Collectivism, unions and nursing professionalism.

'Those within nursing who believe in the value of collective bargaining, and who I exercise it as a means to overcome oppressive environments within their institutions, face ... opposition from administrators and more specifically from nurses who believe it is unprofessional.' Primary health care (PHC) nurses and other PHC workers in New Zealand have taken an historic step forward, by voting overwhelmingly in favour of negotiations for a multi employer collective agreement (MECA) in the PHC sector. The new collective agreement--the PHC MECA--will bring together NZNO members working in general practices, accident and emergency centres and iwi and Maori health provider workplaces. The success of the nationwide ballot has resulted in bargaining being initiated with a record 686 employers, creating the biggest potential NECA in New Zealand.

Saluting nurses' courage

For many of those who voted, it is the first time they have ever voted in a ballot for a collective agreement (CA.) I salute their courage in taking this first step in exercising their collective power to advance fair pay and conditions in the sector and, ultimately, the ability of the nursing profession to provide a better standard of care. At times, some of these nurses would have questioned themselves about whether to join in collective bargaining and they may even have faced criticism from colleagues, employers and the public about their decision.

In some of the higher echelons of nursing, some distaste remains about unionism and its perils for the profession. Nurses seeking more voice within their own workplaces, and realising this through the negotiation of pay and conditions that protect professional practice, do challenge the more traditional value of obedience, inherent in an antiquated view of nursing.

MECA positive for the profession

Working towards a MECA should be viewed positively by the profession. A MECA is a way of creating an environment that enables consensus on working conditions that support and recognise nurses' autonomy and professionalism, while at the same time protecting the client by providing experienced and skilled carers.

The American Nurses' Association's Code for Nurses has a provision that illustrates the value placed on collective bargaining as a way of ensuring high quality nursing care. It states "the nurse participates in the profession's efforts to establish and maintain conditions of employment conducive to high quality nursing care" and goes on to state that defining and controlling the quality of nursing care provided to the client is "most effectively accomplished through collective action." (2)

The central goal of the PHC MECA is to win pay parity--te utu tika--with nurses employed in the public sector. Pay parity for nurses and other health workers in the PHC sector is the only way to ensure an adequate and appropriately paid nursing workforce to deliver PHC services. Without this workforce, health inequalities and rising health costs, due to delayed intervention and treatment, will continue to be perpetuated, placing the delivery of the current Government's PHC strategy at risk.

Since the district health board (DHB) fair pay settlement, the pay gap between nursing working in the public sector and those doing a job of equal value--PHC nurses in the community--has widened. That puts even more pressure on the recruitment and retention of nurses in primary health and undervalues their work of delivering health care to communities.

The initiation of bargaining for the MECA is a hugely significant first step towards pay parity. The challenge now will be to maintain the momentum of the campaign by continuing collective action. Visibility of the pay parity issue will be essential if we are to win.

The DHB campaign for fair pay was won through the activism of NZNO members. Activities such as the national petition and "Go Purple Bay" highlighted public sector nurses' case for better pay and conditions.

Similarly, in the PHC sector, nurses and health workers will need to stand together and tell theft stories in the local and national media. It is heartening to see we already have an army of PHC activists on our email database and more than 100 members and activists attending our paid regional bargaining seminars across the country this month.

At NZNO's third PHC nursing conference in Auckland last month, Health Minister Annette King agreed to take the pay parity for PHC nurses message from the 200 delegates back to the Government. In agreeing to take back the message, delivered by chair of NZNO's PHC Nurses Council Chiquita Hanson, the Minister acknowledged the call for pay parity and encouraged employers to engage in the process. NZNO wants to work with the Government and employers to ensure that the estimated $40 million required to settle the PHC MECA claim is available.

Gathering momentum

We are just beginning to gather the momentum required to close the pay gap and realise our dream of fair pay for all nurses and health workers in Aotearoa. We need to remain steadfast, united and strong.

"Understanding the similarity of goals among different nurses, and the utility of meeting those goals through collective bargaining can, perhaps, help to reshape the value we give to collective thinking and action and their ability to provide for nurses who struggle to protect their practice, their patients and their profession." (1) Kia kaha.

References

1) American Nurses' Association (ANA). (1998) The role of collective bargaining and unions in advancing the profession of nursing. (1998) Nursing Trends and Issues; 3: 2. Washington DC: ANA.

2) American Nurses' Association (ANA), (1985) Code for Nurses. Washington, DC: ANA,

NZNO organising services manager Cee Payne-Harker