National 12 June 2018
Dear Member,

Welcome to the 9th issue for 2018 of ASMS Direct, our national electronic publication.

You can also keep in touch with the latest news and views on health issues relevant to public hospital specialists via our website, which contains links (at the top of the home page) to our Facebook and LinkedIn pages, as well as our quarterly magazine The Specialist. We’re also on Twitter at

Information about upcoming nurses’ strike

NZNO nurses, midwives and health care assistants employed by district health boards have voted in favour of a total withdrawal of labour starting at 0700 hours on Thursday 5 July 2018 and ending at 0700 hours on Friday 6 July 2018. A further total strike has been voted for at 0700 hours on Thursday 12 July 2018 and ending at 0700 hours on Friday 13 July 2018.

In principle, ASMS supports the nurses in their negotiations for better pay but we hope fervently that industrial action can be avoided by the DHBs doing what is required to settle this dispute.

NZNO has yet to give formal notification of this strike action to the DHBs. If these strikes are to proceed, NZNO is required to give at least 14 days written notice.

NZNO members are currently voting on a new offer from the DHBs. If they vote for the offer then the strikes will not proceed (subject to any subsequent unexpected action in these negotiations). Unfortunately, public comments from the DHBs overstating the benefits of the offer and attempting to box nurses into a corner have not been helpful.

Quite correctly the DHBs are now organising in anticipation that the strikes will proceed (while having fingers crossed that they won’t). They have no choice. Essentially services will be expected to run as if it was at night. This will require all elective services (whether theatre lists or clinics) being cancelled on each day of the strike to ensure that hospital services are limited to those that cannot be clinically deferred without endangering life or causing permanent disability. 

The role of SMOs will be to focus on patient safety for patients already admitted or admitted of clinical necessity during the strike period.  Doctors are not trained as nurses and should not do nursing duties. The life preserving services agreements discussed below (agreed between DHBs and NZNO) are expected to address what nursing back-up will be required.

ASMS members should perform only those duties that fall within their scope of practice.

Your duty is to your patient and their safety.  The national ethics committee publication, The Ethical Principle of ‘Do No Harm’ and Industrial Action, and the Medical Council Statement on safe practice in an environment of resource limitation may be helpful (

There hasn’t been a national nurses’ strike for around 30 years and none since the current life preserving services agreement process set out in schedule 1B of the Employment Relations Act has been in force. The life preserving services provisions (which include danger of permanent disability and diagnostic services required to obtain information on potentially life threatening or potentially leading to permanent disability) require:

  • Before bargaining began for the NZNO MECA, the DHBs and NZNO were required to agree as part of their bargaining process agreement a suitably qualified clinical expert who will adjudicate any dispute between the union and the DHBs around what needs to be provided for life preserving services. The agreed adjudicators are the CMOs at each DHB.
  • When notice of industrial action is received, the employer (each DHB) must develop contingency plans and take all ‘reasonable and practicable steps’ to ensure it can provide life preserving services.
  • If your department or service provides life preserving services (as defined in Schedule 1B), all SMOs should be engaged in the contingency planning to help ensure that the appropriate requests are made to NZNO.
  • If the DHB believes (following the advice of ASMS members) that it cannot provide life preserving services without the help of members of the NZNO, it must make a request to the union to assist.
  • This request must be quite specific and refer to the contingency plan and the support required under that plan (hence the importance of SMOs being engaged in the development of that plan including, for example, the number of acute inpatients and the extent of inpatient acuity).
  • This request must be made by the DHB by the close of the day after the notice of industrial action has been received, so it is a very tight time frame.
  • As soon as practicable, but not more than four days after the request has been received, the parties must meet and negotiate in good faith a plan for managing emergencies, including the number of nursing staff that will be required.
  • If the parties are unable to agree they must refer their disagreement to the adjudicator within five days of the notice of industrial action.

Follow this link  to review the Patient Safety provisions in Schedule 1B of the Employment Relations Act 2000, also known as The Code of Good Faith for the public health sector.  Note in particular clauses 11, 12 & 13.

What if my DHB asks me to come in for an extra session or shift?

SMOs, whether specialists or medical or dental officers, are NOT nurses and are NOT employed to undertake nursing duties, particularly when nurses may be on strike.

If you are asked to work longer hours or to do additional sessions or shifts, it is almost certainly because the DHB expects you to cover for nurses or undertake nurses’ duties.  In these circumstances, ASMS advises you to politely but firmly decline to undertake such additional duties and refuse to come in.

If, however, the additional work you are asked to do falls within the range of medical or surgical duties you might ordinarily do within your scope of practice, and you agree to do these extra hours, sessions or shifts, you should do so for a substantial additional payment.

The additional work is NOT what might ordinarily be classified as “overtime” and paid at the after-hours’ rate of T1.5.    It is ADDITIONAL work that should be paid at least at any additional session or shift payment that is normally paid within your service or at a special rate negotiated by you and your colleagues for the duration of this strike.

Did you know…about vocationally-registered ‘training’ fellows?

If you are a ‘training’ fellow with vocational registration, even on a fixed term contract, both the law and the MECA require you to be paid as a specialist on the MECA’s specialist scale (MECA clauses 11.3 and 12.2(a). If you or a training fellow in your service is being underpaid, you should seek advice from an ASMS industrial officer immediately.

Clause 11.3:

Clause 12.2(a):


Kind regards,

Ian Powell