1. FATIGUE AND BURNOUT

The National Executive considered the actions taken following the release of the ground-breaking research on SMO burnout carried out by the Association and released at our branch officers’ national workshop in August. These include:

• Letters sent to all chief executives of the 20 DHBs giving a heads-up on the pending release. Two versions were sent: one to the middle-sized DHBs that were identified as scoring particularly poorly for burnout and a different version to chief executives of all other DHBs.
   
• An invitation to present on burnout findings at the Waitemata joint SMO engagement workshop on 20 September has been accepted by Principal Analyst Dr Charlotte Chambers.
   
• Contact made with occupational medicine specialists.
   
• An abstract has been submitted on burnout findings to the Labour Employment and Work Conference (organised by Victoria University, Wellington). If accepted, the conference is in late November 2016.
   
• A journal article has been submitted to the BMJ Open on key findings from research with co-authors Charlotte Chambers and Professors Murray Barclay, Chris Frampton and Martin McKee.
   
• An invitation has been accepted for Dr Chambers to present on both presenteeism and burnout research at the national Geriatric Society retreat in November 2016.
   
• The burnout research has been included on the agenda for the next round of JCCs.  Where possible Dr Chambers will be attending and presenting at the middle-sized DHBs identified by the research and the larger DHBs.
   
• An article on burnout is planned for the next issue of The Specialist.
   
• Requests have been received from women members to assist with the establishment of a national women in medicine network to assist initially with strategies to deal with high rates of burnout in young women members.

The national office is working on a short advisory document setting out what can be done on the national level (for example, matching resources provided to the outcomes required from DHBs), the DHB level (for example, family friendly policies, resourcing services and departments for their job size), the service and department level (job sizing that allows for leave (including sick and domestic leave), recovery time, a supportive attitude to colleagues, a mentoring system, attention to the physical environment for staff) and the individual level (sustainable work habits, prevention strategies).
 

2. ASMS-MEDICAL STUDENTS ASSOCIATION JOINT COMMUNIQUE ON THE SPECIALIST WORKFORCE IN 2025

On 1 April ASMS and the New Zealand Medical Students Association held a joint special conference on the specialist workforce in 2025 in Wellington. This has been reported separately in The Specialist.  Subsequently the two associations have been working on a joint communique on the subject. Prior to the meeting MSA has already approved a worked through draft. On 1 September the National Executive also approved the draft document.

The next step will involve ASMS and NZMSA meeting to discuss how the communique will be promoted to the public, our respective memberships, DHBs, government and other interested bodies.

The National Executive also received a request from NZMSA for support for a proposed national teaching award for SMOs and RMOs. However, the Executive had some concerns about the specific proposal which have been forwarded to MSA.

ASMS and NZMSA have an agreed collaborative relationship which the National Executive considered and is keen to discuss its application in 2017.

3. DRAFT OLDER PERSONS HEALTH STRATEGY

Along with other organisations and the public, ASMS had the opportunity to make a submission on the Government’s draft Health of Older People Strategy within a very restricted time frame. In summary, the assessment was that the draft strategy was based on worthy goals but there were fundamental questions about resources to achieve them and how they might be evaluated.

While recognising that the health of older people covers a wide range of matters, the focus of the submission was on issues that are of direct concern to our members. This included supporting in principle the vision to:

• prioritise healthy aging and resilience throughout people’s older years
   
• enable high-quality acute and restorative care, for effective rehabilitation, recovery and restoration after acute events
   
• ensure people can live well with long term conditions
   
• better support people with high and complex needs
   
• provide respectful end-of-life care that caters to personal, cultural and spiritual needs.

Although shortages of geriatricians and ‘some other medical specialists’ are acknowledged in the draft strategy, recent ASMS surveys on presenteeism and burnout indicate the DHB specialist workforce in general is under stress. ASMS supports the ‘action’ to ‘Develop a range of strategies to improve recruitment and retention of those working in aged care’ in the draft but such strategies are needed to urgently address shortages across the specialist workforce.

Other points considered by the National Executive for inclusion in the ASMS submission were:

• Better integration and collaboration of services is needed. There is mounting evidence to show the best way to achieve this is through distributed clinical leadership.
   
• Agreement with proposals to promote advance care planning and more effective end-of-life care in general. This requires senior doctors’ time which in turn requires an adequate workforce.
   
• The draft strategy’s proposed ‘action plan’ as a whole makes sense but there is no indication as to whether there is a budget for it. The earlier and more candid draft strategy on the mental health and addiction workforce plan acknowledged ‘all actions in the draft are tentative’ depending on the availability of funding. If the same applies to this strategy and current health funding trends continue, many of the goals are unlikely to be achieved.

4. WOMEN IN MEDICINE

ASMS has been approached separately by two different branch officers seeking the support of the Association to establish either a “subgroup or focus group to offer support or advice for the special issues that women in medicine face” and to “recognise women’s contribution to medicine”.

Requests have also been received for assistance from women members at Hawke’s Bay and Waikato DHBs to work towards the establishment of a formal network of women specialists to provide support and mentoring for issues such as returning to work following parental leave and from long periods of sick leave including recovery from burnout.

The National Executive agreed to further explore this, including the possibility of holding an informal meeting of women delegates at Annual Conference.

5. BULLYING AND HARASSMENT

Previously we have reported on the National Executive discussion on bullying and harassment. These issues have been a serious part of the industrial team’s work for some time – both those who have suffered and those accused of it. Discussion has included the international bullying research conference in Auckland last March, the work with health unions and DHBs and the National Bipartite Action Group, and the Cognitive Institute’s work at the Royal Melbourne Hospital.

At the 1 September Executive meeting, Deputy Executive Director Angela Belich and Senior Industrial Officer Lloyd Woods reported on their visit as part of a wider team to the Cognitive Institute and Royal Melbourne Hospital. Other participants in the team were from DHBs, health unions, NZ Medical Association and Medical Students Association. Angela Belich and Lloyd Woods also took the opportunity to discuss this issue with the Victoria Branch of the Australian Medical Association.

This discussion in Melbourne included the possibility of a memorandum of understanding between the health unions and DHBs. The national office was authorised to pursue the possibility of such an agreement.

6. CTU NATIONAL AFFILIATES COUNCIL: EMPLOYMENT LAW POLICY

Deputy Executive Director Angela Belich represented ASMS at the quarterly National Affiliates Council of the Council of Trade Unions held on 25 August. It was interesting to learn that ASMS is the ninth largest affiliated union. There was a time when we were the second smallest just heading off Actors Equity.

The major issue discussed was the CTU’s re-examination of its employment law policy in the hopes that political parties may take up these changes in their election policies. The examination has two arms: the first is to strengthen the current legislation, reversing the changes made by the current Government that have weakened collective bargaining and initiatives to strengthen it (eg, unions notified of new employees starting work and their contact details and adding the right to collectively bargain and the right to strike to the Bill of Rights Act.

The policy is also looking at institute ‘industry standard agreements’ (not to be confused with the ‘industry standards’ proposed by the DHBs in our MECA negotiations. This would involve having minimum agreements either negotiated between unions and industry groups or, if that fails, have such a minimum set by the Employment Relations Authority (augmented by employer and union representatives). These standards would reflect the minimum in the industry or occupation. The intention would be to set a floor, including a floor for health and safety in areas where there is currently no collective agreement.

The National Executive considered that there were both positives in this initiative and no threats to ASMS members. Consequently, it voted to endorse the proposed policy.

7. OTHER MATTERS

Other matters discussed included:

1. The Executive Director reported on his participation in a teleconference of Health Workforce New Zealand’s Medical Workforce Governance Group in August. This included consideration of profile surveys of the RMO and SMO workforces.
    
2. The National Executive discussed the meeting of the National Joint Consultation Committee (ASMS and DHBs) held the previous day. Subjects included an update on compliance with the Holidays Act (largely confined to shift workers), bullying and inappropriate behaviour, the ASMS burnout survey, and the funding model for vocational medical training.

ASMS BRANCH REPRESENTATIVES: NEXT EXECUTIVE MEETING

Members are invited to forward any issues they may wish to be raised with the National Executive at its next meeting on 16 November to your local Branch President or Vice President (this includes non-DHB employed members who work in the geographic area of these regions). It is possible branch officers might conclude that some of these matters might more appropriately be addressed by the national office.

Below is the list of branch officers:

National Executive: Regional representatives

In addition to National President, Hein Stander (Gisborne) and Vice President, Julian Fuller (Waitemata), the Executive comprises eight regional representatives. They are:

Members are welcome to raise issues and comments with their regional representatives above by clicking on the relevant email address. This includes non-DHB employed members who work in the geographic area of these regions.

Kind regards

Ian Powell
EXECUTIVE DIRECTOR