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”. – Nurses deserve better. They are the backbone of the health sector. We should pay them more. – 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) ( 2Findex.cfm%3Fobjectid%3DE2F74DB8-95EE-6BC7-9E2C313D721B6F11&ei=MwoYVN- EC6OziwLksICoDg&usg=AFQjCNGAwU0xn4WAkHLS_5L-Wp5EIbUdyw&bvm=bv ,d.cGE&cad=rja) 2Findex.cfm%3Fobjectid%3DE2F74DB8-95EE-6BC7-9E2C313D721B6F11&ei=MwoYVN- EC6OziwLksICoDg&usg=AFQjCNGAwU0xn4WAkHLS_5L-Wp5EIbUdyw&bvm=bv ,d.cGE&cad=rja – Our best and brightest are leaving! Pay them more ( 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.” (

School of Business and Economics Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements Problems: The Evidence

School of Business and Economics Health Sector Labour Market Dynamics and Multi-Employer Collective Agreements Problems: The Evidence

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 Is a website created for scenario modelling. I'm happy to spend more time explaining this website more.