Contents. Key Direction 1: Grow our capacity to influence 4

Transcription

1 General Secretary s Report COMMITTEE OF DELEGATES MEETING 20 March 2018 New South Wales Nurses & Midwives Association held at 50 O Dea Avenue, Waterloo Contents Key Direction 1: Grow our capacity to influence 4 Allity Aged Care 4 Enterprise Bargaining 4 Bupa Care Services 5 Bargaining for new Enterprise Agreement 5 Christadelphian Homes Limited 6 Restructure and removal of nursing hours 6 Healthscope Private Hospitals 6 Member Growth and Development 6 New Graduates Orientation 7 The Sydney Clinic 7 Justice Health & Forensic Mental Health 7 Dispute: FTE reductions / Shared Model of Care 7 Dispute: Forensic Hospital Management actions creating unsafe staffing levels/ Failure to consult 8 Linburn Nursing Home 9 Transmission of Business 9 Mid North Coast and Northern NSW Local Health District 9 Foundation phase of the Community Health Campaign 9 Murrumbidgee Local Health District 10 Wagga Wagga Rural Referral Hospital/ Continuing Education Allowance 10 NSW Health Service - non-compliance with NHPPD requirements 12 Hornsby Hospital, Northern Sydney Local Health District 12 John Hunter Hospital, Hunter New England Local Health District 12 Manly Hospital, Northern Sydney Local Health District 13 Mona Vale Hospital, Northern Sydney Local Health District 13 Nepean Hospital Penrith, Nepean Blue Mountains Local Health District 14 Westmead Hospital, Western Sydney Local Health District 14 Ramsay Health Care 14 Enterprise Agreement negotiations 14 Branch Biennial General Meetings 15

2 Key Direction 2: Be innovative in our advocacy and bargaining 17 BaptistCare 17 BaptistCare NSW & ACT Aged Care Enterprise Agreement Family and Community Services 18 Dispute: Aspects of the forced transition of FACS staff to the NGO sector 18 Leading Aged Care Services 19 LASA Template Enterprise Agreement NSW Government 20 Relocation of the IRC of NSW to Parramatta 20 Ramsay Health Care 21 Northside Clinic - Work Health and Safety Investigation 21 Key Direction 3: Promote a world class, well-funded, integrated health system 22 ~ ACTU 22 Change the Rules campaign 22 Central Coast Local Health District 23 Gosford Hospital Redevelopment 23 Ministry of Health 23 A new Managing Complaints and Concerns about Clinicians Policy Directive 23 An amended Occupational Screening and Vaccination Policy Directive 24 Northern Sydney Local Health District - Ministry of Health 25 Northern Beaches Hospital transition process 25 NSW Parliament 25 Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation NSW Aged Care Roundtable Questions to Ask 26 NSWNMA Professional Issues Papers 27 NSWNMA Education Program 27 Arthritis and Osteoporosis NSW and ACT 27 Cultural Competence in Healthcare 27 Elder Abuse Aged Care Forum 28 Environmental Health Seminar 28 NSWNMA Reference Groups 28 Community Nurses and Midwives 28 Education 28 Mental Health 29 Scholarships 29 Bob Fenwick Mentoring Grants Program 29 Old People s Welfare Council 30 Submissions and Inquiries 30 Affordable Housing SEPP 70 Review 30 Work Health and Safety 30 Workplace Inspections 31 ~ addition to draft report 20 March 2018 Page 2 of 36

3 Key Direction 4: Promote the Association as a significant and professional advocate for the health system and our members 32 Key Partnerships 32 Unpacking Rental Affordability Roundtable 32 NSW Council of Social Services 33 NSW Federation of Housing Associations 33 Annexure 1 34 New Agreements Approved by Employees March 2018 Page 3 of 36

4 KEY DIRECTION 1 Grow our capacity to influence In order to win better outcomes for our members, the Association* must grow our influence. Influence comes when Association members and member leaders have the ability to use their collective power to enforce rights and achieve new outcomes in their workplaces, their sector and within the health system. We define the health system as inclusive of everywhere our members work. STRATEGIES 1.1 Grow power and influence by increasing the number of Association members 1.2 Identify new member leaders who can build their workplace influence 1.3 Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence 1.4 Grow the number of Association members actively engaged across the health, disability and aged care systems 1.5 Ensure a focus on retaining as many members as possible (* Association should be read to mean the New South Wales Nurses and Midwives Association and the Australian Nursing and Midwifery Federation New South Wales Branch) Allity Aged Care Enterprise Bargaining After eventually agreeing to bargain in late 2017, Allity have continued to show significant reluctance to negotiate constructively through the first part of The company provided a new pay offer of 2% per year for four years (with no back-pay) and has proposed some other minor changes to the Agreement. The company continues to ignore the majority of the claims put to them. Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.4 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Grow the number of Association members actively engaged across the health, disability and aged care systems Members across Allity have repeatedly said the wages offer is inadequate and that they want a response to each of their claims. Throughout February and early March, ten of the company s fifteen facilities passed resolutions calling on Allity to make an improved pay offer and address the claims that had been put forward. Membership has grown significantly throughout the campaign, and three new branches have been formed. The number of member leaders has also increased and member leaders have taken an active role in the negotiations and in branch and workplace meetings held to pass resolutions. 20 March 2018 Page 4 of 36

5 Membership growth. Identification and development of Member Leaders. Bupa Care Services Bargaining for new Enterprise Agreement Long-running negotiations with Bupa Care Services for an Enterprise Agreement have recommenced. The last negotiation meeting was held in June 2017; negotiations stalled when Bupa provided an administrative pay increase to employees on 1 July 2017 of 2.1%. The focus of negotiations has been staffing and the low wages Bupa pays to nurses. Bupa returned to negotiations in January 2018 and have indicated a new interest in working constructively with the Association and the HSU towards an Enterprise Agreement. The re-commencement of bargaining coincided with a significant increase in Association organising activity in Bupa facilities. Association officers are conducting extensive 1:1 conversations with members and potential members in Bupa facilities around NSW, with a view to visiting all 30 facilities across the state by mid-march. Bupa has made an improved offer of pay and conditions, including a Staffing and Workloads clause and a Family and Domestic Violence Leave Clause. Association officers are simultaneously talking to nurses at Bupa about the National Aged Care Ratios Campaign. Members at Bupa have raised serious concerns about staffing issues, which is both a bargaining claim and the focus of the national campaign. Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.4 Strategy 1.5 Key Direction 2 Strategy 2.1 Strategy 2.2 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure a focus on retaining as many members as possible Review and implement improved Association approaches and processes for collective bargaining and enforcement of rights Ensure that advocacy and bargaining aligns with our growing capacity to influence Extensive 1:1 conversations in the workplace with nurses to: o ensure extensive consultation with members on Bupa s improved offer of pay and conditions; o agitate and build power; 20 March 2018 Page 5 of 36

6 o o recruit members; and identify new member leaders. Use of targeted 1:1 phone conversations with nurses for mapping, recruitment, and potential Member Leader identification. Use of Facebook, SMS and s to reach members. Member feedback on Bupa s offer has shaped our preliminary response to Bupa during bargaining. Linking organising work for bargaining at Bupa with the National Aged Care Ratios Campaign. Membership growth. New Member Leaders have been identified. Bargaining is continuing. Christadelphian Homes Limited Restructure and removal of nursing hours Members at Chamberlain Gardens Aged Care facility on the Central Coast were notified that the facility was going to remove Certificate IV shifts, impacting approximately eight to ten staff. The NSWNMA was notified of the proposed changes on 5 March 2018 by way of written correspondence. Members were extremely upset about the proposed changes. Discussions were held between staff and management on 5 March More meetings are to be held to capture all staff impacted by the proposed changes. Key Direction 1 Strategy 1.3 Strategy 1.5 Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Ensure a focus on retaining as many members as possible Members are incensed at the situation and were vocal about the changes at the meeting with management and have requested industrial support from the Association. Recruitment of new members, with the branch becoming engaged and active. Healthscope Private Hospitals Member Growth and Development In anticipation of the current NSWNMA Healthscope Enterprise Agreement expiring in 2020, an ongoing campaign in preparation of bargaining is well underway. This consists of a focus on growth and development of the members, Branches and workplace leaders, in order to grow our power and influence. 20 March 2018 Page 6 of 36

7 New Graduates Orientation Key Direction 1 Strategy 1.1 Grow power and influence by increasing the number of Association members The Newcastle Private Hospital Branch initiated, and the Association then organised, a Subway luncheon and talking slot at the Newcastle Private Hospital new graduate orientation. Successful approaches to Prince of Wales Private Hospital and Hunter Valley Private Hospital also occurred, however it will be new graduate 2018 in-services instead of orientation, where luncheons/access will be provided. 16 new graduates attended and spoke with Association Officers. Some Branch Officials attended and were introduced to the new graduates. New Member Leaders have been identified. The Sydney Clinic Key Direction 1 Strategy 1.3 Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Members working at the Sydney Clinic at Bronte contacted the Association about management s unilateral change to rosters and hours, along with Work Health & Safety (WHS) issues in relation to malfunctioning duress alarms and insufficient amenities. The Association exercised a Right of Entry notice and visited the workplace. A WHS inspection was required and later undertaken. Management changes to rosters and hours were withdrawn. Amenities and some duress alarm issues were being remedied during the WHS inspection. A Branch formation is to occur. Importantly, the Healthscope Enterprise Agreement provides paid union leave for delegates. A report on the WHS issues has been completed and provided to management, with a number of improvements commenced, including the provision of a new staff room. Justice Health & Forensic Mental Health Dispute: FTE reductions / Shared Model of Care Since October last year members across a number of sites have become increasingly concerned regarding FTE vacancies, Shared Model of Care (SMoC) impacts and excessive workloads. The Association has evidence that FTE staffing has been removed from at least one site. The NSWNMA is currently in dispute and members are providing information. 20 March 2018 Page 7 of 36

8 Key Direction 1 Strategy 1.2 Strategy 1.3 Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Some sites have been visited and Justice Health & Forensic Mental Health (JH&FMH) was requested to provide staffing profiles. In response, only the vacancy rates have been provided, which is not satisfactory. The NSWNMA is now considering the use of Right of Entry (RoE) to gather further information. Bathurst Correctional Centre will form a branch and member leaders have been identified. Members at Wellington, have escalated their issues and reasonable workload training will be conducted so they can immediately formalise their issues through the Award process. The RoE approach has been endorsed by members. Dispute: Forensic Hospital Management actions creating unsafe staffing levels/ Failure to consult The vacancies at the Forensic Hospital again exceed 30 FTE, which has resulted in high levels of overtime, particularly on night shifts where members rostered on afternoon shift proceed to night duty overtime and then return to a rostered shift the following day. JH&FMH management have introduced a policy that staff working overtime must finish at either 03:30 or 05:30 hours to ensure they were available to start at their rostered shift at 13:30 hours. Additionally, the memo inferred that staff had been wrongly claiming payments when not at work; an audit will be undertaken by their payroll department. Key Direction 1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Members called a branch meeting and passed resolutions seeking management maintain the status quo and that the Association pursue management which then resulted in a dispute being lodged. The branch meeting was very well attended and endorsed other measures such as, the limitation of overtime and a renewed campaign to push for the return of 12-hour shifts. The Association notified a Dispute meeting with the Forensic Hospital but failed to persuade them that the practice of sending staff home at 05:30 hours was both a breach of clause 53 and an unsafe practice. The Branch and Association have agreed that a Right of Entry should now be exercised to obtain records related to their non-compliance with the Award. 20 March 2018 Page 8 of 36

9 Records were obtained and revealed 86 occasions from September when staff were sent home at 05:30 hours which resulted in a fall below agreed minimum staffing on the lowest staffed shift. Members have been made aware of the results and are yet to discuss at the branch level. Linburn Nursing Home Transmission of Business In or about September 2017 the Association was advised that Linburn Nursing Home at Burwood would be acquired by Pathways Aged Care Group ( Pathways ) from 1 March Key Direction 1 Strategy 1.1 Strategy 1.3 Grow power and influence by increasing the number of NSWNMA members Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members to use their influence The Association raised concerns with Pathways in regards to: the failure of Pathways to recognise members contracted hours with Linburn; the failure of Pathways to recognise member s previous service with Linburn for the purposes of leave entitlements and the waiving of the probation period; and in the event that Pathways is unable to offer contracted hours then members will need to be offered a redundancy by Linburn. The Association on 27 and 28 February 2018 met with both members and Pathways and negotiated new contracts of employment. Further meetings where held with Linburn in respect to members who were not offered contracts for various reasons. After lengthy negotiations between the Association, Pathways and Linburn, the Association was able to successfully negotiate new contracts of employment with Pathways that would ensure that members contracted hours where transferred as well as all leave entitlements. The Association was able to negotiate a number of redundancies for members who did not want to be transferred to Pathways on a Casual Employment basis. The Association was able to recruit new members as a result of the transmission of business. Mid North Coast and Northern NSW Local Health District Foundation phase of the Community Health Campaign The foundation phase of the campaign is focused on targeted visits and 1:1 conversations with community nurses throughout LHDs. 20 March 2018 Page 9 of 36

10 As part of the Community Health Campaign the Association developed a survey and target sites to: maximise engagement and survey response to build campaign foundation identify leaders and re-engage this sector recruit members map the sites collect the stories of the erosion and privatisation Key Direction 1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems To date 16 Community Centres over a two week period have been visited and with 1:1 conversations held. Members and non-members were engaged in the survey and its importance. Members were encouraged to tell their story about what was happening in their LHD/site, particularly around workloads, erosion of services, outsourcing and the impact of privatisation. Community Health Centre visits resulted in a large spike in responses and identification of leaders who are keen to engage in a campaign. Actively use political and community lobbying campaigns to assist with advocacy and bargaining outcomes. Community nurses shared stories regarding the neglect and financial abuse of the elderly community being forced to use private operators via the My Aged Care model. Survey responses continue to come through and will be collated for the report to present at CoD as a first strategy in visibility for this sector. Murrumbidgee Local Health District Wagga Wagga Rural Referral Hospital/ Continuing Education Allowance An individual inquiry was received by a member who was employed and working as a midwife and held a nursing and a midwifery registration. Her application for Continuing Education Allowance (CEA) was initially rejected by the LHD on the grounds of advice they had allegedly received from the Ministry of Health. The LHD s position was that as the midwifery qualification was the qualification which led to registration (as a midwife) it did not attract the CEA. 20 March 2018 Page 10 of 36

11 Key Direction 1 Strategy 1.4 Strategy 1.5 Key Direction 2 Strategy 2.1 Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure a focus on retaining as many members as possible Review and implement improved Association approaches and processes for collective bargaining and enforcement of rights A search the Association s membership records revealed that a number of members across the State were affected by this and were contacting the Association with individual issues. Following consultation with the relevant Association officers assisting the affected members, a strategic plan was formulated to continue to apply pressure on the LHDs in the individual matters. A number of representations were made to the LHD as to the CEA provisions with the Public Health System Nurses and Midwives (State) Award 2017 and the Continuing Education Allowance policy directive PD2012_002 including the intent of the provision. The matter was resolved prior to reaching a dispute stage. The Association received formal notification from the Murrumbidgee LHD that the advice from the Ministry of Health has been revised and nurses who held dual registrations are eligible for the CEA. Ministry of Health Continuing Education Allowance policy directive was updated (see new PD2018_008) to reflect the intent of the provision. Specifically, sec 3.5 was added: Registered Midwives in Groups 1 and 3 In keeping with the guiding precepts set down in paragraph 17 of the November 2004 decision by the IRC, Registered Nurses who have completed a post graduate qualification that has led to registration as a Midwife are able to apply for CEA on the basis of their midwifery qualification. This is provided that all other criteria for eligibility are met. Both registrations as a Registered Nurse and a Registered Midwife must be current. Registered Midwives who do not hold concurrent registration as a Registered Nurse are not eligible to apply for CEA on the basis of the qualification that led to registration as a Midwife. Such Midwives are eligible to apply for CEA on the basis of a post graduate qualification obtained (in a relevant specialty) in addition to the qualification leading to registration as a Midwife. Apart from removing any ambiguity as to the application of the allowance to midwives with dual registrations, the addition of this section also primitively addresses issues which may arise regarding the date from which the allowance would apply. 20 March 2018 Page 11 of 36

12 NSW Health Service - non-compliance with NHPPD requirements Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Key Direction 2 Strategy 2.3 Strategy 2.7 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Hornsby Hospital, Northern Sydney Local Health District Significant concerns had been raised by members regarding compliance with staffing as set out in the Award. On 22 November 2017 Association officers undertook a records review at Hornsby Hospital exercising right of entry to access documents relating to non-compliance with clause 53 of the Award. Despite the reluctance of the Hospital to provide unabridged copies of requested documents, access revealed breaches of a magnitude not inconsistent with those found at John Hunter Hospital. The Association notified the NSW IRC of a dispute and highlighted the level of noncompliance. Recommendations were sought in similar terms to those achieved for Belmont Hospital. One sticking point was the replacement of, for example, an eight hour shift in its entirety, rather than a partial backfill of a lesser time. The Commission requested that the Association confer with the Ministry and the LHD on this point. Following such discussions, the LHD has now agreed that the starting point must be to fill the shift in its entirety. John Hunter Hospital, Hunter New England Local Health District On 25 August 2017 the Association undertook a review of records at John Hunter Hospital after concerns were raised regarding non-compliance with the terms of Clause 53 of the Award. This review was a result of significant concerns from members regarding unreasonable staffing levels and excessive and unsafe levels of overtime. This review revealed an unprecedented level of non-compliance with NHPPD. The Association s calculations showed some 6,695 nursing hours (or equivalent to 900 days or 23 weeks) below the award required minimums on NHPPD wards over a seven-month period 31 December 2016 to 31 July March 2018 Page 12 of 36

13 On 19 October 2017 the John Hunter Hospital voted to take industrial action in the form of a ban on undertaking follow up phone calls to discharged patients. On the same day HNELHD filed urgent dispute proceedings in the NSW IRC regarding the Association s bans. On 20 October 2017, following a strong recommendation from the Commission, the JHH Branch voted to lift the bans pending resolution of this issue in the Commission. Between October 2017 and February 2018 a number of meetings were held between the Association and the District regarding the issues under dispute in this matter along with three report backs before Commissioner Stanton of the IRC. On 15 February 2018 the parties reported to the IRC that consensus had been reached on issues in dispute. Agreement was reached on amendments to HNELHD Local policies dealing with the following; follow-up phone calls, staffing - rostering and replacing unplanned nursing and Midwifery Leave, and Patient requiring additional supervision. These amendments ensured policies and practices of the District now comply with clause 53 of the Award. HNELHD are now ensuring compliance of minimum NHPPD staffing levels. HNELHD Executive Management issued correspondence to all management staff regarding the requirement for compliance with NHPPD HNELHD fast tracked requirement to vacant nursing positions. HNELHD have implemented a new permanent relief pool in addition to casual positions. Manly Hospital, Northern Sydney Local Health District Concerns from members regarding apparent non-compliance by Manly Hospital to clause 53 of the Award. In response, Association officers notified Manly Hospital of its intention to undertake a records review by exercising right of entry to access documents relating to non-compliance with clause 53 of the Award. Access to documents was obtained on 11 January Following a review and collation of the data received, a disputes meeting has been instigated by the Association to discuss the apparent non-compliance with the award. Mona Vale Hospital, Northern Sydney Local Health District Concerns from members regarding apparent non-compliance by Mona Vale Hospital to clause 53 of the Award. In response, Association officers notified Mona Vale Hospital of its intention to undertake a records review by exercising right of entry to access documents relating to non-compliance with clause 53 of the Award. 20 March 2018 Page 13 of 36

14 Access to documents was undertaken on 30 January Preliminary feedback suggests breaches of a magnitude not inconsistent with those found at John Hunter Hospital. A disputes meeting has subsequently been held regarding non-compliance with the award. Further work may be required to drill down on additional documentation to be provided by the LHD. Nepean Hospital Penrith, Nepean Blue Mountains Local Health District Concerns were raised by members regarding compliance with staffing as set out in the Award. In response, Association officers notified Nepean Hospital of its intention to undertake a records review by exercising our right of entry to access documents relating to non-compliance with clause 53 of the Award. Access to documents was undertaken on 5 February Data is currently being collated. Westmead Hospital, Western Sydney Local Health District Concerns from members regarding apparent non-compliance by Westmead Hospital to clause 53 of the Award. On 20 December 2017 Association officers undertook a records review at Westmead Hospital exercising right of entry to access documents relating to non-compliance with clause 53 of the Award. Records and data have been compiled. This has revealed breaches of a magnitude probably even greater than those found at John Hunter Hospital. A meeting with Westmead Hospital/LHD representatives occurred on 30 January 2018 to discuss these outcomes. A disputes meeting has subsequently been held regarding non-compliance with the award. Ramsay Health Care Enterprise Agreement negotiations The NSWNMA Ramsay Enterprise Agreement campaign has commenced with Enterprise Agreement negotiation meetings underway. Key Direction 1 Strategy 1.3 Strategy 1.4 Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems 20 March 2018 Page 14 of 36

15 Key Direction 2 Strategy 2.1 Review and implement improved Association approaches and processes for collective bargaining and enforcement of rights Negotiations commenced in November 2017, and regular meetings are continuing, with the most recent meeting occurring on 16 March. Our bargaining team includes eight delegates representing the majority of nursing specialities. Delegates come from Lake Macquarie Private, Westmead Private, Kareena Private, Wollongong Private, St George Private, North Shore Private, Tamara Private and Castlecrag Private Hospitals. The current Agreement will nominally expire at the end of March, with a wage increase due in July. Safe Staffing remains our members number one issue; the staffing claims are accompanied by an extensive list of conditions claims. Organising activity continues to put pressure on the employer around targeted issues. Negotiations are continuing. Empowerment of Member Leaders. Education of Member Leaders. Branch Biennial General Meetings Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Strategy 1.5 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure a focus on retaining as many members as possible The Association s Ramsay team s focus is on growth and development of the members, Branches and workplace leaders, in order to grow power and influence. The team maintains 16 Branches and currently have 10 Branches that have completed the BGM process and the remaining six BGMs are scheduled to be held over the next few weeks. Through this process the team recruited a significant number of new members in early 2018, and have had nominations from new delegates. New Member Leaders have nominated for Branch positions and they are passionate about the roles. Baringa Private Hospital at Coffs Harbour will soon form a new branch. All positions have nominations and are awaiting for nurses to return from holidays before holding the meeting. The Association s Ramsay team have been focusing on Member Leader development, mapping and setting targets for new Leaders and contacts across all Ramsay Hospitals in NSW. 20 March 2018 Page 15 of 36

16 Increased Association visibility and presence. Membership growth. Identification, development and empowerment of Member Leaders. Increased social media engagement and awareness. Increased awareness of rights to enforce and question the Enterprise Agreement. Engagement in the new Agreement campaign and a buzz around ratios. New Branch to be formed at Baringa Private Hospital. 20 March 2018 Page 16 of 36

17 KEY DIRECTION 2 Be innovative in our advocacy and bargaining New challenges and environments require new thinking and continuous improvement of professional and industrial advocacy and bargaining. The Association will directly represent and organise members and their workplaces, as well as engage with the community and other key stakeholders, to achieve advancement in professional and industrial outcomes. STRATEGIES 2.1 Review and implement improved Association approaches and processes for collective bargaining and enforcement of rights 2.2 Ensure that advocacy and bargaining aligns with our growing capacity to influence 2.3 Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance 2.4 Actively use political and community lobbying campaigns to assist with advocacy and bargaining outcomes 2.5 Campaign to extend enforceable staffing arrangements for safe patient care into other sectors 2.6 Review Association approaches and processes for linking professional advocacy to organising and growth 2.7 Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups BaptistCare BaptistCare NSW & ACT Aged Care Enterprise Agreement 2017 BaptistCare is a large not-for-profit aged care employer with 23 facilities in NSW. The Association primarily has coverage of Registered and Enrolled Nurses, with the majority of care staff being employed as Care Service Employees. BaptistCare also operate home care services, so the bargaining was undertaken jointly with the Health Services Union and United Voice. The bargaining commenced in September 2017, with employees returning a 66% yes vote in early March The Agreement is currently being lodged with the Fair Work Commission. Key Direction 2 Strategy 2.1 Strategy 2.2 Review and implement improved Association approaches and processes for collective bargaining and enforcement of rights Ensure that advocacy and bargaining aligns with our growing capacity to influence 20 March 2018 Page 17 of 36

18 A number of claims were put to BaptistCare, including a pay increase and improvements to long service leave, parental leave, study leave and family and domestic violence leave. After BaptistCare made an initial pay offer of 2% per year for three years, consultation with members demonstrated a lack of support for this proposal. This view was relayed to BaptistCare causing them to reconsider their initial position on pay. After further negotiations an improved offer was provided. This offer was reflected in the Agreement put to staff for approval in February The outcomes included: o o o o o A pay offer of 2% from December 2017, 2.1% from December 2018 and 2.2% from December Increases to the broken shift allowance and the on-call allowance. Increase to paid adoption leave, partner leave and natural disaster leave. Five days family and domestic violence leave. AiNs to accrue time off in lieu at overtime rates. BaptistCare insisted that the travel and Certificate III allowances be changed and pursued this claim throughout bargaining, resulting in a reduced travel allowance rate and the Certificate III rate being frozen and only applied to current staff. Family and Community Services Dispute: Aspects of the forced transition of FACS staff to the NGO sector Issues continue to arise with the rollout of the NDIS and the decision of the NSW Government to vacate the disability field entirely, which will result in FACS employees being transferred without their consent to various NGO providers. Key Direction 2 Strategy 2.7 Key Direction 1 Strategy 1.2 Strategy 1.5 Key Direction 3 Strategy 3.2 Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Identify new member leaders who can build their workplace influence Ensure a focus on retaining as many members as possible Identify the features of a world class, well-funded, integrated health system The Association felt it had no alternative but to notify the Commission of a dispute relating to global and/or threshold issues of the forced transfer of FACS staff. At the conclusion of the conciliation phase of the dispute, two matters remained outstanding. 20 March 2018 Page 18 of 36

19 Recognition of previous public sector service if returning to the government sector. This remains the subject of discussions and representations with NSW Treasury (NSW PSIR). The Association had also written directly to the Minister for Disability Services and the Public Service Commissioner seeking their respective intervention. Dispute resolution clause. This issue relates to the enforceability of terms and conditions of employment of transferring FACS staff when employed by a NGO provider. This was subject of a Full Bench hearing on 5 October This decision, recently handed down, felt that a change to the dispute clause to achieve clarification would be of little to no utility. The Association will as a result maintain its primary position that the clause as contained in the copied state instrument that follows a transferred employee provides to the Fair Work Commission the same rights and powers as exercised by the IRC of NSW. The Association continues to provide assistance to individual members affected by the transfer. Leading Aged Care Services LASA Template Enterprise Agreement 2016 Leading Aged Care Services (LASA) Template Enterprise Agreement is negotiated to cover employers in the aged care sector who belong to LASA. The use of a template agreement allows the NSWNMA to deliver pay increases and improvements to conditions to members across a significant percentage of the aged care sector. Key Direction 2 Strategy 2.1 Strategy 2.2 Review and implement improved Association approaches and processes for collective bargaining and enforcement of rights Ensure that advocacy and bargaining aligns with our growing capacity to influence In March 2015, the NSWNMA approached LASA to renegotiate the previous LASA template agreement. Claims were developed through member consultation via a survey and phone conference meetings. In June 2015, LASA ceased negotiations and gave employees a 1.3% wage increase by administrative increase, effective 1 July Negotiations between LASA, HSU and NSWNMA recommenced in May Effective member communication and use of Committee of Delegates resolutions resulted in an improved wages offer which was then put to members with all employers voting in favour of adopting the new agreement. Once the parties reached agreement on the template, the template was rolled out to employers, and voted on by employees. Thirty one employers have adopted 43 template agreements so far, covering 80 facilities and 6,229 beds. Some employers have agreed to further improvements to the template which have been negotiated between the NSWNMA, HSU and the individual employer. Of the 31 employers who have adopted the template agreement, the final two agreements were approved by the Fair Work Commission in December March 2018 Page 19 of 36

20 Pay increases of 3% in 2017, 2% in 2018 and 2% in Most allowances to increase by the same quantum as the pay increases. Improvements to conditions including: o o o o o o o Payment of National Police Checks by the employer after 2.5 years of service of continuous service for full-time employees; Family and Domestic Violence Leave (accessed through Personal carers leave); New Influenza Vaccination payments; Inclusion of Home Care classifications; Cashing out of ADOs; Change of roster by mutual agreement within 7 days (allows members to swap shifts); Casual employees to have the same overtime rights as permanent employees. NSW Government Relocation of the IRC of NSW to Parramatta In late January 2018 the NSW Government seemingly decided to relocate the Industrial Relations Commission of New South Wales from the central business district of Sydney to Parramatta. The decision was made without any consultation with the employees working at the Commission, the Public Service Association (PSA) or other users of the Commission including unions and employer representatives. Key Direction 2 Strategy 2.7 Key Direction 3 Strategy 3.4 Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Develop initiatives, affiliations and partnerships on issues that affect NSWNMA members The PSA notified a dispute regarding the lack of consultation and all public sector unions, including the Association, intervened. The Association has argued that the relocation would impose an additional barrier to accessing the Commission particularly for rural and regional members who often fly to Sydney for proceedings. The Government subsequently agreed to engage in some form of consultation, albeit quite inadequate. Unions remain unaware of key aspects of the decision including the Minister responsible and the rationale. The Government has decided to press ahead with the decision despite all unions and users of the Commission being opposed to it. Unions are continuing to lobby Government on the matter. 20 March 2018 Page 20 of 36

21 Ramsay Health Care Northside Clinic - Work Health and Safety Investigation Ramsay have closed their 88 bed mental health facility, Northside Clinic at Greenwich, and relocated operations to a brand new 122 bed facility, Northside Clinic St Leonards, which commenced operations in February. Prior to the opening of the new facility, members raised with the union WHS concerns regarding an unsatisfactory consultation process, manual handling hazards with new bed heights and systems of work issues including a proposed new medications administration system, security and duress arrangements, safe staffing and skill mix and emergency procedures. Key Direction 2 Strategy 2.2 Strategy 2.6 Ensure that advocacy and bargaining aligns with our growing capacity to influence Review Association approaches and processes for linking professional advocacy to organising and growth The Association commenced a WHS investigation with site inspections occurring at the Greenwich facility on 5 February and at the new St Leonards facility on 8 February. WHS inspections have occurred at the old and new facility allowing the union to gain valuable information into potential WHS issues for members with relocation to the new facility. A WHS report will be developed from the investigation with recommendations for Ramsay to address WHS concerns. A valuable advocacy experience for members from which to link to the formation of a Branch and WHS workplace structures. 20 March 2018 Page 21 of 36

22 KEY DIRECTION 3 Promote a world class, well-funded, integrated health system Increasingly, health is becoming a defining political issue in our country and budget decisions impact on the delivery of care. The Association will be an effective advocate for delivery of quality outcomes of care in an ever-changing health system and influence policy and decisionmakers to invest in prevention and universality. STRATEGIES 3.1 Consult with Association members on their vision of an integrated health system 3.2 Identify the features of a world class, well-funded, integrated health system 3.3 Develop an education program for Association members and member leaders 3.4 Develop initiatives, affiliations and partnerships on issues that affect Association members 3.5 Advocate and influence decision makers on key issues that affect Association members and the delivery of care ~ ACTU Change the Rules campaign ACTU Secretary, Sally McManus, will officially launch the ACTU s Change the Rules campaign at the National Press Club tomorrow and her address will talk about the solutions needed to change laws at work because they are no longer strong enough to guarantee and protect workers rights. The Change the Rules campaign will feature local community and workplace campaigning, as well as a nationwide media campaign that will continue up until the next federal election. The TV advertisements are already screening on the major free-to-air channels. The next major campaign event is a national day of action, which will be held as part of the traditional May Day March. The Sydney May Day event will be held on Sunday, 6 May at 11.00am. This year, the March will start at Hyde Park North and head south to Prince Alfred Park. Flyers are available at this CoD and delegates are asked to take these back to your workplace for distribution to your colleagues. The ACTU has asked all unions to encourage members, their family and friends to participate and to have a strong presence at the May Day March. NSWNMA members are asked to wear their scrubs and bring your family and friends; a BBQ, free rides, entertainment and children s activities will be available following the March. 20 March 2018 Page 22 of 36

23 Central Coast Local Health District Gosford Hospital Redevelopment The Gosford Hospital Redevelopment continues with USCC meetings ongoing. Key Direction 3 Strategy 3.1 Consult with Association members on their vision of an integrated health system The Association has been meeting with the CCLHD since late 2017 regarding the redevelopment. The early move of the Cancer Day Unit that occurred in January went well in terms of logistics. However, as the move progressed, members of the Unit saw that management had not been supportive in the workplace. The Association encouraged members to attend the branch meetings that occur every month to raise their issues. The branch and members continue to be canvassed around the consultation they have been involved with. The Association will continue to work with the nurses of the Cancer Day Unit regarding the issues they have raised and identify member leaders. The USCC has helped to identify the concerns the Cancer Day Unit members have in relation to the redevelopment. The Association identified that some wards/units are also extremely concerned about moving to the new building to a new speciality unit (mostly surgical). Ministry of Health A new Managing Complaints and Concerns about Clinicians Policy Directive The Ministry of Health recently approached public health unions to consult on a proposed new Managing Complaints and Concerns about Clinicians Policy Directive, along with some ancillary changes to related policies and information sheets. The approach being adopted by the Ministry will result in any new PD superseding both the current policy (PD2006_007) and the associated Guidelines (GL2006_002). Key Direction 3 Strategy 3.4 Strategy 3.5 Develop initiatives, affiliations and partnerships on issues that affect NSWNMA members Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care It would appear that one of the key drivers of these changes, apart from developing a more robust and consistent approach across NSW Health organisations, is that such processes should be reserved for the more serious issues requiring a formal approach, as opposed to those that should be dealt with at a local level between a staff member and their supervisor/manager. This is a general approach that the Association endorses. It is essential that such a framework is consistently applied and any approach adopted is proportionate to the issue(s) involved. 20 March 2018 Page 23 of 36

24 The Association with other public health unions met with the Ministry. The Association subsequently provided to the Ministry some initial thoughts and feedback on the drafts provided and approach to be adopted. Further consultation pending. An amended Occupational Screening and Vaccination Policy Directive The Ministry of Health recently approached public health unions with an amended draft policy directive Occupational Assessment Screening and Vaccination Against Specified Infectious Diseases. Key Direction 3 Strategy 3.4 Strategy 3.5 Develop initiatives, affiliations and partnerships on issues that affect NSWNMA members Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care The key changes originally proposed included: Re-categorisation of positions to include a Category A High Risk position for workers employed in high risk clinical areas; Mandatory Annual Influenza Vaccination Program for workers employed in Category A High Risk positions; Inclusion of Termination of Employment (where reassignment to a non-high risk clinical area is not feasible); and compliance monitoring and reporting. The Association with other public health unions met with the Ministry. The Association provided to the Ministry immediate feedback and subsequently further detailed comment on a revised draft issued. The Association has been successful in having the draft amended to squarely deal with an identified ambiguity in the original so that it is now clearly understood that NSW Health staff who have a medical contraindication to vaccination etc will be risk managed, and will not be subject of any action to terminate their employment. Termination of employment remains solely an option of last resort in those situations when dealing with staff who refuse to comply with requirements within the policy directive and cannot be reasonably managed in any other way. A handful of other aspects were also subject to feedback by the Association. The revamped directive (PD2018_009) was subsequently released on 5 March March 2018 Page 24 of 36

25 Northern Sydney Local Health District - Ministry of Health Northern Beaches Hospital transition process The NSW Government has contracted Healthscope to build and operate (and be the employing entity of staff) at a new Northern Beaches Hospital located at Frenchs Forest. This new hospital would be in lieu of public health services currently provided at Manly and Mona Vale Hospitals, with Manly Hospital closing entirely, and residual services remaining at Mona Vale Hospital. Key Direction 3 Strategy 3.4 Key Direction 1 Strategy 1.5 Key Direction 2 Strategy 2.7 Develop initiatives, affiliations and partnerships on issues that affect NSWNMA members Ensure a focus on retaining as many members as possible Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Northern Sydney Local Health District ( District ) released in October 2017 a document that set out a suggested expression of interest ( EOI ) process that establishes the framework to manage the transition of staff from Manly and Mona Vale Hospitals to the Northern Beaches Hospital. After receiving feedback from members, the Association and workplace representatives from both hospitals met with the District to discuss the EOI process released, and provide feedback and possible suggested modifications. This was followed up in writing. The EOI process commenced in February Not unexpectedly, it has not alleviated the concerns or uncertainty felt by many members. Despite a lead in time of years, much was needed to be done/clarified/resolved. Following representations from the Association, the timeline was extended till 13 March 2018 to attempt and resolve outstanding issues. NSW Parliament Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation 2016 Disallowance motion to be debated in the NSW Parliament. Key Direction 3 Strategy 3.4 Develop initiatives, affiliations and partnerships on issues that affect NSWNMA members Delegates will recall from previous updates that the then Baird NSW Government (without any prior warning or consideration to consult) had the Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation 2016 ( Regulation ) gazetted. The Regulation further eroded the rights of government sector workers whose role may be subject to privatisation. 20 March 2018 Page 25 of 36