IN THE TASMANIAN INDUSTRIAL COMMISSION

Industrial Relations Act 1984

The background to this application by the Ambulance Employees Association of Tasmania (the Association) is set out in my Interim Decision1.

For the purpose of continuity, the Association's claims now before the Commission can be categorised as follows:

(i) a work value assessment of all classifications contained in the Tasmanian Ambulance Service Award (the Award), and

(ii) the adoption by the Commission of a consent management structure negotiated between the Association and the Tasmanian Ambulance Service (TAS).

The proposed structure rationalises some areas of the Award by seeking to remove and or combine classifications. Also it is proposed that some new classification levels be included.

WORK VALUE

At the outset I make it clear that as the matters before me were substantially part heard at the date of the Commission's most recent State Wage Case decision2, the issues before me will be finalised under the Principles determined by this Commission on 24 April 19873.

In this case Mr Nielsen appearing for the Association informed the Commission that this was the first comprehensive work value review undertaken in the Award.

Whilst a review was undertaken in respect of the Advanced Life Support (ALS) qualification in 1981, it was the contention of the Association that the datum point for the measurement of work value changes should be 1 January 1978 in accordance with Principle 4(c)4.

Whilst I concur with that date, appropriate consideration will be given in this decision to ensure no double counting occurs in respect of the ALS qualification, as assessed in 1981 in matter A No 45 of 1980.

Accordingly the review period will be 1 January 1978 to 11 March 1988, the date the matter came before Anomalies Conference No 10.

In prefacing his case Mr Nielsen said:

Mr Nielsen also submitted that Award changes had been made in 1984 which made it compulsory for new recruits to the Tasmanian Ambulance Service to qualify in ALS. Failure to do so will result in termination.

He said all of the changes should now be incorporated in an "appropriate professional pay structure."

The increases sought by the Association range from 10 percent at the level of Student Ambulance Officer through to 45 percent for those Ambulance Officers (AOS) who have qualified in ALS and have Patient Extrication (PE) qualifications. The claim, inclusive of the 4 per cent second tier, is detailed in more specific terms later in this decision.

Against the foregoing broad background Mr Nielsen commenced to focus his submission on specific identifiable change.

THE ASSOCIATION'S CASE -

AMBULANCE OFFICERS

Mr Nielsen submitted that in 1978 to be considered for employment as an Ambulance Officer (AO) the basic requirement was a current drivers licence and a first aid certificate.

It was in 1978 when a growing emphasis on training of AOs first became apparent.

Exhibit N3, an Interim Ambulance document prepared by Mr N C Gillard, State Training Officer as he then was, identified certain problems with the training of ambulance officers.

In his report dated 6 January 1978 he stated that with the transfer of ambulance officer training to the Ambulance Officers Training Centre, Victoria, there "has been no coordination of in-service instruction" and

The scenario described by Mr Nielsen is that from an uncoordinated development of curriculum and associated teaching systems, progressive, systematic and sophisticated training and operational regimes were progressively put into place.

That progression can be readily traced.

Intake to the Ambulance Service in 1978 was at the level of Ambulance Officer Grade 1.

Clause 29 of the Award Of The Ambulance Services Industrial Board5, as it then was, stipulated that:

Mr Nielsen submitted that the qualification to Ambulance Officer Grade II involved an 87 hour training course which gave a broad, but brief introduction to basic ambulance care.

Whilst up until 1980 Ambulance Officers were required to achieve A02 qualifications, there was no requirement for them to undergo the prescribed examination for advancement to AO Grade 3.

In respect of the status of the AO 2 qualification, the Association contend that the standard was at best only comparable with the 1988 introduction to the basic patient care component of the Certificate of Applied Science Course (CAS).

Indeed AOS who had previously qualified as AO Grade 2 were considered on an individual basis, for exemption from only one unit of the CAS course.

That unit was Introduction to Ambulance Care (Exhibit N3 p.15)

The Ambulance Officer Grade 3 course was utilised in 1978-79 as an upgrading course for existing AOs Grade 2.

This was endeavoured to be undertaken through the Victorian Ambulance Officers' Training Centre. However, Tasmanian AOs were not able to be accommodated by the Victorian Training Centre and the Interim Ambulance Authority, as it then was, decided to conduct the Grade 3 course and examination in Tasmania.

Mr Nielsen said that completion of the A03 course was a prerequisite for the "developmental" Advanced Life Support Course.

Mr Nielsen submitted that the Ambulance Coronary Care course, conducted in November 1978 as a pilot of 4 weeks duration -

The platform upon which the ALS is built is the Certificate of Applied Science. Qualifications at the level of CAS was decided upon by the Interim Ambulance Authority in April 1978. Exhibit N13 indicates:

This is significant because, as Mr Nielsen stated, that was the first time that AOs undertook academic and technically based qualifications overseen by an education authority, i.e. the Victorian Ambulance Officer Training Centre and the Royal Melbourne Institute of Technology.

The first graduates of the CAS completed their course in 1981 and were issued with certificates accredited by the TAFE Board of Victoria.

Subsequently in June 1980 because of difficulty in predicting the excess number of students which would enrol in the training centre in Victoria, the Tasmanian Interim Ambulance Authority decided to conduct the CAS in Tasmania and that "this training be annexed to the Ambulance Officer Training Centre in Victoria."

In 1982 the CAS course was commenced in Tasmania. Thereafter the TAS began to restructure the course to cater for the philosophy of the Tasmanian Ambulance Service which was to put in place an integrated approach to community pre hospital care for the sick and injured.

Mr Nielsen submitted that the Tasmanian approach contrasted dramatically with the Victorian system where specialised restricted units operate.

That is whilst in Tasmania Ambulance Officers are trained in all facets of ambulance work, in Victoria this integrated approach has not been adopted.

In lieu of this approach the Victorian Ambulance system relies on specialised mobile intensive care ambulance (MICA) units.

Patient extrication is also not a specialist function of ambulance officers in that State. This aspect of Tasmanian ambulance work is carried out in Victoria by other emergency authorities.

This serves to illustrate the point made by Mr Nielsen of the fundamental differences which took place when CAS training commenced in Tasmania.

Mr Nielsen also submitted that the

DRIVER TRAINING:

A further example of the upgrading of standards for AOs in Tasmania relates to the introduction in 1979 of formal driver training conducted by the Tasmanian Police Academy Driver Training Unit.

It was submitted by Mr Nielsen that the Tasmanian approach to driver training was considered to be an improvement on the training provided previously by the Goulburn Valley Driver Training complex in Victoria.

The duration of the driver training course has increased from two weeks in 1978 to three weeks in 1979 and seven weeks full time in 1988.

Also the TAS decided to lift the driving performance standard from "D" to "C" grade. In terms of the CAS a "D" grade licence endorsement amounts to a failure.

ADVANCED LIFE SUPPORT:

It was submitted by Mr Nielsen that with the CAS being conducted in Tasmania the TAS began to give greater emphasis to the establishment of foundation knowledge and skills required for further studies required to be undertaken by AOs to obtain the ALS qualification.

In that regard Mr Nielsen said certain modifications were made to various science subjects as well as for mathematics, physics, education and humanity units.

As indicated earlier in this decision the ALS developed from the 1978 pilot course in ambulance coronary care.

At that time one week was spent on theory and introduction. The second and third weeks in clinical instruction and the fourth week was devoted to on-road instruction and protocol instruction.

The thrust of the course, which became the ALS qualification, was to focus on cardiac conditions and care of the coronary patient.

This "team" was formalised into The Medical Advisory Council (the Council) in the period 1 July 1983 to 30 June 1984.

Included on the Council is Dr W Flukes, Medical Officer Royal Hobart Hospital, who supervises the Ambulance Advanced Life Support programme.

Mr Doddridge, who appeared with Mr Nielsen, informed me that the Council meets regularly to evaluate the advanced life support system and to review and update it as necessary.

In that context Mr Nielsen said that:

Certainly that statement by Mr Nielsen is supported when regard is had for the increase in course material over time.

It is evident that the ALS qualification has become the level of qualification considered to be the standard for the TAS.

As Mr Nielsen said:

The ALS became a mandatory qualification for all AOs employed after 17 September 1984.

It was at that time that the Association and the TAS finalised their negotiations which culminated in the signing of a Memorandum of Agreement which specified that particular requirement, as well as other conditions of employment.

The Tasmanian Ambulance Services - Salaries and Conditions of Service Agreement provided inter alia in clause 1, Definitions:

At an operational level, however, there have been instances where AOs have not been able to meet the standards set for ambulance officer, let alone the ALS qualification. This has resulted in the termination of employment. In fact the Commission as currently constituted found in favour of the TAS when it was demonstrated in proceedings⁶ that a particular AO was not able to maintain a skills standard acceptable to the Director and as a consequence his employment was terminated by the TAS.

AIR AMBULANCE

Mr Nielsen informed the Commission that the air ambulance service commenced in 1978.

With the introduction of this service it was stated by the Association that AOs were required to train in aero medical evacuation of patients.

Mr Nielsen said:

In concluding this part of the Association's case Mr Nielsen said there has been an increase in responsibility brought about by the specialised nature of patient care and the associated procedures involved.

ENVIRONMENTAL CHANGE:

The Association's submission in respect of ambulance officers encountering environmental change exposing them to greater risk was advanced under the following headings:

(i) disease transmission
(ii) acts of violence
(iii) hazardous chemical incidents
(iv) specialist ambulance officer functions
(v) case load increase leading to proportionate increase in stress and burnout.

Mr Nielsen's submissions on the above areas of risk were extensive. In broad terms the thrust of what he said is that -

Illustrative of the points made by Mr Nielsen is the potential (and actual occurrence) for AOs to come into contact with body fluid in the normal course of their work when attending to motor vehicle and industrial accidents, assault cases and suicides.

Whilst protective gloves are worn Mr Nielsen said that these may be punctured/torn quite easily, especially where jagged metal is involved.

Also AOs are often confronted with patients who present with fevers, rashes, coughing, vomiting, diarrhoea and other abnormal discharges.

It is to be noted that the Tasmanian Ambulance Service has recently acknowledged Hepatitis B as a potential danger to ambulance officers and an optional vaccination program has been introduced.

In respect of stress, Mr Nielsen said that increased acts of violence place an even greater burden on ambulance officers who are already in a stressful occupation.

The implementation on a trial basis of a stress management program currently conducted by the Occupational Assistance Service is recognition by TAS that the consequences of an AO's job may require him to undertake professional counselling from time to time.

Exhibit N55 provides a further insight into this particular problem.

Mr Gillard, who was Superintendent North-Western Region, stated in correspondence to the Occupational Assistance Service dated 12 June 1987, inter alia -

In accepting the Occupational Assistance Service, on a trial basis, the Director of Tasmanian Ambulance Service said -

CASE LOAD INCREASE AND INCREASE IN STRESS AND BURNOUT: CUMULATIVE STRESS

The Association's submissions on stress have been partly addressed.

This aspect of this case is difficult to assess. Also the question of cumulative stress poses problems for the Commission as no one individual is the same.

Notwithstanding, it is readily acknowledged that some tasks facing AOs in the field can be extremely stressful and without proper attention could result in attendant difficulties for individuals.

The Association contended that with the increase in case load from 21421 cases in 1978 to 27603 to 30 June 1987 - of which 1/3 were urgent or emergency cases (exhibit N62 and N63) the exposure to circumstances which could cause stress have also increased.

The exhibits tendered by Mr Nielsen on the issue of stress demonstrate that those in emergency medical services are in the high risk category for stress.

AMBULANCE OFFICER CHANGES - THE MINISTER'S CASE:

In these proceedings the Minister for Public Administration was principally represented by Mr Shirley.

Mr Shirley, through Mr Dargaville, Superintendent Technical, TAS, who was called as witness for the Minister, sought to clarify certain matters put by the Association.

Whilst agreeing that Patient Extrication and Driver Training are components of the CAS course in Tasmania and which were not an integral part of that course in Victoria, Mr Dargaville said that the UG3 level assigned to the CAS qualification has not changed.

On equipment changes Mr Dargaville said:

On the question of qualifications Mr Shirley whilst acknowledging the differences between the CAS course adopted in Tasmania and that previously undertaken in Victoria (driver training and patient extrication incorporated in the Tasmanian Course) nevertheless held to the view that little change had taken place since 1980.

ADVANCED LIFE SUPPORT:

The Commission brought to the attention of the TAS a decision⁷ of the Ambulance Services Industrial Board which inter alia considered and awarded a $10 a week skills allowance for those AOs with ALS qualifications.

Mr Shirley submitted that few protocols and changes had occurred since that time and therefore no additional work value assessment is now required to be made.

In respect of the ALS being a mandatory qualification for all those employed after 17 September 1984, Mr Shirley said:

Mr Shirley also referred to exhibit N112 to support the Minister's view that few if any ALS changes have taken place since the decision in A45 of 1980.

At page 27 of exhibit N112 Course Co-ordinator Mason Cox states -

I was informed by Mr Shirley that this issue is still under discussion.

Mr Shirley submitted:

AIR AMBULANCE:

The Minister's submissions were in essence that prior to 1985 the air ambulance was equipped with equipment taken from ambulances. Mr Dargaville said:

Mr Shirley then went on to indicate that from 1985 onwards dedicated air ambulances were put into place, which he said:

The evidence solicited by Mr Shirley from Mr Dargaville indicates that an advanced level of training is required for dedicated air ambulance duties.

Mr Dargaville also said:

Mr Shirley subsequently submitted that the major part of the Association's case on air ambulance related to the increase in the volume of work. He said that this did not demonstrate a work value increase.

He also submitted that the skills used in this type of work are already used by "ambulance officers in their daily activities" (transcript P555).

ENVIRONMENTAL CHANGE:

Mr Shirley referred to the evidence of Mr Dargaville in his brief submission on environmental change.

He indicated that whilst there has been some change, policy provisions had been introduced to "protect and address these changes" (Transcript P591).

With regard to stress Mr Shirley submitted that as there has been no demonstrated change in the nature of the work, it is a fact of life that the work is stressful and has always been so.

STRUCTURE:

As has been previously stated, from 17 September 1984 it has become mandatory for ambulance officers to qualify in the ALS.

Mr Shirley said that the Commission will -

DECISION

AMBULANCE OFFICER CLASSIFICATIONS:

As will be noted from the summary of the submissions made by the parties in respect of ambulance officers, a great deal of information has been placed before the Commission.

In essence the Association contend comprehensive work value changes have taken place.

These changes have been categorised under specific headings, broadly outlined in this decision and if endorsed are requested by the Association to produce increases ranging from 10 per cent for student AOs to 45 percent AOs with ALS and PE qualifications; less the 4 per cent second tier increase already awarded.

Changes to ALS qualifications have been discounted by the Minister because in Mr Shirley's submission little has changed from when $10 a week was awarded in April 1981 by virtue of decision A 45 of 1980.

The Association submitted that I should endorse any work value changes I may determine in a structure which recognises that the ALS and PE qualified AO is operating at the level of a paramedic.

This would incorporate in the award the structure commensurate with the requirement that all AOs employed after 17 September 1984 are required to qualify in ALS or have their employment terminated.

The Minister opposes this change and has argued for a structure that would allow an integration recognising the change to the contract of employment after September 1984 and which would not disturb the current award format.

The Association have presented a meticulous case. Their arguments have been supported, in the main, with documentary evidence which has been incorporated in exhibit form in these proceedings.

The difficulty is of course to separate out those changes which meet the requirements of the Work Value Wage Fixing Principle.

Evolutionary changes on their own do not necessarily meet the strict tests required to be applied in cases such as this.

It is clear that in 1978 in service training was ad hoc and that the standard of qualification for AO Grade 2 was at the level of basic ambulance care.

However the fact is that the AO Grade 3 level, a distinct rate of pay level in the Award at that time recognised CAS training and qualifications.

The Grade 3 rate was converted to the Ambulance Officer rate of pay when the Award was varied to delete references to grades.

Mr Nielsen recognised in his submission that the A03 course was a prerequisite for the "developmental" Advanced Life Support course.

Accordingly the rate of pay for the CAS qualification was recognised in the Award.

What was not established in the rate however was the change that took place when the CAS course was conducted in Tasmania from 1982 onwards.

It was at that stage that the TAS philosophy of an integrated approach to pre hospital care was reflected in the CAS course material.

That is patient extrication skills, to produce a rescue specialist were incorporated.

This amounts to a significant work value change. The physical demonstration to the Commission of the work involved was impressive. The skill level and expertise of those AOs involved in the exercise was obvious.

When it is considered that in Victoria, where the CAS qualification was first undertaken by Tasmanian AOs, specialised groups undertake this role it reinforces the worth of that work to the Tasmanian community.

In respect to driver training the submissions and exhibits demonstrate the upgrading that has occurred; both in the duration of the training and license endorsement which altered from "D" to "C" Grade.

It was in the area of the ALS qualification, as I have indicated, that the Minister indicated little change has occurred.

Without traversing all the ground covered in the summary of submissions, I must indicate that I do not agree with the assessment of Mr Shirley that, as he put it "there has been very little change".

Mr Shirley relied on exhibit N112 and in particular the quote "....no further skills have been added", to support his view.

It is of course correct that the decision in A 45 of 1980 rewarded AOs for ALS derived skills.

However exhibit N112 - The History of Advanced Life Support in Tasmania, highlights many changes subsequent to that date.

Reference to that document shows - that in 1982 that the ALS course was extended to cover a wider variety of subjects. The clinical experience segment increased to twelve weeks duration.

The ongoing review of standards is of course a function of the Medical Advisory Council whose philosophy, as stated by Dr Flukes who appeared for the Association, is -

Therefore whilst there has been no addition to the number of specific (256) skill areas, procedures and protocols for those skills have changed and this is partly the thrust of the document (Exhibit N112) in question.

It is clear to me that the standard of performance and the quality assurance programmes in place maintaining those higher standards have contributed to a work value increase. This fact is also evidenced by the debate on the title paramedic.

The fact that this debate should even arise is an indisputable testament to the change in the role of ALS AOs. At that level (ALS) the change really was captured by Mr Nielsen when he said that the Service has progressed from the day of an AO having a drivers licence and some first aid knowledge to that of an integrated and professional emergency health care service.

In respect of the Award change making ALS a mandatory qualification this of course "impacts only on those employed after September 1984. That change must be recognised in any structure but does not alter the work value component of the work assessed for the ALS level.

On the issue of changes consequential to the introduction of the Air Ambulance Service, I find that the submissions of the parties are compatible insofar as there is acceptance that, what may be termed "advanced level training" is required for air ambulance officers.

I consider that some carriage must be given to the Association's case that additional protocols unique to the air ambulance service are required to be mastered.

Whilst to a certain extent Mr Dargaville's evidence is conflicting, he did indicate that "officers need to have an appreciation of factors that are created in the air ambulance."

The Association's submissions on environmental changes were extensive. By contrast the Minister contended that what change had occurred was taken care of by TAS policy initiatives.

On what has been placed before me, it is beyond dispute that AOs are required to work in an environment where risk to their personal safety and well being is an inherent feature of their jobs.

It is however a fact that environmental factors have in the main not changed. What has altered is the prominence given to some of the incidences encountered, e.g. domestic violence, hazardous chemical emergencies, the AIDS virus and the like.

The point made by Mr Dargaville that policies have been introduced by TAS to protect AOs at least demonstrates a real awareness of the potential risks that are inherent in the work of AOs.

On the material before me I am unable to make a final quantitative assessment on the impact of stress. This is a very specialised area and accordingly leave is reserved to the

Association to further explore this area with the Commission.

In the first instance, however, the parties should first aim to reconcile their views on this issue.

STRUCTURE AND USE OF THE TERM PARAMEDIC:

The use of the term Paramedic for ALS qualified AOs is strongly favoured by the Association.

On balance, however, I favour the structure and terminology proposed by the Minister (exhibit S5).

This whole issue was debated in great depth before the Commission. The factor that influenced me the most in rejecting this title is that I do not wish to endorse a variation in. the Award which would or could alter the perception and reality of one integrated ambulance service.

Accordingly, whilst I agree that ALS qualified AOs possess and operate at a level commensurate with what is evoked by the term paramedic, I will not include it in the award, at this stage.

I understand that in time, as all post September 1984 employees will be ALS trained and accredited, the result will be a uniformly qualified TAS. At that time a change in title, would in my opinion be justified.

At this stage however it is my intention to recognise in the pay structure the changes that have occurred in the period of review.

Whilst there will be no change in the title of ALS AOs, reference to patient extrication will be included and will be reflected in the new salaries scale.

Accordingly as I have adopted the Minister's exhibit SS as the structure in the Award, appropriate definitions will be required to be submitted. A drafting conference will be convened by the Commission to discuss this aspect.

WORK VALUE INCREASES:

It is not my intention to segment the quantum of increase into the categories advanced by the Association. This segmentation was as follows -

(i) 10% industry movement.

(ii) 5% increased ambulance skills such as the drawing up of drugs, new equipment, the support role for ALS officers and the use of defibrillation protocol.

(iii) 10% additional for AOs with PE skills.

Further, the increases proposed by the Association translate as follows -

As previously stated the above rates of pay sought by the Association are inclusive of the 4% second tier. (Note the 4 per cent second tier increase was the subject of my Interim Decision8).

In reaching my decision in this matter I am satisfied that demonstrable work value changes justifying the requirements of the Work Value Wage Fixing Principle have taken place.

In most of the areas nominated by the Association quantifiable work value increases have resulted in the period of review.

The major change in qualifications relates to patient extrication. However I have also accepted protocol and procedure changes in the ALS as a significant change. There is no doubt in my mind that the level of sophistication of the protocols has increased adding to the work value of ambulance officers who are ALS trained. I have previously referred to the ever tightening quality control that is exercised across the whole of the TAS. In my opinion this is epitomised at the ALS level.

The emphasis on training has demonstrably increased. The entire standard of the work of AOs has lifted in such a way that it is now more expert. This of course benefits the community at large.

This higher standard of work brought about by concerted training efforts, Medical Advisory Council reviews and updating and additions to course material, is appropriately recognised in a case such as this.

In respect of air ambulance, this aspect is thoroughly canvassed in this decision and in my opinion justifies inclusion in this exercise.

OPERATIVE DATE

Having regard to the totality of the submissions before me I have decided that the following classifications (exhibit S5) and rates of pay shall apply from the first pay period commencing on or after the date of this decision.

In respect of what is to follow in this decision concerning other Award classifications and the management structure, the operative date will be as indicated above.

COMMUNICATION OFFICERS (COs):

In 1978 the TAS did not have dedicated COs. Ambulance Officers were required to undertake radio operation duties on an ad hoc basis during periods when the Station Officer did not carry out this function.

The role of radio officer was to answer phone calls, dispatch ambulances as appropriate and maintain radio contact with crews.

All AOs were required to be familiar with the use of the switchboard and the use of radios and branch station transmitting techniques.

With the establishment of the TAS in 1983 three Regional Communication Centres were created and dedicated communication officers employed.

The job specification for this position dated 7 June 1984 (Exhibit N83) outlines the prime objectives for the Communications Officer as follows:

(a) To co-ordinate and direct the movement of all ambulance crews responding to calls.

(b) To receive and re-direct, as necessary, all calls received in the operations centre of the service.

A new classification and definition - Communications Officer -was included in the 1984 Memorandum of Agreement.

Mr Nielsen submitted that from 1983 the COs role has expanded in terms of technology available and overall responsibility.

A significant change according to Mr Nielsen was said to be the COs operations deployment responsibilities, e.g. patient extrication dispatch, contact with associated emergency services, police, fire and hydro.

Clearly the range of equipment that a CO may be required to operate has altered dramatically during the period 1978 to 1988 (Exhibit N81 and N86 illustrate that point).

Mr Shirley submitted that COs are not required to hold pre requisite communications or other technical qualifications. Also they are not required to be qualified to carry out ambulance officer work.

It was stated by Mr Shirley that the computer aided dispatch equipment installed thus far only in the Southern Region has reduced the work load and made "the task of the position easier".

Mr Shirley submitted that the position of CO should not attract an increase.

DECISION

I consider the introduction of new technology in the Southern Region a significant work value change justifying an increase of 2 per cent in accordance with the Wage Fixing Principles.

As the new technology has not been extended statewide a new classification will be required to be inserted into the Award. The title will be "Communications Officer - Computer Aided Dispatch".

As the computer aided system is implemented in other regions the new rate will apply.

The parties are to prepare the appropriate award variation.

BRANCH STATION OFFICER:

The background to this classification is that prior to 1984 branch stations were maintained by Branch Station Officers with the second officer being classified at Ambulance Officer level.

As the ambulance officer performed the same duties as the Branch.Officer, the TAS recognised the equality of their work.

Accordingly the second officer was increased in classification from Ambulance Officer to Station Officer.

In terms of this work value case Mr Nielsen submitted that Branch Station Officers' responsibilities have increased;

This particular change was recognised in the post 1984 position description as per exhibit N88.

Specifically the duties require the Branch Station Officer to provide:

and

The submission made on behalf of the Minister by Mr Shirley on this issue was as follows:

DECISION

I concur with the submissions of Mr Shirley so far as honorary staff duties are concerned.

Whilst this specific requirement was formally included in the more recent job description, I accept that the value of this work is already comprehended in the rate for this classification.

However as Branch Station Officers are trained operational ambulance officers the increases determined earlier for ambulance officer; ambulance officer with patient extrication; ambulance officer with ALS and ambulance officer with ALS and PE will apply. This is in keeping with the new structure adopted by the Commission in this matter.

New classifications and definitions will be required to be submitted by the parties.

This aspect will be addressed at the drafting conference of the parties with the Commission.

STATE BELIEF OFFICER AND CONTRACT OFFICER:

These positions were established in 1983. The submissions of the parties were that the duties of those positions are the same as for Branch Officer.

In the circumstances my earlier comments in respect to Branch Officer hold, and I decide accordingly.

CLINICAL INSTRUCTOR (CI):

Mr Nielsen submitted that Clinical Instructors have significant additional responsibilities over and above those of an ambulance officer.

He indicated that the clinical instructor classification did not exist in 1978. With the introduction of "fledgling" advanced life support courses in 1978/1979 student ambulance officers were supervised by an "ambulance advanced life support training officer" or as they were alternatively referred to, In Service Training Officer (ISTO).

Up until 1984 ambulance officers with additional training duties did not gain any award recognition, classification or remuneration.

However the increasing emphasis on the role of ISTOs through the apparent upgrading of skills and the examination of those skills is evident when regard is had for the approach of the Interim Ambulance Authority, as it then was (May 1982 - Exhibit N90) to designate certain ambulance officers as In Service Training Coach in respect of nominated units of the Certificate of Applied Science.

In June 1983 the term Clinical Instructor appears for the first time.

Exhibit N91 refers to that title and also that:

Subsequently the "New Agreement", the Memorandum of Agreement (Exhibit N22) operative from 17 September 1984 contained the following definition for Clinical Instructor:

The rate of pay assigned to the new classification equated to that of Station Officer with ALS.

Up until that point of time the ISTO or Clinical Instructor provided predominantly "one to one" training (transcript P267).

Mr Nielsen submitted that in 1984:

Circular No. 117 issued by the TAS on 29 June 1984 stipulated, inter alia, that Clinical Instructor (Patient Extrication and Driver Training) will -

- Hold Advanced Life Support qualifications.

- Hold "Member" status, Institute of Ambulance Officers (Australia); an advantage.

However, whilst the job specification for Clinical Instructor (Exhibit N92) was not confined to a specific area of training (e.g. patient extrication and driver training as,above) i.e. there was no delineation between the various doctrines within TAS (Certificate of Applied Science, Advanced Life Support, Patient Extrication), Clinical instructor appointments were still specific to each of these three areas.

In querying this aspect with Mr Doddridge the following exchange totally clarifies the particular circumstances applicable in 1984:

Mr Nielsen submitted that whereas the clinical instructor role was specific to a particular portfolio, in 1988 the TAS has two clinical instructor portfolios -

(i) Clinical Instructor - Patient Care, Certificate of Applied Science and Advanced Life Support, and

(ii) Clinical Instructor - Patient Extrication, Driver Training.

In respect to (i) the Clinical Instructor is required to be ALS accredited. This is not the case for (ii) above.

The "rationalisation" of the role of Clinical Instructors was confirmed by Mr Shirley. He said -

Later in this decision I will deal with the proposed consent management structure for TAS requested by the parties to be endorsed by the Commission.

However, with regard to Clinical Instructors Mr Nielsen indicated that with the introduction of a new management structure, regional training officer and deputy superintendent positions will be abolished.

The consequences for Clinical Instructors are that they will be responsible for conducting regional training administration tasks, and other associated duties previously performed by regional training officers.

Mr Nielsen also stated -

Mr Doddridge informed the Commission that the foregoing changes, proposed in the management structure, have in fact been in place "from about the middle of 1987". (Transcript P283).

Mr Shirley's submission on this classification was brief. He said that when the Clinical Instructor classification was included in the Memorandum of Agreement it was equated to Station Officer Grade 2 plus ALS.

He said:

DECISION

Contrary to Mr Shirley's submission, there is evidence of work value change if, as I do, Mr Nielsen's submissions are accepted.

The changes may be summarised this way -

(i) the broadening of the CI role consequential to the consolidation of duties into two CI positions.

(ii) The changes to the CI role to be formalised on the adoption of the new management structure (to be addressed later in this decision) have in fact been in operation from mid 1987 (Transcript P283).

I am of the opinion that the changes enunciated by the Association add to the work value of CIs so as to enable consideration for a work value adjustment.

Accordingly I determine that CIs are to receive an additional 2 per cent increase over and above the increases applicable to Ambulance Officer ALS and AO/PE respectively.

I am of the view that the Award definitions should reflect the circumstances as they now are i.e. two Us - one for CAS and ALS and the other for PE and Driver Training.

The Salaries clause will also be required to be varied.

I expect the parties to prepare appropriate Award variations.

DUTY OFFICER (DOs):

This position was introduced as a classification in 1984. The classification evolved from the role undertaken by Station Officers which in 1978 was predominantly a combined communication and station administrative function (Transcript P284).

The Station Officer provided oversight. In an operational sense this was usually limited to case dispatch and vehicle maintenance.

Mr Nielsen submitted that the rate of pay for the Duty Officer classification was aligned with Station Officer, notwithstanding that the duties and responsibilities were significantly broadened.

Whereas the Station Officer from which the DO position evolved was in 1978 as indicated above, the Duty Officer job specification from June 1984 indicates -

and later

Mr Nielsen submitted that the Duty Officer role has developed from 1984 through to 1988 to that of regional operational personnel shift manager.

He said:

I was informed by Mr Nielsen that the duty officer, in addition to the above, is now responsible to manage the functions of the Communications Officer, Branch Officer, State Relief Officer, Contract Officer and Clinical Instructor.

This aspect is currently stated in the 1988 job description for the Duty Officer:

A further matter to be taken into account for work value purposes submitted Mr Nielsen is as a consequence of the abolition of the Regional Training Officer and Deputy Superintendent functions (1987-88) some additional tasks for regional operations will fall to the Duty Officer.

Later in his submission Mr Nielsen indicated that the major effect of this rationalisation of positions was the involvement of DOs in assisting in the co-ordination of regional training. However, it must also be noted that the Association contend wider training involvement for CIs as a consequence of the abolition of the Regional Training Officer position.

Mr Shirley by comparison to Mr Nielsen made some very brief comments on this position. He indicated that post 1984 duties incorporated into the Duty Officer position were recognised at that time as the rate of pay was increased from Station Officer Grade II to Grade III.

Also Mr Shirley strongly put to the Commission that the changes referred to by the Association between 1987 and 1988 regarding training responsibilities, boil down to a liaising role. The DO plays no part in training (transcript p573).

DECISION

On what has been put before the Commission the conclusion I have reached is that the assessment made in 1984 when an upgrading of this classification took place was reasonable at that time.

However, it has to be recognised that as a consequence of the proposed management structure, (described later in this decision) several positions will be deleted, e.g. Deputy Superintendent and training positions.

Accordingly some extra responsibilities will be absorbed at that level.

Also given the increase in complexity in advanced life support and having regard to the fact that the Duty Officer has the responsibility for the tactical command of an ambulance station, it is appropriate that the inherent change in work value is. recognised by the Commission.

My assessment is that a 12 per cent increase is sustainable in accordance with the work value wage fixing principles.

I stress the adjustment made does not include a component for "training". I consider that the identification of training needs, a function performed by DOs, is reasonably comprehended in the salary level now determined. Therefore I emphasise no double counting in respect of what CIs undertake has occurred.

SUPERINTENDENT REGIONAL:

With the introduction of the Ambulance Act in 1982 and the Regulations in 1983, the TAS was formed and three operational regions were established.

Prior to 1983 the Regional Superintendent was subject to Ambulance Board supervision. With the commencement of the TAS, Superintendents became Senior Regional Operations Managers responsible to the Director.

In the transition period between the phasing out of Ambulance Boards and their functions being absorbed by the TAS, Regional Superintendents served on Regional Advisory Councils. These were retained for a 4 year period to facilitate the phasing out of Local Government involvement.

Mr Nielsen submitted that this was a major change affecting the work of Superintendents.

That is from 1978-1984 Superintendents principally performed a secretarial role for local Ambulance Boards. This altered to a regional manager's role during the period of the Advisory Council; which ceased to operate in 1987.

Accordingly for work value purposes, this aspect cannot be included in this review. However, in terms of what their rate of pay was assessed on at the time of the Board structure vis a vis what their functions are now, is of relevance in this matter.

Mr Nielsen submitted that in 1988:

According to Mr Nielsen the work of Regional Superintendents has become more responsible because they are now regional heads compared to their secretarial role with the Ambulance Boards.

Mr Shirley in part submitted that the duties of Superintendents have "actually reduced" (Transcript p.574).

DECISION:

In my view the role of the Regional Superintendent has expanded when compared to the position as it was in 1978 when it was titled Superintendent - Secretary.

Exhibit N106 reveals that the position of Regional Superintendent has undergone significant change. It is now an integral part of the TAS whereas previously the role was confined to the area covered by a local Ambulance Board.

The primary tasks stipulated in Exhibit N106 credential this change. Item 1 of this exhibit stated:

In my opinion this encapsulates very well the very much wider role required to be carried out at this level.

Also reference to the evidence of Superintendent Dargaville indicates the differences in duties. He said:

and later

Having regard to all of the factors involved it is my assessment that a four percent increase is justified on work value grounds.

I appreciate that these positions are part of the management structure review. Nevertheless the duties and responsibilities discussed above will still be part of this position, and therefore the assessment I have made will be added to, or otherwise, when the management structure is discussed later in this decision.

COURSE CO-ORDINATOR (CC):

At the outset of this part of his submission Mr Nielsen identified that the major change occurred during the period 1986-1988.

The first course co-ordinator was appointed in 1979 with an award rate for nurse educator. The appointment was made because of the perceived need to ensure appropriate supervision of the Coronary Care Course first conducted in November 1978.

Exhibit N75 indicates:

In 1980 the coronary care course was extended from 7 to 12 weeks to expand the concept of mobile coronary care service to encompass many other life threatening emergencies.

The course co-ordinator was responsible for arranging and teaching these courses.

In 1981 a Course Co-ordinator CAS was appointed; followed in 1982 by the appointment of a further Course Co-ordinator for patient extrication and driver training.

At that stage no job descriptions for these positions existed.

However, when in 1983 a Course Co-ordinator ALS was appointed a job description was prepared.

At this time the roles and responsibilities of course coordinators were expanded because the State Training Officer was appointed Assistant Director and therefore devoted less time to training. That is course co-ordinators went from a purely teaching role to one where they had far greater involvement in overseeing the actual course and co-ordinating the course itself.

This change was recognised in that the rate of pay for the job was substantially lifted.

Subsequently the course co-ordinator CAS was given extra responsibilities in the areas of budget preparation and policy development; duties which attracted a higher duties allowance.

In 1985 a CI, State Training Unit, was appointed to specifically assist the CC CAS with teaching and student assessments.

Mr Nielsen submitted that the Course Co-ordinator ALS, since September 1984 when it became mandatory for all officers employed subsequent to that date to qualify in ALS, now plays a key role in determining the future employment of ambulance officers.

In 1986 the education program expanded to include a basic cardiac arrest protocol for all qualified ambulance officers.

During 1986 three course co-ordinators resigned. The Superintendent, Southern Region identified certain problems within the Training Unit. Exhibit N109 refers.

From Mr Nielsen's submissions it is apparent that there has been a reduction in the number of course co-ordinators to two.

Subsequent to 1986 the CAS course co-ordinator has the additional responsibility for the ongoing education of staff.

Mr Doddridge said:

In summary Mr Nielsen submitted that:

Mr Shirley established through Mr Dargaville that in 1978 CC's were predominantly involved in a teaching role, whereas in 1988 he said -

In respect of changes in protocol, Mr Dargaville said that "the course co-ordinator is the one that has to put those in place and train the staff" (Transcript P520).

DECISION:

Given the functions of Course Co-ordinators at the front end of facilitating improvements in training and procedures for the TAS, the quantum of increase will be as for ALS/PE i.e. 24 per cent.

The reasons for this quantum of increase are as stated for ALS/PE earlier in this decision. Suffice to say now that these positions are clearly in the clinical stream of ambulance work and therefore the increases determined earlier will apply.

The only qualification is of course that if the CC PE is not ALS trained and it is not a requirement for that position, at this time, then the quantum of increase for the PE position should be 14 per cent.

Similarly if the ALS CC is not required to be PE qualified then the AO ALS increase only will apply.

The parties are to advise me of the particular circumstances at the conference to be held subsequent to the issue of this decision.

MECHANIC:

Mr Nielsen submitted that in 1978 the mechanic was, inter alia, responsible for mechanical work of "a minor nature".

Large jobs were referred to a commercial workshop.

In 1984 the structure changed. Anew job description was introduced which Mr Nielsen submitted identified a developing level of responsibility concerning the preparation and reporting on mechanical programs.

Mr Nielsen indicated that mechanical technology in ambulances has significantly altered the work value of the mechanic.

Also the mechanic is responsible for the maintenance of workshop and station equipment in a $m5.2 complex. The equipment includes a diesel generator for emergency power, air compressor and hoists.

I was informed that TAS had agreed to an increase in the rate of pay for the mechanic to align him with Police Department mechanics.

When regard is had for the evidence of Mr Dargaville when he said -

then the offer made by the Minister is understandable; having regard to the origins of the position under review.

Mr Doddridge for the Association submitted that as the TAS mechanic works on his own, does his own ordering of parts and has to assign his own workload priorities, then a higher rate than proposed by the Minister should be awarded by the Commission.

DECISION:

The Association's claim for a 15% increase over and above rates for mechanics in the Police Department is not supported.

I consider that I am not in a position on the material before me to form an opinion on the relative worth of the work performed by a police mechanic vis a vis the mechanic working on ambulances.

In extending leave reserved to the Association on this matter, I have decided to adopt the submissions of Mr Shirley to increase the existing award rate for the mechanic by 15% per cent.

MANAGEMENT STRUCTURE:

This aspect of this case was put forward as a consent matter.

Mr Ireland for the Minister said in his introductory remarks -

and later

It was stated by Mr Ireland that the new management structure would enable the TAS to manage more efficiently and more effectively.

The proposed structure was advanced by Mr Ireland under a number of headings.

The first of these was the senior management structure which comprises the Director TAS and the new positions of Chief Superintendent, Manager (Administration and Personnel) and Superintendent.

The proposed superintendent classification will obviate the need for specifically titled superintendent classifications such as Regional, Administration, Technical and Training.

In addition to the foregoing positions Mr Ireland requested the inclusion in the Award of an Executive Officer (Administration) position and limited clerical and keyboard salary ranges.

An organisational overview of the structure is that it provides a career structure for ambulance officers.

The practitioner stream as it is referred to provides AOs with three career streams - (i) operational, (ii) training and (iii) country; all leading to the Executive Stream comprised of Chief Superintendent and Superintendent classifications.

On the administrative side of the structure, the parties contend that the existing resources only provide limited support.

The inclusion in the Award of a Manager (Administration and Personnel) and a Executive Officer position, the rates of pay which are to be assessed by the Commission, were said by Mr Ireland to rectify that situation.

Additionally the positions of Personnel and Finance Officer; Accounts Clerk; Office Assistant and some keyboard classifications are proposed to be slotted into the keyboard and clerical salary scales requested to be included in the Award.

In support of the administrative classifications proposed by TAS, particularly in respect of Manager (Administration and Personnel) proposed class XIV ($40921 pa), and Executive Officer proposed class VII (ranging from $28214 to $29595 pa), both inclusive of the 3 per cent State Wage Case decision9 Mr Ireland called as a witness Mr G Duke, Senior Advisory Officer, Personnel Management Division, Department of Public Administration.

Mr Duke said -

In support of the recommended classification levels Mr Duke said that at present the higher levels of the personnel function is carried out almost entirely by the Department of Health Services. He indicated that in many cases -

In that context Mr Duke's evidence was that the Manager (Administration and Personnel) would be required to perform the "widest range of personnel management functions".

When I queried the proposed classification level for this position, having regard to the type of work usually carried out in similar roles in the State Service, Mr. Duke said -

It is to be noted that the title "Regional" is to be deleted, hence the brackets in the quote.

When pressed further by the Commission on the classification level proposed for the position under discussion the following interchange with Mr Duke is of some concern.

Later in the proceedings when Mr Dukes returned to the witness stand he indicated that agencies submit classification assessments along with views on an appropriate classification; it is then up to the Agency head to approve the classification under the Tasmanian State Service Act 1984 (the Act).

Whilst the Commission is of course aware of that procedure, I am nevertheless concerned that the DPA, when their "view" (transcript p.420) was obtained, were not able to advise me on how, in the form of any criteria, that view was formed.

This is particularly the case given that a deal of weight was given to the function in the position relating to involvement in "complex industrial issues" (Primary Task No 2 Exhibt I1).

The Commission requires further detail in respect of this function, as it appears from the proceedings, that an employee in Health Services already undertakes this function.

Subsequent to the Commission raising its concerns, with the appropriate parties to these proceedings, regarding the apparent doubling up on industrial relations duties, I was informed that the position description submitted as an exhibit was in fact incorrect.

Obviously any prospect of double counting must be avoided and therefore leave reserved is given in respect of this classification.

Therefore, having regard to what has been put to the Commission thus far a class XI is endorsed at this time.

With respect to remaining parts of the administrative structure, I am satisfied that the proposals meet the appropriate wage fixing tests and are in accord with the Principles and therefore receive my endorsement.

The parties are requested to prepare appropriate Award variations, including definitions to give effect to the subclause in the Award of -

(i) Manager (Administration and Personnel Class XI Clerical Employees Award.

(ii) Executive Officer Class VII.

(iii) Inclusion of Classes I to VII of the Administrative and Clerical salary scale from the Clerical Employees Award.

(iv) Inclusion of Class I to Class VIII of the Keyboard Employees and Office Assistants Award.

PRACTITIONER OR CAREER STREAM:

In providing a career structure for ambulance officers, the area of focus was submitted by Mr Ireland to be the inclusion in the Award of a new Superintendent classification which it is proposed should replace the existing classifications, as previously indicated, of Superintendents - Regional, Technical and Administration.

Mr. Ireland said:

The rationale behind this part of the structure is to provide a more effective ambulance service and facilitate a more efficient approach to the resolution of industrial and operational issues.

Mr Haines, Superintendent attached to the Director's Office gave sworn evidence on this matter. He indicated the current structure, below the level of Director, does not provide any operational focus; and that there is confusion in the TAS between the existing roles.

The specific proposals are now discussed.

CHIEF SUPERINTENDENT:

The definition contained in Exhibit I1 is acceptable in broad terms. However, I will require more detail to be provided going to "appropriate knowledge, skills and experience". I have in mind the inclusion of illustrative examples of what is meant by those particular words.

Also, on reflection, qualification requirements should be stipulated, notwithstanding reference is made to these in the position descriptions. An indication of typical duties would also enhance the definitions, and will therefore be required.

SUPERINTENDENT:

My comments are as for Chief Superintendent.

Having regard to the foregoing it follows that I support the variations requested to be made.

In doing so I am mindful of some of the difficulties encountered by the TAS and which are in many ways attributable to the present structure.

SALARY LEVELS:

On the question of an appropriate rate of pay for the Chief Superintendent and Superintendents I have already assessed a 4 per cent work value increase for the Regional Superintendent classification.

Notwithstanding that these positions will now be deleted from the Award, the assessed changes earlier in this decision will however continue to be part and parcel of the duties of the Superintendent classification.

This therefore provides an appropriate datum point from which to assess the work value changes inherent in the new management structure.

In addition I am satisfied that whilst clinically based changes i.e. those that relate to patient extrication and advanced life support do not apply to the position of Superintendent, or for that matter Chief Superintendent, it is fundamental that there is a requirement to provide a tactical operational overview for the ambulance service as a whole.

Therefore, given my assessment of increased complexity in a stratified organisation, which the TAS is, and the rationalization of positions that will take place as a consequence of this decision, it is logical that an additional (to the 4 per cent for Regional Superintendent) work value increase be applied in recognition of those changed circumstances; including the inherent flexibility that will now be a feature of -these positions, as described in evidence by Mr Haines. He said -

Having regard to all of the factors referred to above I am of the opinion that a further work value increase of 6 per cent for Superintendents is justified.

With regard to the Chief Superintendent, my comments concerning Superintendents are echoed.

However I should point out that I am not altogether satisfied where this position is located in the management structure.

On close examination of the proposals put before me, and given my involvement with TAS matters over a reasonable period of time, I must indicate my preference for the Chief Superintendent to be located at a second in charge or deputy director level.

I see some potential for conflict in the proposal put forward on behalf of the Minster where the Manager (Administration and Personnel) occupies the same level organisationally as the Chief Superintendent.

I raise this matter now for the further consideration of the parties. In doing so, however, should the structure remain unaltered as a consequence of my comments, or for that matter change to accommodate my suggestion; there is no impact on what has been decided herein in respect of the salary levels determined for the management structure.

Simply, in my opinion the structure would work better, from an organisational perspective if the Chief Superintendent was to assume a higher level in the organisation.

I request that the parties, inform me of their further deliberations. I envisage that this matter be discussed at the drafting conference previously foreshadowed.

With regard to an appropriate salary level for the Chief Superintendent, and having regard to the position description provided, (which with little amendment could very well slot into the second in charge position described above), I consider an increase of 3 per cent above the rate determined for Superintendents is appropriate.

I will require the parties to prepare appropriate award variations i.e. a draft order for my perusal, in respect of this and all other variations now required to be made as a consequence of this decision.

CONCLUSION:

This work value review has entailed a comprehensive analysis of the work performed in all positions contained in the Tasmanian Ambulance Service Award.

Also a new management structure has been put into place to manage a valued community service into the 1990's and possibly beyond.

I have endeavoured to reflect the changes that have occurred over a period of 10 years and two months i.e. 1 January 1978 to 11 March 1988.

I have ameliorated my decision in respect of the advanced life support qualification as a consequence of the review undertaken in 1981.

In reaching my decision, or more appropriately decisions, in this matter, as many issues have been canvassed and determined by the Commission, I have obviously relied on the detailed submissions and material put before me.

In respect of my findings it was pleasing to note the observation made by Mr Duke from the Department of Public Administration, who appeared as a witness for the Minister when he said:

The fact that there has been change in the work of ambulance officers is beyond question.

The emphasis on training over the past ten years has been great. The result has been and continues to be better pre hospital patient care.

Even at this time the intubation of accident victims is under discussion and it may be that this skill will also be added to the already impressive array of techniques able to be used by advanced life support ambulance officers.

I have given recognition in this case to the dramatic change in treatment of patients now able to be provided.

No longer is a person involved in an accident rushed to hospital without the patient first being stabilised as far as is possible "on the road".

There is an ongoing review of techniques and protocols employed by ambulance officers. This is provided by the Medical Advisory Council.

The Tasmanian Ambulance Service, through the stringent standards it adheres to, provides the highest level of quality control.

This is not only of great benefit to the public, but in itself has contributed and will continue to contribute to the high performance level of ambulance officers.

In reaching my decision I have taken stringent account of the Work Value Wage Fixing Principles and have applied the public interest considerations as stipulated in the Industrial Relations Act 1984.

Whilst the increases determined in this decision will add to the cost of the operation of the Tasmanian Ambulance Service, the facts are that the magnitude of the increases are as a result of the work of ambulance officers not having been valued for a very long time.

In that regard the submissions made by the Association indicate a number of identifiable datum points where work value change have occurred.

Finally, I commend the parties for their thorough and exhaustive work value presentations in this matter.

R.K. Gozzi
COMMISSIONER

1 TA.30 of 1988 dated 29 July 1988
2 T.1524, T.1525, T.1549 and T.1550 of 1988
3 T.712, T.665, T.691 and T.625 of 1987
4 Ibid
5 Made a Public Sector Award - T.727 of 1987
6 T.304 of 1985 dated 3 February 1986
7 A No 45 of 1980
8 TA30 of 1988 dated 29 July 1988
9 T.712, T.665, T.691 and T.625 of 1987