National 22 May 2017
Dear Member,

Welcome to the 5th 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 and LinkedIn pages, as well as our quarterly magazine The Specialist. We’re also on Twitter at

Upcoming health Budget is a test of Government’s commitment to public health care

In a few days we will find out if the Government is prepared to let public health care funding slide even further (ie, funding increases significantly less than cost increases including demographic growth for every year since 2009/10) or if it’s going to give the district health boards (including public hospitals) the resources they actually need to look after the health of New Zealand’s communities.

The Government’s Budget for the coming year will be revealed this Thursday 25 May. A pre-Budget analysis by the Council of Trade Unions in conjunction with ASMS Policy & Research Director Lyndon Keene shows that the money allocated for Vote Health will need to rise significantly just to maintain the health services we already have.

As we said in our media release on the pre-Budget analysis, the Government faces a stark choice between stepping up and doing what is morally and fiscally responsible, and the alternative of letting even more people languish in pain as they try to access surgery and other treatment.

The full ASMS media release, including a link to the CTU-ASMS pre-Budget analysis, is on our website at

West Coast DHB being pushed into funding deal that will take money from patient services; implications for other DHBs

ASMS has exposed efforts to force a public ‘private’ partnership on the West Coast DHB that would take money away from patient care and hand it to third party investors. We have learnt that the DHB is being forced to lose its Crown owned land to ACC, which will then build an integrated family medical centre in Westport – incorporating the current earthquake risk Buller Hospital – and then lease the facility back to West Coast DHB.

It is estimated that the increased cost for West Coast DHB through this novel arrangement is between $750,000 and $1,000,000 each year for at least the next 34 years compared with the conventional funding method for capital works. The difference is in the rate of return. That is, the rate of return when the DHB loans from and then repays Government is significantly greater than what the DHB pays the third party (in this case ACC). Just to clarify this is not linked to any ACC rehabilitation or treatment programme; it is part of ACC’s financial investment strategy.

The deal is being brokered by a so-called Partnership Group, on behalf of the Government, and the DHB has been sidelined in the whole process. While ACC is a Crown entity, in this deal it will be operating like a private firm seeking to profit from the financial arrangement.

The full ASMS media release and background Q&A is available online at
Shortly after we put out a media release revealing the back-room deal and the likely consequences, the Ministry of Health issued its own release to confirm the funding arrangements for building the new Westport facility:

This is a form of public-private partnership that it is being rebranded ‘capital recycling’ in order for the Government to distance itself from the opprobrium associated with PPPs, particularly in England. The implications go well beyond this small new facility on the West Coast. It is being considered for the building of a post-earthquake new outpatient centre in Christchurch and no doubt will be floated at least in the Dunedin Hospital rebuild.

ASMS submission on funding formula for vocational training

ASMS has made a submission to Health Workforce New Zealand on the discussion document ‘Investing in New Zealand’s Future Health Workforce’, which outlines a proposed new approach to funding postgraduate training.

We noted that the ‘consultation process’ – two national workshops for selected sector representatives, with lightly detailed background papers – had been disappointing. The proposal itself raises more questions than answers, and these had not been resolved during the poorly managed workshop discussions.

HWNZ argues that the current health workforce is not well aligned to current and projected future health needs (with which we agree). It proposes to better manage post-entry training by redistributing current training resources to areas deemed as having greatest need through a process of competitive tendering (with which we strongly disagree). From our assessment, the proposed funding approach would be unlikely to achieve the stated aim of a future health workforce that is fit-for-purpose, and it presents a high risk of damaging unintended consequences.

Our full submission is available online at

Did you know…about job descriptions?

The DHB is required to consult you whenever it plans to employ a senior medical or dental officer in the same service or on the same roster. Clause 52.1 of the DHB MECA says you are to be consulted on the need for the appointment, the nature of the role, and the skills, qualities and experience appropriate for the appointment. If required, a new or revised job description must be prepared.
More information:

Kind regards

Ian Powell
Executive Director