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School of Business and Economics
Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements
Think Differently About DHB Multi-Employer Collective Agreements
James Hogan(Masters of Commerce Thesis)
School of Business and Economics
Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements
You Know About MECAs
You know the agreement terms and conditions
– Automatic salary band inflation adjustment
– Automatic annual salary band increments for doctors and nurses without performance review
– Rigid junior doctor training runs requirement
You know the process
– Tripartite arrangement between DHBs, unions, Minister of Health
You know how they have affected your DHB.
– There's nothing I can tell you about that.
School of Business and Economics
Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements
Politics, Policy and the Role of Evidence
How should DHBs conduct their Industrial Relations policy?
– Recognise that Clinicians know best, and Clinical Leadership will create the best health workforce that is “good” and “best”. http://www.northlanddhb.org.nz/AboutUs/OurPeople/ClinicalLeadership.aspx)`
– Nurses deserve better. They are the backbone of the health sector. We should pay them more. http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=3589906)
– A positive and profitable workplace is created through good treatment for employees. A negative workplace culture flows from the misalignment of employer and employee interests(Royal Australian College of Physicians) (http://www.google.co.nz/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCEQFjAA&url=http%3A%2F%2Fwww.racp.org.nz%2Findex.cfm%3Fobjectid%3DE2F74DB8-95EE-6BC7-9E2C313D721B6F11&ei=MwoYVN-EC6OziwLksICoDg&usg=AFQjCNGAwU0xn4WAkHLS_5L-Wp5EIbUdyw&bvm=bv.75097201,d.cGE&cad=rja)
– Our best and brightest are leaving! Pay them more(http://www.health.govt.nz/our-work/health-workforce/education-and-training/advanced-trainee-fellowship-atf-scheme)
Its apt that two days out from a general election, I am talking about politics.
But I want you to focus on Economics: verifiable, provable, evidenced-based, policy-focused, real world analysis.
School of Business and Economics
Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements
Little bit of labour market economic theory...
Point (A) is a Magic Point and I will tell you why.
Point (B) is where the MECA agreements have lead your DHBs:
– You're employing fewer workers than you want to.
– You're paying more for each worker than you should be.
– You can't get enough workers even if you want you. Something is stopping you.
– You are powerless to change the workforce terms and conditions. They are set nationally.
“Professor Gorman says there are 582 accredited hospital training positions - enough for the 400 New Zealand medical graduates expected to seek to fill them this year - but bottlenecks remain and need to be cleared .” (http://www.radionz.co.nz/news/national/240482/foreign-doctors-demand-action-on-jobs)
School of Business and Economics
Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements
Problems: The Evidence
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Relative Quantities (Nurses to Medical)
Nursing to Medical
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School of Business and Economics
Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements
Problems: The Evidence
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Relative Quantities (Allied Health to Medical)
Allied Health
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School of Business and Economics
Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements
MECA Distortions: Graduates Can't get Employed
School of Business and Economics
Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements
MECA Distortions: Overseas Attracted by Higher than
Competitive Wages
School of Business and Economics
Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements
Estimating the DHB Workforce
Each workforce effects each other Change in Doctors effects how many nurses are needed.
Change in Nurses effects how many support staff are needed
Change in Man/Admin depended on how many nurses/support staff are needed.....
Not all workforce are equal Doctors produce more “health sector output” per worker than nurses.
Nurses produce more “health sector output” than allied health workers in secondary care providers
Allied health workers produce more “health sector output” then nurses in tertiary providers
Not all health sector providers are equal: Secondary Providers need more nurses: they are nursing constrained
Tertiary Providers have too many nurses: they are nursing over-endowed
Everybody needs more doctors: doctors are systemically scarce. Problem with the System
School of Business and Economics
Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements
Departing thoughts This is a VERY big topic
There's a lot in my thesis – more than 30 mins. I've given you a very big overview
This is your data You made HWIP 7 years ago. And NOW its created a rich data set capable of
supporting the economic and forecasting modelling it was designed to do
These results are EVIDENCE BASED. Underlying all these numbers are individuals.
Because this is YOUR DATA it shouldn't come as a surprise to you, that these are the results: it would be more surprising if these results were a surprises.
Strategic Workforce Planning Www.wiltshirehogan.co.nz Is a website created for scenario modelling . I'm happy
to spend more time explaining this website more.