VMO Arrangements: Under Review

VMO Arrangements: Under Review

Your responses to our VMO survey are informing AMA (NSW)’s ongoing negotiations with the Ministry, and if required, provide critical evidence in arbitrations to amend the Determinations.

THE CHANGE in the State Government brings with it a foreshadowed lifting of the wages cap in New South Wales and presents the opportunity for a review of many industrial arrangements that have not been meaningfully updated for many years.

AMA (NSW) did not wait for the 2023 election to commence its review of VMO arrangements. This process commenced in 2022, and AMA (NSW) and the Ministry commenced discussions regarding the VMO Fee-for-Service (FFS) Determination in late 2022.

By way of relevant background, AMA (NSW) and the Ministry reached agreement in 2018 for the indexing of payments under the FFS Determination, and that agreement expired in 2022. The Ministry approached AMA (NSW) in 2022 to discuss remuneration arrangements. AMA (NSW) has agreed, in principle, to a review of the remuneration arrangements to address the current position whereby some VMOs are remunerated by reference to the current MBS (as may be indexed from time to time), others are remunerated by reference to the 2018 MBS.

The agreement to amendments to the remuneration arrangements is conditional on agreement being reached on other changes to the FFS Determination. In 2022, AMA (NSW) accepted a pay increase for sessional VMOs which precludes the seeking of amendments to the Sessional Determination until July 2023. AMA (NSW) will be seeking a review of sessional arrangements following the review of FFS arrangements.

The AMA (NSW) 2023 VMO Survey

We have recently conducted a survey of VMO members. It is pleasing that so many members have taken the time to complete the survey. To date, 594 have completed the survey and a significant number of those have kindly offered to speak further with AMA (NSW). More than 200 regional VMOs completed the survey.

The VMO Determinations were last the subject of a major review in 2007. Since that time advances in technology, societal expectations regarding work/life balance, an ageing population and complexity of patient presentations to hospitals, and significant workforce challenges demand a review of current arrangements including what is a reasonable on-call commitment and the need to address the fact that many can and do provide services from locations other than the hospital for which they are not remunerated.

VMOs fill the majority of places on on-call rosters for the NSW Public Hospital System. While the extent to which a VMO will be called back into a hospital when on-call will be dependent on specialty and location, 44% of survey respondents said they either always or usually were called to go back into the hospital when on-call. Another 35% were sometimes called back in.

Almost three-quarters (72%) of respondents indicated that they provide services that directly involve patient management from a location other than the hospital (when on-call or otherwise). These are services for which VMOs currently receive no remuneration. A key ask of the Ministry is that they agree to amend the Determinations to permit VMOs to be remunerated for these services as they are in the ACT.

While approximately one-third of respondents indicated that advances in technology had reduced the need to attend the hospital when called, it was somewhat surprising that 41.5% of respondents are unable to access the eMR when not physically present at the hospital.

Several members have recently raised concerns with us, particularly in regional locations, that while a list may not be cancelled by the hospital where they work, the major case or cases on a list are cancelled. The VMO Determinations do not provide for remuneration for cancelled cases, only cancelled lists. Approximately 25% of the 323 respondents who had major cases cancelled told AMA (NSW) that this happens at least once a week, and a further 20% said this occurred at least a couple of times a month, and another 18% at least once a month. Forty percent of respondents received less than 24 hours’ notice, and another 18% received between 24 to 48 hours’ notice. Only 8% received more than 72 hours’ notice. There can be several reasons for cancellation, however, it is concerning that in almost 40% of cases efforts were not made or rarely made to schedule other cases.

Of those regional VMOs who completed the survey, 64% said they never claimed the Professional Support Payment. A recent email to members indicated to us that many VMOs remain unaware of the entitlement, and we will be undertaking an education campaign to ensure members are aware of the entitlements they are able to claim.

The survey responses and additional information that has been provided by members will be critical in AMA (NSW)’s ongoing negotiations with the Ministry, and if required, critical evidence in arbitrations to amend the Determinations. As discussions progress, we may return to you with a further survey to focus our evidence. If you would like further information or would like to speak with us, please email the AMA (NSW) Workplace Relations Team at workplace@amansw.com.au or on +61 2 9439 8822.

Not a member? To join call one of our Membership Team on +61 2 9439 8822 or go to www.amansw.com.au/join-the-ama/

Contributed by AMA (NSW)’s Director of Workplace Relations Dominique Egan.