurse coordinator. Correct, yes.
PN8902
Can you say how many of those 39 will open past 5 pm?---The majority of them
are open past. I don't have that information but the majority are open past.
PN8903
Is it correct to say that the majority are open till approximately 9 pm?---No, the
majority are probably open till 6.30, 7 o'clock - that's the majority.
PN8904
And some later than that?---A very small number are later than that - a small
number.
PN8905
And they vary in size amongst those 39?---Correct.
PN8906
Is it fair to suggest that those clinics with team leaders are the larger ones?
---Correct.
PN8907
So that of the 39, the five larger ones have a team leader and the other 34 don't?
---Correct.
PN8908
Is it also fair to say that at the smaller clinics, the 34, a nurse might be required to
work whilst there is not another nurse present?---Correct. There would be one
nurse on in some cases, yes.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8909
I took you to some of the information provided by Mr Beckett earlier and he's
provided information about the nurses in New South Wales and his information is
that there are 175 nurses employed in New South Wales and of those 143 are
RNs. Does that sound right to you from your experience in New South - - -?
---The majority are RNs, correct, yes.
PN8910
And of those 143 RNs, his evidence will be that 124 of them are level 1s?---Yes,
if that's come from HR, correct.
PN8911
And there are eight level 3s and 11 level 2s?---Mm'hm.
PN8912
So there's 19 level 2 and above and 124 at level 1. It is correct to say, isn't it, that
there are a significant proportion of that 124 level 1s that at some time during
their working week will be required to work at a clinic whilst there's not another
nurse present?---Correct. In the clinic, that's right. The majority of the nurses are
pay point 8s, from what I understand with - they've been working with us for
many years as well. So it's depending on their experience of working in general
practice. So there's a number of them that are also - what page was that on as well
because the majority would be at pay point 8 RNs as well.
PN8913
For the moment, I don't want to concern you with the pay point level - - -?
---Okay.
PN8914
- - - but just the level before the pay point. You had I think with you a copy of the
Nurses Award. Is that right?---Yes, I have it here.
PN8915
And I think you had attached to it that schedule that sets out the classification
definitions?---Yes.
PN8916
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
Could you go to that, please?---Yes.
PN8917
Could you turn to that part of the schedule that starts with "Registered nurses" at
B5?---B5, yes.
PN8918
You will see there in B5.1(a) it sets out an explanation of registered nurse level 1.
Do you see that?---Yes.
PN8919
And it provides at B5.1(a), "An employee at this level performs their duties
according to their level of competence and under the general guidance of, or with
the general access to, a more competent registered nurse who provides
work-related support and direction." Do you see that?---Yes, I do.
PN8920
What I'm suggesting to you is, you have accepted that a significant proportion of
the 124 level 1s work at times without another nurse present?---Registered nurses,
correct, yes.
PN8921
What I'm putting to you is that those nurses are not properly classified as a level 1
because they do not for all or some of their working time work under the general
guidance of or with general access to a more competent registered nurse who
provides work-related support and direction. Do you agree with that?---No, when
it comes to a level 1, if you read the complete (a) and (b) part of the - the way that
I perceive it is, when you read further it talks about the employee level of "perform general nursing duties which include, and not confined to, delivering
and directing comprehensive nursing care, coordinating services" - so the rest of
the - as a total - - PN8922
But you've got to come - sorry?---Sorry, as a total, when you look at the level 1, it
does reflect the nurses that we have in our centres and the pay points make a
difference because when they're at pay point 8 some of our nurses have been there
and they're at 8 the year after, that have been working in our practices for many
years. So the pay point also shows the experience that they have working in the
centres.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8923
What I'm suggesting to you is that to be a level 1, you have to come within (a).
You cannot ignore (a) and say that they cover the duties that are set out in (b), and
(a) requires them to be working under the guidance of a more competent
registered nurse. What I'm suggesting to you is that the significant proportion of
your 124 RN level 1s do not work under the guidance of a more competent
registered nurse - - -?---They work under the - - PN8924
- - - and therefore do not come within the definition of B5.1(a)?---They do
because they have the state nurse coordinator available to them as well, who is a
full-time person available on the phone if need be. I'm the state manager and also
I'm available if need be, but at the end of the day they have the state nurse
coordinator in a New South Wales level that they can contact.
PN8925
That you now say, do you, is the more competent registered nurse who provides
work-related support and direction?---No, if a nurse requires any assistance then
the state nurse coordinator is there to assist them but they also have the doctor
that's onboard in the practice.
PN8926
But do you say that the more competent registered nurse who provides
work-related support and direction - is that the state nurse coordinator, is it?
---That is available if they do need anything further. But our registered nurses are
very competent nurses.
PN8927
I'm not doubting their competence?---Yes.
PN8928
I'm doubting whether they fit within - - -?---But if you read the whole - - -
PN8929
- - - the definition of level 1 or whether they are - - -?---But if you read the whole
definition, isn't that - I read the whole definition and then - to say that if you read
level 2 and you read level 2, the whole amount, the nurses would classify better in
level 1 than they would in level 2. So again it's looking at - that's how I look at it,
as a perception. So when I read level 1 and I read level 2, we have nurses that are
level 1s for many years.
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8930
Are you ignoring B5.1(a)(ii)?---No, I'm not ignoring it but they do have the state
nurse coordinator if they require guidance and further assistance in training, which
is - - PN8931
Is she or he the more competent registered nurse for all 124 RN level 1s? Is that
your evidence?---Sorry, can you repeat that question again.
PN8932
If there is a significant proportion of those 124 that are working without another
nurse present and therefore working without access to a more competent
registered nurse but you say the state nurse coordinator is that more competent
registered nurse - - -?---As well a doctor if they require it.
PN8933
That one role performs the role of more competent registered nurse for all of those
124 RN level 1s who need that more competent supervision. Is that your
evidence?---I'm just trying to think of an instance of how it works in our centres at
the moment. We have nurses that are demographically so close together that if
there is assistance and they do need somebody else for help, they will call another
RN in the local area that we have because the centres are so close-knit when it
comes to that. One of our business managers is also a nurse. I'm a nurse. So
there's always, in New South Wales, a person available to them if they need that,
other than the doctor.
PN8934
So it is - - -?---So it's not just the one state nurse coordinator. There's a few
people that will assist them if they need it.
PN8935
Is it now your evidence that there is a more competent registered nurse in a
neighbouring clinic that they can rely on?---Not rely on but if they have a question
and they need to ask a question, they can contact that person unofficially but there
isn't - - ****
NIKKIE SALAGIANNIS
XXN MR DOWLING
PN8936
Will that person be one of the 19 that are classified at level 2 or above?---It could
be. It just depends on - - -
PN8937
Or it could be another level 1?---It depends on if it's ordering - it might be about
ordering, it might be about, "I've forgotten there's a machine here. Do you have
the same machine as I do? Can you send me the paperwork on how to do the
ECG on this machine?" It totally depends on what the question is. You could go
to your state nurse coordinator because a doctor has asked you to do something
that's out of routine but if you're ringing about you're sterilising something and
there's something wrong with that machine, they will ring their local centre to
speak to their other RN that's on site if they are a level 1, to say, "Is your machine
the same as mine? Can you double-check with me?" So it depends on what
question has to be asked via that nurse.
PN8938
You have 143 RNs in the state of New South Wales?---Yes.
PN8939
87 per cent of those are classified at level 1, 13 per cent are classified at level 2 or
above. Have you seen the material provided by the AMA and its practices in this
proceeding?---No.
PN8940
They conducted a survey and in that survey is set out the classification of 800
nurses. Of those 800 there are 670 registered nurses and 444 of those are level 2
and above. So as a cross-section of the AMA practices two-thirds of their nurses
or 66 per cent are level 2 and above. How do you explain the disparity between
that two-thirds that are level 2 and above when compared to your 13 per cent that
are level 2 and above?---Whether it's what type of - and I know their general
practice as well, so I can understand why you're asking that question but it
depends again on I suppose - and I know - support services.
PN8941
****
NIKKIE SALAGIANNIS
XXN MR DOWLING
Does that suggest that you interpret the award a bit differently to all of those
practices that have responded to the AMA survey?---No, I don't think that I do.
PN8942
You can't otherwise explain the fact that there are two-thirds of their nurses at
level 2 and above and only 13 per cent of yours at level 2 or above?---I can't
explain that.
PN8943
Nothing further, your Honour.
<RE-EXAMINATION BY MR HARMER
[2.15PM]
PN8944
MR HARMER: Ms Salagiannis, you were taken to annexure SN2 to your further
statement. If I could just take you back to that, at page 19?---Sorry, my second
statement.
PN8945
That's right. It's annexure SN2, which is the PNIP Guidelines?---Yes.
PN8946
It may - - PN8947
THE VICE PRESIDENT: NS2.
PN8948
MR HARMER: I'm sorry. You were specifically taken to the heading under
Supervision of the Enrolled Nurse?---Yes.
PN8949
Do you see that?---Yes.
PN8950
And you will see at the end of the first paragraph there it says that registered
nurses may supervise and direct enrolled nurses directly or indirectly. Do you see
that?---Yes.
PN8951
And it's got a reference to direct supervision is when the RN is present and
observes works and directs the EN. Do you see that?---Yes.
****
NIKKIE SALAGIANNIS
RXN MR HARMER
PN8952
Then it goes on to the issue of indirect supervision. I just want to have you
explain to the tribunal how indirect supervision works within IPN and we will just
start with enrolled nurses first of all, if that's all right. So the first sentence there,
"Indirect supervision is when the RN is easily contactable but does not directly
observe the activities of the EN. This requires processes being in place for the
direction, guidance, support and monitoring of the EN's activity." Can you just
explain to the tribunal what, if any, direction, guidance, support, monitoring
protocols are in place within IPN to assist enrolled nurses?---Well, they all receive
an induction process with our state nurse coordinator when they commence
employment to see where their competency levels are and what training we need
to provide them so we have an idea of what we need to provide them in training.
The doctors are aware of what the enrolled nurses are able to execute when they
ask for a particular procedure. They can also contact their state nurse coordinator
if there's an issue. They can contact the doctor if there's a concern or they need
any help. Also, there are other RNs if they need any, they can contact by phone
for any help that they might need.
PN8953
Are there any standard operating procedures or things of that nature to assist?
---There is. It's more like a guidance procedure if they do need any help, but they
do know that they contact their state nurse coordinator ultimately if there is
anything that they need help with, if they can't directly receive information from
their doctor.
PN8954
So if I take standard operating procedures, are they available on an intranet or
anything of that nature?---We do have an intranet, yes, and we do have procedures
available.
PN8955
Is there any other level of support for an enrolled nurse in this area of indirect
supervision that you haven't mention, that you can think of?---In supervision it
could be their local doctor. I mentioned their local nurse, the state nurse
coordinator they can contact. They can also refer - it depends on what the concern
is. If it's to do with machinery, if it's a clinical concern, there's different options
that they can take.
****
NIKKIE SALAGIANNIS
RXN MR HARMER
PN8956
The next sentence, just focusing on supervision by a registered nurse, the RN is
required to observe and assess the EN's competence prior to entering into an
indirect supervisory arrangement, that meaning the RN is not actually present
when (indistinct) - - -?---Correct.
PN8957
- - - the work. Can you just explain to the tribunal how that process works within
IPN?---The state nurse coordinator will meet with the enrolled nurse and go
through a competency guide to check all of the enrolled nurse's and as well as the
RN - whichever nurse is commencing - and mark off that they're competent in
executing that particular service to the patient by the doctor's request, and that's
signed off.
PN8958
So just so I can understand, IPN has a list of competencies which it checks off
with any nurse joining IPN?---Correct, as an induction process, yes.
PN8959
And that's how you assess their competency to perform work in either a direct
supervise level - - -?---Yes.
PN8960
- - - or an indirect supervise level?---Yes, correct.
PN8961
Is that part of the function of a state nurse coordinator, to undertake that
assessment?---Yes, it is, but if we do have another nurse who is one of the
supervisor's in another site and that state nurse cannot attend, then somebody else
will go out of a high level to execute that.
PN8962
I see. You've mentioned your doctors is another level of support for - take the
example of an enrolled nurse, are your doctors familiar with these procedures that
you're outlining to me?---Definitely.
PN8963
****
NIKKIE SALAGIANNIS
They're familiar with the standard operation procedures?---Yes.
PN8964
With the nurse competencies?---Yes.
RXN MR HARMER
PN8965
Is there any corporate level coordination or support across your medical practices
to ensure that these procedures and protocols, competencies, are observed?
---Well, we have our chief medical officer but also a HR department as well, but
at my level as a state manager and my background being in RN for New South
Wales in particular, we make sure that all of these are filed into our employee files
but also we have the intranet because we have a training system on the intranet
which makes sure that nurses have been trained on triaging policy, wound
management policy, OH and S policy - that includes bullying and everything else
- as part of the induction process and that's saved on soft copy as well on the
system, and HR check to make sure that that's been completed by the nurse.
PN8966
Then the last sentence there, "The RN may be located off site, however must be
available for regular direct communication through a structured arrangement."
Can you explain to the tribunal what, if any, structured arrangement you had for
that communication with enrolled nurses in IPN?---Well, the enrolled - they can
call the supervisor if they need help. They can email. Do you mean as in a way
of communication or - yes. If they can't contact their state nurse coordinator, if
it's urgent, by phone - obviously they see the doctor first to see if they can receive
help. If it's clinical, it would go to the doctor. Then if not, they will also contact
the business manager, if required, for any assistance to contact that state nurse
coordinator.
PN8967
How does an enrolled nurse learn of that protocol within IPN?---They receive that
all through the induction process. They make sure they receive all the phone
numbers, the contact people that they are to contact. They have a grievance
policy if there's a grievance policy. There's an induction sheet as well that they go
through, and that's all part of that.
****
NIKKIE SALAGIANNIS
RXN MR HARMER
PN8968
So is that documented in some way or - - -?---Yes.
PN8969
There's an actual process that - - -?---It's in our policy and procedure manual and
it is a process that it's printed off and marked off by the staff.
PN8970
And then just sticking with this area of indirect supervision and if we could just
move to registered nurses. Could you just explain to the tribunal how indirect
supervision of registered nurses occurs in IPN?---It depends again on what the
issue is. If it's clinical or there's a - well, there's obviously the induction process
first to make sure what the nurse's capabilities are and to mark them off to make
sure they are capable in the function that we need them to be in in that particular
practice, and all the contact information is given to the registered nurses. There
are policies and procedures on the intranet, as well as training if they require it on
the intranet. There's the state nurse coordinator, chief medical officer available, as
well as the business manager or myself as the state manager if required.
PN8971
You've mentioned a form of lateral support in terms of other medical practices in
the vicinity that are operated by IPN. Is that something that's encouraged by
IPN?---We do. We have centres - each business manager has a demographic. For
example, it could be Penrith area with the mountains and those nurses and practice
managers are all familiar with each other. So if there is a question or a need of we might need more staff somewhere or we might need somebody to help with
something in particular, we do use each other in that way. The nurses do call each
other, and it's usually about equipment really most of the time. But if need be,
they're available.
PN8972
So your medical practices are in branches within regions under a particular
business manager?---Yes.
PN8973
****
NIKKIE SALAGIANNIS
RXN MR HARMER
Correct?---Correct.
PN8974
And part of the support network for any particular nurse in one centre includes
that array of settings. Correct?---Yes, correct.
PN8975
Could I just take you back to the award and the definition of registered nurse
level 1, page 37 of the award. Mr Dowling took you to entry B5.1(a) and then
subentry (ii). Do you have that?---Yes.
PN8976
It talks about an employee performing their duties - the first part is under the
general guidance of or with general access to a more competent registered nurse?
---No.
PN8977
Can you just explain to the tribunal what your view is of the general access to a
more competent registered nurse for your RN1s within IPN?---If they need
something or clarification with somebody, they can contact their state nurse
coordinator or another level nurse if they're - again, in each area there probably
would be one of the large centres where they can contact that high level nurse if
need be. But it would be the state nurse coordinator, a high level nurse in their
area. It could be myself. It just depends on what the issue is, whether it's clinical,
equipment, policy, process; that type of thing.
PN8978
And you gave some evidence about entry (b) there and the type of services
performed. It's your evidence that the RN1s perform those duties with that
general access referred to at B5.1(a)(ii). Correct?---Yes.
PN8979
You were also asked some questions about nurses at particular levels within states
and there were a number of more senior nurses who were part-time and I think
you refer to what seemed to be a number of part-timers might take up one
full-time equivalent role. Could you just explain to the tribunal what's involved
there?---Whenever we employ nurses we do put the ad out for part-time or
full-time, depending on what's out there because the majority of our nurses that
usually apply for the jobs are either nurses who have worked in hospitals for many
years or they're mums or working mums and they want to be local to the school or
be more available to their children. So we do put full-time and part-time. The
majority of our nurses are probably part-time because they do - so we try and fill
one full-timer's position with two part-time and that will help us with sick leave,
annual leave. It helps them because there's quite a few more RNs that would like
part-time than full-time work, in my experience.
****
NIKKIE SALAGIANNIS
RXN MR HARMER
PN8980
So there's a form of job sharing about the role?---Sure. Yes, it's job sharing,
correct.
PN8981
You were asked about the issue of secondary care at IPN and if I could just take
you to paragraph 26 of your further statement, so that's your second statement?
---Sorry, what page was that again?
PN8982
I'm sorry, it's paragraph 26 of your further statement?---Yes.
PN8983
And you refer to IPN nurses working in certain specialist medical centres who
perform secondary care. Do you see that?---Yes.
PN8984
Is there any other form of secondary care undertaken, utilising your definition, by
IPN nurses?---We have the mental health nursing as well and that's a specialty in
one of our centres that we do have as well, but there's also the mole removal and
lumps, yes.
PN8985
In terms of these specialist nurses that do secondary care, how does that translate
if people went to their pay rate?---It's a higher pay rate. They provide us with that
specialty service and they are paid accordingly with that specialty service. So our
mental health nurse is at $54 per hour, which is relevant to what we receive as
well from a billing perspective when the patients come in. So we do have some
nurses that do specialise. We have some cosmetic nurses as well and they are
paid a higher rate for the use of that experience that they have.
PN8986
You were asked some questions about the career path for nurses in IPN. Can you
just inform the tribunal, if at all, specialisation is one avenue of career path
progression within IPN?---Yes, if nurses want to - we've had a few nurses that are
moving into cosmetic work because one of the doctors there will say, "Look, I'm
interested in doing cosmetic work. Who wants to train in cosmetics?" Some of
the nurses - well, one in particular has chosen to go along that path. So she will
be trained and then she will be receiving that higher rate for that particular type of
work. We have some nurses that want to be more involved in care planning and
things like that." So that's a different specialty that we pay at a different rate as
well.
****
NIKKIE SALAGIANNIS
RXN MR HARMER
PN8987
But I understand you have some specialty centres, if you like, or centres that
specialise in a particular treatment. Can a nurse aspire to pick up the skills to
work in that different centre at a higher rate?---Yes. Predominantly we have more
skin centres, if you looked at the majority, so yes, definitely.
PN8988
You were also asked some questions about appraisals within IPN and you referred
to assessment of a pay increase and one of the factors you referred to was whether
the nurse had had another pay increase within the previous 12 months?---Mm'hm.
PN8989
If you could just explain to the tribunal what were the issues that would have
brought on another pay increase within the 12-month period, outside of
appraisal?---If the nurse came to me and explained that they're finding it difficult,
they're looking at what they want to do moving forward and financially there's an
issue, I always ask, "What is it that you can do then to increase your skill-set or
what you can provide to a particular centre?" and if they say, "Well, I would like
to be involved more with care plans," then there would be an increase where for
every care plan that that nurse might do, it might be that they receive $5 or $10 for
that care plan and they might do it in a 40-minute space of a consult, or it could be
that they're bringing something in - they might help out with procedures or
something like that. So we make sure that they have that skill-set and then we do
increase their pay to that level. It could even be that it's an hourly rate change but
they will be involved more in running a clinic rather than being a part of the
general practice where the people just walk into their treatment room daily.
PN8990
Without a nurse approaching you to ask, does IPN take any initiative in training
up its nurses, giving them the skills that might lead to an additional pay increase?
---If a doctor - we're a service provider to clinicians and clinicians might say,
"Well, I want this service. I really want to" - like in our (indistinct) centre there's
a doctor there that wants to perform more skin sessions and mole removals and
things like that. So it would be that we would then initiate and ask the question to
that area or that demographic if any nurses were interested in maybe a four-hour
session or a five-hour session in skin, and before we advertise out to the general
public. Then if nurses are interested then we can look into upskilling them, but if
they're not then we do post an advert out for anybody interested in working in
skin. But it would also come from the doctor, if that's a service that they require.
****
NIKKIE SALAGIANNIS
PN8991
Thank you, your Honour. I've no further questions.
RXN MR HARMER
PN8992
THE VICE PRESIDENT: Thank you for your evidence, Ms Salagiannis. You
can step down and you're excused from further attendance.
<THE WITNESS WITHDREW
[2.32PM]
PN8993
THE VICE PRESIDENT: Mr Harmer.
PN8994
MR HARMER: Thank you, your Honour. Our next witness is Mark Damian
Beckett.
<MARK DAMIAN BECKETT, SWORN
[2.33PM]
<EXAMINATION-IN-CHIEF BY MR HARMER
[2.33PM]
PN8995
MR HARMER: Mr Beckett, could you please state to the tribunal your full
name?---Mark Damian Beckett.
PN8996
And your residential address?---(address supplied).
PN8997
And your current occupation?---Chief financial officer and company secretary for
IPN.
PN8998
For the purposes of these proceedings, have you prepared a statement dated
17 July 2012?---I have.
PN8999
Do you have a copy of that statement with you?---I do.
PN9000
Is it true and correct in every respect?---Yes.
PN9001
If the tribunal pleases, if I could seek to tender the statement of Mark Beckett
dated 17 July 2012.
****
MARK DAMIAN BECKETT
XN MR HARMER
PN9002
THE VICE PRESIDENT: Exhibit H12.
EXHIBIT #H12 WITNESS STATEMENT OF MARK DAMIAN
BECKETT DATED 17/07/2012
PN9003
MR HARMER: If it please the tribunal, I've no further questions.
<CROSS-EXAMINATION BY MR DOWLING
[2.34PM]
PN9004
MR DOWLING: Mr Beckett, you are the chief financial officer and company
secretary of IPN Medical Centres Pty Ltd?---Yes.
PN9005
And also of Lonix and Millennium Management Holdings Pty Ltd?---Yes.
PN9006
And also of Allied Medical Group Holdings Pty Ltd. Is that right?---Correct.
PN9007
There are several schedules attached to your statement: schedule A, schedule B1
through to B7, and schedule C. Is it your evidence that they were prepared at your
request?---Yes.
PN9008
Given they form part of your evidence, is it correct to assume that you have
checked those schedules and they are accurate, to the best of your knowledge?
---Yes.
PN9009
If I can ask you to turn to schedule B4, please?---Which page number would you
like? There's a couple of pages for B4.
PN9010
B4 commences on page 18?---Mm'hm.
PN9011
Do you have page 18?---Yes, schedule B4.
PN9012
****
MARK DAMIAN BECKETT
XXN MR DOWLING
It has writing in the top left-hand corner in inverted commas, "Schedule B4"?
---Yes.
PN9013
And some typing in the top left-hand corner, very small font, "B4(QLD)"?---Yes.
PN9014
It is the schedule that applies with respect to employment by the IPN companies
for nurses in Queensland. Is that right?---That's correct.
PN9015
If you could assist me in reading it. If we go to the box in the top right-hand
corner there is a column - the seventh column across is a column headed Total.
Do you see that column?---Yes.
PN9016
Then the last box at the bottom of that column is the figure 136. So from that
should we assume that there are a total of 136 nurses employed in the state of
Queensland?---Yes.
PN9017
And those 136 are broken down into casual full-time, permanent and part-time
permanent. If we could deal firstly with the casual employees. Do we take it
from the first box in the column Total that there are a total of 63 nurses employed
as casual nurses in the state of Queensland?---Correct.
PN9018
So something just short of half of the total population of nurses in Queensland are
employed as casual nurses?---Correct.
PN9019
That box at the top also tells us that 56 of those 63 are paid between zero and
10 per cent above the award. Is that right?---56 of the 63, yes, are zero to 10.
PN9020
And have you, in the preparation of this schedule or the instructions to have this
schedule prepared, looked more closely at where those 56 fall within that range of
zero to 10 per cent?---Well, to answer the question, the detail is on schedule B4,
so the detail supports the 56 but additional analysis, other than what's on the
schedule, we have not prepared.
****
MARK DAMIAN BECKETT
XXN MR DOWLING
PN9021
So if we go to the additional information, in my analysis of that additional
information, in looking at those 56 casuals that are described as being between
zero and 10 per cent, I calculate that 38 of that 56 are zero per cent above the
award. It has a zero next to them. Does that accord with your - - -?---If it - - PN9022
- - - understanding of the schedule?---I can't testify to the 36 but if it has zero next
to it then that could well be true.
PN9023
So if it has a zero next to it, we should understand they are zero per cent above the
award; they're on the award?---Correct.
PN9024
So do we take it from that - I'm happy for you to count the numbers of course but
I'm also happy for you to take me at my word?---All right.
PN9025
Do we take it from that then that nearly 70 per cent of those 56 casuals are on the
award?---70 per cent?
PN9026
That's 38 out of 56?---If that's what the numbers come up to be. Again, I will
have to take your word that that's what the percentage is.
PN9027
It seems to me to follow then that 38 out of the total 63 of casuals, which is
60 per cent, are paid on the award. So in the state of Queensland of the casual
workforce 60 per cent of them are earning the award rate. Does that accord with
your understanding of the information set out?---I haven't looked at it that way, is
the truth. The way that I've examined it has been different. So I haven't focused
on the casual. I've looked at the total pool of employees more so than just
Queensland. I've obviously looked at the other states as well.
PN9028
But you have broken it down and you're able to break it down to casuals. You've
got no reason - - -?---No, based upon this, from zero to 10 - I can say that 56 of
the 136 employees within Queensland are at the zero to 10 bracket.
****
MARK DAMIAN BECKETT
XXN MR DOWLING
PN9029
I'm concentrating for the moment - - -?---And if you said the 36 were on the
award, then 36 of 136 employees - - PN9030
38. I'm concentrating for the moment on the casual workforce. That's all I'm
asking you about?---Right, okay.
PN9031
I'm suggesting to you that 60 per cent of that casual workforce is on the award.
Does that accord with the figures?---Okay, if that's what the maths say, yes, I will
take your word for it. I haven't done the math, so I'm not prepared to say your
math is correct but it sounds logical.
PN9032
Could I ask you to turn to B5, please. Again, if for the moment we focus on the
casual workforce and I will deal with some of the other parts of the workforce but
if we focus on the casual workforce. The total number of casual nurses employed
in the state of New South Wales is 77. Is that correct?---Casual workers, correct.
PN9033
And the total number of nurses employed in the state of New South Wales is
175?---Agreed.
PN9034
Of the 77 casuals there are 65 that you have identified in the zero to 10 per cent
range?---Correct.
PN9035
Again, have you looked at more closely where they fit within that zero to
10 per cent range?---No.
PN9036
Did you consider breaking that to zero to 5 and zero to 10?---No.
PN9037
You've broken up the following columns 10 to 15, 15 to 20 in fives. Is there a
reason you haven't broken the zero to 10 into fives?---No, not particularly.
****
MARK DAMIAN BECKETT
XXN MR DOWLING
PN9038
Can I tell you that on my calculation 28 out of the 77 casuals, so 36 per cent, are
on zero per cent above the award. So something like 36 per cent of the casual
workforce is on the award?---Right, okay.
PN9039
Does that accord with your understanding of those figures?---If you're applying
the same logic as you did to Queensland to New South Wales in terms of
identifying employees with a zero percentage increase to award, then I would
agree that the approach would be correct but the maths I would have to testify that
I don't know is what you're telling me.
PN9040
Perhaps if we deal next with South Australia, and they're at B3 which commences
on page 17. Do we understand from there - and it's just one page of nurses.
Should we understand from this material that the total number of nurses employed
in the state of South Australia is 44?---Correct.
PN9041
And 28 of that 44 are casual?---Indeed, that's true.
PN9042
So well over half or 63 per cent I think, approximately, on my figures, of the
workforce is casual?---Mm'hm.
PN9043
And of those 28, again there is a component that are in the zero to 10 per cent
range?---Yes.
PN9044
And that's 27 or 96 per cent of the 28?---Yes.
PN9045
There's only one that falls outside it?---Yes, that sounds logical.
PN9046
Again, have you looked at more closely where those 27 fit within the zero to
10 per cent range?---No, other than that we've done the calculations and they are
reflected in the schedule below.
****
MARK DAMIAN BECKETT
XXN MR DOWLING
PN9047
Of course if you look to the right of the columns next to those that are listed as
casuals, you will see a large number of zeroes that appear down the column
Percentage Over or Under the Award. Do you see that?---So you're on the casual
line and - - PN9048
Sorry, I'm now not in the box in the top right-hand corner?---Okay.
PN9049
I'm now in the substantive schedule?---In the body, down the bottom, yes.
PN9050
So if you go eight columns over, not counting the column that has been blanked
out - - -?---Right.
PN9051
- - - you see a column for Percentage Over/Under Award?---Yes, indeed.
PN9052
And there's a large number of zeros that appear beneath or in that column?
---There are a number that appear as zero, yes.
PN9053
I can tell you that on my reckoning 23 of that 27 that are the casual workforce in
the zero to 10 per cent range are on the award?---Okay.
PN9054
So applying the same logic, 85 per cent of the casual workforce is on the award.
Is that correct?---Of the casual workforce, yes, that could well be true.
PN9055
THE VICE PRESIDENT: It might be 22.
PN9056
MR DOWLING: Thank you, your Honour.
PN9057
Now, if you look at the total workforce and the number of zeros - there seems to
be a dispute about the 22 and the 23, your Honour. Those instructing me are
suggesting 23. If you look at the total workforce now, the total workforce of
nurses is 44 and the zeros that appear in the Percentage Over and Above, there
are, on my reckoning, 25 out of the total pool of nurses of 44 that are on
zero per cent. Do you want to calculate that yourself or are you happy to - - -?
---Is that a question? No, not unless it pleases the court then I won't spend my
time calculating it.
****
MARK DAMIAN BECKETT
XXN MR DOWLING
PN9058
I'm happy for you to take my word on it. I'm telling you there are 25 out of the 44
that are on the award?---Right, okay.
PN9059
So should we take from that that 57 per cent of the entire workforce in the state of
South Australia is on the award rate?---That 25 per cent are on the award rate?
Well, you can refer to that - - PN9060
57 per cent; 25 out of 44?---You can refer to the schedules at the back if you wish,
it might be easier.
PN9061
I just want to do it state by state for the moment?---Okay.
PN9062
So I'm suggesting 25 out of 44 are on the award?---Mm'hm.
PN9063
That's what that chart shows me and I'm suggesting what that means is 57 per cent
of all the nurses in the state are on the award. Is that a proper analysis of your
material?---Most likely.
PN9064
Can I take you to paragraph 23 of your statement and you there seek to summarise
some of the material and you refer to the applicable award rates. What do you
mean when you say "applicable award rate"?---The award rate relating to - sorry,
you're on page 23?
PN9065
Paragraph 23 of the statement on page 4?---Paragraph 23. So in paragraph 23 I'm
referring to the award rates that are reflected in the Nurses Award 2010.
PN9066
Are you only referring to the modern award, the Nurses modern award 2010?
---Yes.
****
MARK DAMIAN BECKETT
XXN MR DOWLING
PN9067
Are you aware of some state awards and their continued operation?---They're not
the ones that (indistinct) made the analysis in comparison - - PN9068
You're referring to the modern award 2010?---Modern award 2010.
PN9069
Thank you. Nothing further, your Honour.
PN9070
THE VICE PRESIDENT: Mr Harmer?
PN9071
MR HARMER: Nothing arising.
PN9072
THE VICE PRESIDENT: Thank you for your evidence, Mr Beckett?---Okay.
Thank you.
PN9073
You can step down.
<THE WITNESS WITHDREW
[2.50PM]
PN9074
MR HARMER: If your Honour pleases, our next witness is Mr Scott Beattie.
<SCOTT EARL BEATTIE, AFFIRMED
[2.51PM]
<EXAMINATION-IN-CHIEF BY MR HARMER
[2.52PM]
PN9075
MR HARMER: Mr Beattie, could you please state to the tribunal your full
name?---Scott Earl Beattie.
PN9076
Your current residential address?---Is (address supplied).
PN9077
And your occupation?---I'm the chief business development officer of IPN.
PN9078
For the purposes of these proceedings, have you prepared a statement dated
16 July 2012?---I have.
****
SCOTT EARL BEATTIE
XN MR HARMER
PN9079
Do you have a copy of that statement with you?---I do.
PN9080
Is that statement true and correct in every respect?---It is.
PN9081
If the tribunal pleases, could I seek to tender that statement, please.
PN9082
THE VICE PRESIDENT: Exhibit H13.
EXHIBIT #H13 WITNESS STATEMENT OF SCOTT EARL
BEATTIE DATED 16/07/2012
PN9083
MR HARMER: If it please the tribunal, no further questions.
<CROSS-EXAMINATION BY MR DOWLING
[2.52PM]
PN9084
MR DOWLING: Mr Beattie, you've given some evidence in your statement
about the corporate structure within IPN and its related companies. So that the
tribunal can be clear, is it correct that Sonic Healthcare Ltd owns Independent
Practitioner Network Pty Ltd?---It does.
PN9085
In turn, Independent Practitioner Network Pty Ltd owns IPN Medical Centres
Pty Ltd?---That's correct.
PN9086
Also, Independent Practitioner Network Pty Ltd also owns Lonix and Millennium
Management Holdings Pty Ltd?---Correct.
PN9087
And Independent Practitioner Network Pty Ltd also owns Allied Medical Group
Holdings Pty Ltd?---Yes.
PN9088
So at least insofar as those companies are concerned, the parent company is Sonic
Healthcare, underneath that is Independent Practitioner Network, and underneath
that is the three companies that I've just identified?---Yes, as best as I can say, yes,
that's right.
****
SCOTT EARL BEATTIE
XXN MR DOWLING
PN9089
All right?---There may be - I think Sonic owns Independent Practitioner Network
Pty Ltd via two different entities but the ultimate parent company of IPN is Sonic.
PN9090
You've also given some evidence about the IPN companies being low margin and
the constant struggle to maintain financial targets. Do you recall that evidence?
---I do.
PN9091
Dealing with the corporate entities, can I show you a document firstly dealing
with Sonic Healthcare Ltd. Have you seen this document before?---I haven't seen
it, no, not in its format as it is, no.
PN9092
It purports to be the concise annual report for 2012 of Sonic Healthcare Ltd. Do
you see that?---Yes.
PN9093
Can I take you to page 2 of the report. There are pages in the bottom left-hand
corner?---Yes.
PN9094
Page 2 sets out a letter from the chairman, Mr Peter Campbell. Do you know
Mr Campbell?---I believe I've been in some meetings with him but I don't know
him very well.
PN9095
He describes Sonic as recording a record net profit in 2012. Does that accord with
your understanding of Sonic's performance in 2012?---I will accept his word.
CONTINUED IN TRANSCRIPT-IN-CONFIDENCE
CONTINUED FROM TRANSCRIPT-IN-CONFIDENCE
PN9102
Does that accord with your understanding of the performance of Sonic?---As
much as I believe this report and it's a statement of Sonic, then yes.
PN9103
If you can turn ahead to page 17. This is part of the director's report. In the table
on page 17 there is what is described as a revenue breakdown in millions of
Australian dollars and there are items for pathology and there's an item for
medical centres, and there's a description of the 2012 statutory revenue?---Yes.
CONTINUED IN TRANSCRIPT-IN-CONFIDENCE
CONTINUED FROM TRANSCRIPT-IN-CONFIDENCE
PN9105
If you turn the page, again as part of the director's report there's a reference at the
top of the page, under the heading Revenue Continued, to Sonic's Medical Centre
business?---Yes.
CONTINUED IN TRANSCRIPT-IN-CONFIDENCE
CONTINUED FROM TRANSCRIPT-IN-CONFIDENCE
****
SCOTT EARL BEATTIE
XXN MR DOWLING
PN9107
The reference to Kinetic and IPN's occupational health business in the following
sentence, it describes them as performing very strongly during the year. That's an
accurate statement too?---Yes.
PN9108
If I can ask you to turn to page 28. You will see there the directors of Sonic are
set out and their remuneration is also set out. It's correct that Dr Goldsmith, who
is the managing director of Sonic is also a director of IPN Medical Centres
Pty Ltd, isn't it?---Yes.
PN9109
And Mr Wilkes, who is listed here as the finance director, is also a director of IPN
Medical Centres Pty Ltd, isn't he?---I believe so, yes.
PN9110
Likewise for Mr Jackson?---Yes.
PN9111
In fact, all three of them - Mr Goldsmith, Mr Wilkes and Mr Jackson - are
directors of not only Sonic but each of IPN Medical Centres Pty Ltd, the company
that's referred to as Allied in the material, and the company that's referred to as
Lonix in the material. That's correct, isn't it?---Yes, they're all subsidiaries. So
those directors are set up for the purposes of obviously managing the affairs and
signing the documents relating to those entities, but yes, they are directors of
those entities.
CONTINUED IN TRANSCRIPT-IN-CONFIDENCE
CONTINUED FROM TRANSCRIPT-IN-CONFIDENCE
****
SCOTT EARL BEATTIE
XXN MR DOWLING
PN9115
If we turn back to page 12?---Yes.
PN9116
Are you able to say from your role, looking at the figure Revenue, the Sonic
figure, are you able to say what the revenue of IPN Pty Ltd was for the period
ending 30 June 2012?---No.
PN9117
Are you able to say what the revenue was for IPN Medical Centres Pty Ltd for the
year ending 2012?---No.
PN9118
Are you saying in your role as the chief business development officer of IPN
Medical Centres Pty Ltd you don't know what the revenue for IPN Medical
Centres Pty Ltd was for the year ending 30 June 2012?---Not off the top of my
head, no. I mean, there are statutory accounting statements that our CFO would
prepare at year end to say how much the business earned. It's not really my role to
prepare this.
PN9119
Have you seen the information?---Not the statutory accounts, no.
PN9120
Is that something you have access to?---I suppose if I asked for it, I could have
access to it.
PN9121
I wonder if you could produce to the tribunal the documents setting out the
revenue, the earnings before interest taxed, depreciation and amortisation, the net
profit after tax and the total assets for each of IPN Pty Ltd, IPN Medical Centres
Pty Ltd and Lonix and Allied. Is there - - PN9122
MR HARMER: If the tribunal pleases, I apologise for interrupting. I mean,
obviously the previous witness was the CFO of the whole group and we didn't
have any questions on this material but if the ANF wants any material at all I'm
sure we could reach an arrangement to provide thorough accounts. Of course
we've just had no notice of this at all and this witness is not the witness that could
or should face these questions and it was the last witness. If the tribunal pleases.
****
SCOTT EARL BEATTIE
XXN MR DOWLING
PN9123
THE VICE PRESIDENT: Yes.
PN9124
MR DOWLING: I don't understand this witness to have said he can't have access
to them. This is the witness that - - -?---I didn't say that I can't have access to
them.
PN9125
You will have access to them and you're able to get them. Is that correct,
Mr Beattie?---Yes, if - well, I suppose the question will be around the fact that it's
a subsidiary of a listed company and market disclosure issues may come up. I'm
not an expert in that but there's certainly been concern around information that
hasn't been released to the market with Sonic as a listed company but beyond that,
I mean I assume if those issues can be dealt with we can produce the statutory
accountants for those companies.
PN9126
All right. I wonder if you could do that, please?---Sure.
PN9127
MR HARMER: If the tribunal pleases, if we could just have an understanding
that the form of order that I mentioned before under section 594 would cover any
information we produce pursuant to that request. We're always happy to provide
whatever is required.
PN9128
THE VICE PRESIDENT: Yes.
PN9129
MR DOWLING: I don't have any objection to that, your Honour.
PN9130
Are you aware of a company trading by the name of Healthscope?---Yes.
PN9131
And the medical centres run by it?---I'm aware that it runs medical centres.
PN9132
****
SCOTT EARL BEATTIE
XXN MR DOWLING
Is it correct to describe them as one of your competitors?---Yes, they are in the
same business of general practice.
PN9133
Are they a smaller operation than IPN?---They have less centres, yes.
PN9134
Is it fair to say they would not operate with the same economies of scale that IPN
would operate at?---As best as I can understand Healthscope as a business that
owns hospitals and pathology and medical centres. As to its exact economies of
scale in terms of purchasing power and things like that, I couldn't say whether or
not they're more efficient than us.
PN9135
Are you aware that Healthscope have negotiated an agreement with the ANF to
cover their practice nurses employed at their general practices operated by them?
---No.
PN9136
Can I show you a document. The reason I asked you, Mr Beattie, about
profitability is you have expressed some concerns in your statement at paragraphs
14 to 16 about the financial margins of IPN companies. The document that I've
handed you is the rates agreed between the applicant in this matter, the ANF, and
Healthscope as to the rates it is to pay its practice nurses. Do you understand the
difference between an enrolled nurse and a registered nurse?---I do.
PN9137
If you deal firstly with that part of the table that is listed RN?---Yes.
PN9138
I can tell you that under the column Year 1, that a nurse commencing with
Healthscope with five or more years' experience will receive $33.33. Do you see
that figure set out in the table?---In year 1, after a year 6 RN. Is that what you're
saying?
PN9139
Yes?---Yes, $33.33.
****
SCOTT EARL BEATTIE
XXN MR DOWLING
PN9140
Yes, the year 6 is to refer to their experience. So if they have done fiver years or
more experience, even if they have just started at a Healthscope clinic, they will
receive $33.33?---Mm'hm.
PN9141
Those nurses listed in RN year 1 through to year 6 - do you understand the
classification system for nurses?---I'm aware of a classification system and I have
sufficient knowledge to say, as you just said, that it's to do with years of service
and there RN status.
PN9142
So I suggest or I'm putting to you that those nurses listed as RN year 1 through to
year 6 represent level 1 and 2 registered nurses in the classification structure?
---Okay.
PN9143
And those that are listed as RN med year 1, year 2, year 3 and year 4, represent
level 3 registered nurses, and that there's an additional agreement for level 4
nurses who are nurse practitioners and practice managers to receive $50. What
I'm suggesting to you is knowing what you know about Healthscope and the
margins they have to deal with, is it fair to suggest that if they are able to run their
business profitably and agree to these rates with the margins they run, that you
would be able to agree to these rates with the margins that you run?---Well, I
suppose my first answer to that is I don't know whether Healthscope are running
profitably in their medical centre business. I suppose the second answer is we
know what we know about our business in terms of what we can afford and what
is an efficient way of employing registered nurses and we certainly understand
that registered nurses are a useful part of the medical centre environment. I don't
know, because there's a lot of numbers here, how much of an increase this would
be on the rates we currently pay. But I suppose I would refer to the statement that
I made which is that if that resulted in a significant increase in the costs of the
nurses, that would affect our margins quite substantially because they're a
significant part of our cost base and that would affect our profitability.
****
SCOTT EARL BEATTIE
XXN MR DOWLING
PN9144
But are you not able to tell the tribunal what your margins are, what your revenue
for the year 2012 was or what the profit for the year ending 2012 June was?---Not
in a statutory way or in a way that I could say that I know the number.
PN9145
In any way are you able to vaguely say what the revenue was for the year ending
June 2012?---Well, I understand the way our business works. I understand the
dynamics of our business and that's what I made the statement about.
CONTINUED IN TRANSCRIPT-IN-CONFIDENCE
CONTINUED FROM TRANSCRIPT-IN-CONFIDENCE
PN9150
Is that your evidence?---Yes.
CONTINUED IN TRANSCRIPT-IN-CONFIDENCE
CONTINUED FROM TRANSCRIPT-IN-CONFIDENCE
****
SCOTT EARL BEATTIE
XXN MR DOWLING
PN9152
Nothing further, your Honour.
<RE-EXAMINATION BY MR HARMER
[3.14PM]
PN9153
MR HARMER: Mr Beattie, you've been asked some questions about the
profitability of IPN in the context of the Sonic Healthcare Group. Do you have
any understanding as to the accounting structure of IPN in terms of the various
corporate entities? They run separate accountants, I assume?---They do run
separate accounts.
PN9154
And the concept of EBIT, is your understanding that that's earnings before interest
and tax?---Yes.
PN9155
And you've mentioned that part of the growth in revenue for IPN in recent times
was through acquisition of medical practices?---Correct.
CONTINUED IN TRANSCRIPT-IN-CONFIDENCE
CONTINUED FROM TRANSCRIPT-IN-CONFIDENCE
PN9159
And when in your statement you're referring to the IPN medical practices as being
low margin businesses, are you taking into accountant that ultimate profitability
after leveraging, interest, et cetera?---Yes.
CONTINUED IN TRANSCRIPT-IN-CONFIDENCE
CONTINUED FROM TRANSCRIPT-IN-CONFIDENCE
PN9161
Did you look at margins per each medical centre? I mean, how is that - - -?
---Mark Beckett, our CFO, certainly reports on the margins of every one of our
medical centres, yes.
****
SCOTT EARL BEATTIE
RXN MR HARMER
PN9162
Does that involve attributing to each medical centre a component of interest and
the costs?---It would in the final accounts. Typically what's happened is those
centres are looked on a medical centre EBITDA basis. So from an operational
perspective you've got the business operators knowing how well they're doing by
sort of how profitable is that business before taking into account the costs of
financing that business. Typically that's then consolidated and then the interest
and tax and depreciation, amortisation lines are put through, along with central
costs, to arrive at the consolidated figure.
CONTINUED IN TRANSCRIPT-IN-CONFIDENCE
CONTINUED FROM TRANSCRIPT-IN-CONFIDENCE
PN9165
Are you aware of what your practice nursing costs are as a percentage roughly of
your total labour cost?---Well, the measure that we have is typically the way in
which we look at our business. Is to understand how many nursing hours are
being worked compared with the number of doctor hours that are being worked,
and we typically try and keep across our business slightly higher than one 1:1
ratio. So including the reception staff, the practice manager and the nurses at each
clinic, there are about as many hours as that on as there are doctor hours. So one
to one is rough ration that we - sometimes it's 1.1, depending on the centre;
sometimes 1.2, 1.3. But you would aim for 1 to 1.1. Nurses typically make up
about slightly less than a third of that cost. So if I was to take that measurement
in my head, I would then say that nurses would make up about a third or slightly
less than a third of that 16, 17 per cent - whatever that maths works out at.
****
SCOTT EARL BEATTIE
RXN MR HARMER
PN9166
Thank you, your Honour. No further questions.
PN9167
THE VICE PRESIDENT: Mr Dowling?
PN9168
MR DOWLING: Your Honour, my apologies, I had intended to tender the Sonic
annual report for 2012.
PN9169
THE VICE PRESIDENT: That will be exhibit D47.
EXHIBIT #D47 SONIC ANNUAL REPORT FOR 2012
PN9170
MR DOWLING: Thank you, your Honour.
PN9171
MR HARMER: If the tribunal pleases, would it be possible for the totality of the
evidence relating to finances, at least insofar as we entered into percentage costs,
et cetera, to be subject to the section 594 order?
PN9172
THE VICE PRESIDENT: Yes. You will ensure that a draft order adequately
covers all of the evidence that you seek to cover.
PN9173
MR HARMER: If it please the tribunal.
PN9174
THE VICE PRESIDENT: Thank you for your evidence, Mr Beattie. You can
step down.
<THE WITNESS WITHDREW
[3.23PM]
PN9175
THE VICE PRESIDENT: Is your other witness required for cross-examination,
Mr Harmer?
PN9176
MR HARMER: That concludes our witness evidence. We do have some
additional documents we may seek to tender as part of our case so I wouldn't seek
to close our case. But certainly in terms of witness, that concludes our evidence,
if the tribunal pleases.
PN9177
THE VICE PRESIDENT: Ms Hartley wasn't required for cross-examination?
PN9178
MR HARMER: She wasn't, your Honour, and certainly I do seek to tender the
statement of Ms Jun Lei Hartley, if the tribunal pleases.
PN9179
THE VICE PRESIDENT: That statement will be exhibit H14.
EXHIBIT #H14 WITNESS STATEMENT OF JUN LEI
HARTLEY
PN9180
MR HARMER: Thank you, your Honour.
PN9181
THE VICE PRESIDENT: Were there other documents that went beyond that?
PN9182
MR HARMER: Yes, your Honour, as I mentioned earlier today, some discussion
with the union around production of documents from the union and there is some
additional survey material that, subject to what's produced by the union, I may
seek to press tomorrow, if the tribunal pleases.
PN9183
THE VICE PRESIDENT: Yes. Very well. Thank you.
PN9184
MR RITCHIE: Your Honour, it might be an appropriate time for me to indicate
that we won't be relying on the statement of Krystyna Gruba that's been provided.
I think that's annexure S in our witness statements. So the following witnesses for
which statements were provided that will not be relied on for the purposes of the
hearing are: Debra Johnstone, which is annexure B; Sharon Martin, annexure C;
Carolyn Fleming, annexure E; S. Bronchinetti, annexure G; Ms Gruba, as I
mentioned, annexure S; and Linda McColl, annexure T. With that, VECCI
concludes its case.
PN9185
THE VICE PRESIDENT: Does that mean that you've now completed your
evidence, Mr Ritchie?
PN9186
MR RITCHIE: It does, your Honour.
PN9187
THE VICE PRESIDENT: We might be getting up to you, Mr Follett.
PN9188
MR FOLLETT: We have one witness, your Honour, and she is ready for
attendance first thing tomorrow morning. She's coming down from Sydney this
afternoon and I think it's highly likely, subject to Mr Dowling's
cross-examination, that we would be finished by lunch.
PN9189
THE VICE PRESIDENT: Yes. Is there anything further that can be raised or
needs to be raised today?
PN9190
MR FOLLETT: Can I just mention as a housekeeping matter, your Honour, I
had raised at the hearing date of 3 September an issue about my client's companies
and medical centres and their interaction with the list of respondents. I understand
yesterday an updated list of respondents was provided to the tribunal and
distributed amongst the parties. I've reviewed that and your Honour will note, if
you have a look at it, that of the two employing entities, there's about four or five
entries for each one. I think that's really just a hangover from certain individual
medical practices being listed as run by one of those two companies. At the end
of the day, if any order was made binding on those two companies, it would cover
them but - - PN9191
THE VICE PRESIDENT: We'll certainly make sure that you're caught one way
or the other.
PN9192
MR FOLLETT: That's right. But having said that, your Honour, we don't have
any issue with the way it's been dealt with and for our part that's accurate as far as
we're concerned.
PN9193
THE VICE PRESIDENT: Yes. Very well. It would appear appropriate to
adjourn now until 10 am tomorrow morning.
<ADJOURNED UNTIL FRIDAY, DECEMBER 2012
[2.28PM]
LIST OF WITNESSES, EXHIBITS AND MFIs
DAMIEN BISHOP, AFFIRMED ............................................................... PN8424
EXAMINATION-IN-CHIEF BY MR RITCHIE............................................ PN8424
EXHIBIT #R16 WITNESS STATEMENT OF DAMIEN BISHOP.............. PN8434
CROSS-EXAMINATION BY MR DOWLING ........................................... PN8472
RE-EXAMINATION BY MR RITCHIE ...................................................... PN8514
THE WITNESS WITHDREW.................................................................... PN8526
MARGARET GEARY, SWORN ............................................................... PN8531
EXAMINATION-IN-CHIEF BY MR RITCHIE............................................ PN8532
EXHIBIT #R17 WITNESS STATEMENT OF MARGARET GEARY ........ PN8539
CROSS-EXAMINATION BY MR DOWLING ........................................... PN8562
RE-EXAMINATION BY MR RITCHIE ...................................................... PN8605
THE WITNESS WITHDREW.................................................................... PN8610
EXHIBIT #D46 WITNESS STATEMENT OF ELIZABETH
ROBINSON .............................................................................................. PN8623
NIKKIE SALAGIANNIS, SWORN............................................................ PN8624
EXAMINATION-IN-CHIEF BY MR HARMER .......................................... PN8626
EXHIBIT #H10 WITNESS STATEMENT OF NIKKIE SALAGIANNIS
OF 17/07/2012 ......................................................................................... PN8636
EXHIBIT #H11 WITNESS STATEMENT OF NIKKIE SALAGIANNIS
OF 04/12/2012 ......................................................................................... PN8644
CROSS-EXAMINATION BY MR DOWLING ........................................... PN8646
RE-EXAMINATION BY MR HARMER ..................................................... PN8943
THE WITNESS WITHDREW.................................................................... PN8992
MARK DAMIAN BECKETT, SWORN ..................................................... PN8994
EXAMINATION-IN-CHIEF BY MR HARMER .......................................... PN8994
EXHIBIT #H12 WITNESS STATEMENT OF MARK DAMIAN
BECKETT DATED 17/07/2012 ................................................................ PN9002
CROSS-EXAMINATION BY MR DOWLING ........................................... PN9003
THE WITNESS WITHDREW.................................................................... PN9073
SCOTT EARL BEATTIE, AFFIRMED ..................................................... PN9074
EXAMINATION-IN-CHIEF BY MR HARMER .......................................... PN9074
EXHIBIT #H13 WITNESS STATEMENT OF SCOTT EARL
BEATTIE DATED 16/07/2012.................................................................. PN9082
CROSS-EXAMINATION BY MR DOWLING ........................................... PN9083
RE-EXAMINATION BY MR HARMER ..................................................... PN9152
EXHIBIT #D47 SONIC ANNUAL REPORT FOR 2012 ............................ PN9169
THE WITNESS WITHDREW.................................................................... PN9174
EXHIBIT #H14 WITNESS STATEMENT OF JUN LEI HARTLEY ........... PN9179