The Perils of Integrating Wellness and Safety and Health and the Possibility of a Worker-Oriented Alternative.

Integration of workplace wellness with safety and health has gained momentum on the initiative of the state allied with a segment of large employers and some health and safety professionals. Integration has a dual potential: to fundamentally reshape occupational health in ways that profoundly benefit workers, or to serve neoliberal corporate goals. A focus on the workplace and the ways work and health interact broaden the definition of a work-related injury or illness and emphasize and challenge the employer decisions that create hazards and determine risk. However, the implementation of integration is taking place in a context of corporate dominance and the aggressive pursuit of a neoliberal agenda. Consequently, in practice, integration efforts have emphasized individual worker responsibility for health and fail to actually integrate wellness with safety and health in a meaningful way. Can an alternative be envisioned and pursued that realizes the promise of integration for workers?

Evaluating the impact of a new pay agreement on New Zealand nursing.

AIM: 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). BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.