IN THIS ISSUE Artifical intelligence - APEX
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TTHE
New Zealand’s Specialist Union
Allied Scientific & Technical
P INT
December 2018
IN THIS ISSUE
Artifical intelligence
There is much hype around artificial intelligence and its potential
effects in healthcare, including risk to job security. How do we get AI
to work for us, and what are the risks?
President’s message
2018 bargaining analysis
History of smoko
Why is bargaining so slow?
Divisional newsletters
And more . . .
Journal
Contents
From the President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
APEX Feature: Artificial Intelligence . . . . . . . . . . . . . . . . . . . . . . . . . 4
2018 Bargaining Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
APEX Office Over the Break . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Lakes DHB Loses Facilitation Application . . . . . . . . . . . . . . . . . . . . 10
Congratulations Martin Chadwick . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Employer Stalling Tactics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
A History of Smoko . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Domestic Violence Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Wellbeing & Bullying: Strange Bedfellows . . . . . . . . . . . . . . . . . . . . 16
Divisional Newsletters
Psychologists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 18
Medical Imaging Technologists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Anaesthetic Technicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Medical Laboratory Workers . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . 24
Physiotherapists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
T P INT
THE
DECEMBER 2018 2
From the
President
Well, another year is nearly gone. What • being given deadlines that are might be, keep good records. Bullying
a busy year it has been with phenomenal unrealistic is described as repeated behaviour, so
levels of activity. I’m sure many of you a pattern will need to be established.
• overburdening with excessive tasks
can relate to that. 2018 has been full of It is important to prevent further
compared to colleagues (setting
promise, with expectations that years of psychological damage as soon as possible,
someone up to fail)
neglect of the Allied Health sector would so get advice and tell someone you trust
be addressed. The appointment of Martin • frequently changing instructions – a delegate is a good start. If someone
Chadwick as the new Chief Allied Health without explanation else can observe the same behaviour you
Professions Officer reporting to the are in a far better position.
• allocating tasks beyond an
Director General of Health is hopefully a
individual’s ability with the deliberate Remember that you are not at fault.
positive sign.
intent of undermining confidence There is no shame attached to being
A number of critical issues have arisen bullied: that belongs entirely to the bully.
• blocking promotion by refusing to
this year, apart from the obviously They may well have been bullied too,
endorse a pay rise
important bargaining ones that many but that’s no excuse for perpetuating
of our APEX divisions are involved in at • excluding the target from knowingly harmful behaviour.
the moment. However, I would like to discussions about their work or
! On that note I’d like to wish everyone
concentrate on just one: bullying. responsibilities
best wishes for the holiday season and
The individual cases are horrendous • micromanaging with the obvious hope you all have a safe and enjoyable
in their own right. However, I want to implication of incompetence. time. See you next year.
talk about how we collectively create Who is the target, and why? The short
an environment where bullying is answer is that it could be anyone. Some
unacceptable. That no matter who you people become targets because the
are, you are confident to say “No, Stop bully perceives they are weak or lack
it.” Not just if you are the target, but confidence, others because they are
even if you observe it happening to popular and/or are perceived as a threat.
someone else.
I am at a loss to understand why
Unfortunately there are very real fears employers allow situations like these to Stewart Smith
that people commonly report for not develop and then do nothing about them
coming forward. APEX President
once they are identified. It is a collective
• It could get worse. blindness that perniciously blights many
of our workplaces. There are significant
• You will become the target instead.
consequences to being bullied, ranging
• Career retribution, which can be from feelings of loss of control and being
active or passive, but never benign. unable to carry out usual tasks without
coming under threat, to serious health
The common feature of this is repeated
concerns including PTSD. It results in
deliberate intentions to undermine.
lower productivity, increased sickness,
Insidious and is clearly contrary to an employer’s
responsibilities to provide a workplace
How do you know it’s happening to that is free from harm. Inaction on the
you? This might seem obvious but while part of an employer to address this type
some behaviour is overt it is just as of activity effectively condones it, as
likely to be covert. Bullies tend to be there is no feedback to the perpetrator.
secretive, although power and control
can be maintained by overtly creating an What can you do?
environment of fear amongst those who
Talk about it with your work colleagues.
witness it. Some of the things that may
If you are being bullied or think you
point to you being bullied are things like:
T P INT
THE
3 DECEMBER 2018
APEX Feature
ARTIFICIAL
INTELLIGENCE
A conference on Artificial Intelligence been in the realm of fantasy or sci-fi is airport. In labs, we may have machines
(AI) in healthcare, organised by the Royal here already. reading bugs and cells for us, but we will
Australian and New Zealand College still need people to help patients and
Dr Nguyen’s point is this: we can’t stop
of Radiologists (RANZCR) was held clinicians understand their results, and
change. The Luddites smashing machines
recently in Sydney. Congratulations to more big data population-based work
in the industrial revolution didn’t stop
the college for taking the initiative. to prevent disease or respond better to
the revolution.
microbial threats.
There is much hype around AI and its
potential effects on healthcare, including The Luddites were an early 19th- We have an ever-increasing volume of
risk to job security. This conference century group of English workers who work, so will having technology that
sought to put some perspective on what destroyed machinery, especially in screens for “normal” allow the remaining
is happening now, as well as future gazing. cotton and woollen mills, as a means of workforce to concentrate more
Importantly, it sought to give better protest against industrial development. productively on the abnormal?
understanding about what is involved in Whether this is a true representation
of what the Luddites were all about Dr Nguyen noted that those who enjoy
making AI work for us, and what good as
(see the end of this article) or not, the hype around AI are often those for
well as risks might arise.
the term Luddite has since become whom it’s core business – and those
We are largely focusing here on the synonymous with a person opposed who seek financial benefit. Those who
subsets of AI, mainly machine learning to increased industrialization or new buy healthcare services, however, won’t
(ML), a little deep learning (DL) and technology. want to pay any more than they do now.
to some extent neural networks There is a risk, therefore, that savings will
(NN). There are other acronyms that Stephen Hawking said, “Intelligence is be sought from existing areas to allow
you’ll come across too, including ANI the ability to adapt to change.” And the introduced of new technologies.
(artificial narrow intelligence, which many have noted that innovation for Given that staff represent 70% of cost
describes AI that can perform only a some is disruption to others. We need of healthcare, looking at shifting money
narrow range of specific tasks), AGI to recognise what’s coming
(artificial general intelligence; AI with and make active decisions
human-like transferable intelligence about what and where we
and problem-solving) and ASI (artificial should harness the new
superintelligence; AI whose intelligence technologies. We need to
substantially exceeds that of the most think and plan for what
gifted humans). will happen to changing
roles. A big question in my
Dr Jordan Nguyen is on the “speakers mind is what impact AI will
tour” and has an interesting website have on future job security.
(see www.drjordannguyen.com). He is How will the displacement
an electrical engineer by training and, of jobs happen? Will they
amongst other things, has worked in simply disappear? or will we
the disability field. Some of his work has change to do other things?
involved linking occipital (visual cortex)
Examples are already
lobe electrical signals through a head
with us. Bank tellers
band, to the cloud, to a computer in a
lost jobs when ATMs
car to enable a young man with cerebral
were introduced. But
palsy drive using his eyes – and only
we still crave the human
his eyes. Dr Nguyen also showed us
experience, so we kept
passenger drones that are transporting
(some) tellers and just
people now (in China at least) and an
changed what they did.
electric car that autonomously drove
Smart gates at immigration
around a racetrack at 260kph – again in
hasn’t removed the need
China. The stuff that may previously have
for human beings in the
T P INT
THE
DECEMBER 2018 4
fact that technology is an enabler. In
tech already exists pathology, a machine learning model other challenges
is reducing the number of slides
• 24/7 ECG that recognises • Disease versus disorder: At autopsy
pathologists need to review. Whilst the
impending MI and dispatches an 60% of dementia cases were found
machine identifies more disease than
ambulance before it happens. to be due to Alzheimer’s, but only
is there, it is very good at identifying
10% had only Alzheimer’s. For
• Medical data gathered from sweat, when there is no disease. This has in
reliable AI we need to learn from
detected through clothing or a one instance halved the number of films
those who have only Alzheimer’s if
wearable patch, available in real pathologists need to read, allowing them
that is what we want to diagnose
time. to get through more work. It is also a
on MRI. And of course, if you look
good example of how working with AI
• Retinal screening that can predict closely enough, everyone is sick.
will enhance what we do.
cardiac disease. (So, can voice
• Not all data always exists
recordings of emotional speech To harness the good, we need to define
detect, well . . . ?) our purpose and act. And we must be • Frequency of data collection can be
prepared to innovate or be disrupted. variable.
• Ultrasound (instead of
There will be change, and some of it
mammography) of breast screened • Prevalence may be an issue. Only
will be rapid. We need to see a shift
by AI, leaving the negatives to look a few people who suffer X disease
in focus from intervention-centred to
at. limits the ability to machine learn,
patient-centred care. And, perhaps most
hence the focus on normal rather
• A machine that can take a scan and importantly, we need to make decisions,
than abnormals.
quantify the size and volume of and not let the decisions be made for us.
anatomical features. • Huge datasets are required due to
It’s here already, and more is coming. We
the huge variability between people.
from the human workforce budget to need to make some decisions about how
Genetics, environment (including
an AI-based workforce is going to be and what, and lead the change.
nutrition), education and physical
tempting.
What’s holding AI back? environment vary.
We’ve all heard that “The role of the • Having many data sources also
radiologist will be obsolete in 5 years.” AI in its simplest form is pattern
recognition; but if the pattern changes, brings in variability in both quality
Such comments have been around and quantity.
since 2010, when the potential of AI the machine can no longer recognise it.
For instance, developing facial recognition AI cannot perform contextual reasoning.
became apparent.Yet here we are:
technology using the faces of thousands For example, if presented with the
radiology remains a key discipline,
of white males enabled accuracy to a 1% sentence, “The councillors rejected the
and we have a workforce shortage
margin of error. However, accuracy fell demonstrators’ permits because they
– not just radiologists by MITs and
to 35% when confronted with the face of advocated violence”, 99% of people
sonographers as well.
a black female; the pattern changed, and understand it’s the demonstrators
When new technologies are introduced, the machine could no longer be relied advocating violence, not the permits.
they are not always entirely fit for upon to get it right. And can we trust However, the sentence confuses
purpose. Early AI has over-promised and what it is that the machine has learnt? machines built to comprehend language
under-delivered. One example is in labs, because they lack the contextual
In the case of a machine learning the
where a machine can now tell us the reasoning to make sense of the ambiguity.
difference between a wolf and a dog, the
classification of bugs – but only if they (Or, perhaps we should say they currently
machine learned the difference to 1%
lack the intelligence. Whether general
(AGI) and super (ASI) intelligence in
AN EXISTENTIAL THREAT? machines is even possible is a matter of
The Terminator. The Matrix. Ex Machina. We love to speculate about whether AI debate amongst the experts in the field.
will turn against us, or turn evil. Will AI become an existential threat to our species? What they do tend to agree on, however,
What do the experts say? is that if AI with contextual reasoning
arrives at all, it is decades away at least.)
The real worry isn’t malevolence, but competence. A superintelligent
Cost is always a factor. Healthcare costs
AI is by definition very good at attaining its goals, whatever they may continue to increase despite successive
be, so we need to ensure that its goals are aligned with ours. Humans governments trying to cap spending.
don’t generally hate ants, but we’re more intelligent than they are Who will improve medical practice,
– so if we want to build a hydroelectric dam and there’s an anthill healthcare providers or consumers?
there, too bad for the ants. The beneficial-AI movement wants to If medicine charges what it thinks the
avoid placing humanity in the position of those ants. value of our work is, we might be in for
a surprise. Value-based payment pay
— The Future of Life Institute
systems for outcomes, not interventions.
aren’t anaerobic. And AI requires big data accuracy until someone realised a picture To determine outcomes, you need
which we often simply don’t have access of a dog in snow was being categorised data – which we are now collecting.
to in our little world. More on these as a wolf – the machine had learnt what For example, machine learning could
challenges below. snow looked like. create an order of merit from the
But we must not lose sight of the sum of patient data, practitioner data,
T P INT
THE
5 DECEMBER 2018
hospital and environmental data, which make the diagnosis? people thought.
can then provide a pattern of behaviour
Enigma is another initiative. Enigma Anonymisation requires the removal of
and outcomes identified down to the
involves 300 scientists from 185 identifying features. However, this is not
individual practitioner. This will bring
institutions in 33 countries gathering sufficient. Deidentification needs to add
value-based medical systems to our front
data from more than 30,000 subjects. some “noise” to the data; for example,
door.
Genetic and imaging data are being changing date of birth to age by decade.
To learn, AI needs huge datasets, gathered through systemic methods to But conventionally de-identified data is
millions of parameters, known “ground generate longitudinal data. Biobank is also increasingly being able to be identified
truth” (is it a dog or a cat? is it a gathering big data. – and publicly released. The question is:
normal chest X-ray?), and enormous how private is our data?
computing power. But despite all these challenges,
thousands of people are working to Long story short – it isn’t. Current
Machine learning requires a data set.
overcome them. We now have auto anonymisation protocols are inadequate
It takes thousands of images for a
machine learning where, alongside the to guarantee that personal data is safe.
computer to be able to recognise a
direct machine learning described above, De-identification protocols are 20 years
human, and thousands of chest X-rays
the machine itself learns more from the old now and no longer fit for purpose.
to recognise a normal one. But, images
learning already done. We have “models” There is a trade-off between utility and
are not all the same: machines need to
that a machine can learn from – it privacy. We want to use big data, but we
learn to identify the limits or parameters
doesn’t have to be real data, just data will have to decide the value of privacy
of “normal”. This is easier for some
that will get to ground truth. over the benefits derived from big data.
applications than others. Group A
streptococci have a narrower range of Not collecting or using big data is not
Privacy Problems an option – there is too much good
normal than human chest X-rays.
Every time we use a cell phone, swipe that can come from it.
The datasets are on their way in a credit card, get caught on CTV, or In 1930, we found that 12 points on
radiology: ImageNet has over 15 million Google something, data is created. And a fingerprint could identify a unique
labelled high-resolution images, in we need a dataset for machines to learn individual. What does it take to de-
22,000 categories. But getting enough from: but what if this data is “sensitive”. identify a person in today’s dataset
radiologists to decide if the images are
London Underground collected data world? How many individual points of
normal or not – to determine ground
from individuals’ cell phones to map data (use a credit card, a Google search,
truth – is a sizable task and a rate limiting
crowd movements. This was thought appearance on CTV) do we need to have
step. There is also the question of
to be acceptable use because the data to uniquely identify an individual from a
whether the information is in the data.
was de-identified or anonymised – or so large dataset?
For example, is an X-ray alone enough to
The answer is surprising – and perhaps
frightening. In a data set of 1.5 million
people carrying cell phones in a 1 km
area, just 4 datapoints will identify any
individual 95% of the time. In a dataset
built from 1.1 million people paying by
credit card at a restaurant, 3 datapoints
were 90% successful at identifying an
individual.
If we make the spacial and time
information less precise i.e. Greater
area and wider time frames, will that
additional noise help? The answer is
only to a point; one trial found this only
extended the number of points to re-
identification by 2.
Standards and Control
AI ignores boundaries and borders.
Our legislators are slow, our regulators
slower. It is unlikely these mechanisms
are fit for purpose in this new era.
How we might solve these challenges is
only just starting to be thought about.
International work is underway on
providing standard terminology, big data
reference architecture and governance
of big data and AI. But this is a global
responsibility, not just the concern of a
few people in a back room.
T P INT
THE
DECEMBER 2018 6
Progressive Luddites The follow is an excerpt from the Smithsonian Magazine from
March 2011, written by Richard Conniff.
Despite their modern reputation, the original Luddites were neither opposed to technology nor inept at using it. Many were highly skilled
machine operators in the textile industry. Nor was the technology they attacked particularly new. Moreover, the idea of smashing machines as a
form of industrial protest did not begin or end with them.
British working families at the start of the 19th century were enduring economic upheaval and widespread unemployment. A seemingly endless
war against Napoleon’s France had brought “the hard pinch of poverty,” wrote Yorkshire historian Frank Peel, to homes “where it had hitherto
been a stranger.” Food was scarce and rapidly becoming costlier. Then, on March 11, 1811, in Nottingham, a textile manufacturing centre, British
troops broke up a crowd of protesters demanding more work and better wages.
That night, angry workers smashed textile machinery in a nearby village. Similar attacks occurred nightly at first, then sporadically, and then in
waves, eventually spreading across a 70-mile swath of northern England from Loughborough in the south to Wakefield in the north. Fearing a
national movement, the government soon positioned thousands of soldiers to defend factories. Parliament passed a measure to make machine-
breaking a capital offense.
One technology the Luddites commonly attacked was the stocking
frame, a knitting machine first developed more than 200 years earlier
by an Englishman named William Lee. Right from the start, concern that
it would displace traditional hand-knitters had led Queen Elizabeth I to
deny Lee a patent. Lee’s invention, with gradual improvements, helped
the textile industry grow—and created many new jobs. But labour
disputes caused sporadic outbreaks of violent resistance. Episodes of
machine-breaking occurred in Britain from the 1760s onward.
As the Industrial Revolution began, workers naturally worried about
being displaced by increasingly efficient machines. But the Luddites
themselves “were totally fine with machines,” says Kevin Binfield,
editor of the 2004 collection Writings of the Luddites. They confined
their attacks to manufacturers who used machines in what they called
“a fraudulent and deceitful manner” to get around standard labour
practices. “They just wanted machines that made high-quality goods,” says Binfield, “and they wanted these machines to be run by workers who
had gone through an apprenticeship and got paid decent wages. Those were their only concerns.”
So, if the Luddites weren’t attacking the technological foundations of industry, what made them so frightening to manufacturers? And what
makes them so memorable even now? Credit on both counts goes largely to a phantom.
Ned Ludd, also known as Captain, General or even King Ludd, first turned up as part of a Nottingham protest in November 1811, and was
soon on the move from one industrial center to the next. This elusive leader clearly inspired the protesters. And his apparent command of
unseen armies, drilling by night, also spooked the forces of law and order. Government agents made finding him a consuming goal. In one case, a
militiaman reported spotting the dreaded general with “a pike in his hand, like a serjeant’s halbert,” and a face that was a ghostly.
In fact, no such person existed. Ludd was a fiction concocted from an incident that supposedly had taken place 22 years earlier in the city of
Leicester. According to the story, a young apprentice named Ludd or Ludham was working at a stocking frame when a superior admonished
him for knitting too loosely. Ordered to “square his needles,” the enraged apprentice instead grabbed a hammer and flattened the entire
mechanism. The story eventually made its way to Nottingham, where protesters turned Ned Ludd into their symbolic leader.
The Luddites, as they soon became known, were dead serious about their protests. But they were also making fun, dispatching officious-
sounding letters that began, “Whereas by the Charter”...and ended “Ned Lud’s Office, Sherwood Forest.” Invoking the sly banditry of
Nottinghamshire’s own Robin Hood suited their sense of social justice. The taunting, world-turned-upside-down character of their protests
also led them to march in women’s clothes as “General Ludd’s wives.”
They did not invent a machine to destroy technology, but they knew how to use one. In Yorkshire, they attacked frames with massive
sledgehammers they called “Great Enoch,” after a local blacksmith who had manufactured both the hammers and many of the machines they
intended to destroy. “Enoch made them,” they declared, “Enoch shall break them.”
People of the time recognized all the astonishing new benefits the Industrial Revolution conferred, but they also worried, as Carlyle put it in
1829, that technology was causing a “mighty change” in their “modes of thought and feeling.” Men are grown mechanical in head and in heart,
as well as in hand.” Over time, worry about that kind of change led people to transform the original Luddites into the heroic defenders of a
pretechnological way of life. “The indignation of nineteenth-century producers,” the historian Edward Tenner has written, “has yielded to “the
irritation of late-twentieth-century consumers.”
The original Luddites lived in an era of “reassuringly clear-cut targets—machines one could still destroy with a sledgehammer,” Loyola’s Jones
writes in his 2006 book Against Technology, making them easy to romanticize. By contrast, our technology is as nebulous as “the cloud,” that
Web-based limbo where our digital thoughts increasingly go to spend eternity. It’s as liquid as the chemical contaminants our infants suck
down with their mothers’ milk and as ubiquitous as the genetically modified crops in our gas tanks and on our dinner plates. Technology is
everywhere.
The original Luddites would answer that we are human. Getting past the myth and seeing their protest more clearly is a reminder that it’s
possible to live well with technology—but only if we continually question the ways it shapes our lives. It’s about small things, like now and
then cutting the cord, shutting down the smartphone and going out for a walk. But it needs to be about big things, too, like standing up against
technologies that put money or convenience above other human values. If we don’t want to become, as Carlyle warned, “mechanical in head
and in heart,” it may help, every now and then, to ask which of our modern machines General and Eliza Ludd would choose to break. And
which they would use to break them.
T P INT
THE
7 DECEMBER 2018
APEX 2018
BARGAINING
ANALYSIS
The formation in late-2017 of the Jacinda to mediation in early 2018, another offer settlement with nearly mirror-image
Ardern-led Government stirred up was rejected by members in March. An settlements for their nursing and allied
a real confidence in union members, independent panel and a new offer failed health MECAs. At the same time, we
particularly in the health sector, to to avert a 24-hour strike on July 12. But were beginning to hear rumours of
start tackling issues that Labour had in early August 2018, NZNO members increased control over DHB bargaining
campaigned on – stagnant wage growth, accepted a fifth offer to address from a group of four cabinet ministers:
pay equity issues for predominantly concerns around pay, equity and staffing. Grant Robertson (Finance), Iain Lees-
female-occupations, and under staffed The main benefits were three years of Galloway (Workplace Relations), Chris
public health services. The sentiment of 3% increases and additional steps in the Hipkins (Education), and David Clark
“Let’s do this”, which had supercharged salary scales, as well as commitment to (Health).
Ardern’s rise in political popularity, implement pay equity by the end of 2019
quickly heated up the arena of collective and a safe staffing system (known as Industrial Action Kicks Off
bargaining. People’s expectations were CCDM) by 2021. In September, APEX advocates were told
rising. the nurses’ settlement would not flow
Flow On into the nearly two-dozen collective
Nurses’ Strike The traditional pattern of bargaining has agreements that were being bargained
In early December 2017, the 27,000 been that whatever the NZNO MECA on behalf of pharmacists, anaesthetic
nurses, midwives and health care settles for will be delivered to the Public technicians, physiotherapists and others
assistants covered by the New Zealand Service Association Allied and Nursing around the country. As a result, APEX
Nurses Organisation multi-employer documents, as well as to midwives members, beginning with perfusionists
collective agreement (MECA) with covered by MERAS. This is known as flow at ADHB, began to ballot for industrial
District Health Boards, rejected an offer on. action. Quickly we saw a change in
of 2% pay rises for three years. negotiating tack, and APEX members
So as soon as NZNO had settled, the
began to be offered salary increases in
And although DHBs and NZNO headed PSA rode the coat-tails of the nurses’
line with the nurses’ settlement – all
clinical documents were being
offered the same. But the offers
were being tightly controlled
by central government. The
DHBs seemed unable to make
offers that were even a little
bit different to what had been
offered to PSA members in the
same professions.
In October and November
some APEX groups settled for
the standard deal, but other
groups boxed on, particularly
the (industrially powerful)
anaesthetic technician groups,
who began regular and sustained
strike action at Lakes, Hawke’s
Bay and Northland DHBs.
Despite the disruptive effect
of industrial action, DHB
negotiators began complaining
the four Ministers were refusing
A spectacular breach to allow them to make any offer
T P INT
THE
DECEMBER 2018 8
MERRY
CHRISTMAS!
APEX wishes you a very merry
Christmas and a safe and happy
new year!
The APEX office is closed from December 24
until January 14.
However, we will have an advocate in the office
between 10am and 3pm on the non-stat days to
deal with emergencies.
If you have an emergency on a stat holiday, please
call Deborah on 021 614 040.
beyond the standard deal. a substantial way across two unions, inequality of power in the employment
the DHBs have not shown any mood relationship and erodes constructive
Strike action spread beyond APEX. In
to allow different sets of conditions collective bargaining at the DHB level.
late November 2018, more than 1000
in different areas across the same The effect of this on the future of
midwives covered by the union MERAS
profession. Instead, DHBs have sought to collective bargaining remains to be seen.
issued 540 strike notices to get the
settle an agreement with one union and
DHBs to make an offer beyond what had As we head into 2019 all of the APEX
use that as leverage to force the other to
been offered to NZNO’s midwives. MECAs – radiographers, radiation
accept identical terms. The Government
therapists, physicists, sonographers,
2019 – Wellness for Us has also begun demonstrating an
psychologists, laboratory workers,
increasing resolve to wait out industrial
Through 2018 DHB employees and physiologists are all up for negotiation.
action – not just in health, but in other
unions leveraged favourable political At the same time as the Government
parts of the public sector – classrooms
conditions to improve their salary and promises a ‘wellness Budget’ in 2019,
and courtrooms.
conditions. But the increased Ministerial it will be negotiating with some of the
control of bargaining has imposed The increased control over collective hardest working, least recognised, most
barriers to tailoring collective bargaining bargaining by the Ministerial Quartet essential health professionals in the
outcomes at an individual DHB level for leaves health professions with a single de country. The government will have to
professions like anaesthetic technicians facto employer – the Ministry of Health. practice what they preach. Wellness for
and pharmacy. At law the DHB is the employer, but this the public begins with wellness for us.
is supplanted in reality by tight control
And where professions are split in from Wellington. This magnifies the
T P INT
THE
9 DECEMBER 2018
LAKES DHB LOSES
FACILITATION
APPLICATION
Lakes DHB applied to have the Criteria for facilitation necessary, but we also maintained that
Employment Relations Authority (ERA) our goal was to get back to mediation
grant the right to have our anaesthetic Against this background, the ERA to seek settlement. The ERA found that
technician bargaining referred to looked first at whether the bargaining only one day of mediation didn’t meet
facilitation. That application was had been unduly protracted, whether the threshold of “extensive” efforts.
opposed by APEX, and successfully so. extensive efforts had been made to
reach settlement and whether there As for serious difficulties, the ERA noted
The decision is worthy of a read, but for
are serious difficulties necessitating the parties’ differing opinions around
those who think legal decisions are less
facilitation. what a salary package might look like.
interesting than paint drying (and yes I
Whilst an important issue for both
can see that point of view), here are the Lakes did claim the bargaining had been parties (as the money usually is!) the
key points. unduly protracted, but the ERA found ERA didn’t feel “serious” related to how
that “unduly protracted” has both a genuinely the parties held a view but
What is Facilitation? temporal (timing) and activity (how how difficult it might be, what hurdles
Facilitation is a provision of the much has happened) element, and was might need to be overcome, to reach
Employment Relations Act (ERA) that also mindful that ‘unduly’ meant exactly agreement. They also noted that such
is rarely used but allows for parties that!. Whilst the ATs at Lakes had a hurdle might lie in LDHB’s refusal to
to a dispute to have a third-party initiated bargaining over a year before release financial information surrounding
determination about a bargaining this case came to be heard, there was their position. Obviously the more
outcome. The parties may or may not also effectively an abeyance to bargaining we know about the basis (financial or
accept the determination: i.e. it is not of some 5-6 months due to the DHB’s otherwise) of an employer’s position
binding on the parties. focus on the NZNO dispute. Once the more we are able to maneuver to
APEX and Lakes reconvened, there had find a settlement – without that we
Why is it not often used? in total only been 4 days in bargaining are negotiating in the dark. The system
and one day in mediation – hardly unduly has long recognised that negotiation
A basic focus of the Employment
or protracted. without information is like breathing
Relations Act is “the parties”. The
provisions of good faith, direct bargaining without oxygen – it is essential if a good
“Extensive efforts” outcome is sought.
etc all provide a platform underpinned
by the responsibility of the parties The ERA also considered whether
The ERA also noted that LDHB felt the
to resolve issues and progress the “extensive efforts” had been made
APEX claim would disadvantage Lakes
employment relationship. Mediation to resolve the difficulties between
in attracting at least some ATs given the
supports that focus, but facilitation, the parties, and noted that this
fierce labour market we have for this
where a third party offers up a required a “wide scope, far reaching or
specialist and essential workforce. The
settlement, does not. comprehensive . . . range of activities”.
ERA therefore noted that further fruitful
APEX felt if we couldn’t get back to
And, in fairness, most parties agree with discussion between the parties must be
bargaining, strike action would be
this focus. When a third party settles possible when so much opportunity to
an agreement, neither party “owns” find middle ground existed.
it, which in turn means the deal often Onto the next criteria which might
isn’t cemented in and the same issues allow facilitation: That during bargaining
arise again on renewal. Given the Act there has been one or more strikes
prioritises the relationship between or lockouts; and that they have been
the parties, getting to facilitation is not protracted or acrimonious.
easy. The ERA assesses against legislated
criteria; the view of the ERA in the Yes there had been 4 days of strike!
Lakes situation is detailed as But was it protracted? The ERA
follows. noted strikes can continue for
weeks and even months,
T P INT
THE
DECEMBER 2018 10public interest”, but
did helpfully refer to
Judge Perkins of the
Employment Court
who said:
“The whole purpose
of the strike action
. . . is to cause . . .
inconvenience and it
is a valid bargaining
tool where carried
out in accordance
with statutory
requirements . . .
The rights to strike
lock out are part of
ensuring a balance
to the relative
negotiating positions
of the parties in
industrial bargaining.
Any steps to reduce
their effectiveness is
not to be taken unless
there are sound
principled reasons for
doing so.”
albeit not commonly in Health. Four strike or lockout; and if it were to In summary, the
days in 8 months of bargaining was not occur, it would be likely to affect the ERA ruled against Lakes DHB on all
felt to be protracted by the ERA, nor public interest substantially. At that points and referred the parties back to
were they acrimonious as the manner in time our members had not instructed negotiations, including with the help of
which LPSs were agreed and provided us to take further strike action, so none mediation, and through using good faith
attested to. was proposed, and on that basis the provisions such as the access to financial
ERA member declined to rule on this and budgeting information.
Lastly criteria. It was not therefore necessary
Finally, that a party has proposed a for the ERA member to rule on “the
CONGRATULATIONS
MARTIN
CHADWICK
APEX congratulates Martin Chadwick sitting alongside the Chief Medical We anticipate Martin may shake a few
on his appointment to the new role Officer and the Director of Nursing things up in his new role. As NZ’s
of allied health lead at the Ministry of in what is now known as the “clinical specialist allied scientific and technical
Health. Martin was previously the allied cluster” at the Ministry. We were practitioners union representing over
scientific and technical lead at BOP DHB doubly pleased to see the position go to 4000 members, we look forward
and before that CMDHB. He has also someone who is both familiar with the to working alongside Martin and
chaired the National DAH group and NZ scene and passionate about allied progressing the challenges we already
lead the radiology workforce group. scientific and technical practitioners, our have – and any he may throw at us!!
role and the benefit we bring to the care
APEX lobbied hard to have this new role
of patients.
at the Ministry of Health established,
T P INT
THE
11 DECEMBER 2018EMPLOYER
STALLING
TACTICS
attempt to frustrate members. the inherent inequality of its relationship”
The motivation behind stalling with its workers. As a result, union
tactics for employers is simple What does it look like? membership at AFFCO-run sites has
– the longer bargaining drags Over in the United States, for example, it plummeted, dropping from 95% in 2010
on, the more likely it is that is very common for employers to ‘starve to only 10% in 2017.
their workers will cave and out’ fledgling collectives. 52% of unions
Delaying and refusing to
accept unfavourable terms of are unable to settle their first collective
settlement, or even give up on agreement within a year, and 25% aren’t meet for bargaining
settled after more than 3 years. In New The most common and frustrating
reaching a collective agreement Zealand, the most notorious example stalling tactic is when an employer
at all. is AFFCO, a major meat processor that refuses to meet and bargain in an
One of the most frequently asked was taken over by Talley’s Group in 2010. efficient and timely manner with the
questions we get from our members is Since 2010, AFFCO has prevented union union bargaining team.
‘why does collective bargaining taking so
long?’
As our analysis of this year’s APEX
bargaining shows, members across many
of our divisions have found themselves
frustrated with how long it is taking
many DHBs to make offers capable
of settlement. This year, microscopic
oversight of collective bargaining by
central government has been one reason
for delaying settlement; in many cases,
our members have had to threaten or
follow through on strike action simply
to get an offer on the table. Anaesthetic
technicians have had a particularly hard
time of it.
meetings from taking place at work, The trouble is that there is no hard and
The duration of bargaining for any locked out union organisers, closed fast rule or time limit on how quickly
particular collective agreement will on-site union offices, banned union employers must meet with us to bargain.
of course depend upon all of the newsletters and t-shirts, sought to stop Of course, outright refusing to meet is
surrounding circumstances. For instance: its workers from criticising it online, and illegal, but beyond that, it’s murky.
• how many members there are even held unlawful lockouts of workers
while at the same time aggressively The Code of Good Faith in Collective
• whether the collective bargaining targeting union members with offers Bargaining only provides that “the parties
involves multiple employers of individual employment agreements. must meet each other, from time to
• whether it is the parties’ first such Collective bargaining has dragged on for time, for the purposes of bargaining.
collective agreement years, beset by litigation that has cost the The frequency of meetings should be
Meat Workers Union $500,000 a year in reasonable and consistent with any
• how contentious the claims are, and legal fees. agreed bargaining arrangements and the
• what the current and historic state duty of good faith”. But what frequency
In the words of the Court of Appeal, counts as ‘reasonable’? The New Zealand
of the employment relationship is it was “obvious” that “the company’s
like. courts have not directly addressed this
purpose was to fragment the future question yet, so we do not have a clear-
But, whatever the exact circumstances, bargaining strength of the workforce by cut answer. Australia and the US have
there is always the risk of the employer, isolating individual workers” and that an analogous requirement to “meet at
or employers stalling bargaining in an AFFCO did so by “[taking] advantage of reasonable times” but the Australians
T P INT
THE
DECEMBER 2018 12also lack clear legal guidance.
In the United States, the National Labor
Relations Board’s decision in El Paso
Electric Company v The International
Brotherhood of Electrical Workers
discussed the issue. The El Paso Electric
Company was found to have breached its
obligations because it had:
• Delayed meeting for bargaining a full
two months after initiation.
• Met with the union to bargain on
average only once a month.
• Refused employees unpaid time off
to attend bargaining.
• Only agreed to meet in the or unreasonable stands on issues, faith.
evening and on weekends without raising new issues at the eleventh hour,
reasonable grounds. Delegates need perseverance and
breaching bargaining process agreements,
resilience. Not all employers will
• Arbitrarily and repeatedly cancelled and/or refusing to propose alternative
intentionally delay bargaining, but we
planned meetings. solutions.
have the primary responsibility to our
• Repeatedly refused the union’s Positional bargaining is where the members to ensure employers do not
requests to meet. employer comes to the bargaining make bargaining drag on needlessly. It is
table with a fixed agenda and effectively our responsibility to keep the pressure
• Bad faith bargaining strategies attempts to turn collective bargaining on employers and ensure that times are
Even once bargaining has begun, into a form of haggling. They will have set to meet and bargaining progresses.
employers have tactics that can drag a private position as to what they are This will help to keep employers on their
out negotiations. ‘Surface bargaining’ willing to settle for and instead of toes and will also provide a useful paper
and ‘positional bargaining’ are two types meeting the union’s claims they will fight trail if there is so much undue delay that
of bad faith bargaining strategies which to settle for the lowest amount possible we decide to take a case against them for
routinely frustrate and stall union efforts at each step of the process, thus dragging undermining bargaining.
to reach a collective agreement with bargaining on for months. ‘Take it or
employers. leave it’ offers are one extreme example Industrial Action
of a positional bargaining tactic. Industrial action remains our single most
Surface bargaining tactics may For example, recent bargaining between powerful tool. A strong and staunch
include knowingly making APEX Anaesthetic Technicians and membership can move mountains, even
certain DHBs arguably reflect an if it is only inch-by-inch. In 2018, many
proposals that we could of our groups have had to threaten or
underlying positional bargaining approach.
never accept, reneging on DHBs across the country have been actually strike simply to get an offer on
agreements, taking inflexible refusing to budge from a one-size-fits-all the table. The fact that this has been
or unreasonable stands on deal. The main strategic goal of this tactic necessary is a real pain, but it also
issues, raising new issues at appears to be limiting the overall costs of reflects the power of workers to use
settlement, but the DHBs are so fixated industrial action to progress bargaining.
the eleventh hour, breaching The following APEX groups have had
on matching outcomes that they will not
bargaining process agreements, even agree to creative and low or neutral to take industrial action just to get the
and/or refusing to offer costing policies that take into account DHBs to provide an offer:
alternatives to proposals. local circumstances. • Anaesthetic Technicians at
Hawke’s Bay, Lakes, MidCentral,
Surface bargaining is where the
Solutions Nelson Marlborough, Northland, and
employer merely ‘goes through the For members, especially if you’re a Southern DHBs.
motions’ of bargaining without seriously delegate or part of a group seeking your
• Perfusionists at Auckland DHB.
intending to engage and compromise first collective agreement, you need to
with the union bargaining team. An be highly attuned to the kind of tactics • Physiotherapists at Waikato DHB.
employer is surface bargaining when they employers are likely to use to demoralise
• Pharmacists at Nelson
attend bargaining meetings, but they do members and undermine bargaining.
Marlborough DHB.
not take the union’s concerns seriously This encompasses bad faith bargaining
and they do fully not participate in the strategies, stalling tactics, bypassing Delaying tactics during bargaining is going
give-and-take of the collective bargaining APEX, bad-mouthing the union to non- to remain a problem with employers for
process. Other surface bargaining members, and much more. Fortunately, in the foreseeable future. A combination of
tactics may include knowingly making New Zealand we do have the option of active and engaged members, industrial
proposals that we could never accept, seeking damages against especially hostile action and vigilance in detecting these
reneging on agreements, taking inflexible employers for such breaches of good tactics is our best strategy.
T P INT
THE
13 DECEMBER 2018A HISTORY OF
SMOKO
The Employment Relations Amendment
Bill currently before Parliament will, if
passed, restore in statute the right of
employees to take regular meal and rest
breaks through the day.
The Bill will provide for one ten-minute
paid rest break between 2 and 4 hours
of work, a thirty-minute unpaid meal
break between 4 and 6 hours, and
another ten-minute paid rest break
between 6 and 8 hours.
The legislative changes are a
continuation of the struggle between
workers and bosses over the right to
decent breaks during work. Rest breaks,
or “smoko” as it has often been called in
New Zealand and Australia, is a fairly old and no morning or afternoon tea. When specification of what compensatory
custom that goes back to the gold-rush the miner’s union voted to support measures have to be provided to
days. 30-minute lunch breaks, the next day workers in essential industries who
one miner, Pat Hickey, kept eating his cannot be given their breaks may
There’s even a town called Smoko in pie past the 15 minutes, with the mine have quite an effect on contractual
alpine north-eastern Victoria, Australia. manager standing over his shoulder. obligations. The new provisions will
Lore has it that in the 1850s gold miners Ordered to return to work, Hickey said require additional payments and/or
on the way to the mountains would stop “I haven’t finished my pie yet.” At which additional periods of time off work when
there for a rest and a smoke – from point Hickey was fired, setting off a
there the town got its name. Over here successful 11-week strike – the workers Smoko-Ho creek waterfall
on the west coast of the South Island, won their right to 30 minutes for smoko
a small creek called Smoke-Ho runs and Hickey and six other miners were
down from the mountains towards a reinstated to their jobs. The strike also
small mining town with a big history – led to law changes around industrial
Blackball. action to requirements workers in
To figure out how the Smoke-Ho creek essential industries to give advanced
got its name you have to go all the way notice of strike action that still have an
back to 1908, when miners who worked impact on APEX members today.
underground got 15 minutes for lunch By the 2000s, most workers
employee’s are required to work through
covered by awards and then
their breaks. What this will be will have
collective agreements had
to be negotiated between employers and
some form of rest breaks
unions in coming months.
provided. And smoko breaks
were enshrined into law for The right to a decent smoko for
all workers in 2008 under workers in essential industries has
the Clark-Government. But always corresponded to the degree of
they were repealed under organisation and strength unions have at
the Key-government in the coal face. Making sure we get enough
2014. time to eat our pie or panini is still is as
important to our health and wellbeing
The return of legislative rest
as it was back in Blackball a hundred and
breaks to the Employment
ten years ago.
Relations Act and the
T P INT
THE
DECEMBER 2018 14WORKPLACE SUPPORT
for victims of
DOMESTIC
VIOLENCE
Back in July, Parliament enacted the But the Act also represents the that only around 1.5% of female
historic Domestic Violence Victims’ culmination of a major shift in national employees, and around 0.3% of
Protection Act 2018, making New consciousness. male employees, are likely to utilise
Zealand the first country in the world to paid domestic leave provisions in
As a country, we are collectively
enact paid domestic violence leave as a any given year. Made proportional
recognising that domestic violence
universal right. to NZ’s population, this rate would
doesn’t stop at the workplace door and
cost employers a total of around
What does the Act do? are putting our money where our mouth
$20 million per year, as against
is to help those affected by it.
From 1 April 2019, every employed the whopping $400 million in
person in New Zealand will be entitled What’s the evidence lost productivity due to domestic
to 10 days of paid domestic violence violence. The policy will probably pay
around these policies? for itself.
leave per year to support them in dealing
with the effects of domestic violence. This is a world-first, but there are 3. Abusers don’t stop at the workplace
In addition, people affected by domestic research-backed reasons to believe that door either. Victims may be stalked
violence will be able to urgently request these policies will be a win-win-win for and harassed in their workplaces
variations to their working arrangements employees, employers, and society as a or sabotaged from attending work
(place, days, and hours of work). whole. or performing in their jobs by
1. Domestic Violence is a workplace their abusers. The Act sets up a
Why is this such a big deal? issue. Right now, the effects of process for securing victims in their
New Zealand has the worst rates of domestic violence on employees workplace and varying their terms
domestic violence in the world. are estimated to cost employers in of work. These kinds of workplace
New Zealand around $400 million safety strategies have proved critical;
Enacting this law provides the victims of in at least one Australian case they
each year. Secure employment is
domestic violence with greater financial have successfully prevented an
also a key pathway out of domestic
and employment security; factors that employee’s husband from abducting
violence, providing those affected
can be crucial in breaking free from their son and murdering her.
with a way to maintain domestic and
the cycle of domestic violence. These
economic stability.
substantive provisions are themselves a What is APEX doing
huge victory. 2. Research from Australia indicates
about this?
As always, APEX’s plan is to stay one step
ahead. We are introducing a new ‘support
for victims of domestic violence’
clause as a standard claim for all of our
collective agreements.
This new clause goes above and beyond
the Act, by taking effect immediately
instead of after 6 months of employment.
It also ensures that affected employees
can go to whichever manager they feel
most comfortable confiding in, and it
stresses the importance of treating any
related discussions and requests with the
utmost confidentiality, including keeping
no record of personal information
disclosed in these conversations without
express consent.
T P INT
THE
15 DECEMBER 2018WELLBEING &
BULLYING
STRANGE BEDFELLOWS
— By Dr Deborah Powell inevitably seeing MITs on a day shift and to get safer hours of work – which
back at the hospital that evening and required more RMOs to be employed
I was at bargaining for the MITs
overnight. Likewise, having finished a – in late 2017. ATs are in short supply,
recently – a forum in which the
40-hour week, MITs are at the hospital psychologists are fighting to maintain
issue of wellbeing in very real terms
multiple times at all hours over the appropriate caseloads: the list goes on.
is on the table.
weekend days, effectively working a 12-
Demand Bullying
day stretch.
And during this we have the ongoing
The demand for radiology services MITs not alone and relentless bullying culture that we
continues to grow, and the number of
MITs are not alone: nurse staffing don’t seem to be making much, if any,
MITs fails to keep up. Previous work
issues were front and centre of their traction on – despite considerable
practices, such as on call systems, are
industrial action in 2018. The government efforts. I believe these issues are linked.
no longer safe for many of the staff and
pledged an additional $300M to help, The link is not direct: we know two
inevitably impose negative health impacts,
plus promising a CCDM system (Care people in stressed environments can
not just from fatigue but the myriad
Capacity Demand Management; a nursing react differently – one becoming a bully
consequential impacts the “stress” of
“correct” staffing level system) to be and one not. The stressed environment
work has on our physiology.
implemented by 2021. SMOs (senior in and of itself is not the cause. But it is
On call is fine when the call backs are doctors) are facing huge levels of an environment within which bullying can
of an occasional nature, but where call burnout as their workload outstrips their flourish, and I believe is an environment
backs effectively become on-duty, and numbers. supported through management culture
remembering call is in addition to the and behaviours.
And, of course, RMOs went on strike
normal working day or week, we are
MIT bargaining
Back to the MITs bargaining – it
was early days. We had met for
a day in prebargaining and this
was our first actual meeting
formally at the bargaining table. It
was a pleasant two days. Things
were relatively low key as is
normal at the outset. We were
tabling claims (but hadn’t got
to money yet), and the parties
shared several key concerns:
fatigue, wellbeing, demand 24/7,
recognition and reward. The
employers’ advocate made two
statements, however, that are
pertinent to this issue. First, in
the context of how we assess
the implementation of shift work
rostering to meet demand, he
said:
“The DHBs don’t want any more
restrictions (in the MECA); if we
are moving to more shifts there
T P INT
THE
DECEMBER 2018 16You can also read
