Editorial: Health a case for mandatory arbitration

File photo / NZH

Strikes have become a depressingly familiar part of the health system. A couple of years ago, it was junior doctors flexing their muscle.

Now, radiographers and laboratory workers are involved in a months-long campaign of partial and, occasionally, full strikes.

As usual, the unions involved insist the action is not using disrupted patient care as a bargaining chip but is about getting contracts settled in a fair and meaningful way.

But no matter how much care is taken, there is always substantial upheaval when strikes take place. And, inevitably, patients who have crucial examinations or treatment delayed or interrupted are the major losers.

A call by district health boards for the Government to review the right of health workers to strike is, therefore, most timely. They made it clear yesterday that they have had enough of patient safety being compromised.

The chief medical officers of all 20 boards have written to the Health Minister, Tony Ryall, urging him to make disputes over pay or conditions in the health system subject to compulsory arbitration, as is the case with other public safety workforces, such as the police.

The freedom to withdraw labour should never be eliminated lightly. But, whatever the rights and wrongs of the present strike, there is good reason to believe the time has come for compulsory independent arbitration in the sector.

Hospitals provide an essential service. They are the only port of call for the ill. There is no alternative supplier of their services. As it is, sick people must wait impotently as disputes wind their way to a conclusion.

The present one bears all the hallmarks of a workforce that some time ago set aside any ethical pangs over its entitlement to strike. As the weeks have passed, positions have become more entrenched and the posturing ever greater.

This has led to over-the-top statements that are hardly helpful, such as the district health boards' complaint that the radiographers and laboratory workers are using "dirty" tactics.

Of equally dubious nature was their mention yesterday of two patients whose scans were deferred by the present action and who had now been diagnosed with inoperable liver cancer.

"It is not known if this would have been treatable if the scan had been done at the time requested two weeks previously," the boards said. If so, why mention it, other than to stir public outrage over the strike?

But, clearly, the action has, at the very least, led to considerable delays in the likes of breast x-rays. That, in itself, reinforces the case for such disputes to be subject to compulsory arbitration.

If Mr Ryall is unwilling to go there, he could consider the intermediate step of an independent body that would determine what levels of services health workers must maintain during a strike, so no patient is placed at greater risk.

The level of service would vary significantly, depending who was on strike and where.

But a compelling case can be made for the most direct approach to the problem. The public would be both reassured and better served by the absolute surety of compulsory arbitration, and health workers would not be hugely disadvantaged.

The change would simply accelerate negotiations while making little, if any, difference to the final result in terms of pay and conditions.

During the junior doctors' strike of 2008, the Medical Council suggested the time to move to compulsory arbitration had come. Unsurprisingly, a Labour Government was unmoved.

Now, the push by district health boards has substantially raised the ante. So, too, has health workers' increasing penchant for industrial action. If the Government acts, as it should, there will surely be no complaints from the public.