Photo: Getty

On doctors, unions and competing interests

We in the medical profession can learn something from the new chief of police in Minneapolis, writes Dr David Galler.

Following the death of George Floyd the spotlight has rightly settled on a close examination of police behaviour, as well as on the role of the police unions in setting and maintaining a culture that seems to promote violence against citizens of colour and in protecting officers from being held accountable for it. This focus has led many to conclude that some police unions are primarily self-serving and not interested in meeting the needs of the public they are there to support and protect.

It is pleasing to note that in Minneapolis at least, the new chief of police, Medaria Arrodondo, not only made himself immediately accessible to protesters but has withdrawn from the police union contract negotiations in an effort to ensure that any restructuring of the contract will “provide more transparency and flexibility for true reform”.

He is looking for the transformation of a deeply dysfunctional service that has clearly lost its way – his goal is to create a force that the community will view “as legitimate, trusting and working with the communities’ best interests at heart” and to achieve that everything will need to change.

The United States of America, despite its great institutions, bastions of liberal thinking and brilliant people, is at its heart a dog-eat-dog place, where everyone seems to be fighting for themselves and where the ideal of the common good is seen as a socialist and therefore very bad idea. Unionism for good, or for bad, falls into that category.

Given this antipathy, the strength of the police unions and their pervasive influence over police culture might seem out of place, but it isn’t. It’s a reflection of a deeper and darker theme, the need to maintain control at all costs. They are not there to serve communities but to keep the peace in order to maintain the status quo and intertwined with that is a deep vein of systemic racism. Many of those police forces are, in many ways, like another gang and their unions give unionism a bad name.

The union movement I recognise was born as a result of the class system of a bygone time to protect the rights of people who were exploited and subjected to poor working conditions, low pay and few rights. Although much has changed in the world since the heady and combative days of our 1913 and 1951 strikes, the place of unions in New Zealand is still up for debate, reflecting quite stark ideological differences between different government positions on their place and influence.

Although these differences at home clearly pale into insignificance compared to what I saw in the United States during a sabbatical in Boston, when I was the Vice President of the Association of Salaried Medical Specialists (ASMS), they do need to be reconciled.

Many years ago, soon after I joined the ASMS and still wet behind the ears, I met Ken Douglas, then president of the CTU. It was a time when labour relations were on the up and the relationship between employers and employees was good with both sides recognising that they were in fact on the same side, the fortunes of both inexorably interlinked; the success of business depended totally on the wellbeing and engagement of their employees and vice versa.

I remember asking him, tongue in cheek, about what he thought of us, a union of well-to-do senior medical staff coming together to be even better off? He laughed and gave me the nuanced answer I had already come to myself – the success of our association rested entirely in aligning our aspirations and actions with those of the public, to continually fight for a high-quality public health service for all New Zealanders.

There is a fine balance here that unions like ours need to be constantly aware of, and the same goes for other medical associations like the colleges that represent the different specialty areas from general practice to medicine, paediatrics, anaesthesia and the surgical subspecialties.

I know from my time working within the bureaucracy that many there see doctors and doctors’ groups as primarily being self-serving, standing up primarily for their own interests and those of their narrow specialty group and not engaging in broader advocacy for issues important to society. My sense is that is changing and change it must.

In this era of climate change, and in the aftermath of our extraordinary success in managing the Covid-19 pandemic, at this time, ripe with opportunity, Heather Simpson’s report into the New Zealand health and disability system, will be released tomorrow. I expect and hope that it will be bold and challenging, and that it will provoke a wide ranging and open discussion about what the future might hold to keep us together to create a better, high quality health system that actively prevents disease, promotes wellness, addresses the gross inequities in access to services and outcomes that we see now and improve the health of all New Zealanders.

All of us will be watching – and we in the medical profession can learn a lot from Medaria Arradondo, the new chief of police in Minneapolis. This is the time to put aside narrow interests and to be “legitimate, trusting and working with the communities’ best interests at heart”.



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