Public Health Sector: Pay and Employment Equity Review. Report & Response Plan

Transcription

1 Public Health Sector: Pay and Employment Equity Review Report & Response Plan May 2008

2 Public Health Sector: Pay and Employment Equity Review 1 Table of Contents EXECUTIVE SUMMARY... 2 Rewards... 3 Participation... 6 Respect and Fairness... 9 Pay and Employment Equity Policy issues BACKGROUND PROCESS The 6 Steps in the Process The Quantitative Data The Qualitative Data Response Plans OVERVIEW OF THE WORKFORCE VERIFICATION OF FINDINGS Findings in relation to Rewards Findings in relation to Participation Findings in relation to Respect & Fairness RESPONSES TO THE IDENTIFIED GENDER EQUITY ISSUES Rewards Reward Responses Gender pay gaps Participation Participation Responses Strategies to build workforce capacity and increase female participation Respect and Fairness Respect & Fairness Responses Building positive Workplace Cultures Pay and Employment Equity Policy Pay & Employment Equity Policy Responses IMPLEMENTATION: THE WAY FORWARD ATTACHMENT A - TERMS OF REFERENCE ATTACHMENT B SUMMARY OF VERIFICATION FINDINGS ATTACHMENT C SUMMARY OF DHB RESPONSES ATTACHMENT D WORKFORCE GROUPS: OCCUPATIONS ATTACHMENT E WORKING PARTY MEMBERSHIP ATTACHMENT F DRAFT IMPLEMENTATION PLAN ATTACHMENT G IMPLEMENTATION PLAN: DHB ACTION... 69

3 Public Health Sector: Pay and Employment Equity Review 2 Public Health Sector: Pay and Employment Equity Review EXECUTIVE SUMMARY This Report and Response Plan arises from Pay and Employment Equity (PaEE) Reviews conducted in five District Health Boards (DHBs) during the first half of 2007, and verification of the findings from those five DHBs by the remaining 16 DHBs in the second half of the year. The Terms of Reference for the Public Health Sector Pay and Employment Equity Review are contained in Attachment A. The Review has been overseen by a Bipartite Working Group (Attachment E) Despite the Public Health Sector 1 being a female dominated one, the average total remuneration of women working in the Sector is considerably less than the average total remuneration of men. Seventy-nine percent of the permanent workforce of District Health Boards (DHBs) are female and 21% percent are male. A number of Responses in this Report propose specific bipartite projects to address particular PaEE issues. Where there are existing projects in the Sector addressing similar issues, then wherever possible the work should be integrated so as to avoid duplication or inconsistent outcomes. The Future Workforce Strategic Plan contains a number of projects under which some of the proposed Responses in this Report could be incorporated. The most efficient approach may be to refer the Response to the relevant Future Workforce project. However to ensure that the Response is not lost in the wider project, it is recommended that a PaEE reporting process be established. To this end it is recommended that a PaEE Bipartite Committee continue to operate. The constitution and terms of reference of the Committee should be reviewed to determine the appropriate post Review structure. It is proposed that the continuing work of the PaEE Committee come under the umbrella of the Health Sector Relationship Agreement to ensure that the work is coordinated and prioritised. 1 In this Report, the Public Health Sector refers only to the 21 District Health Boards. Pay & Employment Equity in the New Zealand Blood Service (NZBS) will be addressed in a subsequent report.

4 Public Health Sector: Pay and Employment Equity Review 3 A draft Implementation Plan is at Attachment F and those Responses which require action on the part of individual DHBs are detailed in the abbreviated Implementation Plan at Attachment G. It is noted that there are many positive initiatives already underway or planned within individual District Health Boards or across the Sector which link with some of the Reponses arising from this Review. Ensuring that other relevant initiatives have a gender equity focus will assist in addressing many of the issues arising from this Review. It also needs to be noted that there was considerable variation in how the findings from the five sample DHBs were verified by the 16 other DHBs. In some instances the relevant data was not available for analysis or staff numbers for particular occupations in the DHB were too small to reach a conclusion. Findings from the five sample DHBs have been listed as verified if a majority of the 16 other DHBs reached the same conclusion as the sample DHBs. The relative size of the DHBs was not taken into account. However the verification process has identified a consistent picture of the gender equity issues which need to be addressed within the Sector. Issues which only exist in a minority of DHBs will have generally been addressed through their local Response Plans. Rewards The Public Health Sector Pay and Employment Equity Review found that the difference in the average total remuneration between women and men across the Sector is greater than 5% and ranges between 50 to 100% in a majority of DHBs. Even when the more highly paid and predominately male medical and CEO occupations are removed from the calculations, the gap of greater than 5% remains in a majority of DHBs. The gender gaps in average total remuneration also exist within many occupations. Three major factors impact on women earning on average significantly less in total remuneration than men within the Sector: the lower paid occupations in the Sector are predominately filled by women; the higher paid occupations in the Sector are predominately filled by men; and a majority of women employees work part-time. However no significant gender pay gaps were identified in relation to full-time equivalent (FTE) base pay within occupations other than Senior Medical Officers (see page 28 for further details). This is largely due to the fact that the overwhelming majority of employees in the Sector work under Collective Agreements with defined salary steps through which progression is based on years of service.

5 Public Health Sector: Pay and Employment Equity Review 4 The average total remuneration gender gaps within occupations arise due to the lower level of participation of female staff, ie part-time employment. Women are employed for an average of 0.82 FTE in the Sector while men average 0.92 FTE. This equates to the average female employee in the Sector working one less day per fortnight than the average male employee. The Reviews conducted in each of the DHBs did not undertake any salary comparisons of particular occupations within the Public Health Sector or with occupations in other sectors which may require comparable skills, qualifications, training and experience. These are matters which need to be examined as part of a pay investigation. Through the responses to the staff surveys, the female dominated clerical / administrative staff group (93% female) indicated the greatest level of concern about the fairness of their pay. This concern was evident in 12 DHBs which examined this finding from the draft National Report (4 DHBs did not reach a conclusion on this finding). As the only data on this issue before the Review Committees was the perceptions of staff as expressed in their responses and comments in the staff surveys, no firm conclusions could be drawn about whether any particular jobs in the Public Health Sector are undervalued. Pay investigations of female dominated (70% or greater female employees) occupations within the Sector would need to be conducted in order to reach such conclusions. Such investigations would need to be prioritised and carried out over time. Given the consistent responses across DHBs from clerical / administrative staff, it is proposed that this group should be the first to be more closely examined. The group does traverse a wide range of clerical / administrative functions. There are currently four clerical / administrative Multi Employer Collective Agreements (MECAs) which operate on a regional basis as well as some other Collective Agreements covering clerical / administrative work between health sector unions and DHBs. It is proposed that a representative sample of clerical / administrative jobs across a range of DHBs be examined using an agreed bipartite process to ascertain if there is a basis for a full pay investigation of some or all clerical / administrative jobs in the Sector. Following this, other female dominated occupations within the sector should be prioritised and examined. This should be done on a systematic basis with the objective of establishing robust relativities between various Public Health Sector jobs ensuring there is no gender bias in describing and valuing jobs. This would be a complex exercise requiring extensive goodwill and cooperation from all parties. It may also have some implications outside the Sector for those occupations (eg social workers) which exist in other parts of the public sector.

6 Public Health Sector: Pay and Employment Equity Review 5 This work should be conducted as part of the tripartite work programme which has prioritised the exploration of a single relativity-based approach to terms and conditions in the Sector. Arising from the full reviews conducted in the five sample DHBs and the subsequent verification reviews in the remaining 16 DHBs, a number of responses to the findings in relation to the Rewards equity indicator are proposed. These include: clerical / administrative staff: valuation of their work, career progression and training & development identification of priorities for pay investigations for female dominated occupations Senior Medical Officers (SMOs): further examination of the pay of female SMOs compared to male SMOs Senior Managers: further investigation by individual DHBs into gender pay gaps further investigation of yet unexplained gender pay gaps within occupations in certain DHBs Reward Responses 1.1 That a bipartite project be undertaken to: evaluate a representative sample of clerical / administrative DHB jobs to ascertain if there is a basis for a full pay investigation address other issues raised by the clerical / administrative workforce in many DHBs: career paths, training and development, performance assessment. 1.2 That a bipartite project be undertaken to identify and prioritise any other female dominated (70% or greater female employees) occupations within the sector which may warrant a formal pay investigation. 1.3 That a bipartite project be undertaken to further examine differences in rewards of female Senior Medical Officers (SMOs) in comparison to male SMOs. 1.4 That DHBs further examine any identified gender differences in pay for Senior Managers to ensure they are not the result of gender bias in recruitment, selection, starting salaries, retention and progression processes. 1.5 That DHBs further investigate any gender pay gaps identified by their Review to ensure that any differences are explainable and justifiable, and to rectify any they find that are not.

7 Public Health Sector: Pay and Employment Equity Review 6 Participation Forty-five percent of the permanent female DHB workforce are employed in Nursing / Midwifery which constitutes 39% of the total permanent workforce. Thirty-six percent of the permanent male workforce are employed in the more highly paid Medicine Workforce Group which constitutes 13% of the total permanent workforce. The Workforce Group breakdown of both the female and male permanent DHB workforce is shown in the following pie charts 2. Unkwn 3% Medicine 6% Unkwn 3% Technical 5% Allied Health 11% Corporate & Othr 23% Care & Support 7% Nursing 45% Corporate & Othr 23% Technical 6% Allied Health Care & 7% Support 8% Medicine 36% Nursing 16% DHB Female workforce DHB Male workforce A majority of female employees work part-time. The average full-time equivalent (FTE) proportion for female staff in the sector is 0.82 compared to 0.92 for men. The level of part-time work is the major contributor to the gap in average total remuneration between men and women within individual occupations in the Sector. The level of casual employment within the Sector was not consistently analysed across the DHBs as part of the Review. There was anecdotal evidence that some staff are choosing to work on a casual basis for the flexibility it offers them. The Health Workforce Information Programme (HWIP) does gather data on numbers of casuals within occupations who are currently available for casual employment, but the data does not indicate to what extent casual staff are utilised. An examination in one DHB revealed that casuals / locums accounted for 6.3% of the total payroll. From the September 2007 HWIP data, 82% of the casual pool staff in DHBs are female compared to 79% of permanent staff (see table 2, page 17). 2 Health Workforce Information Programme data, 30 September 2007

8 Public Health Sector: Pay and Employment Equity Review 7 It is recommended that HWIP collate data from DHBs on their use of casual staff by occupation by gender as a proportion of the total payroll (see Response 4.2). A major challenge facing the Public Health Sector is how to better support its predominately female part-time work force and to remove barriers to greater participation by these staff. In response to staff surveys conducted in most DHBs, a majority of female staff did not agree that their DHB actively supports opportunities for the advancement and growth of part-time employees. Part-time staff who are health professionals are all required to complete the same minimum number of hours of training and development as full-time staff in order to maintain their practicing certificates under the provisions of the Health Practitioners Competence Assurance Act 2003 (HPCAA). This can place additional pressures and personal cost on them if the training and development opportunities are not available during their regular hours. There are potentially significant benefits for both employees and management if part-time staff are better supported to enable them to participate more fully in the Public Health Sector workforce. There is significant potential for labour and skill shortages to be reduced as a consequence. For example if five nurses who are currently working 3 days a week, or a total of 3 full-time equivalents (FTEs) between them, were each able to increase their participation to 4 days a week they would total 4 FTEs between them. Many employment overheads (eg training, practicing certificates) are the same or similar for full-time and part-time staff. For many women, the decisions they make about the hours they work are personal choices balancing their work and life/family commitments. However around a quarter of female part-time employees who responded to the staff surveys on the issue indicated that they would like to work more hours now if circumstances were different. These circumstances included: Suitable childcare close to their workplace More suitable rostering / hours arrangements Less stressful workload The Future Workforce Strategic Plan 3 proposes the implementation of policies and programmes that enable work/life balance, focussing on: a family friendly environment 3 Page 16, Nurturing and Sustaining the Workforce. Priority: Enhancing people strategies

9 Public Health Sector: Pay and Employment Equity Review 8 access to accessible/affordable dependants care flexible work arrangements and wellness programmes that support workforce diversity sustainable recruitment and retention. The 2004/2005 Healthy Workplace Stocktake provides an overview of existing DHB initiatives as the basis for further development in this area. A number of the proposed Participation responses in this Report may have cross-over with existing or proposed Future Workforce projects and should therefore be integrated with those projects whilst ensuring that the PaEE issues are reported on and monitored as part of the wider project. For example work on rostering and flexible hours is currently being undertaken as part of the Safe Staffing project. However that project is confined to nursing staff and the gender equity issues identified in this Review need to be addressed across the Sector. A number of responses to the findings in relation to the Participation equity indicator are proposed. These principally relate to the lower levels of workforce participation of women in the Sector as evidenced by the high levels of part-time employment amongst women across all occupations in the Sector compared to male staff. Participation Responses 2.1 That a national bipartite research project be undertaken to examine available New Zealand and international material on flexible hours and rostering and make recommendations for a pilot of more flexible hours and rostering systems for the New Zealand Public Health Sector environment. That such a pilot be conducted in a range of DHBs of varying size. 2.2 That noting the commencement on 1 July 2008 of the Employment Relations (Flexible Working Arrangements) Amendment Act 2007, DHBs develop policies on the administration of applications for flexible working hours under the Act in their DHB. 2.3 That DHBs develop policies and strategies around the following issues to assist part-time and casual staff to more fully participate in the workforce: career pathways and advancement of part-time employees equitable access to training & development opportunities for part-time employees access to information, meetings, project participation, etc for part-time employees.

10 Public Health Sector: Pay and Employment Equity Review That DHBs explore options for providing greater support for staff who have children. These could include: provision of child care, school holiday and after school programmes directly or in conjunction with a local provider and/or other local employers breastfeeding facilities a cost benefit analysis of providing subsidies for child care. 2.5 That DHBs provide support for employees to help them achieve better work-life balance including: incorporation of initiatives to address the work-life balance needs of staff in annual performance discussions ensuring managers are equipped to assist staff address work and family/caregiving responsibilities. 2.6 That a bipartite project be undertaken to develop strategies to support and increase the participation of female Senior Medical Officers (SMOs). These strategies could include: active search and encouragement of female candidates for SMO positions, particularly in areas where women are under-represented retention strategies for female SMOs identification of barriers to women s transition to and participation in the SMO workforce and strategies to overcome them. 2.7 That DHBs develop a Remote Working Policy for their DHB and explore opportunities for staff to work remotely to provide them with another level of flexibility. Respect and Fairness There are potentially significant benefits for both staff and management in improving the workplace culture in their DHB. Although it is debatable whether workplace culture is a gender equity issue, it is evident from the responses to staff surveys in many DHBs that women have a less positive view than men about the culture of their workplace. The Report of the Safe Staffing / Healthy Workplaces Committee of Inquiry (June 2006) noted that a motivated, satisfied workforce is key to achieving organisational success. The Health Workforce Advisory Committee (HWAC), established to provide advice to the Minister of Health, has also recognised the importance of healthy work environments.

11 Public Health Sector: Pay and Employment Equity Review 10 National guidelines produced by the HWAC identify high-level principles that underpin an ideal workplace culture. These include: having the health and well-being of the person as its primary objective valuing employees and promoting trust between staff people working collaboratively as teams and forming constructive relationships to achieve shared objectives enabling effective and open multi-level communication channels encouraging and supporting change and innovation, fostering creativity and promoting continuous learning fostering a risk management approach that supports staff and is not simply risk aversion having a culturally aware environment that is supportive of, and responsive to, the increasing diversity of the workforce, and recognises and adapts to changing worklife balance. The Future Workforce Strategic Plan 4 proposes the development, promotion and sharing across DHBs best practice tools that foster supportive environments and positive cultures. The Healthy Work Environment Stocktake has identified useful areas for future shared development. The Health Sector Relationship Agreement s first priority project is about embedding constructive engagement as an enduring approach to public health and disability sector relationships. Two responses to the findings in relation to the Respect and Fairness equity indicator are proposed relating to building more positive workplace cultures in DHBs. Respect & Fairness Responses 3.1 That DHBs continue to work to build positive and supportive workplace cultures which: provide a safe and harassment free work environment actively value and support staff recognise and celebrate long service and special contributions of staff. 3.2 That Future Workforce projects aimed at Fostering Supportive Environments and Positive Cultures ensure that they have a gender equity focus. 4 Page 15. Nurturing and Sustaining the Workforce. Priority: Fostering Supportive Environments and Positive Cultures.

12 Public Health Sector: Pay and Employment Equity Review 11 Pay and Employment Equity Policy issues The implementation of the Responses contained in this Report will require ongoing oversight. It is proposed that a Bipartite Committee similar to the one that coordinated this review continue to coordinate, monitor and report on Pay and Employment Equity issues in the Public Health Sector and in particular the Response Plan for the Sector. The constitution and terms of reference for the Committee should be agreed between the parties under the Health Sector Relationship Agreement. The quality of workforce data used by the DHB reviews was variable. The Health Workforce Information Programme (HWIP) is working with DHBs to improve workforce data as part of the DHBs Future Workforce Strategic Plan. The programme produces a quarterly report which includes a range of tables and charts providing a detailed snapshot of all workforce groups in the Sector. Currently only a couple of the HWIP tables and charts include a gender breakdown. The inclusion of a gender breakdown in all these tables would be useful for the monitoring of female participation particularly within individual workforce groups and occupations. The inclusion in the quarterly reports of trend lines showing changes to female participation levels within workforce groups and occupations would also be useful in tracking the success of some of the proposed responses in this Report. A range of other data is currently collected from DHBs as part of the HWIP and for other workforce planning and negotiation purposes. This data could also be used to develop additional reports for monitoring and reporting on PaEE issues, particularly changes in remuneration gaps between women and men. Data from DHBs should also be collated on use of casual staff by occupation by gender as a proportion of the total payroll. Workforce data is also produced by other organisations such as the New Zealand Health Information Service and the Medical Council of New Zealand. This data should also be reported on by gender. A number of DHBs have acknowledged as part of their local response plan that they need to develop policy and training on pay and employment equity. It is recommended that all DHBs undertake this work. During the Reviews, each DHB appointed a project sponsor to act as a support for the project facilitator and the DHB Review Committee and to represent the work of the committee to senior management within the DHB. It is recommended that DHBs now appoint a senior manager to have ongoing responsibility for PaEE issues and implementation of their local Response Plan.

13 Public Health Sector: Pay and Employment Equity Review 12 Pay & Employment Equity Policy Responses 4.1 That a Bipartite Pay and Employment Equity (PaEE) Committee operating within the framework of the Health Sector Relationship Agreement continue to coordinate, monitor and report on PaEE issues in the Public Health Sector and in particular the Response Plan for the Sector. 4.2 That the quarterly Health Workforce Information Programme (HWIP) Reports include: a gender breakdown in all tables trend lines showing changes to female participation levels within workforce groups and the larger occupations. Further, that other HWIP reports be developed to assist the Bipartite PaEE Committee monitor and report on progress in reducing pay and employment inequities in the Sector. These reports should include data from DHBs on use of casual staff by occupation by gender as a proportion of the total payroll. Other Ministry and related workforce data also be reported on by gender. 4.3 That DHBs develop and implement: a policy supporting pay and employment equity for women in their DHB a training/awareness programme on gender related issues in their DHB, with particular emphasis on Human Resources and staff who may be the first point of contact when women experience difficulties in this area a process specifically for addressing gender related issues reported by staff. Further, that DHBs appoint a senior manager to have ongoing responsibility for PaEE issues and implementation of their Response Plan.

14 Public Health Sector: Pay and Employment Equity Review 13 BACKGROUND In March 2004 the Taskforce on Pay and Employment Equity in the Public Service and the Public Health and Public Education Sectors reported its findings. The Taskforce developed an action plan focusing on addressing the gender pay gap in the state sector. The overall premise of the action plan is that: Women and Men should have equitable opportunities to access rewards, to participate and to be treated with respect and fairness. Any gender differences in the distribution of Organisational rewards, participation levels and experience of respect and fairness should be explainable and justifiable. In 2004 Cabinet agreed to a Plan of Action for Pay and Employment Equity by adopting many of the Taskforce recommendations. The mechanisms for giving effect to Government commitment include completing pay and employment equity reviews and developing response plans. A Ministerial Reference Group decision in May 2005 for the planned and managed approach to pay and employment equity review roll-out specified that in the Public Health Sector, pay and employment equity reviews would be overseen within a bipartite structure and be undertaken in a representative sample of District Health Boards followed by a verification process across the rest of the sector. The agreed Terms of Reference for the Public Health Sector Pay and Employment Equity Review are set out in Attachment A. Five DHBs were chosen to carry out a full review - Auckland, Hutt Valley, Mid Central, Otago and Taranaki. Those reviews were completed in August The Reviews were charged with investigating and assessing whether women and men: 1. Have an equitable share of rewards (including pay but not just pay) 2. Participate equitably in all areas of the DHB 3. Are treated with equal respect and fairness The draft National Report arising from the reviews in the five sample DHBs contained a range of findings in relation to the three equity indicators - Rewards (findings 1.1 to 1.13), Participation (findings 2.1 to 2.16) and Respect & Fairness (findings 3.1 to 3.4). The findings from these five DHBs involved in the first stage of the Public Health Sector Pay and Employment Equity Review were consolidated into a draft National Review Report which was referred to the other 16 DHBs for verification in the later part of The verification Reviews in the 16 DHBs were conducted between August 2007 and January 2008.

15 Public Health Sector: Pay and Employment Equity Review 14 PROCESS This Report and Response Plan arises from Pay and Employment Equity (PaEE) Reviews conducted in five District Health Boards (DHBs) during the first half of 2007, and verification of the findings from those five DHBs by the remaining 16 DHBs in the second half of the year. The Terms of Reference for the Review are contained in Attachment A. The Review has been overseen by a Bipartite Working Group (Attachment E) The process used by the Review Committees in the five sample DHBs was developed by the Department of Labour Pay and Employment Equity Unit. This is the same process that was used by the Public Education and Public Service sectors. The DHB Review Committees endorsed Project Plans which outlined the stages, processes and timetable for their Review. Working Together Agreements were signed off by members of the Review Committees. Communications Plans were also adopted by the Review Committees and newsletters were distributed to staff via and hard copy. Additional information on the Reviews was also made available to staff on DHB intranets. The 6 Steps in the Process 1. Deciding on the important gender equity issues to investigate Both qualitative and quantitative data was collected by the Committees to identify priorities. The supporting data came from a variety of sources such as payroll, collective employment agreements and Human Resources policies. The Committees also surveyed staff to find out their perceptions of the gender equity issues being investigated. 2. Undertaking preliminary analysis The Committees analysed the supporting data having regard to the three equity questions on Rewards, Participation and Respect & Fairness. Guidelines were developed on a national basis to assist the Committees decide what areas to investigate further. Where the preliminary analysis indicated there were no gender equity issues, further examination of these areas was not pursued. 3. Carrying out follow up analysis Where initial data showed a gender disparity the Committees carried out further investigation to discover why this disparity occurred and if the reason was valid.

16 Public Health Sector: Pay and Employment Equity Review Validation of Provisional Findings The Committees circulated their Provisional Findings to staff for a period of consultation. Staff feedback on the Provisional Findings was gathered through various methods including further staff surveys and staff meetings. Following the feedback on the Provisional Findings, the Committees finalised their findings. 5. Preparation of DHB Final Report 6. Preparation of DHB Response Plan The Committees developed Response Plan based on the findings of their review. Given the less comprehensive nature of the verification Reviews, a similar but truncated process was used by the 16 DHBs undertaking the verification. The Quantitative Data DHB Workforce data as at 30 September 2007 from the DHB Health Workforce Information Programme (HWIP) has been used for this Report along with data collected during the individual DHB reviews. A summary of the data is included in pages More detailed data including the occupations which make up each of the Workforce Groups is contained in Attachment D. In examining the payroll data, a number of apparent coding errors were evident in most DHBs. While this had little impact on the analysis of the larger occupational groups, there is a potential that data analysis for small occupational groups could be skewed, especially if an employee on a relatively high salary was inappropriately analysed in a lower salary occupation. Where apparent anomalies were identified, they were checked and corrected if necessary, though it is not possible to guarantee that all errors were identified. The Qualitative Data All DHB Reviews used a similar staff survey to find out staff perceptions and views on the issues being investigated. This opportunity to have a say was taken up by almost 12,000 staff across the 21 DHBs. These surveys were the prime source of qualitative data considered by the Review Committees. The Review findings in relation to respect and fairness were largely drawn from the responses to the staff surveys in DHBs. While some of these responses may not have related to gender specific issues, they did provide a good snapshot of the perceptions and views of staff at the time the surveys were undertaken.

17 Public Health Sector: Pay and Employment Equity Review 16 Although the surveys were not undertaken as statistical samples and were open to all staff to complete, the profiles (gender and age groups) of the respondents in most DHBs matched the profiles of all staff in that DHB. As such Review Committees generally had confidence that the gender differences identified in the staff responses could be relied upon in formulating their findings on qualitative issues. Response Plans Each DHB has developed a Response Plan arising from their Review. The Responses have been summarised in Attachment C under each of the equity indicators and issue category. References to individual DHBs have been removed from the Responses.

18 Public Health Sector: Pay and Employment Equity Review 17 OVERVIEW OF THE WORKFORCE This section of the Report contains an overview of the Public Health Sector workforce. DHB Workforce data as at 30 September 2007 from the DHB Health Workforce Information Programme (HWIP) has been used for this section of the Report. Seventy-nine percent of the permanent workforce of District Health Boards (DHBs) are female and 21% percent are male. Forty-five percent of the permanent female DHB workforce are employed in Nursing / Midwifery which constitutes 39% of the total permanent workforce. Thirty-six percent of the permanent male workforce are employed in the more highly paid Medicine Workforce Group which constitutes 13% of the total permanent workforce. The Workforce Group breakdown of both the female and male permanent workforce is shown in table 1 below. Table 1: Permanent Headcount % of workforce Workforce Group Female % F Male Total F % M % T % Medicine 2,994 40% 4,508 7,502 6% 36% 13% Nursing / Midwifery 20,858 91% 1,997 22,855 45% 16% 39% Care & Support 3,064 74% 1,053 4,117 7% 8% 7% Allied Health 5,337 86% 905 6,242 11% 7% 11% Technical 2,510 76% 794 3,304 5% 6% 6% Corporate & Other 10,481 79% 2,829 13,310 22% 23% 22% Unknown 1,413 75% 469 1,882 3% 4% 3% Total 46,657 79% 12,555 59, % 100% 100% The Workforce Group breakdown of both the female and male casual workforce is shown in table 2 below. Table 2: Casuals Headcount % of workforce Workforce Group Female % F Male Total F % M % T % Medicine % % 32% 11% Nursing / Midwifery 3,139 93% 230 3,369 43% 14% 38% Care & Support 1,551 80% 387 1,938 21% 24% 22% Allied Health % % 3% 4% Technical % % 5% 4% Corporate & Other 1,269 83% 268 1,537 17% 17% 17% Unknown % % 5% 5% Total 7,349 82% 1,599 8, % 100% 100%

19 Public Health Sector: Pay and Employment Equity Review 18 The Workforce Group breakdown by average age, length of service and average full-time equivalent (FTE) by gender of the permanent workforce is shown in table 3 below. Table 3: Permanent Average Age Average Length of Service Average FTE Workforce Group F M F M F M Medicine Nursing Midwifery Care & Support Allied Health Technical Corporate & Other Unknown Total The total staff headcount and average FTE by gender by DHB is shown in table 4 below. Table 4 Headcount Full-time Equivalent DHB F % F M T Av. F Av. M Av. T Auckland Bay of Plenty Canterbury Capital & Coast Counties Manukau Hawkes Bay Hutt Valley Lakes * MidCentral Nelson Marlborough Northland Otago South Canterbury Southland Tairawhiti Taranaki Waikato Wairarapa\ Waitemata West Coast Whanganui Total * FTE data unavailable More detailed data including the occupations which make up each of the Workforce Groups is contained in Attachment D.

20 Public Health Sector: Pay and Employment Equity Review 19 VERIFICATION OF FINDINGS There was considerable variation in how the findings from the five sample DHBs were verified by the other 16 DHBs. In some instances the relevant data was not available for analysis or staff numbers for particular occupations in the DHB were too small to reach a conclusion. Findings from the five sample DHBs have been listed as verified if a majority of the other 16 DHBs reached the same conclusion as the sample DHBs. The relative size of the DHBs was not taken into account. However the verification process has identified a consistent picture of the gender equity issues which need to be addressed within the Sector. Issues which only exist in a minority of DHBs will have generally been addressed through their local Response Plans. Not all finding in each DHB were clear cut and an assessment was made on how that response should be best classified. Findings in relation to Rewards The draft National Report arising from the reviews in the five sample DHBs contained 16 findings in relation to the Rewards equity indicator. Eight of these have been verified in a majority of the other 16 DHBs. Quantitative findings in relation to Rewards indicator All Staff 1.1 The draft National Report from the 5 sample DHBs found that: The average total remuneration between women and men is greater than 5% and the difference is less than 5% when doctors are excluded from the data. Verified: All 16 DHBs found this to be true. Source: Payroll data. The draft National Report from the 5 sample DHBs found that: The average total remuneration between women and men is less than 5% when doctors are excluded from the data. Not verified: 5 DHBs found this to be true, 11 found it not to be true. Source: Payroll data. 1.2 The draft National Report from the 5 sample DHBs found that: There is a difference greater than 5% on the starting salaries for men and women. Not verified: 6 DHBs found this to be true, 2 found it not to be true, 8 did not reach a conclusion. Source: Payroll data.

21 Public Health Sector: Pay and Employment Equity Review The draft National Report from the 5 sample DHBs found that: Women are less likely to be available for work that attracts penal rates. Not verified: 5 DHBs found this to be true, 9 found it not to be true, 2 did not reach a conclusion. Source: Payroll data. 1.4 The draft National Report from the 5 sample DHBs found that: Medical The lowest paid occupations are dominated by women. Verified: 13 DHBs found this to be true, 2 found it not to be true, 1 did not reach a conclusion. Source: Payroll data. 1.5 The draft National Report from the 5 sample DHBs found that: Female Senior Medical Officers (SMOs) earn less than male SMOs. Verified: 10 DHBs found this to be true, 6 found it not to be true. Source: Payroll data. 1.6 The draft National Report from the 5 sample DHBs found that: Female Senior Medical Officers (SMOs) start on lower salaries than male SMOs. Not verified: 6 DHBs found this to be true, 5 found it not to be true, 5 did not reach a conclusion. Source: Payroll data / personnel records. Other Clinical 1.7 The draft National Report from the 5 sample DHBs found that: There are salary differences greater than 5% between male and female medical radiation technologists (MRTs), psychologists and social workers. Not verified in relation to medical radiation technologists: 3 DHBs found this to be true, 7 found it not to be true, 6 did not reach a conclusion. Not verified in relation to psychologists: 3 DHBs found this to be true, 7 found it not to be true, 6 did not reach a conclusion. Not verified in relation to social workers: 4 DHBs found this to be true, 8 found it not to be true, 4 did not reach a conclusion. Source: Payroll data.

22 Public Health Sector: Pay and Employment Equity Review 21 Admin/Management 1.8 The draft National Report from the 5 sample DHBs found that: Male senior managers are paid more than female senior managers Verified: 10 DHBs found this to be true, 4 found it not to be true, 1 did not reach a conclusion. Source: Payroll data. 1.9 The National Review questioned: If all clerical/administrative roles are appropriately valued in comparison with other roles Verified: 12 DHBs also shared this concern, 4 did not reach a conclusion. Source: Staff Surveys The draft National Report from the 5 sample DHBs found that: Cleaners (from the DHB that employs cleaners). The collective does not include recognition for extra responsibilities, a meal allowance, penal rates. Not verified: 1 DHB found this to be true, 1 found it not to be true, 14 did not reach a conclusion as they use contractors for cleaning. Source: Collective Agreement. Qualitative results in relation to Rewards indicator (Staff perceptions obtained from the surveys) 1.11 The draft National Report from the 5 sample DHBs found that staff perceived that: Rewards for base pay are evenly shared. Verified: 10 DHBs found this to be true, 3 found it not to be true, 3 did not reach a conclusion. Source: Staff Surveys The draft National Report from the 5 sample DHBs found that staff perceived that: Men and women are paid the same rates for similar work. Verified: 12 DHBs found this to be true, 2 found it not to be true, 2 did not reach a conclusion. Source: Staff Surveys The draft National Report from the 5 sample DHBs found that staff perceived that: Overall women and men have the same chances for promotion. Verified: 14 DHBs found this to be true, 2 did not reach a conclusion. Source: Staff Surveys.

23 Public Health Sector: Pay and Employment Equity Review 22 Findings in relation to Participation The draft National Report arising from the reviews in the five sample DHBs contained 16 findings in relation to the Participation equity indicator. Eight of these have been verified in a majority of the other 16 DHBs. Quantitative results in relation to Participation indicator All Staff 2.1 The draft National Report from the 5 sample DHBs found that: At least half of women workers are part-time (less than 40 hours per week for most occupations). Verified: 13 DHBs found this to be true, 3 found it not to be true. Source: Payroll data. 2.2 The draft National Report from the 5 sample DHBs found that: Most part-time workers are women. Verified: All 16 DHBs found this to be true. Source: Payroll data. 2.3 The draft National Report from the 5 sample DHBs found that: Men take more study leave than women. Not verified: 2 DHBs found this to be true, 8 found it not to be true, 6 did not reach a conclusion. Source: Payroll data. NB: Some study, such as unpaid weekend conferences, is not usually included in the payroll data of DHBs. 2.4 The draft National Report from the 5 sample DHBs found that: Women are proportionally represented in senior management. Not verified: 8 DHBs found this to be true, 8 found it not to be true. Source: Payroll data. 2.5 The draft National Report from the 5 sample DHBs found that: One DHB indicates that women are under-represented in the governance and management Reference Groups. Not verified: 2 DHBs found this to be true, 9 found it not to be true, 5 did not reach a conclusion. Source: Gender breakdown of Committee membership.

24 Public Health Sector: Pay and Employment Equity Review 23 Nursing 2.6 The draft National Report from the 5 sample DHBs found that: There are barriers to promotion for part-time nurses. Not verified: 3 DHBs found this to be true, 10 found it not to be true, 3 did not reach a conclusion. Source: Payroll data. 2.7 The draft National Report from the 5 sample DHBs found that: Most nurses work part-time. Verified: 15 DHBs found this to be true, 1 did not reach a conclusion. Source: Payroll data. 2.8 The draft National Report from the 5 sample DHBs found that: Medical Senior nursing positions are full-time. Not verified: 5 DHBs found this to be true, 10 found it not to be true, 1 did not reach a conclusion. Source: Payroll data. 2.9 The draft National Report from the 5 sample DHBs found that: Senior Medical Officers positions are male dominated. Verified: All 16 DHBs found this to be true. Source: Payroll data The draft National Report from the 5 sample DHBs found that: Male Senior Medical Officers are more likely to be paid on the higher steps of the salary scale in the collective than female Senior Medical Officers Verified: 11 DHBs found this to be true, 2 found it not to be true, 3 did not reach a conclusion. Source: Payroll data. Admin/management 2.11 The draft National Report from the 5 sample DHBs found that: Admin/management is a Female dominated profession. Verified: All 16 DHBs found this to be true. Source: Payroll data.

25 Public Health Sector: Pay and Employment Equity Review The draft National Report from the 5 sample DHBs found that there are a: High number of part-time workers in Admin/management. Verified: 10 DHBs found this to be true, 6 found it not to be true. Source: Payroll data. Qualitative results in relation to Participation indicator (Staff perceptions obtained from the staff survey) 2.13 The draft National Report from the 5 sample DHBs found that staff perceived that: People can work part-time and pursue a career. Not verified: 8 DHBs found this to be true, 5 found it not to be true, 3 did not reach a conclusion. Source: Staff Surveys The draft National Report from the 5 sample DHBs found that staff perceived that: Staff are encouraged to participate in training and development. Verified: 14 DHBs found this to be true, 2 did not reach a conclusion. Source: Staff Surveys The draft National Report from the 5 sample DHBs found that staff perceived that: The DHB is committed to assisting employees to maintain work life balance. Not verified: 3 DHBs found this to be true, 11 found it not to be true, 2 did not reach a conclusion. Source: Staff Surveys The draft National Report from the 5 sample DHBs found that staff perceived that: Onsite childcare facilities meet (or would meet) their needs. Not verified: 5 DHBs found this to be true, 6 found it not to be true, 5 did not reach a conclusion. Source: Staff Surveys.

26 Public Health Sector: Pay and Employment Equity Review 25 Findings in relation to Respect & Fairness The draft National Report arising from the reviews in the five sample DHBs contained 4 findings in relation to the Respect and Fairness equity indicator. Two of these have been verified in a majority of the other 16 DHBs. Qualitative results in relation to Respect and Fairness indicator (Staff perceptions obtained from the staff survey) 3.1 The draft National Report from the 5 sample DHBs found that staff perceived that: Men and women both felt equally valued as employees. Verified: 14 DHBs found this to be true, 2 found it not to be true. Source: Staff Surveys. 3.2 The draft National Report from the 5 sample DHBs found that staff perceived that: The DHB deals fairly with employment related issues and grievances. Not verified: 8 DHBs found this to be true, 8 found it not to be true. Source: Staff Surveys. 3.3 The draft National Report from the 5 sample DHBs found that staff perceived that: Harassment, discrimination and other inappropriate behaviours are not tolerated. Verified: 10 DHBs found this to be true, 6 found it not to be true. Source: Staff Surveys. 3.4 The draft National Report from the 5 sample DHBs found that staff perceived that: While the majority of staff indicate there is no issue with work-life balance, those that do indicate issues are more likely to be women. Not verified: 6 DHBs found this to be true, 5 found it not to be true, 5 did not reach a conclusion. Source: Staff Surveys.

27 Public Health Sector: Pay and Employment Equity Review 26 RESPONSES TO THE IDENTIFIED GENDER EQUITY ISSUES 1. Rewards Arising from the full reviews conducted in the five sample DHBs and the subsequent verification reviews in the remaining 16 DHBs, a number of responses to the findings in relation to the Rewards equity indicator are proposed. These include: clerical / administrative staff: valuation of their work, career progression and training & development identification of priorities for pay investigations for female dominated occupations Senior Medical Officers (SMOs) : further examination of the pay of female SMOs compared to male SMOs Senior Managers: further investigation by individual DHBs into gender pay gaps further investigation of yet unexplained gender pay gaps within occupations in certain DHBs Reward Responses 1.1 That a bipartite project be undertaken to: evaluate a representative sample of clerical / administrative DHB jobs to ascertain if there is a basis for a full pay investigation address other issues raised by the clerical / administrative workforce in many DHBs: career paths, training and development, performance assessment. 1.2 That a bipartite project be undertaken to identify and prioritise any other female dominated (70% or greater female employees) occupations within the sector which may warrant a formal pay investigation. 1.3 That a bipartite project be undertaken to further examine differences in rewards of female Senior Medical Officers (SMOs) in comparison to male SMOs. 1.4 That DHBs further examine any identified gender differences in pay for Senior Managers to ensure they are not the result of gender bias in recruitment, selection, starting salaries, retention and progression processes. 1.5 That DHBs further investigate any gender pay gaps identified by their Review to ensure that any differences are explainable and justifiable, and to rectify any they find that are not.

28 Public Health Sector: Pay and Employment Equity Review 27 Gender pay gaps The Public Health Sector Pay and Employment Equity Review found that the difference in the average total remuneration between women and men across the Sector is greater than 5% and ranges between 50 to 100% in a majority of DHBs. Even when the more highly paid and predominately male medical and CEO occupations are removed from the calculations, the gap of greater than 5% remains in a majority of DHBs. The gender gaps in total average remuneration also exist within many occupations. Three major factors impact on women earning on average significantly less than men within the Sector: the lower paid occupations in the Sector are predominately filled by women; the higher paid occupations in the Sector are predominately filled by men; and a majority of women employees work part-time. However no significant gender pay gaps were identified in relation to full-time equivalent (FTE) base pay within occupations other than Senior Medical Officers (SMOs). The total remuneration gender gaps within occupations arise due to the lower level of participation of female staff, ie part-time employment. Women are employed for an average of 0.82 FTE in the Sector while men average 0.92 FTE. This equates to the average female employee in the Sector working one less day per fortnight than the average male employee. The Reviews conducted in each of the DHBs did not undertake any salary comparisons of particular occupations within the Public Health Sector or with occupations in other sectors which may require comparable skills, qualifications, training and experience. These are matters which need to be examined as part of a pay investigation. As the only data on this issue before the Review Committees was the perceptions of staff as expressed in their responses and comments in the staff surveys, no firm conclusions could be drawn about whether any particular jobs in the Public Health Sector are undervalued. Pay investigations of female dominated (70% or greater female employees) occupations within the Sector would need to be conducted in order to reach such conclusions. Such investigations would need to be prioritised and carried out over time. This should be done on a systematic basis with the objective of establishing robust relativities between various Public Health Sector jobs ensuring there is no gender bias in describing and valuing jobs. This would be a complex exercise requiring extensive goodwill and cooperation from all parties. It may also have some implications outside the Sector for those occupations (eg social workers) which exist in other parts of the public sector. This

29 Public Health Sector: Pay and Employment Equity Review 28 work should be conducted as part of the tripartite work programme which has prioritised the exploration of a single relativity-based approach to terms and conditions in the Sector. The draft National Report from the 5 DHBs which conducted full Pay and Employment Equity Reviews identified a number of gender pay gaps which were subject to verification in the other 16 DHBs. None of the gender pay gaps found in three Allied Health professions (Medical Radiation Technologists, Psychologists and Social Workers) were verified across the Sector. Clerical / administrative staff Through the responses to the staff surveys, the female dominated clerical / administrative staff group (93% female) indicated the greatest level of concern about the fairness of their pay. This concern was evident in 12 DHBs which examined this finding from the draft National Report (4 DHBs did not reach a conclusion on this finding). Female clerical / administrative staff in many DHBs also generally expressed lower confidence than other staff that: they are provided with good opportunities for training and development their job performance is fairly assessed they receive honest and candid feedback on their performance There are currently four clerical / administrative Multi Employer Collective Agreements (MECAs) which operate on a regional basis as well as some other Collective Agreements covering clerical / administrative work between health sector unions and DHBs. In late 2007, the PSA approached the DHBs to seek the DHBs agreement to establishing a national MECA for clerical / administration workers, with nationally consistent terms and conditions of employment. Given the consistent responses across DHBs from clerical / administrative staff, it is proposed that this group should be the first to be more closely examined. The group does traverse a wide range of clerical administrative functions and there are currently four Collective Agreements which operate on a regional basis. It is proposed that a representative sample of clerical / administrative jobs across arrange of DHBs be examined using an agreed bipartite process to ascertain if there is a basis for a full pay investigation of some or all clerical / administrative jobs in the Sector. Senior Medical Officers (SMOs) The Medical Group is the highest paid workforce group in the Public Health Sector. Forty percent of the Group are female and this proportion is increasing. Currently 54% of Resident Medical Officers are female and 43% of Registrars are female. Only 25% of

30 Public Health Sector: Pay and Employment Equity Review 29 Senior Medical Officers (SMOs) are female however this has increased from 17.7% in Data from the Medical Health Workforce Annual Survey shows an overall 6% increase in the female proportion of the medical workforce (including GPs) from 31.3% in 1998 to 37.3% in The female percentages in the main Public Health Sector medical groups during the period 1998 to 2006 are shown in the following chart. 60 Female percentage of Medical Groups ( ) House Officers Registrars Specialists The draft National Report found that female SMOs earn less than male SMOs. This was verified in 10 out of 16 DHBs. A lesser proportion of female SMOs than male SMOs are paid on the higher salary steps (7 to 13). In the top three SMO salary steps only around 16% are women. One explanation for this gender gap is that it is a cohort effect and that as the increasing proportion of women entering medicine move through the profession, the gap will be reduced over time. However other factors such as women working in a narrower range of specialties and not remaining in the Public Health Sector for sufficient years (12 years service are required to reach the top SMO salary step) may also be having an impact. The draft National Report found that female SMOs start on lower salaries than male SMOs. However this finding was only verified in 6 DHBs. Five found it not to be true and five did not reach a conclusion. The national finding suggested that more men than women were being appointed at higher steps in the SMO salary scale than their years of registration would have otherwise reflected. Due to the mobility of the SMO workforce, years of service with an individual DHB will generally not be a reliable indicator of what salary step an individual SMO should be on. 5 Source: MCNZ/NZHIS, 2008

31 Public Health Sector: Pay and Employment Equity Review 30 However in the examination of one large DHB which employs about 450 SMOs, there was not a significantly greater proportion of men (29%) than women (28%) who were being paid above their salary step if it was based solely on their years of service with that DHB. To confirm whether more men than women were being appointed at higher steps in the salary scale would require an examination of individual personnel and medical registration records. Investing the extensive resources required for such an examination may be hard to justify. Examination of strategies to support female SMOs widening the range of specialties they participate in and to remain in the sector should be the priority to address the lower proportion of female SMOs who are paid in the higher salary steps. Senior Managers The draft National Report also found that male Senior Managers earn more than female senior managers. This was verified in 10 out of 16 DHBs. The national finding was unclear about what level of Senior Management was identified as having the gender pay gap. A number of DHBs looked at the Executive level and others also examined the next level down. It is recommended that DHBs ensure that any gender differences in pay for Senior Managers that they identified during the course of their reviews are not the result of gender bias in recruitment, selection, starting salaries, retention and progression processes. Other occupational gender gaps Some DHBs indentified other individual occupations within their DHB which appeared on initial examination to have a gender pay gap of 5% or greater in average FTE salaries. On closer examination, a number of these were explainable and justifiable. Some were related to the average length of service of individuals, while others were jobs which were not actually the same. However not all differences were explainable and closer examination is required within those DHBs to ascertain if these differences are explainable and justifiable and to rectify any they find that are not.

32 Public Health Sector: Pay and Employment Equity Review Participation A number of responses to the findings in relation to the Participation equity indicator are proposed. These principally relate to the lower levels of participation of women in the workforce as evidenced by the high levels of part-time employment amongst women across all occupations in the sector compared to male staff. A number of the proposed Participation responses in the report may have cross-over with existing or proposed Future Workforce projects and should therefore be integrated with those projects ensuring that the PaEE issues are reported on and monitored as part of the wider project. For example work on rostering and flexible hours is currently being undertaken as part of the Safe Staffing project. However that project is confined to nursing staff and the gender equity issues identified in this Review need to be addressed across the Sector. Participation Responses 2.1 That a national bipartite research project be undertaken to examine available New Zealand and international material on flexible hours and rostering and make recommendations for a pilot of more flexible hours and rostering systems for the New Zealand Public Health Sector environment. That such a pilot be conducted in a range of DHBs of varying size. 2.2 That noting the commencement on 1 July 2008 of the Employment Relations (Flexible Working Arrangements) Amendment Act 2007, DHBs develop policies on the administration of applications for flexible working hours under the Act in their DHB. 2.3 That DHBs develop policies and strategies around the following issues to assist part-time and casual staff to more fully participate in the workforce: career pathways and advancement of part-time employees equitable access to training & development opportunities for part-time employees access to information, meetings, project participation, etc for part-time employees. 2.4 That DHBs explore options for providing greater support for staff who have children. These could include: provision of child care, school holiday and after school programmes directly or in conjunction with a local provider and/or other local employers breastfeeding facilities a cost benefit analysis of providing subsidies for child care.

33 Public Health Sector: Pay and Employment Equity Review That DHBs provide support for employees to help them achieve better work-life balance including: incorporation of initiatives to address the work-life balance needs of staff in annual performance discussions ensuring managers are equipped to assist staff address work and family/caregiving responsibilities. 2.6 That a bipartite project be undertaken to develop strategies to support and increase the participation of female Senior Medical Officers (SMOs). These strategies should include: active search and encouragement of female candidates for SMO positions, particularly in areas where women are under-represented retention strategies for female SMOs identification of barriers to women s transition to and participation in the SMO workforce and strategies to overcome them. 2.7 That DHBs develop a Remote Working Policy for their DHB and explore opportunities for staff to work remotely to provide them with another level of flexibility. Strategies to build workforce capacity and increase female participation The Public Health Sector workforce is predominately female (79%) and a majority of female employees work part-time. The average full-time equivalent (FTE) proportion for female staff in the sector is 0.82 compared to 0.95 for men. For nursing, the largest occupational group, women work on average 0.81 of an FTE compared to 0.95 for men. The level of part-time work is the major contributor to the gap in total remuneration between men and women within individual occupations in the sector. For many women, the decisions they make about the hours they work are personal choices balancing their work and life/family commitments. However around a quarter of female part-time employees who responded to the staff surveys on the issue indicated that they would like to work more hours now if circumstances were different. These circumstances included: Suitable childcare close to their workplace More suitable rostering / hours arrangements Less stressful workload

34 Public Health Sector: Pay and Employment Equity Review 33 The Future Workforce Strategic Plan 6 proposes the implementation of policies and programmes that enable work/life balance, focussing on: a family friendly environment access to accessible/affordable dependants care flexible work arrangements and wellness programmes that support workforce diversity sustainable recruitment and retention. The 2004/2005 Healthy Workplace Stocktake provides an overview of existing DHB initiatives as the basis for further development. There are significant benefits for both employees and management if part-time staff are better supported to enable them to participate more fully in the Public Health Sector. There is also significant potential for labour and skill shortages to be reduced as a consequence. For example if five nurses who are currently working 3 days a week, or a total of 3 full-time equivalents (FTEs) between them, were each able to increase their participation to 4 days a week they would total 4 FTEs between them. Many employment overheads (eg training, practicing certificates) are the same or similar for full-time and parttime staff. The potential for increased workforce participation by women in the Sector can be seen in the following example. In one of the larger DHBs which employees over 1,900 Registered Nurses, only 30% work full-time and 41% work 3 days or less. In the age group (29% of these Nurses), only 22% are full-time and 54% work 3 days or less. In the older age groups the proportion of women working full-time does not increase significantly. A similar pattern exists in other DHBs where levels of part-time employment increase dramatically amongst women in the age group. This is most likely driven by the child care responsibilities of many of these women during these years of their lives. NB: This data only reflects the contracted hours of these Nurses. Many may work additional hours on a regular basis. 6 Page 16, Nurturing and Sustaining the Workforce. Priority: Enhancing people strategies

35 Public Health Sector: Pay and Employment Equity Review 34 Despite the high level of part-time employment in the sector, a majority of staff responding to surveys did not agree that their DHB actively supports opportunities for the advancement and growth of part-time employees. Issues which should be explored to provide greater opportunities for women to participate more in the sector are: Flexibility of hours and rosters Work-life balance Child care Remote working Support for training and development Casual employment The level of casual employment within the Sector was not consistently analysed across the DHBs as part of the Review. There was anecdotal evidence that some staff are choosing to work on a casual basis for the flexibility it offers them. The Health Workforce Information Programme (HWIP) does gather data on numbers of casuals within occupations who are currently available for casual employment, but the data does not indicate to what extent casual staff are utilised. An examination in one DHB revealed that casuals / locums accounted for 6.3% of the total paid to employees. From the September 2007 HWIP data, 82% of the casual pool staff in DHBs are female compared to 79% of permanent staff. It is recommended that the HWIP collate data from DHBs on their use of casual staff by occupation by gender as a proportion of the total payroll. Flexible hours and rostering The main hospital shift is from 7 a.m. to 3 p.m. The hours of this shift have not adapted over the years as changes in the composition of the workforce have occurred. The shifts have remained the same since the days when the female nursing workforce was predominantly single and did not have children. Lack of suitable flexibility in hours results in some women who are health professionals withdrawing from the workforce or only seeking casual work to give them greater control over their hours. This can result in the waste of the significant investment in training and skills development that has been invested in and by these health professionals. A number of DHBs reported that during the MeNZB immunisation program they were able to recruit many nurses not currently on the Public Health Sector workforce to administer the vaccinations in schools. The hours suited these women who had children.

36 Public Health Sector: Pay and Employment Equity Review 35 Many DHBs have some limited alternative shift arrangements which are more suitable for some staff, however the standard shifts remain the norm. There are significant and complex issues associated with hospital rostering and staffing arrangements. Many of these have been identified in the Report of the Safe Staffing / Healthy Workplaces Committee of Inquiry (June 2006). A Public Health Sector wide examination of more flexible hours and rostering would offer potential benefits to both staff and management. There is significant international research and literature on working hours and rostering within the health sector. Many of the issues are common throughout the world. A national bipartite research project could examine this material and make recommendations for a pilot of more flexible hours and rostering systems for the New Zealand environment. Such a pilot could be conducted in a range of DHBs of varying sizes. Work-life balance Work-life balance is at the forefront of public debate about how we work and live. Work-life balance is about effectively managing the juggling act between paid work and the other activities that are important to people. These activities include time with family, participation in community activities, voluntary work, personal development, leisure and recreation. The 'right' balance is a very personal thing and will change for each person at different times of their lives. There is no 'one size fits all' solution. Staff who responded to the surveys did not perceive that their DHB was committed to assisting employees maintain work life balance. However staff did perceive that their immediate Manager was committed to assisting employees maintain work life balance. Work-life balance should be included as a standard item for discussion with staff in their annual performance appraisal. The recent passage of the Employment Relations (Flexible Working Arrangements) Amendment Act 2007 will change the way some employees and employers make and respond to requests for flexible working arrangements. The Act will come into force on 1 July The Act provides certain employees with the right to request a variation to their hours of work, days of work, or place of work. To be eligible for the right to request, an employee must have the care of any person and have been employed by their employer for 6 months prior to making the request. When making the request, the employee must explain how the variation will help the employee provide better care for the person concerned.

37 Public Health Sector: Pay and Employment Equity Review 36 The Act will require employers to consider the request for flexible working arrangements and provides the only grounds upon which they can refuse a request. The Act also provides a process for how requests are to be made and responded to. The development as a priority by DHBs of policies covering how applications for flexible working hours will be handled within the DHB is essential if they are to be prepared for the introduction of the new legislation. Such a policy would also provide general guidance to management and staff on how applications for part-time work are assessed, as well as a reference on how other conditions of employment apply to part-time employees. Child care The availability of suitable and affordable child care impacts on the ability of many employees, particularly female employees, to more fully participate in the workforce. Some DHBs currently have arrangements with local child care providers for places to be available for DHB staff. However no DHB provides any subsidy for this care and the hours of these centres do not suit many shift workers. The main hospital shift from 7 a.m. to 3 p.m. presents problems for staff with child care responsibilities at both ends of the day. The government s 20 hours free early childhood education scheme assists some employees, but only those with children aged three or four. School holidays and after school periods also present another level of complication for many employees. Examination of the potential usage of employer co-ordinated child care, school holiday and after school programs should be carried out by DHBs. It would be worth conducting this examination in conjunction with other local employers. Employer subsidised child care is becoming more common in New Zealand and in Australia in a bid to attract and retain skilled staff. With continuing difficulties being experienced by DHBs in recruiting and retaining highly trained and skilled health professionals, a cost benefit analysis of providing subsidised child care in the Public Health Sector should be carried out. There are potential savings in overtime, training and other overheads if existing staff are able to increase their part-time hours as a result of better access and affordability of child care. The needs of staff who have other family caring responsibilities (eg aged parents) were not canvassed by the DHB reviews, although the Employment Relations (Flexible Working Arrangements) Amendment Act 2007 will cover staff who have the care of any person. Remote Working Opportunities for Remote Working (including home based) are currently limited, particularly amongst clinical staff within the Public Health Sector. However amongst administrative,

38 Public Health Sector: Pay and Employment Equity Review 37 managerial and information technology staff for example there may be some work that can be performed outside of DHB workplaces. With the rapid advancement in technology, the possibilities for remote work by other staff, including clinical, will expand and DHBs need to plan to take advantage of the efficiencies that these possible ways of working may offer their DHB as well as their staff. There are significant issues of security of records, health and safety, etc which would need to be addressed and codified. The possible opportunities for staff to work remotely to provide them with another level of flexibility should be explored by DHBs and Remote Working Policies developed by these DHBs. Support for Training and Development Part-time staff who are health professionals are all required to complete the same minimum number of hours of training and development as full-time staff in order to maintain their practicing certificates under the provisions of the Health Practitioners Competence Assurance Act 2003 (HPCAA). This can place additional pressures and personal cost on them if the training and development opportunities are not available during their regular hours. DHBs should explore how they can provide more support for the training and development needs of their part-time staff in particular.

39 Public Health Sector: Pay and Employment Equity Review Respect and Fairness Two responses to the findings in relation to the Respect and Fairness equity indicator are proposed relating to building more positive workplace cultures in DHBs. The Future Workforce Strategic Plan 7 proposes the development, promotion and sharing across DHBs best practice tools that foster supportive environments and positive cultures. The Healthy Work Environment Stocktake has identified useful areas fro future shared development. Respect & Fairness Responses 3.1 That DHBs continue to work to build positive and supportive workplace cultures which: provide a safe and harassment free work environment actively value and support staff recognise and celebrate long service and special contributions. 3.2 That Future Workforce projects aimed at Fostering Supportive Environments and Positive Cultures ensure that they have a gender equity focus. Building positive Workplace Cultures There are potentially significant benefits for both staff and management in improving the workplace culture in their DHB. Although it is debatable whether workplace culture is a gender equity issue, it is evident from the responses to staff surveys in many DHBs that women have a less positive view than men about the culture of their workplace. The Report of the Safe Staffing / Healthy Workplaces Committee of Inquiry (June 2006) noted that a motivated, satisfied workforce is key to achieving organisational success. The Health Workforce Advisory Committee (HWAC), established to provide advice to the Minister of Health, has also recognised the importance of healthy work environments. National guidelines produced by the HWAC identify high-level principles that underpin an ideal workplace culture. These include: having the health and well-being of the person as its primary objective valuing employees and promoting trust between staff people working collaboratively as teams and forming constructive relationships to achieve shared objectives 7 Page 15. Nurturing and Sustaining the Workforce. Priority: Fostering Supportive Environments and Positive Cultures.

40 Public Health Sector: Pay and Employment Equity Review 39 enabling effective and open multi-level communication channels encouraging and supporting change and innovation, fostering creativity and promoting continuous learning fostering a risk management approach that supports staff and is not simply risk aversion having a culturally aware environment that is supportive of, and responsive to, the increasing diversity of the workforce, and recognises and adapts to changing worklife balance. The Health Sector Relationship Agreement s first priority project is about embedding constructive engagement as an enduring approach to public health and disability sector relationships. A number of DHBs are already working on strategies to improve their workplace culture. Should there be a demand by DHBs for a sector wide strategy and campaign it should be developed through a bipartite process to address the issue and provide resources and materials for DHBs to use or adapt. The State Services Commission has also produced a useful guide: Creating a Positive Work Environment: Respect and Safety in the Public Service Workplace. Recognising and valuing staff There was generally a high level of staff confidence that they were treated fairly and honestly by their managers. However compared to the other staff welfare indicators highlighted by the staff surveys, the proportion of staff who felt valued as employees was not as high. This is an area which should be attended to by DHBs as it does have an impact on staff morale and productivity. From the survey results in most DHBs, it is clear that staff are fairly confident in their immediate manager. However their views are not as positive when asked about the organisation as a whole. Greater visibility of senior management in the workplace, speaking directly to staff in their work environment, has the potential to help break down the them and us divide between senior management and staff and improve morale and productivity. Staff need to know first hand that senior management are approachable and listening to their concerns and ideas. DHBs should develop strategies to ensure there is regular recognition of special contributions that individual and groups of staff make. A formal recognition and celebration scheme for staff who have worked for the DHB for significant numbers of years could also be implemented if not in place already. These should be more than just a pro-forma letter. Staff need to know that their service and contribution to the DHB is genuinely appreciated.

41 Public Health Sector: Pay and Employment Equity Review 40 Harassment and inappropriate behaviour All DHBs have strong policies of zero tolerance of inappropriate behaviours. However based on the staff survey responses, there is clearly a need to increase the confidence of staff that their DHB does not tolerate inappropriate behaviours and has active strategies in place to address these issues. Promotion of these policies does not appear to be uniform across the sector. While some areas appear to have very good systems and staff awareness in place, others do not. In any workplace, the inappropriate behaviour of just one or two individuals can have a negative impact on workplace morale and productivity. Management need to present good role models and act firmly to stamp out inappropriate behaviour wherever it is evident. Although the number of formal complaints in most DHBs is small, the level of comment about this issue received through the staff surveys indicates that a more proactive approach is required in DHBs. This should aim to ensure that the policy is enforced and that staff feel supported in seeking to report and eliminate inappropriate behaviours.

42 Public Health Sector: Pay and Employment Equity Review Pay and Employment Equity Policy The implementation of the Responses contained in the report will require ongoing oversight. It is proposed that a Bipartite Committee similar to the one that coordinated this review continue to coordinate, monitor and report on Pay and Employment Equity issues in the Public Health Sector and in particular the Response Plan for the Sector. The constitution and terms of reference for the Committee should be agreed between the parties under the Health Sector Relationship Agreement. The quality of workforce data used by the DHB reviews was variable. The Health Workforce Information Programme (HWIP) is working with DHBs to improve workforce data as part of the DHBs Future Workforce strategic plan. The programme produces a quarterly report which includes a range of tables and charts providing a detailed snapshot of all workforce groups in the Sector. Currently only a couple of the HWIP tables and charts include a gender breakdown. The inclusion of a gender breakdown in all these tables would be useful for the monitoring of female participation in particularly within individual workforces and occupations. The inclusion in the quarterly reports of trend lines showing changes to female participation levels within workforce groups and occupations would also be useful in tracking the success of some of the proposed responses in this Report. A range of other data is currently collected form DHBs as part of the HWIP and for other workforce planning and negotiation purposes. This data could also be used to develop additional reports for monitoring and reporting on PaEE issues, particularly changes in remuneration gaps between women and men. Workforce data is also produced by other organisations such as the New Zealand Health Information Service and the Medical Council of New Zealand. This data should also be reported on by gender. A number of DHBs have acknowledged as part of their local response plan that they need to develop policy and training on pay and employment equity. It is recommended that all DHBs undertake this work. During the Reviews, each DHB appointed a project sponsor to act as a support for the project facilitator and the DHB Review Committee and to represent the work of the committee to senior management within the DHB. It is recommended that DHBs now appoint a senior manager to have ongoing responsibility for PaEE issues and implementation of their local Response Plan.

43 Public Health Sector: Pay and Employment Equity Review 42 Pay & Employment Equity Policy Responses 4.1 That a Bipartite Pay and Employment Equity (PaEE) Committee operating within the framework of the Health Sector Relationship Agreement continue to coordinate, monitor and report on PaEE issues in the Public Health Sector and in particular the Response Plan for the Sector. 4.2 That the quarterly Health Workforce Information Programme (HWIP) Reports include: a gender breakdown in all tables trend lines showing changes to female participation levels within workforce groups and the larger occupations. Further, that other HWIP reports be developed to assist the Bipartite PaEE Committee monitor and report on progress in reducing pay and employment inequities in the Sector. These reports should include data from DHBs on use of casual staff by occupation by gender as a proportion of the total payroll. Other Ministry and related workforce data also be reported on by gender. 4.3 That DHBs develop and implement: a policy supporting pay and employment equity for women in their DHB a training/awareness programme on gender related issues in their DHB, with particular emphasis on Human Resources and staff who may be the first point of contact when women experience difficulties in this area a process specifically for addressing gender related issues reported by staff. Further, that DHBs appoint a senior manager to have ongoing responsibility for PaEE issues and implementation of their Response Plan.

44 Public Health Sector: Pay and Employment Equity Review 43 IMPLEMENTATION: THE WAY FORWARD It has been recommended that a Bipartite Pay and Employment Equity (PaEE) Committee operating within the framework of the Health Sector Relationship Agreement continue to coordinate, monitor and report on PaEE issues in the Public Health Sector and in particular the Response Plan for the Sector. A number of Responses propose specific bipartite projects to address particular issues. If there are existing projects addressing similar issues, then wherever possible the work should be integrated so as to avoid duplication or inconsistent outcomes. A number of the Responses require action at the DHB level, and DHBs should report back through the Bipartite PaEE Committee on progress on these issues. DHBs should also review and amend their local Response Plans to include relevant recommendations from the National Response Plan. A detailed implementation plan should be developed by the Bipartite PaEE Committee. This plan should include the: action to be taken person or group responsible for implementation people or groups to be consulted timetable for implementation success indicators The Implementation Plan should be monitored and updated by the Bipartite PaEE Committee. A draft Implementation Plan is at Attachment F and those Responses which require action on the part of individual DHBs are detailed in the abbreviated Implementation Plan at Attachment G. It is important that staff are kept informed about what action is being taken as a result of the Review. Almost 12,000 DHB staff participated in the reviews and they have an expectation that they will see some outcomes from the process. Communications should be drafted nationally and issued to DHBs for distribution to staff through the DHBs communication channels. It is recommended that a further Pay and Employment Equity Review be conducted in the Public Health Sector in 3 years.

45 Public Health Sector: Pay and Employment Equity Review 44 ATTACHMENT A - TERMS OF REFERENCE 1. Approach to the Public Health Sector Review The review will be a bipartite process in which, the Health Sector unions and the DHBs will commit to developing a shared understanding of the issues and analysis of the information in order to achieve outcomes acceptable to all. Non CTU Health Sector Unions will be provided with copies of the project brief and terms of reference once they have been agreed. They will also receive updates of the project as it progresses The non CTU Health Sector unions and non union employees will be involved in the review process at an individual DHB level. The review will be based on the process recommended in the Department of Labour Pay and Employment Equity Unit (PEEU) review workbook Working Towards Pay and Employment Equity for Women, including the establishment of review committees in 5 DHB (Auckland, Taranaki, MidCentral, Hutt Valley and Otago) who will review and analyse information. The process will be an evidenced-based process and will gather information from the 5 DHBs. Examine the information with a gender lens to see if there are differences in outcomes by gender. The information gathered may highlight differences in the outcomes for men and women and the review committee would then look to explore the reasons behind these differences. Where it is considered that the reasons behind the differences are not justifiable, a response to address the outcomes will be developed to form part of a response plan for pay and employment equity in the Public Health Sector. There will be individual DHB Response Plans as well as a National Response Plan Prior to being finalised the National Response plan will enter a process of verification with the other 16 DHBs. The NZ Blood Service may decide to participate in this process or may decide to carry out a full review. This review is being carried out at a time when the DHBs are entering into major negotiations which may affect significant numbers of staff should this become unmanageable timeframes may need to be reviewed. All data and information gather will be used for the purposes of this review. Committee members will not discuss or share information outside of the meetings unless agreed by the committee as part of the review process. 2. The Purpose of the Bipartite Working Group The purpose of this group is to maintain a national overview of and consistency in the implementation of the Pay and Employment Equity Review process across the 21 DHBs. 3. Membership of Bipartite Working Group 1 Representative from each of the 5 DHB implementing the review process 5 Representatives from the CTU Health Sector Unions National Coordinator Pay and Employment Equity Reviews (to act as facilitator and implementer of decisions made by the group) The contact person from Pay and Employment Equity Unit.

46 Public Health Sector: Pay and Employment Equity Review The Role of the Bipartite Working Group Plan the process and determine the scope of the work o Identify the actions, support and resources required o Development of a national verification process that gains the agreement of the other 16 DHBs. Use the data available to identify data collation and analysis requirements and determine any further information needs to assist the review committee in each DHB Assess the review tool for applicability to the District Health Board environment Provide overall coordination of the review process o Ensure that each of the 5 DHBs know what the expectations are in regard to carrying our the review o Develop feedback mechanism for remaining 16 DHB o Develop response plan which identify the levels at which issues would be most appropriately addressed. Provide progress reports to o The National Bipartite Health Sector Group, on a two monthly basis o The Ministry of Health on a 6 monthly basis 5. How the Parties will work together The parties will work together in a manner consistent with the principles of good faith. Attend training on the Department of Labour s P&EE training modules. Adopt a joint problem solving approach to issues and difficulties. Give early warnings to flag any difficulties or concerns. Endeavour to abide by realistic and agreed timeframes. Identify expectations of how information will be used in the process and respect these expectations. Develop joint communications principles and a National Strategy. Provide all information as required. Members of the group will commit to fully participating at meetings and arrive prepared. The working group is a decision making group and therefore group members must attend meetings with authority to make decisions. To assist this where ever possible all material for meetings will be sent out in advance to enable representatives to obtain the appropriate authority. Dates for meetings will be agreed in advance. While the parties will attempt to achieve consensus in decision making should this prove impossible an independent facilitator may be employed to assist the group move forward. 6. The purpose of the review The purpose of the review is to help identify Whether or not DHB employment practices are gender neutral Areas in which the DHB are delivering on pay and employment equity Whether there are gender differences that may require further investigation to assess if there is a negative impact on women s experiences at work A response plan to address any gender differences that are not justifiable

47 Public Health Sector: Pay and Employment Equity Review The review process In the 5 DHBs the review will be conducted following the process recommended in the Department of Labour Pay and Employment Equity Unit (PEEU) review workbook. However, the review will also include a national verification process, which will involve the other 16 DHBs The review process is a six-step procedure: Creation of a gender profile Preliminary analysis Follow up analysis Validation Preparation of review report Develop a response plan 8. The National Response Plan The working party and the committees will develop an agreed response plan for those identified gender-differences in outcomes that are not justifiable. There will be a national response plan which identify the levels at which issues would be most appropriately addressed. The individual DHB issues are likely to include significant employment equity issues arising from policies, practices, behaviours and cultures. There will be a principled basis for prioritising issues in the response plans. The parties agree to consider processes, which will allow for the examination of differences in outcome by gender in current and future work related to employment processes and practices. The pay component of the pay and employment equity review in the Sample DHBs could lead to a response in regard to a perceived anomaly in the remuneration of one or more occupational groups relative to others. Such a response could be: A proposal for a pay investigation at either a national or individual DHB level A proposal that the matter be addressed directly in the following round of collective bargaining, and / or A proposal that adjustments in remuneration be made by DHBs (within existing funding) If the findings and the proposed response(s) were validated by the DHBs and Unions, and Ministers accepted the response plan for the sector for implementation, the remuneration issue could then be addressed through: Business cases for increases to baseline funding as part of the budget process; DHBs meeting the increases within existing funding; or The usual bargaining processes.

48 ATTACHMENT B SUMMARY OF VERIFICATION FINDINGS This table provides a visual summary of the verification of the findings of the 5 sample DHBs who conducted full reviews. Not all finding in each DHB were clear cut and an assessment was made on how that response should be classified. The DHBs are numbered A P and are not identified by name. 1. Rewards - Quantitative findings 1.1 The average total remuneration between women and men is greater than 5% The difference is less than 5% when doctors are excluded from the dataa 1.2 There is a differencee greater than 5% on the starting salaries for men and women 1.3 Women are less likely to be available for work that attracts penal rates 1.4 The lowest paid occupations are dominated by women 1.5 Female Senior Medical Officers (SMOs) earn less than male SMOs 1.6 Female Senior Medical Officers start on lower salaries than male Specialist Medical Officers 1.7 There are salary differences greater than 5% between male and female - medical radiation technologists (MRTs) - psychologists - social workers. 1.8 Male senior managers are paid more than female senior managers 1.9 Committee have questioned if all clerical roles are appropriately valued in comparison with other roles 1.10 Cleaners (from the DHB that employs cleaners, rather than contracting out cleaning services). The collective does not include recognition for extra responsibilities, a meal allowance, penal rates A B C D C C E F G C C C H I J K L M N C C C C C O P C Rewards - Qualitative findings (staff perceptions from surveys) 1.11 Rewards for base pay are evenly shared Men and women are paid the same rates for similar work Overall women and men have the same chances for promotion.