OIA14032022 SAXTON Clinical Working Hours Combined.pdf

11th April 2022

Amber Saxton
Private/Individual
Email: [FYI request #18857 email]

Dear Amber

Official Information Act Request for – Clinical Working Hours

I write in response to your Official Information Act request received by us 14th March 2022, you
requested the following information:

“Hospital has many doctors at different pay scales and responsibilities. Many of which are
demanding for the team. Paediatrics and General Medicine have been two of the demand
rotation. With regards to general medicine and pediatrics departments.

1)  what is the list if senior medical officers designated to be clinical supervisors for
medical students from the university if Auckland (i.e. who are the SMOs who can sign
CSRs)
2)  from above, what is the FTE of each SMO, and number of hours expected on site.
a.  if applicable, what is their salary as per Association of Salaries Medical
Specialist contact
b.  what has this been for the last 10 years
c.  if unavailable, what is their generic SMO payscale
3)  to prevent burn often doctors get rostered time off
a.  how many days in a row can an SMO work as per contact
b.  what is the policy around SMO rostered days off
c.  what compensation is given when SMO do work beyond their day off? e.g.
come in on a RDO
4)  With regards to house Officer
a.  what are the run catagories for house officers on paediatrics and general
Medicine attachments, ergo number of expected hours
b.  what is their pay as per pgy# and run catagory from above
c.  what has this been for the last 10 years?
d.  what is the maximum number of days house officers in the attachments
above have to work in a row
e.  what is the rostered day off policy for house officers in the rotations
mentioned above?
5)  With regards to trainee interns
a.  how many hours per week are trainee interns expected to be on placement in
runs above?

b.  as they are not paid, what protections are ensured trainee interns have proper
rest and food breaks?
c.  how many days in a row are trainee interns expected to be on placement
Counties Manukau Health

Private Bag 93311, Otahuhu, Auckland
T: 09 276 0000 | cmdhb.org.nz

d.  what is the dhb policy for rostered days off for trainee interns
e.  how does dhb manage the expectations for trainee interns to be present
with their health and wel being in a demanding field
I request al  information in a tabulated excel document.”

We transferred questions 1, 5a, 5b and 5c to the University of Auckland however wil  respond to the
remainder of your request (i.e the questions in bold).

Counties Manukau Health Response:
For context Counties Manukau Health (CM Health) employs over 8,500 staff and provides health and
support services to people living in the Counties Manukau region (approx. 601,490 people). We see over
118,000 people in our Emergency Department each year, over 490,000 outpatient appointments each
year, and over 2,000 visitors come through Middlemore Hospital daily.

Our services are delivered via hospital, outpatient, ambulatory and community-based models of care.
We provide national, regional and supra-regional specialist services i.e. for orthopaedics, plastics, burns
and spinal services.  There are also several specialist services provided including tertiary surgical services,
medical services, mental health and addiction services.

1)  What is the list if senior medical officers designated to be clinical supervisors for medical
students from the university if Auckland (i.e. who are the SMOs who can sign CSRs)
We have transferred this question to the University of Auckland (UoA).

2)  From above, what is the FTE of each SMO, and number of hours expected on site.
a.  if applicable, what is their salary as per Association of Salaries Medical Specialist
contact
b.  what has this been for the last 10 years
c.  if unavailable, what is their generic SMO payscale
Question 1 was transferred to the University of Auckland, which will be providing the
list of names you seek. As we do not hold the relevant names, we are unable to provide
the information you are seeking in response to question 2.

We are, therefore, refusing this aspect of your request under section 18(e) of the Official
Information Act as the information requested does not exist, in the sense that we do
not hold the list of names to which the information relates.

CMDHB has a small number of SMOs who are University employees and their services
are outsourced to the DHB. It is also important to note that all SMOs teach and train
junior staff as part of their professional roles.

3)  To prevent burn often doctors get rostered time off
a.  how many days in a row can an SMO work as per contact
This is dependent on each individual SMOs contract.

In general, ful  time SMOs work 40 hours per week, if they choose to be on the acute
roster they may work extra hours to cover those periods, the frequency of this work wil
depend on the number of SMOs on the roster.

b.  what is the policy around SMO rostered days off
CM Health does not have a specific policy in relation to this, rostered days off are
guided by the Senior Medical and Dental Officers Collective Agreement (link below):
•  https://tas.health.nz/assets/ER/ASMS-Senior-Medical-Dental-Officers-MECA-
1-April-2020-31-March-2021-1.29Mb.pdf

c.  what compensation is given when SMO do work beyond their day off? e.g. come in
on a RDO
There are entitlements within the Senior Medical and Dental Officers Collective
Agreement to provide additional remuneration:
•  https://tas.health.nz/assets/ER/ASMS-Senior-Medical-Dental-Officers-MECA-
1-April-2020-31-March-2021-1.29Mb.pdf

Any requests for an SMO to work on a day they would not normal y work on would be
arranged by agreement between the service and the individual SMO. Remuneration and
adequate recovery time would also be agreed.

4)  With regards to house Officer
Selection of clinical attachments covered by the OIA
When identifying the House Officer clinical attachments (runs) covered by the OIA we have;
•  Included runs that are covered by general medicine run descriptions which includes
relief
•  Excluded medical sub specialty runs and those in acute assessment / medical
assessment units where these runs are not covered by the general medicine run
description.
•  Included runs that are covered by general paediatric medicine run descriptions which
includes relief
•  Excluded paediatric sub specialty or surgical runs
Two RMO MECAs
There are two RMO Col ective Agreements (MECAs) that govern terms and conditions of
employment for Resident Medical Officers (RMOs) they are;
•  20 DHB and NZ Resident Doctors’ Association Multi Employer Collective Agreement
dated 17 May 2021 – 31 March 2024 (NZRDA MECA)
•  20 DHB and Specialty Trainees of New Zealand Multi Employer Collective Agreement
dated 14 December 2021 – 13 December 2023 (STONZ MECA)
At the date of this OIA the salary scales, method for calculating run categories and the limits on
consecutive days of work are different in each MECA. When providing responses to the OIA this
has been split to identify NZRDA MECA and STONZ MECA.

The first STONZ MECA came into effect on 10 December 2018 and when responding to Question
4c the data for STONZ MECA commences from this date. Prior to this date the only MECA in
force was the NZRDA MECA.

Run Categories
Run categories are based on a band of hours as set out in the table below. This band of hours
represents the weekly hours averaged over the 13 week run rotation (clinical attachment) and
does not reflect the actual hours worked from week to week as this wil  fluctuate dependent on
the roster pattern.
Category
Hours
F
40-44.9
E
45-49.9
D
50-54.9
C
55-59.9
B
60-64.9
A
65+

NB any reference in the OIA to an A+ or A++ run category relates to how relievers are paid (see section
below on Reliever Salaries). The band of hours where this is referenced is 65+

Some of the runs covered by the OIA operate different summer and winter rosters through the House
Officer training year. Where summer and winter rosters are in place the run category for summer and
winter has been provided.

Salary Scale and PGY#
RMOs are paid as salaried workers with salaries based on their salary scale year and run category for the
run rotation. The salary scale year is based on post graduate experience (expressed as PGY #). At a House
Officer level the salary scale starts at Year 1 and the maximum is Year 4.

PGY1 is the equivalent of House Officer salary scale Year 1 and the House Officer will move to the next
year of the salary scale at the beginning of their next PGY year (subject to continuous service) until they
reach Year 4 of the scale.

Relievers Salaries
RMOs employed as “relievers” are paid a salary two categories above the category of the majority of
runs on which they are employed to provide cover.

Where the provision for an additional two steps would place the RMO above the top of the House Officer
scale an RMO who is on year 3 Category A or year 4 category B is paid Category A year 4 plus the amount
set out at Al owance 1 gross per annum. An RMO who is on year 4 Category A is paid the additional
amount set out at Allowance 2 gross per annum.

Additional allowance amount based on each MECA;
•  Allowance 1 – NZRDA MECA $5,000
•  Allowance 1 - STONZ $5,300
•  Allowance 2 – NZRDA MECA $10,000
•  Allowance 2 - STONZ $10,600
The reference to A+ and A++ in this OIA regarding relief run categories is used to identify where the two
steps above is higher than an A category run for payment purposes.

a.  what are the run categories for house officers on paediatrics and general Medicine
attachments, ergo number of expected hours
At the date of the OIA request the run categories are as follows noting that where
there is a different roster in summer and winter these have been listed separately.

NZRDA
NZRDA
STONZ
STONZ
DHB
Run
Summer
Summer
Description
Run
Winter Run
Run
Winter Run
Category
Category
Category
Category
Counties
General
Medicine
B
B
B
A
Counties
Medicine
Relief
A+
A
A+
A+
Counties
Paediatrics
E
C
E
C

b.  what is their pay as per pgy# and run catagory from above
At the date of OIA the annual salary based on PGY year is set out for each RMO MECA.
The Urban House Officer Scale (non shift work) rosters applies for each RMO MECA.

RDA MECA Salary @ 14 March 2022
NZRDA
DHB
Run Description
Summer Run
Salary
Salary
Salary
Salary
Category
PGY1
PGY2
PGY3
PGY4
Counties
General Medicine
B
$96,585
$104,557
$110,475
$116,394
Counties
Medicine Relief
A+
$118,975
$125,713
$132,451
$137,451
Counties
Paediatrics
E
$66,608
$72,106
$76,186
$80,273

RDA MECA Salary @ 14 March 2022
NZRDA
Winter Run
Salary
Salary
Salary
Salary
DHB
Run Description
Category
PGY1
PGY2
PGY3
PGY4
Counties
General Medicine
B
$96,585
$104,557
$110,475
$116,394
Counties
Medicine Relief
A
$109,906
$118,975
$125,713
$132,451
Counties
Paediatrics
C
$86,593
$93,742
$99,045
$104,353

STONZ MECA Salary @ 14 March 2022
STONZ
DHB
Run Description
Summer
Salary
Salary
Salary
Salary
Run
PGY1
PGY2
PGY3
PGY4
Category
Counties
General Medicine
B
$106,200
$114,200
$120,100
$126,100
Counties
Medicine Relief
A+
$129,100
$135,700
$142,400
$147,700
Counties
Paediatrics
E
$75,200
$80,800
$84,800
$88,900

STONZ MECA Salary @ 14 March 2022
STONZ
DHB
Run Description
Winter Run
Salary
Salary
Salary
Salary
Category
PGY1
PGY2
PGY3
PGY4
Counties
General Medicine
A
$120,000
$129,100
$135,700
$142,400
Counties
Medicine Relief
A+
$129,100
$135,700
$142,400
$147,700
Counties
Paediatrics
C
$95,800
$103,000
$108,300
$113,600

c. what has this been for the last 10 years?
The information in appendix 1 details the run category and pay as per PGY year for the
past 10 years for each run. Where the salary for the run category and PGY year has
increased as a result of a general MECA increase this has been noted in the comment
field as "General MECA salary increase."

The response to this question has been split into NZRDA MECA and STONZ MECA.

d. what is the maximum number of days house officers in the attachments above have
to work in a row
The limits on consecutive days of work for non-shift rosters in each RMO MECA differ.
In the NZRDA MECA non shift rosters detailed at Schedule 10 of the MECA limit the
number of consecutive days worked in a row to 10. For any weekend duty worked in
these rosters the RMO is granted a week day (Monday – Friday) rostered completely
free from duties (RDO) in compensation for the weekend duty worked.
In the STONZ MECA the limit on the number of consecutive days worked in a row is up
to a maximum of 12 days.

The maximum number of days House Officers in the attachments (detailed at our
response to question 4a) have to work depends on their terms and conditions of
employment. If they are covered by NZRDA MECA terms and conditions their maximum
number of days worked in a row will be 10. If they are covered by STONZ MECA terms
and conditions their maximum number of days worked in a row will be 12.

e.  what is the rostered day off policy for house officers in the rotations mentioned
above?
This depends on the individual RMOs terms and conditions of employment. Al  of the
runs listed at question 4a) are Schedule 10 rosters in the NZRDA MECA and as such
House Officers on NZRDA MECA terms and conditions have week day RDOs on their
roster.
House Officers who are on STONZ terms and conditions of employment do not have
week day RDOs on their roster, there is no MECA contractual provision to provide this.
This is why run categories for STONZ may be higher than NZRDA because they are
working more days. The run category does not always change between the two MECAs
because this wil  depend on where the average weekly hours sit within the category
band.

5)  With regards to trainee interns
a.
how many hours per week are trainee interns expected to be on placement in
runs above?

b.
as they are not paid, what protections are ensured trainee interns have proper
rest and food breaks?
c.
how many days in a row are trainee interns expected to be on placement
Questions 5a-5c have been transferred to the University of Auckland.

d.
what is the dhb policy for rostered days off for trainee interns
CM Health does not have a specific policy regarding rostered days off for trainee
interns, as we do not directly employ them.  We are, therefore, refusing this
aspect of your request under section 18(e) of the Official Information Act as the
document al eged to contain the information requested does not exist.

e.
how does dhb manage the expectations for trainee interns to be present with
their health and wel being in a demanding field
This question has been transferred to the University of Auckland.

I trust that the information we have provided is helpful. You are entitled to seek a review of the response
by the Ombudsman under section 28(3) of the Official Information Act.  Information about how to make
a complaint is available at www.ombudsman.parliament.nz or Freephone 0800 802 602.

Please note that this response or an edited version of this may be published on the Counties Manukau
Health website. If you consider there are good reasons why this response should not be made publicly
available, we will be happy to consider this.

Yours sincerely

Dr Peter Watson
Acting Chief Executive Officer
Counties Manukau Health

OIA14032022 SAXTON – Clinical Working Hours
Appendix 1

NZRDA MECA
DHB
Run Description
Run
Category
Comment / Detail
EffDate
PGY1
PGY2
PGY3
PGY4
Counties Manukau
General Medicine
B

14/03/2012
$86,839
$94,007
$99,327
$104,650
Counties Manukau
General Medicine
B
General MECA increase
03/09/2012
$88,576
$95,887
$101,314
$106,743
Counties Manukau
General Medicine Summer
A
Summer and winter roster came into effect
25/11/2013
$100,793
$109,110
$115,288
$121,468
Counties Manukau
General Medicine Winter
B
Summer and winter roster came into effect
25/11/2013
$88,576
$95,887
$101,314
$106,743
Counties Manukau
General Medicine Summer
A
General MECA increase
24/11/2014
$101,801
$110,201
$116,441
$122,683
Counties Manukau
General Medicine Winter
B
General MECA increase
24/11/2014
$89,462
$96,846
$102,327
$107,810
Counties Manukau
General Medicine Summer
A
General MECA increase
30/11/2015
$102,564
$111,028
$117,314
$123,603
Counties Manukau
General Medicine Winter
B
General MECA increase
30/11/2015
$90,133
$97,572
$103,095
$108,619
Counties Manukau
General Medicine Summer
A
General MECA increase
13/02/2017
$104,102
$112,693
$119,074
$125,457
Counties Manukau
General Medicine Winter
B
General MECA increase
13/02/2017
$91,485
$99,036
$104,641
$110,248
Counties Manukau
General Medicine Winter
A
Winter run category changed
26/02/2018
$104,102
$112,693
$119,074
$125,457
Counties Manukau
General Medicine Summer
A
General MECA increase
01/04/2019
$106,705
$115,510
$122,051
$128,593
Counties Manukau
General Medicine Winter
A
General MECA increase
01/04/2019
$106,705
$115,510
$122,051
$128,593
Counties Manukau
General Medicine Winter
B
Winter run category changed
09/12/2019
$93,772
$101,512
$107,257
$113,004
Counties Manukau
General Medicine Summer
A
General MECA increase
30/03/2020
$109,906
$118,975
$125,713
$132,451
Counties Manukau
General Medicine Winter
B
General MECA increase
30/03/2020
$96,585
$104,557
$110,475
$116,394

Counties Manukau
Medicine Relief
A+

14/03/2012
$106,971
$113,027
$119,086
$124,086
Counties Manukau
Medicine Relief
A+
General MECA increase
03/09/2012
$109,110
$115,288
$121,468
$126,468
Counties Manukau
Medicine Relief Summer
A+
Summer and winter roster came into effect
25/11/2013
$109,110
$115,288
$121,468
$126,468
Counties Manukau
Medicine Relief Winter
A+
Summer and winter roster came into effect
25/11/2013
$109,110
$115,288
$121,468
$126,468
Counties Manukau
Medicine Relief Summer
A+
General MECA increase
24/11/2014
$110,201
$116,441
$122,683
$127,683
Counties Manukau
Medicine Relief Winter
A+
General MECA increase
24/11/2014
$110,201
$116,441
$122,683
$127,683
Counties Manukau
Medicine Relief Summer
A+
General MECA increase
30/11/2015
$111,028
$117,314
$123,603
$128,603
Counties Manukau
Medicine Relief Winter
A+
General MECA increase
30/11/2015
$111,028
$117,314
$123,603
$128,603

Counties Manukau
Medicine Relief Summer
A+
General MECA increase
13/02/2017
$112,693
$119,074
$125,457
$130,457
Counties Manukau
Medicine Relief Winter
A+
General MECA increase
13/02/2017
$112,693
$119,074
$125,457
$130,457
Counties Manukau
Medicine Relief Summer
A
Summer run category changed
26/02/2018
$104,102
$112,693
$119,074
$125,457
Counties Manukau
Medicine Relief Winter
A
Winter run category changed
26/02/2018
$104,102
$112,693
$119,074
$125,457
Counties Manukau
Medicine Relief Summer
A
General MECA increase
01/04/2019
$106,705
$115,510
$122,051
$128,593
Counties Manukau
Medicine Relief Winter
A
General MECA increase
01/04/2019
$106,705
$115,510
$122,051
$128,593
Counties Manukau
Medicine Relief Summer
A+
Summer run category changed
09/12/2019
$115,510
$122,051
$128,593
$133,593
Counties Manukau
Medicine Relief Winter
A
General MECA increase
30/03/2020
$109,906
$118,975
$125,713
$132,451
Counties Manukau
Medicine Relief Summer
A+
General MECA increase
30/03/2020
$118,975
$125,713
$132,451
$137,451

Counties Manukau
Paediatrics Summer
D

14/03/2012
$68,870
$74,557
$78,777
$82,995
Counties Manukau
Paediatrics Winter
C

14/03/2012
$77,855
$84,283
$89,052
$93,824
Counties Manukau
Paediatrics Summer
D
General MECA increase
03/09/2012
$70,247
$76,048
$80,353
$84,655
Counties Manukau
Paediatrics Winter
C
General MECA increase
03/09/2012
$79,412
$85,969
$90,833
$95,700
Counties Manukau
Paediatrics Summer
D
General MECA increase
24/11/2014
$70,949
$76,808
$81,157
$85,502
Counties Manukau
Paediatrics Winter
C
General MECA increase
24/11/2014
$80,206
$86,829
$91,741
$96,657
Counties Manukau
Paediatrics Summer
D
General MECA increase
30/11/2015
$71,482
$77,385
$81,765
$86,143
Counties Manukau
Paediatrics Winter
C
General MECA increase
30/11/2015
$80,808
$87,480
$92,429
$97,382
Counties Manukau
Paediatrics Summer
D
General MECA increase
13/02/2017
$72,554
$78,546
$82,991
$87,435
Counties Manukau
Paediatrics Winter
C
General MECA increase
13/02/2017
$82,020
$88,792
$93,815
$98,843
Counties Manukau
Paediatrics Summer
E
Summer run category changed
28/05/2018
$63,091
$68,299
$72,163
$76,034
Counties Manukau
Paediatrics Winter
C
General MECA increase
01/04/2019
$84,071
$91,012
$96,160
$101,314
Counties Manukau
Paediatrics Summer
E
General MECA increase
01/04/2019
$64,668
$70,006
$73,967
$77,935
Counties Manukau
Paediatrics Winter
C
General MECA increase
03/03/2020
$86,593
$93,742
$99,045
$104,353
Counties Manukau
Paediatrics Summer
E
General MECA increase
30/03/2020
$66,608
$72,106
$76,186
$80,273

STONZ MECA
Note: The STONZ MECA came into effect on 10 December 2018. Where the run category came into effect prior to this date the effective date is listed as 10/12/2018.
DHB
Run Description
Run
Category
Comment / Detail
EffDate
PGY1
PGY2
PGY3
PGY4
Counties Manukau
General Medicine Summer
B
STONZ MECA came into effect
10/12/2018
$99,900
$107,700
$113,400
$119,200
Counties Manukau
General Medicine Winter
A
STONZ MECA came into effect
10/12/2018
$112,900
$121,700
$128,200
$134,700
Counties Manukau
General Medicine Summer
B
General MECA increase
25/11/2019
$102,900
$110,900
$116,800
$122,800
Counties Manukau
General Medicine Winter
A
General MECA increase
25/11/2019
$116,300
$125,400
$132,000
$138,700

Counties Manukau
Medicine Relief Summer
A
STONZ MECA came into effect
10/12/2018
$112,900
$121,700
$128,200
$134,700
Counties Manukau
Medicine Relief Winter
A
STONZ MECA came into effect
10/12/2018
$112,900
$121,700
$128,200
$134,700
Counties Manukau
Medicine Relief Summer
A
General MECA increase
25/11/2019
$116,300
$125,400
$132,000
$138,700
Counties Manukau
Medicine Relief Winter
A
General MECA increase
25/11/2019
$116,300
$125,400
$132,000
$138,700
Counties Manukau
Medicine Relief Summer
A+
Run category change
09/12/2019
$125,400
$132,000
$138,700
$144,000
Counties Manukau
Medicine Relief Winter
A+
Run category change
09/12/2019
$125,400
$132,000
$138,700
$144,000

Counties Manukau
Paediatrics Summer
E
STONZ MECA came into effect
10/12/2018
$70,800
$76,200
$80,100
$84,100
Counties Manukau
Paediatrics Winter
C
STONZ MECA came into effect
10/12/2018
$90,200
$97,200
$102,300
$107,500
Counties Manukau
Paediatrics Summer
E
General MECA increase
25/11/2019
$72,900
$78,500
$82,500
$86,600
Counties Manukau
Paediatrics Winter
C
General MECA increase
25/11/2019
$92,900
$100,100
$105,400
$110,700