National 10 January 2017
Dear Member,

Welcome to the second issue for 2017 of ASMS Direct, our national electronic publication.

You can also keep in touch with the latest news and views on health issues relevant to public hospital specialists via our website, which contains links (at the top of the home page) to our Facebook, Twitter and LinkedIn pages, as well as our quarterly magazine The Specialist.

Farewell Dr Chris Cresswell

We are saddened by the tragic death of our Whanganui Branch President Dr Chris Cresswell while mountain bike riding on 31 December 2016.

Dr Cresswell was the acting clinical director of the emergency department at Whanganui Hospital and very popular among his professional colleagues and in the community.

He was a highly passionate and compassionate doctor, full of exuberance. While concern for the patients he treated was central to his work, he also saw the role of the doctor extending into broader issues, including the effects of environmental and trade policies on people’s health and well-being.

This involvement in broader issues also required courage, a personal quality he had an abundance of.

I attended an impressive Powhiri and service for him in Moutoa Gardens, Whanganui, last Saturday. The willingness of the Iwi to make this historically significant site available for these events by itself was a significant reflection of the high esteem that Maori placed in Dr Cresswell. They were very moving and powerful events that were attended by around 1,000 people including emergency medicine specialists from other parts of New Zealand. Dr Cresswell clearly deeply touched the lives of so many.

Our thoughts are with his family, friends and colleagues at this sad and difficult time.

Resident Doctors’ Association letter to ASMS members on their MECA dispute with DHBs

Through their own means DHBs have been directly or indirectly distributing to SMOs their views of the industrial dispute between them and the RDA on behalf of resident medical officers which has led the decision to hold a three-day strike commencing Tuesday 17 January.

To provide some balance below is a link to a letter from the RDA to ASMS outlining their perspective. Please note that it is dated 22 December, about a week before the RDA gave the DHBs formal strike notice. (

Despite the issuing of formal strike notice negotiations between the parties have continued most recently as today in an endeavour to reach a settlement or at least make good progress in which case the strike would be called off.

DHB Chief Executives happy to receive, less willing to give

The latest report on district health board chief executive salaries shows that they are continuing to get higher pay rises than they’re prepared to give others. In a media release yesterday we said:

“Once again we’re seeing that the level of pay rises being handed to the people running our public hospitals is out of sync with what is being offered to those doing front line clinical and other work. They really need to think about the message they’re sending by doing this.”

ASMS analysis of the figures found that district health board chief executive salaries increased by a conservatively estimated 2.2% in the year from June 2015 to June 2016, excluding end-of-contract payments. This is more than five times the inflation rate (0.4%) for that period. Looking at a longer timeframe, chief executive salaries appear to have increased by an average of 20.6% from June 2010 to June 2015.

Meanwhile, they are insisting in collective agreement negotiations that the staff they employ accept a 1% pay rise in the first year. (

The need for greater physician advocacy in the 21st century

“Senior doctors naturally advocate for their patients as part of providing quality health care but there are interesting questions to consider about what form this advocacy should take and how far it should go.”

This was the subject of a media release from ASMS last week. (

This is highlighted in an article in the December issue of The Specialist ( The article was written by Associate Professor Phil Bagshaw, who is a general surgeon and also chairs the Canterbury Charity Hospital Trust, spoke on this topic at the recent ASMS Annual Conference in Wellington.

Associate Professor Phil Bagshaw is one of this country’s leading proponents on active advocacy by senior doctors and other health professionals in the face of high levels of unmet health needs and continual belt-tightening within public hospitals. He argues very eloquently for a much greater level of physician advocacy, which I’m sure will resonate with many doctors and stimulate some thinking and discussion among others.

In the article, Phil Bagshaw writes that the history of physician advocacy has much to teach the doctors of today, and is as relevant as ever in the current constrained environment.

He urged senior doctors, and the professional organisations representing them, to actively advocate for patients’ health and safety.

“Patients want us to be their champions and to fight publicly and effectively for their right to health care. Who else, they believe, is as well placed as we are to do so? It is undoubtedly a privilege to represent them in this way.”

Deafening clamour from alarm bells going off in the public health sector

In a media statement released between Christmas and New Year ASMS asked how many times do alarm bells have to go off in the public health sector before the Government and DHBs sit up and take notice.

There are a myriad of signs that the health system is under unsustainable pressure. These include significant unmet health need in the community, comparisons with the Mid-Staffordshire hospital scandal, high levels of burnout and presenteeism among the senior medical workforce, and ASMS research showing that a quarter of surveyed senior doctors intend to leave either medicine or their district health board within the next five years. (

Kind regards
Ian Powell