in the arguments to support proposals, perhaps we should be referring to the stifling effect ( of current grading critieria) on our morale

(KT, Tweed Heads)

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is it likely to be possible to prove that CMO's actually save money, or is this theoretical? would the issue of potentially better medical care from more experienced staff be given at least equal importance compared with money-saving issues (or is money all that matters?)

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This is a great start, and should probably go out (ie: put on CMOA website) whether or not anyone gives any comments - we need to generate some debate and interest.

Do we need to be careful not to overextend our aim ? - this could prejudice our action before we even get going.

We do however need to find out which or all of these segments are the important one to our members - is it possible to have a straw poll going on each of these segments ?                (not sure how to do this .. .. perhaps gauge it by the number of comments each section attracts .. Webmstr)

On the same vein, how about an area for comment on each section - particularly in the negative (these arguments need to be known if we are to develop effective counter - arguments     .(well here they are .. Webmstr)

(MB, Camden)

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David you have produced a superb communication network which undoubtably will considerably help the decision around the new CMO award.

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Regarding changes to the award:

a Suggestion... That CMOs are able to move from fulltime to permanent part-time and from permanent part-time to fulltime without penalty, given reasonable notice.
Arguments for: eg. Parents could share childcare responsibilities and keep their jobs and skills.
Precedents: eg. schoolteachers have this option.
Arguments against: may interfere with staffing levels.

(DT Tweed heads)

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suggesting a new Logo for the CMOA


(Comrade Rod Street, Tweed Heads)

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Q. Having paid a fortune to be represented by ASMOF is there any added benefit to joining your organisation (CMOA) as well? [David Engel, Tweed Heads]



A. good Q. asked by many other CMOs as well. CMOs cannot represent themselves in an industrial court and neither can the CMOA - only ASMOF or HREA can do this, making membership of one of these organisations adviseable.

These industrial organisations however have large memberships that have little relationship to CMO practice - ASMOF having most of the staff specialists and clinical academics and HREA having many allied health workers. We believe that an organisation that looks at the WHOLE spectrum of CMO endeavour - Educational, Professional and Industrial - is far more likely to be successful in looking after its members interests in the long run. A good example of this is the CMOA website organised by David Brock - ASMOF and HREA would not be capable or interested in doing the same for Career Medical Officers.

Anaesthetists and Emergency Physicians have their own professional organisations as well as many having membership of an industrial organisaton such as ASMOF or the AMA. CMOs need to be united as a separate, identifiable group that have strength in their common interest - only the CMOA can provide this focus.

At $100 / Yr it's real good value!! Join!

[John Egan, CMOA President]

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I wonder whether there should be a CMO Award at all. The Queensland System (and other states) has a combined award which recognises specialist qualifications by a higher entry level and a higher ultimate salary.

There is little difference between a "CMO" of fifteen years experience and say a Specialist of 2-5 post graduate experience, why then should there be two awards. I think the preferred option would be to set levels of entry to the Senior Medical Officers Award appropriate to non specialists and advancement similar to the SS, but with perhaps a lower final attainment level which acknowledges the specialist qualifications.

This would eliminate the CMO status and recognise that the CMO is in fact a non specialist Senior Medical Officer, and this would be portable to all the areas which currently CMO's work.

The position of CME could be still taken up by an organisation such as the "CMO" Association, or in fact CME could be set up within the specialist colleges, such as Psych or Emergency. What do others think?

(MK Coffs Harbour)

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I AGREE IN PRINCIPLE WITH MK'S ARGUMENT ABOVE. I BELIEVE WE SHOULD APPEAR ON 'THE SCALE OF THINGS'; THERE SHOULD BE A UNIFIED SCALE WITH SPECIALISTS BUT OF COURSE OUR PROGRESSION WILL HAVE TO BE LIMITED.

(RS Rozelle, Sydney)

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In developing our own award/salary structure, we should be developing a list of priorities of what we think is extremely important down to those things that can be "bargained away". This will of course take time.

I'm afraid that I've had enough recent experience of how the Health bureaucracy works to know that they are very very good at "playing the game" and will use any method to delay and obfuscate when they think it's going to cost money. This has some implications:

1. We have to have good quality marshalled evidence to show that CMO's are very good value for money

2. We need the help of those used to arguing in these circles. None of us are going to be good enough, or even able to get to "first base: without the backing of one or more of these organisations. This however, means that we also must deal with the other agendae that these organisations have eg: staff specialists with ASMOF, General Practitioners with the AMA. I'm not sure what other HAREA agendae HAREA will have - but it would surprise me if even the enlightened organisational structure that they have would entirely be CMO driven.

ie: - we are, in political terms, "just another lobby group". We have to become good at lobbying for ourselves cos no one else will !!!

Michael's idea of using the staff specialist award has many plusses. It's a long standing award that everyone understands, portability is at least recognised as an issue, and it might help the staffies from feeling paranoid about us if handled appropriately.

I still feel that we will lose our way if we don't have both arms of the organisation- the educational and industrial, working together. There are good and bad things about having the award populated with educational standards - I guess we'll see what happens with the MMO Agreement.

About the MMO - I don't know a whole lot but I do know that they had to show that they were cohesive enough to go on strike before anything tangible occurred - prior to that they had been run around in circles by the dept. The involvement of the AMA also helped. If you have specific questions I could try and find ut about them - we should be trying to increase our communication with this group anyway. ? does anyone have know why they pulled out of our industrial convention?

(MB, Camden)

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I have been having further thoughts about the Senior Medical Officers Award. Its probably unlikely that there can be anything added to the SMO Award at this time because it has been to the Industrial Courts in July 1998 and a settlement has been agreed which probably means nothing can be added to this award currently.

However I think another option would be to change the CMO Award to the Senior Medical Officers (non-specialist) Award and model this on the existing Senior Medical Officers Award.

I have problems including in the award levels of clinical expertise as the Multi-Skilled Medical Officers (MMO) Award does, I believe this is too proscriptive and gives the employer too much power.

Calling the award the Senior... describes the MO as more than JMO or Registrar. The point about unsociable hours is not addressed adequately in the existing SMO award, where payments above the award to the level of 5% gross salary are at the discretion of the CEO. I know of decisions not being made > 6 mths after applications for 5% increase, hence this does not work. There is another payment in the existing SMO award which goes to 10% but this is at the discretion of the Dept of Health and very difficult to get approval.

(MK, Coffs Harbour)

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I have just spoken to Australian Salaried Medical Officers Federation's (ASMOF) Executive Director, Peter Sommerville, about various options regarding the future of the CMO award. From his point of view he would like to see some developments relatively urgently, and is reviewing the current "proposals" mailed out to all CMOA members and listed on our web-site

Whilst other states have combined awards for "Specialist" and "Non-Specialist Senior Medical Officers", he sees "political" difficulties combining these 2 groups in NSW.

These "difficulties" relate to the DUAL industrial representation for NSW CMOs by both ASMOF and HREA (Health and Research Employees' Association of NSW)

ASMOF currently has exclusive representative rights for all Staff Specialists in NSW, and does not wish to share those rights with HREA. If ASMOF developed a combined staff specialist and CMO award, then it would be opening the door to HREA to represent Staff Specialists, as HREA would then need to be involved in all discussions affecting that award.

ASMOF would only agree to this, if HREA allowed ASMOF to have representative rights to all "Junior" medical officers (ie interns, RMOs, Registrars, etc) , a group of doctors they don't currently have access to.

Therefore it maybe politically more reasonable to retain our current "CMO Award" or re-invent it as a "SMO (Non-Specialist) Award", along the lines of the existing SMO award, but tailored to our needs.

(DB, Tweed Heads)

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I agree entirely with what Peter Somerville is saying and reiterate that now the award is to be renegotiated the time factor is critical.

You would be shovelling it uphill to get ASMOF to help in your plans if it meant getting into bed with HAREA.

The opportunity is there to pick out all the best parts of the Senior Medical Practitioners (Staff Specialists) award and incorporate it in a new award aptly named the same, but in brackets (Non-Specialist).

The difference is this award has to have had the overtime anomaly addressed properly (i.e. you don't have to beg to get the 5%, as Michael has pointed out, for onerous duties)

The award needs to have defined rates of pay for after-hours and overtime incorporated.

(PL)

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I have problems including in the award levels of clinical expertise as the Multi-Skilled Medical Officers (MMO) Award does, I believe this is too proscriptive and gives the employer too much power.

(MK, Coffs Harbour)

Re credentialling - do we need to looking at alternative ways of providing this (I note that the credentialling of MMO agreement is not really working yet )

Section d (ii) as far as possible needs to be deleted.

I would like to suggest that the new award be modelled on the Senior Medical Officers Award.

Entry at 3 years postgraduate level and then advancement per year on service in the same field to year 5, then a holding period until year 7 when the position would be called a Senior Multi-Skilled MO or CMO whatever. The level should be related to the years and not the skill level which I believe should be separated from the award.

Education should be also modelled on the SMO award, Multi skilled MO should have access to Post graduate education in doses similar to the Staff Specialists. The justification for this is clearly in the requirements to practice Benchmark Medicine, particularly at the unsavory hours in which some CMO's find thmselves working.

Skills levels could be developed by the Association and included as guidelines for the Area Health Services (AHS) to use for selection purposes.

CME would be an expected requirement by the AHS and would need to be presented each year or three year period.

Should there be more provision for involving the educational programme more in the award, or should it be kept separate?

The point about unsociable hours is not addressed adequately in the existing SMO award, where payments above the award to the level of 5% gross salary are at the discretion of the CEO. I know of decisions not being made > 6 mths after applications for 5% increase, hence this does not work. There is another payment in the existing SMO award which goes to 10% but this is at the discretion of the Dept of Health and very difficult to get approval.

(MK, Coffs Harbour)

Any new Award has to have had the overtime anomaly addressed properly, with defined rates of pay for after-hours and overtime incorporated. (i.e. so you don't have to beg to get the 5% in SMO Award, for "onerous" duties, etc)

(paraphrased from PL)

Some comments from a relative outsider regarding your proposals for award negotiation: As some of you may know I have been friends with Mary Webber for years, and I used to be an Air Traffic Controller (ATC). So I have experience with a totally different award structure, and thought that you might be interested in some comments from a different industrial perspective.

Firstly, ATC used to be subject to an overtime payments barrier at an artifically low level. However this was removed in the early to mid 1980s. I don't remember exactly when, but I could find out if anyone is interested, or if it helps your arguments. The result was a significant benefit for everyone over grade 2 (out of then 5 grades.)

Secondly, I don't know the full details of the AMA Safe Hours campaign, but I believe this is essential. ATC is a profession that demands clear thinking, lots of decision making etc, just like doctors. The ATC profession, because if they screw up it hits the news bigtime, is very heavily controlled and regulated by guess who - the medical profession.

ATC's have lots of nice things like:

a) maximum duty periods (10 hours, whether rostered shift or overtime),
b) minimum break times (1 x 30 min break in a 7 hour shift, 2 x 30 min breaks in an 8 hour or longer shift),
c) minimum time between shifts (10 hours, whether rostered or overtime) &
d) maximum number of consecutive days that can be worked (10), whether rostered or overtime, all because the medical profession's human factors experts have decreed that it is not safe for the human being to continue to work safely without these things.

I think you might be approaching the unpalatable hours thing the wrong way. Several unions that I am aware of have successfully combined many old allowances, into one higher overall salary. This has the sellable advantage of being much easier to administer. Air Traffic Contoller's (ATC's) used to put in a fortnightly time sheet, and a fleet of clerks laboriously calculated every shift allowance and penalty rate, and you got your money a month later. A few years ago the ATC association calculated the average across the whole country of all weekend & shift penalty rates, except overtime and public holidays, and put in a claim for that amount to be paid to everyone all the time, plus a bit more.

They were successful. This had several advantages:

a) Shiftworkers did not lose money when they went into management positions, thus attracting better candidates.
b) No one has to submit a time sheet, except to claim overtime and public holidays. This is now done by team leaders on shifts.
c)The employer saved a fortune because they did not need to employ a small fleet of pay clerks.

What I am suggesting is that CMOs consider the following:

1) Take your proposed new base rates as being the Monday-Friday normal hours rate.
2) Calculate all shift penalty and weekend penalty rates applicable for two types of rosters, which for convenience I will call A and B. An A roster, that you consider reasonable - say maximum of two weekends and 4 overnights per month. And a B roster, which would be the no outside life type of roster.
3) Calculate these allowances as a percentage of the base hourly rate by adding the dollar values over a fornight and calculating the percentage value over the normal rate of pay for the fornight, say A - 20% and B - 35%
4) This rate would then be payable for all shifts. And voila - you have generated additional pay scales for each CMO grade. eg. CMO 3.3 A, and CMO 3.3 B

So if your employer wants you to work an unsociable roster - you should be paid for all shifts at a higher rate. If they change you from a decent roster to an inhuman one you claim payment for all shifts at a higher rate.

I understand that some CMOs already work under individual enterprise bargain type agreements which include all allowances, and these could be looked at for ideas. If you can get more money, and make yourselves appealing to the employer by saving on admin costs - it should be win-win for everyone. Good luck. ATC Award information may be available from Civil Air Operations Officers Association of Australia. I don't know if they're on the web.

(Karyn, [Provides support services to the CMOA including printing CMO Bulletin])

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CMOs' Comments to General Salary Increase between 0 - 20 %

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I would like the award to include all on-call benefits enjoyed by Senior Medical Officers, such as financial compensation for use of motor vehicle, mobile phone, and appropriate remuneration. Presently we lose money by being on-call, (ie: have to provide own car & phone & limit our social and family activities)

(RS, Tweed Heads)

If we aren't being paid In-Charge Allowance because Management believes we are already being financially compensated for afterhours responsibilities as CMO II or III , then why aren't we entitled to the full penalty rates calculated according to our CMO hourly rate. Why fix our penalties to Registrar Rates ?!?

(MM, Tweed Heads)

I think you might be approaching the unpalatable hours thing the wrong way. Several unions that I am aware of have successfully combined many old allowances, into one higher overall salary. This has the sellable advantage of being much easier to administer. Air Traffic Contoller's (ATC's) used to put in a fortnightly time sheet, and a fleet of clerks laboriously calculated every shift allowance and penalty rate, and you got your money a month later. A few years ago the ATC association calculated the average across the whole country of all weekend & shift penalty rates, except overtime and public holidays, and put in a claim for that amount to be paid to everyone all the time, plus a bit more.

They were successful. This had several advantages:


a) Shiftworkers did not lose money when they went into management positions, thus attracting better candidates.
b) No one has to submit a time sheet, except to claim overtime and public holidays. This is now done by team leaders on shifts.
c)The employer saved a fortune because they did not need to employ a small fleet of pay clerks.

What I am suggesting is that CMOs consider the following:

1) Take your proposed new base rates as being the Monday-Friday normal hours rate.

2) Calculate all shift penalty and weekend penalty rates applicable for two types of rosters, which for convenience I will call A and B. An A roster, that you consider reasonable - say maximum of two weekends and 4 overnights per month. And a B roster, which would be the no outside life type of roster.

3) Calculate these allowances as a percentage of the base hourly rate by adding the dollar values over a fornight and calculating the percentage value over the normal rate of pay for the fornight, say A - 20% and B - 35%

4) This rate would then be payable for all shifts. And voila - you have generated additional pay scales for each CMO grade. eg. CMO 3.3 A, and CMO 3.3 B

So if your employer wants you to work an unsociable roster - you should be paid for all shifts at a higher rate. If they change you from a decent roster to an inhuman one you claim payment for all shifts at a higher rate.

I understand that some CMOs already work under individual enterprise bargain type agreements which include all allowances, and these could be looked at for ideas. If you can get more money, and make yourselves appealing to the employer by saving on admin costs - it should be win-win for everyone. Good luck. ATC Award information may be available from Civil Air Operations Officers Association of Australia. I don't know if they're on the web.

Karyn
[Currently provides clerical support services to the CMOA including printing CMO Bulletin]

There are CMOs wishing take leave without pay to gain post-graduate qualifications without risking losing their longterm employment.