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 Industrial Relations and Reform Workplace and Enterprise Agreements Workplace bargaining has seen a marked increase in activity during the year with more than 100 separate agreements registered in the area of Hospital Salaried officers. Many first-round Workplace and Enterprise agreements expire during 1997. The Division will be actively assisting the industry to develop successor agreements consistent with Government wages policy, improving productivity and achievement of other reforms such as improving flexibility and responsiveness to health service needs. In other areas of the health workforce, the Health Workforce Reform division has been actively involved in productivity initiatives under the relevant Enterprise Agreements and a number of forums have been held Statewide, particularly for nursing and ancillary workers. Extensive support has been provided to the industry in relation to salaried and visiting medical practitioners’ agreements - including a review of these agreements to assist targeting of future priorities. A nursing reference group, consisting of metropolitan and rural Directors of Nursing and industrial relations officers, was established during the year. The group reviewed the wages clause in respect of the provisions pertaining to Level 4 and Level 5 nurses and sought recommendations to establish a review system. The reference group engaged a consultant to make recommendations and these will be considered by industry. Review of Nurses (ANF -WA Public Sector) Award The Workplace Relations Act 1996 has placed new obligations on parties to awards to reduce them to containing only "allowable matters" as defined within the Act. This follows from commitments made by the parties to the Nurses (ANF -WA Public Sector) Award (and other awards) in order to qualify for safety net adjustments. An industry nursing review group has been set up to ensure that this work is concluded by 1 July 1998, by which time the Federal Commission will commence arbitration over disagreed award clauses. Salaried Officers The Industrial Section has provided assistance to more than 20 health services in the development of productivity-based arrangements within the context of enterprise bargaining. Agreement has also been reached concerning award consolidation. The Section has been instrumental in advising the Industry on development, processing and implementation of workplace agreements for many categories of staff including general managers, medical practitioners, administration, managerial, allied health and others. More than 2000 employees are now covered by these agreements. Remuneration The Division has been active in providing industry support in classification and remuneration issues including:
Enrolled Nurses Career Structure A new career structure developed out of the Enrolled Nurses Enterprise Bargaining Agreement was developed for enrolled nurses. It has been trialled and will be retrialled commencing August 1997. Introduction of Patient Care Assistants Patient Care Assistants are gradually being introduced in health services around the State following agreement for this to happen in the Hospital Government Workers Enterprise Bargaining Agreement. Health Workers Enterprise Agreement Negotiations for an enterprise agreement for aboriginal health workers have been ongoing for a number of months. It is expected that agreement will be reached with the Australian Liquor Hospitality and Miscellaneous Workers Union.
Best Practice Quality Management Program This project is designed to improve patient care by reducing variation in treatment. The initiative has the potential to deliver better health outcomes while reducing costs. The Department has supported the introduction and development of clinical pathways because of the potential benefits to the health system and because the process of implementing multi-disciplinary pathways encourages health service providers to explore the links between clinical pathways, quality improvement and best practice. The project has successfully involved medical staff from all teaching hospitals and several non teaching hospitals in developing a multidisciplinary approach to quality improvement. Designing clinical pathways for key processes can reduce cost and clinical complications, while significantly improving the quality of patient care. The Division has developed a networking group to support the implementation of clinical pathways. Through this group a number of initiatives have been taken, including a visit to Western Australia by Dr Robert Halder from the Juran Institute who provided practical advice and support on how to implement clinical pathways and related protocols. Teaching hospitals and non-teaching hospitals have been provided with funds to evaluate the impact of clinical pathways. These two projects will provide a baseline for estimating improvements in quality and cost across the system. Process Mapping In 1996/97 training was provided to project participants from a variety of metropolitan and non- metropolitan health services to examine and improve key health service processes. The experiences of the health services involved and the outcomes achieved will be shared with industry in a workshop to be delivered in conjunction with the Health Workforce Reform Division’s Human Resources Conference in November 1997. National education and training reform Competency standards to guide education and training for Aboriginal Health Workers have received national endorsement. They have been endorsed on an interim basis subject to review over a 12 month period due to acknowledgment that in some settings the standards will not be fully appropriate as a result of specific local, clinical or cultural differences. The Department has supported National Training Reform through forums and consultations directed at the development of national competency standards to guide education and training for health industry employees. Draft competency standards have been completed for Alcohol and Other Drugs Workers, Ancillary Workers, Dental Health Workers and Mental Health Work. Policy Development and Review All human resource management policies have been reviewed over the past 12 months. Some have required minor amendments to ensure that they meet the requirements of the Public Sector Management Act 1994, but many needed significant revision and further development to ensure they reflect Government policy and contemporary human resource management practices.
Health Industry Diversity Awards Project The Diversity Policy Statement was issued in November 1996. The Policy recognises the economic and social benefits of a diverse workforce. The Department has committed itself to reviewing recruitment and selection practices to encourage people from diverse backgrounds into the workforce. An award to recognise Diversity achievements across the health industry will be introduced. The Awards aim to promote the benefits of achieving and managing workforce diversity and to recognise both individual and organisational input into the achievement of corporate goals. It is expected that the first Awards will be presented in October 1997. Promotion of Women in Management A paper developed by the Division, addressing the lack of women in senior and executive management was endorsed by the CMC. Two of the more significant recommendations were that the Commissioner of Health endorse the promotion of women in the workplace as an organisational priority; and an advisory group be established at the executive level to progress the promotion of women in the workplace. The advisory group has held its inaugural meeting and it is planned that this project will be given a high priority in 1997/98 Clinical Reform Through a series of workshops and meetings conducted by the Kings Fund Management College, over 150 health professionals discussed important areas for clinical reform and identified issues that needed to be considered. The workshops also served to raise awareness about the need to involve clinicians, medical practitioners in particular, in the development and implementation of clinical reform. In addition, a Medical Council has been established to provide advice and direction on clinical reform throughout the State. The Council will be responsible for prioritising areas of clinical reform and developing and implementing processes to bring about change. Workforce supply Supply and demand issues in regard to nursing have been highlighted and courses of action initiated for co-operative industry progress (marketing strategies, attraction and retention mechanisms, vacancy monitoring). The impact of the nursing shortage on providers, and hence the public, has been lessened by the action taken and initiatives pursued by the Health Department and industry partners. Negotiations are continuing on the proposed development of a three year labour agreement with the Department of Employment, Education, Training and Youth Affairs, the Department of Immigration and Multicultural Affairs and the Health Department. This is a short term strategy which will facilitate the smooth entry of overseas nurses to Western Australia. A collaborative project between Pharmacy bodies and the Health Department of WA is planned to assess the current status and anticipated changes in the profession, specifically regarding workforce supply, demand and skills mix. Strategies similar to those currently being employed in the analysis of Nursing, as well as new joint initiatives will be pursued to provide a comprehensive picture of the Pharmacy workforce and visions of the future. Management Development A Management Development Strategy is underway which underpins all management and strategic workforce development initiatives. The aims are to assist Managers reach their full potential through leadership and competency development to enable them to meet organisational goals and provide strategic health reform direction; and to identify and develop a pool of multi-skilled, mid-level managers within the Government Health Industry who have the potential to become future leaders, particularly by targeting those under-represented and diverse members of our workforce. The Future Leaders Program is a major initiative which aims to identify future leaders who are currently working within the Government Health Industry, specifically targeting women and others from EEO target groups to ensure that the industry has a depth of management expertise and capacity. It also aims to develop a pool of experienced, multi-skilled mid-level managers who can respond quickly to unplanned organisational needs. Human Resource Link Newsletter The Human Resources Link newsletter continues to be a valuable communication tool for the Health Workforce Reform Division. The end of 1996/97 saw HR Link’s 37th edition. It is currently received by 900 individuals and worksites throughout the state and is also distributed throughout all Australian States and Territories and overseas, in line with the Division’s commitment to global information exchange. The second annual Health Industry Human Resource Conference was an overwhelming success with 200 participants. Planning for the 1997 conference is well underway and promises to be another successful networking and educative forum for health industry HR professionals. The Division also continues to sponsor the Peter Baldwin Memorial Award for Outstanding Achievement in Human Resources, which recognises individuals who exemplify the ethos of human resources. The 1996 award was won by Tess Valli from Sir Charles Gairdner Hospital. Improvement Through Information The Improvement Through Information project addresses the need for collection of human resources performance data for the following purposes:
A set of indicators has been developed, and a questionnaire was tested in a large scale pilot survey conducted at Fremantle Health Service, Leeuwin-Vasse Health Service, and Rockingham/Kwinana Health Service. Benchmarks developed in 1996/97 which will provide health services with tools to assess performance in managing their human resources. The project will allow system wide analysis of the data collected and facilitate benchmarking within the industry. Occupational Safety and Health While 1996/97 saw the introduction of new Occupational Safety and Health Regulations to be used in conjunction with the Occupational Safety and Health Act 1984, the implications of this legislation for health service units (HSUs) continued to be addressed in a series of workshops, conducted by the Department’s Occupational and Environmental Health Unit. Guidance notes have been produced to provide practical information on the adoption of safe work procedures within health service units. Issues covered included infection control, work-related stress, driving safety, hazardous substances, x-ray film processing, personal protective equipment and clothing and asbestos management. Injury prevention A model statistical report was prepared on the Department’s workers’ compensation performance highlighting trends in accidents, injuries and diseases. This will be produced annually and disseminated to General Managers to assist in benchmarking OSH performance and targeting injury prevention strategies. A draft statistical report has been prepared however, finalisation requires additional data from other State/Territory Health Departments which has been requested but is taking time to assemble. Model Risk Management Reports showing readily available Workers’ compensation data was also produced and presented to General Managers. These risk management reports detail a range of pertinent information on workers’ compensation claims incurred by a HSU and are available upon request. The tables below illustrate other workers’ compensation performance measures. These figures suggest an encouraging downward trend with regards to the overall number of claims incurred by the Department while the average costs per claim continues to rise. However, due to continued increases in the total wage role and a concerted effort by the Department’s Insurer to settle some long term claims has resulted in a slight increase in the Departments annual premium. The annual frequency rate continues to show a steady decline. The estimated costs of claims and the premium rate also indicate a downward trend. The actual number of "lodged claims" and the overall incurred costs for those claims have continued to decrease. These figures however, confirm that the costs per claim are still on the rise. Due to increased wage role, administration fees, associated medical expenses and common law settlements the annual premium charge has continued to marginally increase.
*Statistical data collected to provide these rates was not available from all health services. These figures represent feedback from 75 per cent of health service units.
The Health Workforce - Demographic Views The Government Health Industry employs a significant proportion of the Government workforce in WA. Health Services and sites within the Industry are required to undertake and maintain the Equal Employment Opportunity (EEO) Demographic Survey in accordance with the Directorate of Equal Opportunity in Public Employment (DEOPE) requirements. This information is designed to be useful to local management for planning, as well as providing a picture to government of the workforce they employ. The total number of employees in the Government Health Industry excluding Teaching Hospitals rose from 13,982 in 1995/96 to 15,399 in 1996/97. The proportion of Health Services who have partially or completely implemented procedures to record EEO data as required has risen over the last few years - from 36 per cent in 1995/96 to 86 per cent in 1996/97. The response rate at health services and other sites where the survey has been implemented has been variable, perhaps due to lack of maintenance procedures. In total, 57 per cent of industry staff have responded to the survey.
Percentage of EEO groups in each salary range The proportion of staff in each EEO or Gender group who are employed in the lowest salary ranges is fairly constant, with the exception of the Aboriginal and Torres Strait Islander group, where 80 per cent are employed in salary ranges 1 and 2. The maximum of any other group is 53 per cent (People With Disabilities), closely followed by Women (52 per cent). The overall total for these salary ranges is 49 per cent.
Percentage of gender group in each salary range Men disproportionately populate the top salary ranges, while women, people with disabilities and Aboriginal and Torres Strait Islanders form just a small part of these salary bands. Almost 30 per cent of men (28 per cent) are employed in salary ranges six and above, while only nine per cent of women and four per cent of Aboriginal and Torres Strait Islander employees (one third and one seventh respectively of the figure for men) are employed at this level. Seventy per cent of men are employed on a permanent, full time basis, compared with 49 per cent for women.
Per cent of Staff in each Employment type by Gender and EEO Group
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