Buchan J, North N
Queen Margaret University, Edinburgh, UK.
Int Nurs Rev. 2009 Jun;56(2):206-13. doi: 10.1111/j.1466-7657.2009.00715.x.
This paper examines the labour market impact of a new national pay award for nurses implemented in New Zealand in 2004/5 - the Multi-Employer Collective Agreement (MECA).
The health system in New Zealand is unusual in that, while retaining a public sector system, the focus of pay determination for nurses over the last 20 years has shifted first from national to local pay determination, and then more recently reversed this trend, moving back to a national level pay determination. The shift back to a national pay determination approach in 2004/5 is therefore worthy of examination, both in terms of its labour market impact, and as a case study in the use of national level pay determination.
The research was conducted in 2007-8. A rapid appraisal method was used, based on key stakeholder interviews, a document and literature review and a review and analysis of available data on the New Zealand nurse labour market, and trends in application rates to schools of nursing were assessed. In addition, interviews with managers of two District Health Boards, and interviews with five non-government employers of nurses, were conducted.
Indicators pointing to improvements included: steady (though not rapid) growth in staff numbers; reduced difficulty in recruiting; reduced vacancy rates; and increased application rates to schools of nursing. Managers interviewed in the study supported these positive indications, but some health-care employers not covered by the pay award reported negative knock-on effects (e.g. needing to match DHB rates, increased retention and recruitment difficulties).
Available nurse labour market data provide an incomplete but compelling picture of the positive impacts of the MECA in a period of a very tight labour market. While much of the content of the 2004/5 agreement could be characterized as a 'normal' pay bargaining contract, there were also issues that differentiated it from the norm. In particular, it included an agreement to establish a safe staffing commission to assess the impact and implications of low staffing levels, nursing workload, and to establish guidelines on safe staffing and healthy workplaces.
本文考察了2004/05年在新西兰实施的一项针对护士的新的全国性薪酬裁定——多雇主集体协议（MECA）对劳动力市场的影响。
新西兰的医疗系统不同寻常，在保留公共部门体系的同时，过去20年里护士薪酬确定的重点先是从全国性转向地方性薪酬确定，最近又逆转了这一趋势，回到了全国性薪酬确定。因此，2004/05年回归全国性薪酬确定方法这一转变，无论从其对劳动力市场的影响来看，还是作为全国性薪酬确定使用方面的一个案例研究，都值得审视。
该研究于2007 - 2008年进行。采用了一种快速评估方法，基于对关键利益相关者的访谈、文件和文献综述以及对新西兰护士劳动力市场现有数据的审查与分析，并评估了护理学校的申请率趋势。此外，还对两个地区卫生局的管理人员以及五家护士非政府雇主进行了访谈。
表明情况有所改善的指标包括：员工数量稳步（虽不迅速）增长；招聘难度降低；空缺率降低；护理学校的申请率提高。研究中接受访谈的管理人员支持这些积极迹象，但一些未受薪酬裁定覆盖的医疗保健雇主报告了负面的连锁反应（如需要与地区卫生局的薪酬水平匹配、留用和招聘困难增加）。
现有的护士劳动力市场数据虽不完整，但有力地呈现了在劳动力市场非常紧张的时期MECA所带来的积极影响。虽然2004/05年协议的许多内容可被视为一份“正常”的薪酬谈判合同，但也有一些问题使其有别于常规。特别是，它包括一项设立安全人员配置委员会的协议，以评估低人员配置水平、护理工作量的影响及后果，并制定安全人员配置和健康工作场所的指导方针。
