Dr Michael Bassett

Dr Michael Bassett

Newspaper Columns

Health Union Extremism


Developed societies everywhere are ageing. Health workers are doing well from this. They stand high in public estimation as a rapidly increasing portion of the population needs their ministrations. Governments know they are popular and sometimes feel obliged to be especially generous to them, especially if an election is coming up. Tony Blair's government has poured money into health force salaries, more than doubling the health budget over the last decade. Sadly, there has been little improvement in hospital throughput, and an actual decline in productivity within the sector. It's the same here. Recent figures show that hospital productivity has fallen drastically. Yet, with the 2005 election in the offing Labour agreed to a whopping 30% increase in nurses' pay. It was a replay of the "Nurses are Worth More" campaign of 1985-86 that also delivered substantial pay rises.

Unfortunately, whenever one section of the workforce gets a disproportionate increase, it generates high expectations amongst others. Since Stan Rodger's epoch-making State Sector Act of 1988 the relativities that used to rule within the public sector are less rigid. Gone are the days when the Public Service Association would push forward one group of workers where there was a demonstrable shortage, win large pay increases, and then push them into every corner of the bureaucracy. But informal linkages within sectors still exist, and right now health seems to be in the middle of some flow-on skirmishes resulting largely from the 2005 nurses' settlement. This was predictable. I recall being surprised that Annette King, the then Minister of Health, was so sanguine about the likely flow-on effects from the nurses' settlement. Things would take their course, she said blandly.

Well, they have. King no longer handles the fallout. Rolling strikes by junior doctors, radiographers and lab workers have been going on for much of the last 12 months. They are being masterminded by Dr Deborah Powell whose organization, Contract Negotiation Services, is used by junior doctors, radiographers and laboratory workers. These groups aren't affiliated to the CTU and are fighting their own battle for a place in the sun. Powell's demeanor often resembles that of an old-style soviet workers' and peasants' inspector as she lays about her. She wants national awards; she'd be overall commissar. Power over workers appears more vital than advancing their interests. Powell knows the health scene, and how to handle gullible journalists who rarely question her tactics. She gets headlines with irrelevant arguments such as she used late last year when complaining that a five-figure sum awarded to the Prime Minister warranted similar increases for her workers. Sometimes Powell has minor windfalls such as with the back payment of meal allowances that many junior doctors seemed surprised to receive. She springs new demands, more headlines, and has district health boards constantly on the back foot. Her group acts as though more money can't possibly be a problem. All DHBs need to do is take orders from her.

However, it's time Dr Powell's union members started weighing whether she might be more of a liability than an asset. While she doesn't negotiate directly with ministers, they fund the DHBs. And it's clear the DHBs hate her tactics. Last year they dug in for a long time during negotiations with junior doctors, and they have said some very rude things about her conduct. Following 30 days of industrial action that cost strikers their wages, junior doctors won very little. On 4 December 2006 Prime Minister Clark pointedly singled out Powell for criticism, noting that DHBs were more willing to negotiate with groups where she wasn't involved. Last week Pete Hodgson said much the same, albeit in code. Yet the problems continue. DHB stubbornness always returns whenever she's around. The government seems happy to weather her storms.

Strikes cause maximum inconvenience to patients and other staff. Hospital waiting lists lengthen whenever they occur. Over the last year thousands of non-urgent, but necessary operations have been put off whenever blood transfusions and laboratory testing are withdrawn. Now it's radiographers. Using sick people as pawns is a pretty disgraceful tactic. Health workers risk losing the support that is naturally theirs. Some people are calling for hospital strikes to be banned, as they are for police, or want a return to compulsory arbitration.

There's a message for the government in this. Think very carefully before settling a large sum on any one group within a sector. Flowons are inevitable. They certainly won't help hospitals deliver better services to patients for whom services are designed.