NATIONAL 22 August 2019
Dear Member,

Welcome to the 13th issue for 2019 of ASMS Direct, our national electronic publication. 

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24-hour MRT Strike – 7am Monday 26 August to 7am Tuesday 27 August

Some time ago APEX (the union covering MRT staff employed by DHBs) gave notice of a 24-hour day strike by DHB-employed MRTs from 7am Monday 26 August until 7am Tuesday 27 August. This will put radiology and other services (particularly emergency departments) under pressure early next week.

We are aware that DHBs have negotiated agreements with APEX for the delivery of Life Preserving Services (“LPS”) during the strike. These agreements include provision for the appointment of what is called a ‘gatekeeper’ and ’gatekeeper protocols’.

The gatekeeper is a radiologist or an “agreed alternative clinician” at the DHB with the relevant scope of practice, competence and ability to perform the role during the strike period. We should note that the term ‘gatekeeper’ is not a legal term appearing in a statute but has been adopted by the parties to the LPS agreement.

Under the gatekeeper protocols, in the first instance, the clinician treating the patient shall raise directly with the gatekeeper a request for LPS assistance, including the grounds for making the request.

The role of the gatekeeper is to determine whether it is appropriate to proceed with the request for LPS. In making that determination, the gatekeeper may consult the treating clinician or any other clinician the gatekeeper considers necessary.

This is a cumbersome process to vet, second guess or filter requests for radiology services during the strike and appears to undermine the clinical judgement of the clinician treating or assessing the patient in the first place. Further, it places the radiologist (or other) gatekeeper in the invidious position of potentially challenging the clinical assessment of a colleague in a different speciality and scope of practice. The appointment of gatekeepers raises collegial and ethical issues we believe should be avoided.

Our advice is you may avoid these difficulties and risks by declining to act as a gatekeeper. You are under no legal or contractual obligation to your employer to accept a gatekeeper role.

However, if you do decide to accept a gatekeeper role, we strongly advise you to carefully read and understand your DHB’s agreement with APEX for the provision of Life Preserving Services and become familiar with the definition of Life Preserving Services and the obligations and role you have agreed to take on.

If you remain concerned, you should contact MPS or your medical indemnifier or an ASMS industrial officer for further advice.

ASMS was not consulted by DHBs about this strike or their LPS agreements with APEX. Nor did they seek our advice as to payment for any member who takes on a gatekeeper role. Nevertheless, members have begun to ask us what they should be paid if they take on a gatekeeper role.

Our advice is: you should be paid the relevant rates for additional shifts, duties or hours that DHBs negotiated with ASMS and agreed to pay during the RDA strikes earlier in the year. That agreement and those rates are available online at

We also note that some members, who may not be gatekeepers, may find themselves working additional hours or different shifts or duties during this strike. This is quite likely to occur in emergency departments. In these cases, we would expect the additional remuneration negotiated and agreed with DHBs’ nationally, that applied during the recent RDA strikes, to also apply during this strike of MRTs.


Kind regards,

Ian Powell