Publications
The Specialist
Issue 62 - March 2005
Proudly Sponsored by:
- Time to Achieve Non-Clinical Time
- New National Executive Elected
- Infantilism
- Underlying Principles Central to Effectiveness of MECA
- Sabbatical Leave on Full Pay
- New Opportunities in Joint ASMS-DHB Consultation Committees
- Significance of New Nurses' National DHB Collective Agreement (MECA)
- Tax Rate on Back Pay
- The MOSS is Dead; Arise the Medical Officer
................................................................................................................
Time to Achieve Non-Clinical Time
A barely noticed recent statistic offers useful advice on the implementation of recognition of non-clinical time for activities not directly related to the care of an individual patient. The Quarterly Employment Survey conducted by the Department of Labour for the December quarter 2004 revealed that whereas the average ordinary time was $25.30 in the public sector, it was only $18.85 in the private sector. The main reason for this differential of $6.45 is that public sector employees, especially those in the education and health services, are much more likely to be union members and consequently much more likely to be covered by a collective agreement compared with private sector employees. The collectivity provided by unionism makes the difference.
Generic MECA Clauses
This is a critical lesson for the ASMS in the implementation of time for non-clinical duties provided by the national DHB collective agreement (MECA). The MECA sets the scene for the implementation of non-clinical duties by three generic clauses covering underlying principles, mutual obligations and quality improvement environment. In all cases these general requirements should be read in conjunction with each DHB’s responsibility to ensure that ASMS members have sufficient non-clinical time.
In the first case, Clause 1 covering underlying principles, includes the following responsibilities of each DHB:
- Collective negotiations and responses to workplace challenges and issues are to be ‘actively’ encouraged.
- The requirement to ‘ensure the workplace is well resourced, professionally supportive and conducive to a very high standard of individual clinical practice.’
Next, Clause 8 covering mutual obligations includes the requirement of DHBs to provide ASMS members with the ‘resources and support reasonably necessary to enable’ them to ‘discharge their obligations’.
Finally, Clause 36 covering quality improvement environment requires credentialling processes to be agreed between each DHB and the affected ASMS members. Credentialling, which under the MECA should be clinician-led, is to consider the resources required for a particular service; in other words, it has become another tool for ASMS members to secure sufficient resources including non-clinical time.
Hours of Work & Job Size
Hours of work & job size is another critical clause (12) directly relevant to time for non-clinical duties. Not only are hours of work and the job size to ‘objectively’ measure the requirements of the service but they also must recognise the time reasonably required (another objective standard) to complete duties and responsibilities. In addition to routine duties (eg, ward rounds, clinics and lists), work at other DHB locations and rostered after-hours duties, the clause also requires hours of work and job size to include ‘non-clinical duties and responsibilities’ and includes a cross-reference to the job description clause (49).
This is the context in which each DHB’s responsibility is to ensure that there is an adequate allocation of time set aside for non-clinical duties which should be sufficient for each ASMS member to practice within college guidelines and to meet professional standards. These standards are set by professional or legal bodies and not by a DHB’s financial constraints or managerial declarations.
Job Descriptions and Non-Clinical Time
The new comprehensive job description clause requires job descriptions to be mutually agreed and provides the recommended format and content (there is no other recognised recommendation). It includes a non-exhaustive list of non-clinical duties which do not relate to the direct care of an individual patient: on-the-job
The MECA then expressly requires each DHB to provide a sufficient allocation of time for non-clinical duties. In this specific context, it is not determined by the DHB but rather based on external professional standards. Again in this context, the DHBs through the MECA accept the Council of Medical Colleges’ advice (as the overarching body of colleges in New Zealand) that these non-clinical duties should make up at least 30% of the total job size (excluding rostered after-hours call duties and clinical leadership or service management roles).
Thus the 30% for non-clinical duties is the professionally recommended minimum standard and accepted as such by DHBs under the MECA (there is no other accepted professional standard). In other words, there has to be a very good, obvious and transparent reason why the 30% minimum should not apply in particular instances. In these circumstances, it should be based on a professional collegial consensus at a departmental or service level and not inconsistent with college standards.
Achieving Non-Clinical Time
However, achieving non-clinical time is not simply a matter of each ASMS member putting their hands up and saying pay me for the 30% please. In the first instance the non-clinical duties must be undertaken. If one expects to be paid 30% non-clinical time, then one must spend that time on non-clinical duties.
Second, if members make the mistake of seeing the 30% simply and only as an individual entitlement, then they will be more likely to fail to achieve it. The success to achieving 30% will be the adoption of a collective and collegial approach in which colleagues in each department and service work together in pursuit of the objective.
At the risk of over-simplifying the situation, there are in broad terms four means of achieving the appropriate allocation of time for non-clinical duties. These are:
1. Increased job size (eg, payment of more hours or sessions to increase to 30%).
2. Increased senior medical staffing.
3. Reducing clinical work to around 70% of the time for routine duties and
responsibilities.
4. Any combinations of the above.
The ASMS can play a key role in pursuing the implementation of sufficient time for non-clinical duties. These include:
- Running strategic planning sessions for members at a departmental or wider DHB level.
- Supporting, including advocacy where required, the collective efforts of members in individual departments.
- Use of credentialling, as one of the tools for providing the quality improvement required by the MECA.
- Working through the joint DHB-ASMS consultation committees created by the MECA.
The high level of ASMS membership, reinforced by the MECA, gives us the necessary strength that we need to achieve sufficient time for non-clinical duties which in the large majority of cases should be 30% of the total time for routine duties and responsibilities. What is needed to complete the picture is the empowerment and assertive confidence of Association members based on their collectivity and collegiality. If this is achieved then so is sufficient non-clinical time.
Executive Director
................................................................................................................
New National Executive Elected
Elections for the Association’s National Executive have now been completed and Returning Officer Ron Burgess has declared the following members elected unopposed for a two-year term: 1 April 2005 - 31 March 2007. The incoming National Executive is:
| President: | Jeff Brown (MidCentral) |
| Vice President: | David Jones (Capital & Coast) |
| Region 1 | Gail Robinson (Waitemata) |
| Judy Bent (Auckland) | |
| Region 2 | Paul Wilson (Bay of Plenty) |
| Andrew Munro (Waikato) | |
| Region 3 | Torben Iversen (Tairawhiti) |
| Alastair Macdonald (Capital & Coast) | |
| Region 4 | Brian Craig (Canterbury) |
| John MacDonald (Canterbury) |
With one exception all previous members of the National Executive sought re-election and have been returned. Dr Anthony Duncan (psychiatrist) with the Hutt District Health Board did not seek re-election in Region 3 and has been replaced by Dr Torben Iversen, an obstetrician & gynaecologist with the Tairawhiti District Health Board at Gisborne Hospital.
We would like to thank Anthony Duncan for his work with the National Executive over the past two years and in particular to acknowledge the time and effort he contributed as a member of the Association’s MECA negotiating team. Each session seemed to go on and on, and then there was another one a month later! We know Dr Duncan will continue to be active in Association affairs and look forward to his support at a local and regional level.
................................................................................................................
Infantilism
Maybe it’s the cyclist in the park, trim under the sleek metallic helmet with elbow, knee and wrist guards, cruising along the path…at five km/h. On his tricycle. Or perhaps it’s the playground, all rubber-cushioned with no apparatus over 1.5 m high, where mothers and fathers are co-playing with their precious offspring. Rather than half-watching from the benches.
Then I reflect on the Paediatric Registrar who is not allowed to prescribe insulin, the RMO who is not permitted to insert a chest drain, the House Officer who is prevented from clerking a patient in ED. Insulin can only be prescribed by an Endocrine Specialist or Fellow, chest drains only inserted by cardiothoracic or surgical Registrars, ED patients to be seen by a Registrar before a House Officer can even enter the cubicle.
I am struck by the protection from the challenges of professional life, by the protection from the ability to forge creative adaptations to the normal vicissitudes of managing patients. I wonder what will ensue when the emotional training wheels come off.
I note that certain training schemes have required that trainees work outside of RDA rosters, or forfeit their prospects of specialisation. Of necessity to accumulate a rota of procedures, to tick the boxes of skill acquisition. Of College curricula driven by logbooks of easily measurable outcomes. Of the sheer difficulty of calculating the worth of apprenticeship.
I see trainees frustrated that their keen mentors and teachers are frequently absent at interminable meetings and committees.
I see SMOs frustrated that “their” junior staff are not observing the entire courses of acute illnesses over several days without break.
I see patients impatient with repeating histories, with perceptions of layers of competence to endure before a “real” decision is made, with demands to see the most senior clinician at the moment of presentation.
I see managers keen to manage risk, to streamline services. To follow the call to “do it once, do it right, by someone fit for the purpose”. Where trainees are an expensive encumbrance on a balance sheet.
And all these imperatives, worthy at their own level, accumulate to frustrate. Increasingly all the players express dissatisfaction with what has evolved. The loss of the best of apprenticeship learning – the art, the difficult decisions, the complex ethics, the resource allocation, the true mentoring. Where an individual can progress and learn safely – for patient, learner, and teacher – treading the path from following in the footsteps to walking in the very shoes.
Where a focus on skill-based and modular learning limits the very entanglement with the patient – physical, emotional, ethical – that enriches and enhances the doctor-patient relationship on the shared path to healing. Where this entanglement is displaced later and later in the career of doctors in training. And in the process they are robbed of identity, meaning, and a sense of accomplishment.
To return to the park and playground – kids have been told by their coaches where on the field to stand, told by their parents what colour socks to wear, told by their referees who’s won and what’s fair. Perpetual access to their parents infantilises the young, keeping them in a permanent state of dependency. Whenever the slightest difficulty arises they’re constantly referring to their parents for guidance.
Increasingly, and especially in the larger centres, we have travelled a long way down the path of infantilising the medical workforce. There are some pockets of resistance, and attempts to preserve and reintroduce the best of apprenticeship and mentoring whilst maintaining service delivery. But no concerted, in the truest sense of the word, effort to reverse the infantilising.
For if we, as a profession, really trust our profession, our colleagues, our teachers, and our learners, we will affirm that all doctors in training - which is surely the entirety of our career – have the potential to be every bit as competent, and as incompetent, as their seniors.
We become, in a way, all the wise adults we’ve had the privilege to know.
Jeff Brown
National President
................................................................................................................
Underlying Principles Central to Effectiveness of MECA
The national DHB collective agreement (MECA) contains key underlying principles (Clause 1 of the MECA; refer to box) which if read in isolation read like well-intentioned but ineffective words. But if read in the context of being part of a document which is legally binding on district health boards and directly related to specific rights, entitlements and DHB obligations which follow in the rest of the text of the MECA, then they have critical and tangible significance to the benefit of ASMS members.
These underlying principles are, in summary, the requirement for DHBs (as well as the ASMS) to:
- Recognise the importance of collegiality within the workplace.
- Actively encourage collective negotiations and responses to workplace challenges and issues (in other words, collective negotiations is the agreed most appropriate means of addressing not only the negotiation of a collective agreement such as the MECA but also all other matters which have a collective impact on all or groups of ASMS members).
- Recognise that senior medical staff are constrained by their ethical and professional obligations.
- Recognise the public expectations that senior medical staff should not refuse treatment to patients.
- Recognise the increasingly demanding medico-legal environment in which senior medical staff are required to practise. Consequently, therefore, DHBs are required to undertake reasonable measures to ensure that workplaces are well resourced, professionally supportive and conducive to a very high standard of individual clinical practice.
These underlying principles have contractual status particularly when read in the context of the ‘nuts and bolts’ of the MECA. Some of these ‘nuts and bolts’ include provision of accessible quality sabbatical and secondment; sufficient time for non-clinical duties; coping with and compensating for RMO shortages; providing a non-punitive environment for addressing quality improvement initiatives; facilitating the undertaking of research; computer technology; physical working conditions; and staffing levels. In fact, the list is potentially limitless.
Integral to the principles is their linkage with practice and the challenge of the ASMS (including all members) will be to ensure that DHBs do link them both directly and explicitly. One of the main vehicles of ensuring the effectiveness of the linkage is the joint consultation committees of each DHB and the ASMS that the MECA requires us both to form.
Ian Powell
Executive Director
|
1. Underlying Principles 1.1 The parties acknowledge the importance of collegiality within the 1.2 The parties recognise that employees are constrained by their ethical 1.3 The parties acknowledge the increasingly demanding medico-legal |
................................................................................................................
Sabbatical Leave on Full Pay
There are many provisions in the MECA which over time will assist our members to build a high wall to block out the cruel images and harsh demoralising landscape of the recent, unlamented “health reforms”.
The MECA is the Association’s most recent achievement in its long-term strategy to encourage and support members as they reclaim their workplace and control of their clinical practice. The promotion of non-clinical time and the 70:30 split is already achieving results and despite its grudging and sometimes incremental implementation by some employers is rapidly gaining acceptance and within the term of this MECA will become a standard feature of all hospital workplaces.
Beyond the immediate workplace, by agreeing to the new MECA Clause 37, the employers have made a very emphatic commitment to support the Professional Development and Education of Association members. This new clause opens with a resounding statement:
District Health Boards recognise the importance of actively encouraging their employees
to undertake professional development and education.
That statement reinforces the employers’ commitment in Clause 36 to foster a quality improvement environment and will positively underpin their interpretation and application of our members’ entitlements to CME, Secondment and Sabbatical Leave under Clause 37.
Sabbatical - The Basic Entitlement
The full entitlement is set out in Clause 37.3 of the MECA but the basic features of it are:
- the leave is for 3 months or other agreed period;
- it may be one continuous period or a series of separate periods;
- the leave is on full pay;
- eligibility is after every 6 years of service;
- it is to be used for visits to relevant clinical sites and institutions;
- to refresh clinical knowledge and awareness or develop new skills.
Unlike the sabbatical provision in most previous agreements, there is less uncertainty about the new entitlement and much less scope for an employer to decline an application. However that does not mean that the entitlement is absolute and every six years every SMO can organise a programme, apply for the leave and make their bookings!
Approval is not guaranteed but nor is it left to the unfettered discretion of the employer. Funding and staffing considerations suggest there will be a limit on the number of SMOs who can take sabbaticals at any one time or even in any one year.
DHB-Wide Planning Process
In the course of negotiating the MECA both the employer and employee parties understood and agreed that within each DHB the local parties would need to:
Develop an agreed plan for the effective provision of and access to high quality
professional development and education for employees including continuing medical
education, secondment and sabbatical.
This plan will be developed by a local body with the grand title Workforce Development Taskforce in accordance with the requirement of Clause 6 of the Appendix to the MECA.
The need for a plan and a set of local ground rules for sabbatical is self-evident, particularly when you look at the maths behind the entitlement. In a service of 6 clinicians, there could well be one person away each year. In a service of at least 24 clinicians, if left unchecked there could be two or more doctors absent on paid sabbatical every day of every year!
However desirable that might be, there is simply neither the funding nor the staffing to allow that to happen. Hence the need for a sensible and realistic plan that is fair to all those who wish to have at least one sabbatical.
Notwithstanding the need for a plan there is no requirement for sabbaticals to be put on hold until a plan is developed. That would be unreasonable. However, if you are contemplating a sabbatical within the next year or so, the ASMS encourages you to share your plans with your clinical director and colleagues soon, rather than face disappointment later.
The Approval Process
Having developed a sabbatical programme and obtained preliminary agreements, at least in principle, from the institutions you wish to visit, you will need the approval of the relevant clinical director and service or group manager. It would of course be prudent to consult them closely as you develop your programme to enhance your prospects of approval. Their approval should not be unreasonably withheld. That is a very important protection and allows you (with ASMS support) to challenge a refusal.
Clause 37.3(c) requires that where practical the planned dates for your programme must be agreed with the employer at least one year in advance. This is an important limitation that probably means you will need to begin planning your sabbatical at least two years in advance.
Although Clause 37.3(b) provides a mechanism for a doctor to seek approval before they have the necessary 6 years’ service, given the need for a plan and perhaps the need to ration sabbaticals within a DHB and within a service, it is unlikely that many will obtain approval under this provision.
In Conclusion
The right to three months’ sabbatical leave on full pay, every six years is an important and welcome entitlement for ASMS members. It will encourage DHBs and services to establish close and enduring links with the international medical community and centres of innovation, research and excellence throughout the world. Furthermore, it will support the common goal of promoting a quality improvement environment.
It may become a valuable enticement when recruiting staff from the international community and luring highly skilled New Zealand graduates back home and it will certainly assist long serving New Zealand specialists avoid burnout and seek stimulating relief at critical intervals throughout their medical careers.
The ASMS encourages members to begin thinking of a sabbatical for themselves but the pressing first step is for services and senior medical staff groups to begin the discussions about the rules for rationing or approving sabbaticals across the organisation. This will no doubt be one of the items on the agenda for the coming round of Joint Consultation Committees required under MECA Clause 56. But that is a topic for another day.
Henry Stubbs
Senior Industrial Officer
................................................................................................................
New Opportunities in Joint ASMS-DHB Consultation Committees
One of the most important features of the new national DHB collective agreement (MECA) is the creation in each DHB of joint ASMS-DHB consultation committees (see box for the MECA clause). These committees will have an important role both over matters relevant to the implementation and expansion of the MECA provisions and other matters outside of the MECA.
While there are some differences, these joint consultation committees will have some similarities with the previous ASMS negotiating teams when we negotiated separate collective agreements with each of the DHBs (and their predecessors). One of the main differences is that these previous negotiations were over core terms and conditions of employment (21 different times). Under the MECA these core terms and conditions are now only negotiated once (nationally) freeing up the new joint consultation committees to focus on ‘above core’ issues.
The scope of issues that the consultation committees might cover is unlimited but would be expected to include:
- Staffing levels and support.
- Sufficient time for non-clinical duties.
- Sabbatical and secondment.
- Adequacy of workplace conditions, resources and accommodation.
- Patient safety related concerns.
- Ensuring that credentialling addresses resource needs.
- Fairness and transparency of appointment processes including senior medical staff involvement.
- Additional recruitment and retention benefits.
The ASMS encourages members to consider becoming involved in these joint consultation committees. We will be looking to establish our own teams to participate in these committees which are as representative as possible of our members. They have considerable potential to positively advance the collective interests of all DHB-employed ASMS members.
|
Joint Consultation Committee Each employer and the Association will form joint committees based on equal representation to consider matters of mutual interest, including matters covered by this Agreement. Unless otherwise agreed these joint committees will meet at least three times each calendar year and when requested by either the employer or the Association. |
................................................................................................................
Significance of New Nurses' National DHB Collective Agreement (MECA)
[The article below has been kindly provided for The Specialist by Geoff Annals, Chief Executive of the NZ Nurses Organisation (NZNO)]
Greetings to our ASMS colleagues! NZNO members appreciate the support ASMS members gave throughout our negotiations with DHBs for a national employment agreement. In acknowledging your support I am happy to take the opportunity to explain why we believe the settlement is not only industrially important but is also of significant professional importance.
The industrial significance of this settlement is obvious. It has achieved substantial pay gains for nurses and midwives employed by DHBs, it has changed the basis of pay negotiations from maintenance of relativities to establishment of worth and it has re-established one national employment agreement.
These things are of huge importance but probably the greatest significance of this settlement is in the way it forms a basis on which nurses can begin to re-build their profession.
This may seem an inflated expectation of an industrial settlement but a brief analysis reveals the DHB MECA settlement to be nursing’s greatest professional opportunity in a generation. It is crucial this opportunity is recognised and taken. The professional gains that will follow are of great importance not only to nurses and midwives but also to doctors. You are the professionals with whom nurses work most closely and your professional success is inextricably linked with the ability of nurses and midwives to exercise their own professional authority over their practice.
Like doctors, nurses assume the ability to act as professionals.
However, most nurses find the reality of their daily practice, more often than not departs markedly from this. Too often the real authority for making fundamental decisions about how nursing care is delivered does not rest with nurses. I am sure many doctors also identify with this situation.
This state of affairs arose when cost cutting displaced professional standards and patient care as the over-riding service imperative in the ‘Health Reforms’ of the 1990s.
These changes were not only detrimental to nursing and medicine but more significantly were detrimental to patient safety.
For example, as the authority for establishing nursing levels was shifted from principal nurses to general managers, human resource managers and financial managers, there was a general reduction in the relative number of nurses employed so that often too few nurses were employed to keep patients safe. Efficiency is laudable but its pursuit without informed regard for the essential service objectives of patient safety is pure folly.
Increasingly finding themselves on the back foot, nurses have often had to make the best of limited resources even when this exposes them and the public to unreasonable risk. Professional authority has been eroded to the point where the fundamental capacity of nurses to act as professionals has often been lost. Still held to account for their professional practice, very often nurses have not been left the professional authority to fulfil their professional duty of care.
The DHB MECA settlement provides a real opportunity to correct this intolerable state. It does so in three main ways:
1. It attacks the root cause of nursing workforce supply failure; artificially
low pay.
Pay that reflects nurses’ worth is essential to make nursing attractive to school
leavers. Without a healthy supply of nurses nursing will always be a compromising
profession. In fact, unless school leavers see nursing as an attractive career option,
nursing is a profession without a future.
2. It commits DHBs and the Government to an independent inquiry into
staffing.
The objectives of this inquiry are;
a) To develop and implement a system of nursing and midwifery staffing levels
which provide:
* Efficient and safe services to patients
* Manageable and safe workloads
* Acknowledgement of the professional nature of their practice and time and
support to maintain professional standards.
b) To agree on sustainable solutions.
c) To ensure evidence based practice is used in all DHBs and avoid duplication of
resources and effort.
d) To address concerns in a way that has the confidence of nurses and midwives
and provides a mechanism for them to respond immediately if workloads exceed
the determined level.
Nurses, along with many doctors, believe that staffing arrangements and staffing
levels in DHBs often do not allow professional standards to be maintained and that
public safety suffers as a result. Now we have the opportunity to present the
evidence and make the changes shown to be necessary for safe care.
Establishment of the conditions for all nurses to give safe and effective care will be
the single most important factor to reverse the exodus of experienced nurses from
practice.
3. It re-establishes a single collective employment agreement for DHB
nurses and midwives employed by DHBs.
A single collective employment agreement is fundamental to the sense of collectivity
and unity of nurses that is one of NZNO’s core values.
throughout
of all New Zealanders, not just to those who are served by their specific employer.
Together these three features of the DHB MECA agreement do indeed constitute the greatest professional opportunity for nursing in a generation and we invite the ASMS to join with us in celebrating this achievement.
Geoff Annals
Chief Executive Officer
New Zealand Nurses Organisation
................................................................................................................
Tax Rate on Back Pay
We recently received an enquiry from a member about the correct tax rate for the back pays most of you will shortly receive. It seems the member was advised by his employer that IRD required back pay to be taxed at the “extra emolument” rate, which he was also advised was significantly higher than his marginal tax rate of 39%.
We referred the query to our advisers in these matters, Sherwin Chan & Walshe Ltd Chartered Accountants and Business Advisers of Lower Hutt whose advice we are pleased to reprint for your information.
In summary, back pay will be taxed at one of the following rates: 22.2%; 34.2% or 40.2%. If your employer deducts tax at a higher rate you should challenge them and seek an explanation, and where appropriate an adjustment in a subsequent pay.
Sherwin Chan & Walshe offer the following advice:
With the recent settlement of the new national collective employment agreement many members will receive a lump sum payment for back dated pay. Back pay is taxed at a different rate. Tax on back pay is calculated differently to normal PAYE earnings. IRD require back pay to be taxed as follows:
- Take your last 4 weeks gross income
- Multiply by 13 to give your annual gross salary
- Add the gross back pay you will receive.
- The sum is your total salary for the year.
If your total salary for the year is less than $38,000 then multiply your back pay by 22.2% and subtract this from your back pay. This is your net back pay;
OR
If your total salary for the year is between $38,000 and $60,000 then multiply your back pay by 34.2% and subtract this from your back pay. This is your net back pay;
OR
If your total salary for the year is greater than $60, 000 then multiply your back pay by 40.2% and subtract this from your back pay. This is your net back pay.
In the following example we illustrate how a member who is paid fortnightly is taxed on their back pay.
Dr A currently earns $2,500 per fortnight before tax and is about to receive a lump sum payment of $4,000 for back pay. Here is how Dr A’s tax on the back pay should be calculated:
Last 4 weeks income ($2,500 x 2) $5,000
Multiply by 13 $65,000
Add gross back pay $4,000
Total Salary for the year $69,000
Tax on back pay ($4,000 x 40.2%) $1,608
Net back pay ($4,000 – $1,608) $2,392
The question many people ask is “why is the tax rate on my back pay higher than my current marginal tax rate?”
The answer to that question is ACC. Every employee must pay an ACC earner’s levy to cover the cost of non-work related injuries. The ACC earner’s levy deduction is $1.20 per $100 of earnings or 1.2%. The maximum earnings on which ACC is payable is $92,189 for the year ended 31 March 2005.
It is important to remember that this is a generic example only and that each individual’s tax situation is different. There may be other factors that effect your tax position. For advice on your specific situation you should discuss the matter with your Chartered Accountants professional advisor.
................................................................................................................
The MOSS is Dead; Arise the Medical Officer
Among the many changes brought about by the national DHB collective agreement (MECA) is a symbolic but important definitional change. The previous unflattering ‘medical officer of special scale’ (MOSS) term has been replaced. The new term for ex-MOSSs is now ‘medical officer’. In other words, there are two categories of senior medical officers - specialists (vocational registrants) and medical officers (general registrants).
The same point applies to ‘dental officers of special scale’ and ‘dental officers’. The DHBs have been advised to quickly and thoroughly adapt to this language change.
................................................................................................................
