12 July 2024
Simon Dalton
[FYI request #26710 email]
Tēnā koe Simon,
Your request for official information, reference: HNZ00047563
Thank you for your email on 10 May 2024, which was subsequently refined on 17 May 2024.
You requested Health New Zealand | Te Whatu Ora (Health NZ) for the following under the
Official Information Act 1982 (the Act):
“Part A
For context the current Association of Salaried Medical Specialists (ASMS) SECA with
Te Whatu Ora (Health NZ) states: “The date an employee met the requirements for
vocational registration (or its overseas equivalent) will be used to assess when an
employee would have been first placed on the specialist scale (not the date when the
employee was vocational y registered).” This clause was added to the most recent
ASMS SECA.
Please provide copies of all communication (email or formal letter) within the last 2
years regarding the starting or initial salary step placement for Senior Medical Officers
(SMO's) from Te Whatu Ora senior staff (eg Margie Apa and Andrew Slater) to and
from ASMS (email domain "asms.org.nz" will allow easier searching). Emails that
discuss salary step placement issues for existing SMO staff should also be included.
Essentially a keyword search "salary scale" or "salary step" where the sender or
receiver is "asms.org.nz" should make this quick and simple.
Any internal policy document or guidelines that relate to this subject ie to the
placement of new or existing SMO's on the ASMS SECA salary steps should be
included.
Part B
In how many cases in the last 10 years have SMO's been found to have been placed
incorrectly on the salary scale and subsequently had this amended?”
Response
Please find our response to each part of your request below.
“Part A: Please provide copies of all communication (email or formal letter) within the last 2
years regarding the starting or initial salary step placement for Senior Medical Officers
(SMO's) from Te Whatu Ora senior staff (eg Margie Apa and Andrew Slater) to and from
ASMS (email domain "asms.org.nz" will allow easier searching). Emails that discuss salary
step placement issues for existing SMO staff should also be included.”
Please see attached
Appendix 1-A for emails in scope of your request. Note that some
information is withheld under section 9(2)(a) of the Act to protect privacy. The need to
protect the privacy of individuals is not outweighed by the public interest in the release of
this information.
“Any internal policy document or guidelines that relate to this subject ie to the placement of
new or existing SMO's on the ASMS SECA salary steps should be included.”
Please refer to the table below, which sets out the general guidelines used by the National
Office and district areas for determining Senior Medical Officer (SMO) salaries.
Area
Guidelines for determining SMO salaries
National Enabling Office
Refer to the ASMS Multi-Employer Collective Agreement
and Waitematā
(MECA) (refer to
Appendix 1-B).
Bay of Plenty
For permanent appointments, the salary is driven by the
SMO MECA (refer to
Appendix 1-B)
• To determine step and increment date, work out
when consultant received their specialist registration
and count years worked going forward.
• For those SMOs newly qualified and trained in New
Zealand and have completed their fellowship, count
the fellowship year as one year as specialist and
place them on Step 2.
Capital and Coast
The district uses the ASMS Single Employer Collective
Agreement (SECA) for guidance.
https://asms.org.nz/employment-advice/meca/
MidCentral/Taranaki
The district uses the ASMS Single Employer Collective
Agreement (SECA) for guidance (i.e. when a consultant
becomes eligible for vocational registration).
https://asms.org.nz/employment-advice/meca/
• For Australasian trained SMOs, it will be when they
gained fellowship with the relevant college.
• For International Medical Graduates (IMGs), it is
usually based on when they obtained their specialist
qualification in the respective country.
Step 1 is counted from the date they obtained fellowship
or specialist qualification.
Northland
The district uses the
National District Health Boards’
Principle Application of the MECA Salary Scale (refer to
Appendix 1-C).
• For the Medical Officer step placement, the district
counts the number of years worked as a registrar and
Medical Officer, in a relevant area of medicine, less 3
years, to determine the correct step.
• For the new Fellow salary scale in the SECA, the
district places Fellows/Medical officers on this scale
once they have received their fellowship, and before
they receive vocational registration.
• For the Specialist step placement, the district bases
this off the date vocational registration was achieved
and how many years of experience they have had as
a specialist. Since the new SECA has been
implemented, there are now different rulings. The
placement of a SMO on the specialist scale will be
the date they became eligible for vocational
Area
Guidelines for determining SMO salaries
registration (when they became a Fellow), this will
also be used as their increment date.
Southern
It is based on the date of their fellowship for the New
Zealand/Australian-trained SMOs or Board Certification
(including those issued by overseas equivalent
professional registration bodies) and the date when they
become a specialist.
(refer to attached
Appendix 1-D)
Waikato
Medical Officers (general registration)
• years of relevant experience as a medical officer,
usually excludes 2 years house officer.
Specialists
• years of relevant experience as a specialist
(vocational registration in the branch of medicine
employed).
• internal relativities also considered alongside the
salary steps of existing SMOs of similar qualifications
and experience.
From the 2023 Collective Agreement
• step placement now counts from the time they met
the requirements for vocational registration (rather
than actual date of vocational registration) as does
the date for the first step progression, then annual (cl
12.2(a)).
Whanganui
The district counts the number of years since vocationally
registered/board certified, i.e. Step 1 from first year as
consultant.
“Part B: In how many cases in the last 10 years have SMO's been found to have been placed
incorrectly on the salary scale and subsequently had this amended?”
This information is not tracked in existing Health NZ systems. This part of your request is
therefore refused under section 18(e) of the Act as this information does not exist.
How to get in touch
If you have any questions, you can contact us at
[email address]. If you are not happy with this response, you have the right to make a complaint to the
Ombudsman. Information about how to do this is available at
www.ombudsman.parliament.nz
or by phoning 0800 802 602.
As this information may be of interest to other members of the public, Health NZ may
proactively release a copy of this response on our website. All requester data, including your
name and contact details, will be removed prior to release.
Nāku iti noa, nā
Andrew Slater
Chief People Officer
People and Communications
TeWhatuOra.govt.nz
Health NZ, PO Box 793,
Wellington 6140, New Zealand
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APPENDIX 1-B
CONFIDENTIAL
ASMS MECA Step Placement Principles
(Reviewed August 2021)
1. CRITICAL REQUIREMENTS
a. In order to ensure that Auckland DHB is applying a consistent and compliant approach to step placement for all
SMOs, it is critical that:
All decision-makers are familiar with these principles and apply them to all step placement decisions
All required approvals are confirmed before any offer is communicated, and a record of those approvals is
kept on the SMO’s file for future reference
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o
Requests for such approvals must be made in writing and must provide all relevant information –
including information regarding internal relativities for the Directorate and in other comparable
services across Auckland DHB
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The key considerations and rationale for
all decisions made regarding placement on the Specialist Salary
Scale must be recorded and kept on the SMO’s file, together with a record of negotiations with an SMO over
their step placement on commencement of employment (e.g. emails exchanged/proposals/responses)
For Medical Officers and Fellows, where a decision departs from the formula/guidance below, the key
considerations and rationale must be recorded on the SMO’s file.
These Placement Principles will be reviewed everytime the MECA is re-negotiated or prior as appropriate, by
ER/IR Manager, HR Director – Partnering and Management, Chief Medical Officer and SMO Subject Matter
Expert from the Recruitment Team, to ensure that they are still valid and consistent with any changes to the
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MECA.
2. MEDICAL OFFICERS (MOs) and FELLOWS
a. Medical Officers
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Step placement for Medical Officers (MO) will depend on the their qualifications and experience and will be
determined on a case by case basis in accordance with Clauses 11.4 and 12.2(a) of the ASMS Collective
Agreement (MECA).
the
Auckland DHB applies the following formula to guide decisions about placement on the Medical Officer Scale:
Total of Registrar years and Medical Officer years worked (excluding years worked as a House
under
Officer), less three years
= Relevant year on the Medical Officer Scale = Salary Step
Notes:
If application of this formula produces a result that is significantly less than remuneration as an RMO
(for an equivalent job size) then the HR Director – Partnering and Management may approve a higher
step.
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If there are other reasons why the Head of Department and/or Service Clinical Director does not wish
to apply the formula and/or believes the outcome of applying the formula is unsuitable, approval for a
different approach may be given by the Chief Medical Officer.
b. Fellows
As Fellowship roles are training positions, Fellows are generally appointed on Step 1 of the Medical Officer scale
regardless of their background, experience or registration status, but may also be appointed on terms and
conditions applicable to a Registered Medical Officer (RMO) if they are working an RMO roster. Any deviation
should be approved by the Chief Medical Officer.
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Notes:
If a specialist with vocational registration currently employed with Auckland DHB takes up Fellowship training
in another specialty, they will be moved from the Specialist scale and placed on the relevant step of the MO
scale for the duration of the training. The move from one scale to the other will be approved by the HR
Manager for the Directorate.
However, a specialist undertaking a Fellowship training role within a sub-speciality (of the specialty in which
they are employed to work) will continue on the Specialist scale. Also, some specialties like Radiology may
employ newly qualified specialists in a Junior Specialist role as a Fellow for sub speciality training. These
doctors, if registered as a specialist, will be placed on the SMO scale.
A Fellow currently or previously employed on Step 1 moving/coming back to another Fellowship role after 1
year will progress to Step 2.
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3. SENIOR MEDICAL OFFICERS (SMOs)
Step placement for SMOs will depend on the SMO’s qualifications and experience and will be determined on a
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case by case basis in accordance with Clauses 11.3 and 12.2(a) of the MECA.
Clause 11.3 defines a Medical Specialist to mean any medical practitioner:
Who is vocationally registered by the Medical Council;
In one of the approved branches of medicine;
Employed in that branch of medicine; and
Has minimal oversight.
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SMOs who meet the above definition are eligible to be placed on the Specialist Salary Scale.
The following principles apply when deciding where to place the SMO on the Specialist Salary Scale:
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Under the MECA, placement on the salary scale is by negotiation.
Any negotiation must be in consultation with the Service Clinical Director and the HR Manager for the
the
Directorate.
In negotiating the appropriate step placement, regard should be had to:
o
Relevant experience
o
Qualifications
o
Alignment with the placement of existing employees with similar qualifications and experience.
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Salary step is determined with reference to the National DHBs Principle – Application of the MECA Salary
Scale (updated 2020)
4. NEW ZEALAND GRADUATES
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For New Zealand qualified doctors to be placed on the Specialist Salary Scale, they must have Vocational
Registration (VR) with the Medical Council of New Zealand.
To determine their position on the Specialist Salary Scale (if they have VR), SMO experience includes
all
experience since the date of VR and may also include
relevant experience prior to attaining VR – e.g. any
fellowship in a relevant discipline.
Because an SMO cannot be placed on the Specialist Salary Scale until they have attained VR, they should be
aware of the following:
a. The time period between Fellowship being awarded and VR is a process of verifying documents and can take
3-6 months once the VR application has been lodged. In most cases this period will not be more than 6 months.
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b. When a doctor applies for VR on achievement of the Fellowship, the doctor may not be employed in the role
of an SMO on Step 1 of the SMO scale until they have provided Payroll with a copy of the VR APC. Their date of
commencement in the role following receipt of the VR APC becomes their anniversary date. A clause to this
effect must be included in their employment agreement.
Other considerations for New Zealand medical graduates are as follows:
a. .
When a doctor has attained VR during Fellowship training, they remain on the Medical Officers scale
until this training period has been completed. If they are offered a role as an SMO they will be paid on the
Specialist scale from their date of commencement in the SMO role. Their anniversary date is the date on
which they commence in the SMO role.
b. In some cases, the doctor may go overseas soon after gaining Fellowship and defer their VR until they return.
Reasons for this could be to obtain further training or to gain specialist registration and employment in
another country for a period of time. Relevant experience in such cases may include the time spent on the
overseas fellowship, but they will not be eligible to be placed on the Specialist scale until they have attained
VR. If experience gained on any fellowship prior to attaining VR (whether undertaken overseas or not) is to
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be taken into account for the purposes of negotiating step placement, one or more of the following should
generally apply:
The fellowship was undertaken in the same discipline in which the SMO is going to be working at
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Auckland DHB, or, in Auckland DHB’s assessment, a closely related discipline
The experience gained on the fellowship has been a key factor in Auckland DHB’s decision to offer
employment to the SMO
The knowledge gained during the fellowship will add other demonstrable value to the Service or
Directorate such that it should be recognised in the SMO’s remuneration.
c.
VR in one speciality will count towards experience for determining salary step for appointment as a Specialist
in a new speciality. However, VR in one speciality will not entitle the doctor to be placed on the SMO scale if
they undertake Fellowship training in another speciality – see above.
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d. Where the SMO has an additional ‘super’ speciality qualification within the speciality, there may be provision
for an additional step to be awarded after considering internal relativities. This decision will be approved by
the HR Manager for the Directorate.
5. INTERNATIONAL MEDICAL GRADUATES (IMG)
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UK and IRISH DOCTORS
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SMO experience is counted from Certificate of Completion ()date (and not VR in NZ). CCT is issued by the General
Medical Council (GMC) of the UK and the Fellowship equivalent, which allows the doctor to go on the GMC
Specialist Register. This date is available on the GMC Website.
USA DOCTORS
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SMO experience is counted from the date they became Board Certified.
OTHER COMPARABLE HEALTH SYSTEM DOCTORS (including Australia)
SMO experience is counted from the date they started working in a specialist role and/or qualified to be a
specialist.
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6. GENERAL NOTES
Annual Practice Certificate (APC)
Doctors must not start in the role until they have gained the APC for the relevant registration in New Zealand for
their applicable scope of practice i.e. General registration for appointment on Medical Officer Scale and
Vocational/Locum Tenens for the Specialist scale.
Anniversary Date
For all IMG doctors joining Auckland DHB from overseas, date of commencement in an SMO role is the
anniversary date for Step increases.
All NZ registered specialists coming to us from another DHB or returning to NZ can use the VR date as their
anniversary date if approved at a Service level. Otherwise, anniversary dates for NZ registered specialists will be
as provided for above
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SMO Workbooks are required for all doctors appointed under the ASMS MECA.
Credentialing is required for all appointments on the Specialist scale.
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Allowances must be included in the SMO workbook and all allowances, other than on call and availability must be
detailed in the SMO’s offer letter.
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APPENDIX 1-C
NATIONAL DISTRICT HEALTH BOARDS’ PRINCIPLE
APPLICATION OF THE MECA SALARY SCALE
The national DHB MECA clauses 12.2 (a) and (b) state:
“(a) The initial placement of an employee on the applicable salary scale shall be negotiated between
the prospective employee and employer, in consultation with the clinical director (or equivalent) of the
applicable service and taking into account 12.2 (b) below and factors such as years of relevant
experience and qualifications.
(b) The parties recognise that the new salary scales introduced from 1 January 2012 for Medical and
Dental Specialists and Medical and Dental Officers have removed the bottom three steps of the
previous scales. To avoid potential inequities in placement of new employees it is agreed that initial
placement should take into account relevant years of experience and relevant qualifications, and align
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with step placement of the existing employed workforce with similar levels of qualification and
experience.”
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This Principle should be read in conjunction with the Senior Medical and Dental Officers Collective
Agreement (MECA) and the Regional Operational Protocols for Senior Medical and Senior Dental
Officers – Job Size and Remuneration January 2006.
DEFINITIONS
“Medical Specialist” means any medical practitioner who is vocationally registered by the Medical
Council under the Health Practitioners Competence Assurance Act 2003 in one of the approved
branches of medicine and who is employed in either that branch of medicine or in a similar capacity
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with minimal oversight.
“Fellow” means any medical practitioner that meets the definition of “Medical Officer” as per the
MECA, and who is appointed to a Fellowship role. A medical practitioner appointed to a Fellow role
may or may not be vocationally registered. They will have completed all training requirements but may
not have completed enough time within the training programme to be vocationally registered. The role
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is likely to require a degree of oversight.
“Medical Officer” means any medical practitioner who is registered under the Health Practitioners
the
Competence Assurance Act 2003 and who falls within the coverage clause of the MECA Agreement
and who is not a medical specialist. Therefore Fellows are considered to be Medical Officers within
this definition.
“Dental Specialist” means any dental practitioner who is registered by the Dental Council under the
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Health Practitioners Competence Assurance Act 2003 as a dental specialist in one of the approved
branches of dentistry and who is employed in that branch of dentistry or in a similar capacity with
minimal oversight.
“Dental Officer” means any dental practitioner who is registered under the Health Practitioners
Competence Assurance Act 2003 and who falls within the coverage clause of the MECA Agreement
and who is not a dental specialist.
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BACKGROUND
In regard to the employment offer, the appropriate scale must be determined ((a) Medical and Dental
Specialists or (b) Medical and Dental Officers). Then the appropriate step must be determined, taking
into account DHB MECA clauses 12.2(a) & (b) and the following principles.
National Principle Application of the MECA Salary Scale - December 2012
PRINCIPLES
SPECIALISTS
•
Medical or Dental Specialists should be placed on the step commensurate with their years of
relevant experience since vocational registration, and relevant qualifications and align with step
placement of existing workforce with a similar level of qualification and experience.
•
To maintain relativity with employed Specialists, placement on the MECA step will be based on the
current to new step translation as stated in the MECA clause 12.4(a), therefore for all
appointments in 2012, the benchmark for step one for a Medical or Dental Specialist is up to four
years of experience since becoming eligible for vocational registration. (NB given the translation
retained the original service date for those on Step 4, a Specialist with 4 years’ experience who
translated to Step 1 will have incremented to Step 2 during the 2012 calendar year; those
Specialists on Steps 1 to 3 had their increment dates reset to 1 January).
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•
In alignment with the MECA, five years of experience will equate to Step 2 with each additional
year of experience being place on the next step accordingly.
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•
As the original cohort affected by the changes progresses through the scale (based on
accumulation of service) this ‘benchmark’ will move with them. For example, SMOs with 1 to 4
years’ experience who translated to Step 1 in the new scale on 1 January 2012, will have accrued
2 to 5 years’ experience and progressed to Step 2 by 1 January 2013, so this would become the
benchmark. See below for complete table.
•
Where vocationally registered preceding a Fellowship appointment, the time spent in that
Fellowship role, will be recognised upon subsequent appointment to a Medical or Dental Specialist
role.
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FELLOWS & MEDICAL OFFICERS
•
Appointment to a
Fellow role will be on a step commensurate with the years of relevant
experience within the employing specialty and align with step placement of existing workforce with
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a similar level of qualification and experience.
•
To maintain relativity with employed Fellows, placement on the MECA step will be based on the
the
current to new step translation as stated in the MECA clause 12.4(c) noting that placement on
Step 1 is based on up to four years of experience for all appointments in 2012. This benchmark
will shift over time in the same manner as for Specialists.
•
Appointment to a
Medical or Dental Officer role will be on a step commensurate with the years of
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relevant experience within the employing specialty as per the following formula. This is calculated
as the aggregate of worked Registrar years and Medical Officer years, less three years (steps).
This formula maps the step that will equate the base step remuneration at a level relative to the
RMO scale. If this produces a result that is significantly less than remuneration as an RMO (for an
equivalent job size) then the GM-HR may approve a higher step.
GENERAL
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•
Time spent not practicing as an SMO is not counted as part of “years of relevant experience”
subject to Clause 12.5, below:
Clause 12.5 Absence due to Approved Unpaid Leave
a) Notwithstanding any of the provisions of this clause, an employee on approved
parental leave under Clause 28 of this Agreement shall receive their annual salary
advancement on the due date when it falls during the period of leave.
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National Principle Application of the MECA Salary Scale - December 2012
b) Subject to meeting the threshold of satisfactory performance an employee is entitled
to receive their annual salary advancement unless they have had more than six
months of approved unpaid leave in the period under review
c)
Employees who have had more than six months approved unpaid leave shall be paid
a pro rata lump sum payment on their advancement date subject to satisfactory
performance in the period worked.
d) The pro rata payment will be calculated on the difference between their current salary
step and the next step on the salary scale.
e) Notwithstanding this provision, however, subject to meeting the threshold of
satisfactory performance, employees are entitled to receive their full annual salary
advancement if their unpaid approved leave is for the purpose of gaining further
experience or professional development relevant to their duties and responsibilities.
•
SMOs who have not trained in an Australasian training programme or have worked overseas prior
to their New Zealand employment, for purposes of step and scale (specialist or medical officer)
placement, will generally be recognised for “years of relevant experience” worked in their overseas
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position, even though they may not be vocationally registered at time of appointment and are
required to be supervised for a period before vocational registration is granted. Act
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Recognition of PhD and MD qualifications may be taken into account for step placement. Other
training qualifications are generally considered part of professional development for SMOs and
shall not be taken into account. Final approval shall rest with the GM-HR.
•
Annual increments should be one step only. However, recognition of PhD and MD qualifications
once employed within the DHB may occur through step increase only where the SMO has taken
leave and has materially forfeited their annual step increment. Any other remuneration
enhancement should not be by way of advancement of steps.
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•
Each SMO appointment and remuneration offer shall be approved by the GM-HR (or their
delegate) and CMO. If an SMO Appointments Committee is active then the CMO may delegate
this responsibility to the committee who shall maintain oversight of SMO remuneration components
(i.e. step placement and any enhancements).
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•
Application of the SMO Scale is as per the following table which also includes the basis of
placement
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TABLE ONE: APPLICATION OF MECA SALARY SCALE
SPECIALIST
FELLOW
MEDICAL OFFICER (MO)
Definition
“Specialist” per the MECA is
“Fellow” means any medical
“Medical Officer” per the
defined as any medical
practitioner that meets the
MECA is defined as any
under
practitioner who is
definition of “Medical Officer”
medical practitioner who is
vocationally registered by the
as per the MECA, and is
registered under the Health
Medical Council under the
appointed to a Fellow role. A
Practitioners Competence
Health Practitioners
medical practitioner appointed
Assurance Act 2003 and who
Competence Assurance Act
to a Fellow role may or may
falls within the coverage
2003 in one of the approved
not be vocationally registered.
clause of the MECA
branches of medicine and
They will have completed all
Agreement and who is not a
who is employed in either
training requirements but may
medical specialist.
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that branch of medicine or in
not have completed enough
a similar capacity with
time within the training
minimal oversight.
programme to be vocationally
registered. The role is likely to
require a degree of oversight.
Criteria
•
Appointment to a
•
Appointment to a Fellow
•
NOT appointed to a role
specialist role
role
as Medical Specialist
•
SMO is vocationally
•
Completion of all training
•
MO is NOT in a registrar
registered
requirements for specialist
role (neither training nor
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National Principle Application of the MECA Salary Scale - December 2012
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Step on
Application of MECA Salary Scale – Expected years’ experience as at:
Scale
1 Jan 2012
1 Jan 2013
1 Jan 2014
1 Jan 2015
1 Jan 2016
1 Jan 2017
1 Jan 2018
1 Jan 2019
1 Jan 2020
1 Jan 2021
1
1st – 4th year
1st year
1st year
1st year
1st year
1st year
1st year
1st year
1st year
1st year
2
5th year
2nd – 5th year
2nd year
2nd year
2nd year
2nd year
2nd year
2nd year
2nd year
2nd year
3
6th year
6th year
3rd – 6th year
3rd year
3rd year
3rd year
3rd year
3rd year
3rd year
3rd year
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4
7th year
7th year
7th year
4th – 7th year
4th year
4th year
4th year
4th year
4th year
4th year
5
8th year
8th year
8th year
8th year
5th – 8th year
5th year
5th year
5th year
5th year
5th year
6
9th year
9th year
9th year
9th year
9th year
6th – 9th year
6th year
6th year
6th year
6th year
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7
10th year
10th year
10th year
10th year
10th year
10th year
7th – 10th year
7th year
7th year
7th year
8
11th year
11th year
11th year
11th year
11th year
11th year
11th year
8th – 11th year
8th year
8th year
9
12th year
12th year
12th year
12th year
12th year
12th year
12th year
12th year
9th – 12th year
9th year
10
13th year
13th year
13th year
13th year
13th year
13th year
13th year
13th year
13th year
10th – 13th year
11
14th year
14th year
14th year
14th year
14th year
14th year
14th year
14th year
14th year
14th year
12
15th + year
15th year
15th year
15th year
15th year
15th year
15th year
15th year
15th year
15th year
13
16th + year1
16th + year
16th + year
16th + year
16th + year
16th year
16th year
16th year
16th year
14
17th + year2
17th year
17th year
17th year
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15
18th + year3
18th + year
18th + year
1 As at
1 October 2013, all specialists who have been on Step 12 for 1 year or more move to Step 13 and
new staff with 16+ years’ experience are placed on Step 13
2 As at
5 March 2018, all specialists who have been on Step 13 for 1 year or more move to Step 14 and
new staff with 17+ years’ experience are placed on Step 14
3 As at
1 April 2019, all specialists who have been on Step 14 for 1 year or more move to Step 15 and
new staff with 18+ years’ experience are placed on Step 15
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