Senior doctors welcome new Medical Council Chair

Source: Association of Salaried Medical Specialists

The senior doctors’ union welcomes the election of Dr Curtis Walker as the Medical Council’s new chair.

The Medical Council of New Zealand announced yesterday that Dr Walker, a renal and general physician at MidCentral District Health Board, is to take over the role from Auckland surgeon Andrew Connolly (

Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS), thanked Mr Connolly for his leadership of the Medical Council.

“His dedication to the medical profession coupled with a common sense approach to resolving issues has made him a superb leader, and ASMS has enjoyed working with him,” says Mr Powell.

“We are delighted to welcome Curtis Walker to the role and look forward to continuing our good relationship with the Council.”


Opinion: Ian Powell – Leadership needed on safe staffing

Source: Association of Salaried Medical Specialists

When Health Minister David Clark was publicly criticised for dropping a requirement on his health ministry to publish the results of a set of narrow and misleading health targets in public hospitals, I defended him.

The Minister’s decision to drop this reporting showed a willingness to engage in a more thoughtful and effective fashion with his portfolio, which included exploring more robust alternatives.

Politically-driven targets cause potentially dangerous unintended consequences, especially in an environment of sustained underfunding. They are highly likely to have contributed to some patients going blind while waiting for eye-care appointments. It’s what can happen when DHBs are pressured to put crude surgery volumes ahead of monitoring patients with chronic conditions and necessary clinical follow-ups.

That is the legacy of the previous Government’s targets, particularly those in hospitals, and its overall approach to health. It tacitly encouraged poor decision-making, short-term thinking, and in some cases, neglect. The health system has too many moving parts and complex problems to distil into simplistic widget counts. The damage caused by the rigid application of targets was exacerbated by underfunding and short-staffing.

The false sense of productivity and transparency engendered by the targets (reinforced by financial retrenchment) papered over a workforce staffing crisis and poor service planning (within and between DHBs). It’s easy to see their attraction for publicity-sensitive politicians, so we admired Dr Clark for doing something brave and sensible.

We are less impressed by his attitude to an idea we put forward to combat the crisis in specialist staffing. We believe the specialist workforce is short by about 20%, an estimate derived from surveys of clinical leaders around the country. What more damning evidence is required than the shocking 50% burnout rate experienced by our highly qualified overworked hospital specialists.

Read more here:


Hospital specialists under increasing pressure due to under-estimated strength of strikes

Source: Association of Salaried Medical Specialists

“Health bosses have under-estimated both the level of support for the ongoing strikes by resident (junior) doctors and the impact on hospital specialists who are shouldering heavy workloads as a result,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

Resident medical officers (RMOs) who belong to the Resident Doctors Association (RDA) have walked off the job twice over stalled negotiations on a new collective employment agreement, and plan to strike again for 48 hours from 12 February. Members are also being balloted on a potential fourth strike.

Mr Powell says the strikes have energised the RMO workforce, with doctors concerned by the DHBs’ strategy in the negotiations to roll back on earlier gains over safer working hours and to undermine the effectiveness of their union.  Instead RDA membership has increased.

Senior doctors, meanwhile, are challenging the message from health bosses that hospitals are coping well during the strikes.  “The reality is somewhat different for people on the clinical front line,” he says.

“Our members are telling us that they are under intense and increasing pressure as they shoulder heavier workloads during strikes caused by the DHBs’ failure to reach an agreement. Specialists are tired and frustrated, and they’re already seeing the effects on patient care and waiting times.”

A hospital specialist who is also a clinical leader and who did not wish to be named says:

“I have done nothing else for the whole of January other than contingency planning and begging favours. No quality improvement work, no winter planning, no RMO education.

“DHBs implying it’s business as usual is – at best – particularly disingenuous and also a slap in the face to those who are actually shouldering a heavy and increasing burden, while the ‘masters of industry’ sit in their offices making their battle plans.”

Mr Powell says other senior doctors have also communicated their frustration to ASMS with the DHBs’ lack of progress to settle the dispute.

“They are really under the pump to do more work and it’s obviously very frustrating and concerning for patients if clinics or surgery lists are cancelled or pushed back. DHBs need to urgently resolve this entirely avoidable situation.”


MIL-OSI New Zealand: Solution to district health board financial deficits rests with the Government

Source: Association of Salaried Medical Specialists

“The solution to district health boards’ financial deficits rests with the Government.”

This was response to the published report that almost all DHBs were tracking towards financial deficits for the financial year ending 30 June from Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS). Read the New Zealand Herald story here:

“There are three main reasons for these deficits.  The first is the effects of eight successive years of underfunding that the current Government inherited.  The Labour led coalition improved funding in its first year, but one good year does not compensate for eight years of underfunding.  Underfunding leads to DHBs being forced to defer essential work such as building maintenance which only becomes more expensive when it eventually has to be paid for.”

Mr Powell added that the current Government is responsible for further increasing health funding to address this failure.

“The second reason is that the costs of treating acutely ill patients is continuing to increase due to factors such as the aging of the population, population growth and the effects of poverty.  Cost increases due to increased demand are greater than funding increases.

“The third reason is that there is a lot of waste and duplication in DHBs because of the lack of clinical leadership distributed through the senior medical workforce.  Genuine engagement with senior doctors would improve both the quality of patient-centred care and financial performance.

“Senior doctors are experts in complexity.  They are well placed to contribute to improving the financial performance of DHBs by improving complex systems.  But how can they when there is a lack of a sufficient engagement culture in their DHB.  Further, how can doctors who are overworked, burnt out, and working while sick (even infectious) make this contribution?”

Mr Powell said the Minister of Health had to take responsibility for requiring DHBs to genuinely support distributing clinical leadership throughout the specialist workforce and to address the crisis of specialist workforce shortages.

MIL OSI New Zealand