EXECUTIVE 28 March 2019
Dear Member,

This is the first Executive Direct for 2019, reporting on a recent meeting of your National Executive on Wednesday 20 February (informal meeting focusing on the Association’s strategic direction) and Thursday 21 February (regular meeting). We normally send members an Executive Direct after each Executive meeting and also put these on our website (www.asms.org.nz). The Executive will next meet on 2 May.

The informal meeting discussed the proposed ASMS SMO safer staffing accord, the ongoing DHBs-RDA industrial dispute, the Minister of Health’s Letter of Expectations to DHBs, the Association’s strategic direction and priorities, and a proposal to conduct gender pay gap research. Health Minister David Clark met with the Executive for part of the meeting, and as always this provided a useful and frank discussion. The Executive expressed disappointment over the Minister’s failure to provide leadership in the ASMS safer SMO staffing accord and also the DHBs-RDA dispute.

The formal Executive meeting the next day discussed a number of issues, including the issues raised during the informal meeting and additional matters such as preparations for next year’s negotiations on the DHB MECA, an upcoming meeting of SMO shift workers organised by ASMS, planning for the Association’s special anniversary conference in June and the national branch officers’ workshop immediately following, climate change, and the process for appointing a new ASMS Executive Director to succeed Ian Powell.

Immediate Past President

Immediate Past President Dr Hein Stander has resigned his position on the Executive due to changes in his other commitments. The Executive acknowledged his significant contribution to the Executive, including as National President, and wished him well for the future.

Gender pay gap research

The Executive has approved a significant research project to investigate whether a gender pay gap exists for the Association’s members. This project will draw on Census and IRD data, and will be carried out for the Association by Motu Economic Research at a cost of up to $30,000.

For some time the Association has been scoping out work to determine if a gender-based pay gap exists for our members. A pilot survey has been undertaken to test the parameters of such research, and the Association’s industrial team has been working with DHBs to see if any would be willing to release payroll data for analysis. These discussions with DHBs are ongoing.

The Association’s research project will combine 2013 Census data with earnings data from the Integrated Data Infrastructure to compare the total and hourly earnings of male and female medical specialists in New Zealand for their work in DHBs. It will evaluate the extent to which any differences identified can be explained by factors including hours worked and effective experience. It will also be possible to examine incomes from the private sector alongside this.

Strategic direction

The Executive further considered the Association’s strategy and priorities after discussion at the informal meeting the day before, and adopted the strategy document 2018-2021. This document describes the environment Association members are working in, aspects of the environment that need to improve, key people and organisations to engage with, and describes national office capacity. This is a three year strategic direction with the intention of updating it annually.

Minister of Health’s ‘Letter of Expectations’

The Executive considered Health Minister David Clark’s annual ‘Letter of Expectations’ to DHBs. This identified equity of access and outcome as areas where DHBs would be held to account. The Letter also required DHBs to proactively identify unmet need. However, the Letter contains two significant omissions in relation to the senior medical workforce.

The Executive passed the following resolution:

That the Association advise the Minister of Health of its serious concern over the failure of his Letter of Expectations to DHBs to address the vulnerability of the senior medical workforce in DHBS and to recognise and promote the importance of distributed clinical leadership in improving the quality of patient centred care and financial performance.

DHBs-RDA industrial dispute

The Executive considered a report on a meeting in January with Health Minister David Clark to discuss progressing the Association’s proposed SMO safer staffing according. National President Murray Barclay, Vice President Julian Fuller and Executive Director Ian Powell attended this meeting for ASMS, with Director-General of Health Ashley Bloomfield and two of the Minister’s advisors also in attendance. In addition to the accord initiative, the Association expressed concern over the direction of the industrial dispute between the Resident Doctors’ Association and the 20 DHBs.

The Executive also discussed and endorsed a proposed Memorandum of Understanding (MoU) between the Association and the Resident Doctors’ Association on a process to address unintended consequences of Schedule 10 of the RMO MECA. This MoU aims to assist those close to an affected service to address unintended consequences, notes the importance of a whole-of-medical-team approach to the delivery of 24/7 patient-centred care, and includes recognition of the precarious state of the SMO workforce.  ASMS will be discussing this MoU with the DHBs and will also report it back to members.

ASMS 30th Anniversary Conference

The Association turns 30 in 2019 and a special anniversary conference is being held in Wellington on 27 June to mark the occasion, with the theme of why a public health system is worth fighting for. The Executive discussed arrangements for the conference at both its informal meeting and regular meeting.

The programme is still being finalised but confirmed formal speakers so far include Professor Martin McKee from the London School of Hygiene and Tropical Medicine, Health Minister Dr David Clark, and Dr Otmar Kloiber, Secretary-General of the World Medical Association.

The Executive approved a number of actions in relation to the arrangements for the special conference, including meeting the travel and related costs of attendance for the Association’s life members and also two representatives from the Medical Students Association.

Renegotiating the DHB MECA 2020

Preparations for negotiation of the ASMS-DHB MECA for DHB-employed members were discussed at the Executive informal meeting and again the next day. Bargaining is to be initiated 60 days before expiry of the MECA (ie, January 2020) and a bargaining process agreement will be negotiated. The Association’s Constitution gives responsibility for the negotiating of collective agreements to the National Executive. An advocate and deputy advocate as well as bargaining support will be provided from the Association’s national office.

The Executive positively acknowledged the direction being taken in the MECA preparations.

Update on achieving a good outcome for members working on public hospital shifts

The Executive considered efforts to progress issues affecting SMOs working shifts within public hospitals, and endorsed the actions taken so far.

Executive member Andrew Ewens had convened a working group of SMOs working shifts to discuss issues arising. This group met in Wellington in March following the Executive meeting. An online survey was sent beforehand to approximately 400 Association members identified as shift workers. The information from the survey provided a stocktake on current shift work patterns and arrangements, while also identifying issues requiring further consideration.

Further work will be needed following the working group meeting, and the Executive approved the organisation of a follow-up face-to-face meeting of the working group if necessary.

Planning national branch officers’ workshop

The annual national branch officers’ workshop is scheduled for the day after the special anniversary conference, 28 June 2019. As always, it will feature discussions on a range of relevant issues. The National Executive discussed a possible programme for the workshop, including a shift work session based on the membership survey results.

Annual conference resolution on climate change, health care and SMOs

Delegates to the 2018 Annual Conference adopted the following resolution in relation to climate change and health care:

That members be encouraged to contemplate the full cost of CME-related air travel, including atmospheric carbon release. To that end, members should consider carbon offsetting, and the Association support employer reimbursement of air travel-related carbon costs as part of legitimate CME travel expenses. The Association itself should move to routine carbon offsetting for work-related air travel for its employees, and its members.

The National Executive considered a report on implementing this resolution within the Association. It was noted that the Association would commence promoting carbon offsetting at its regular Joint Consultation Committee (JCC) meetings with DHB chief executives and senior managers.

The Executive approved the implementation of the Annual Conference resolution in respect of members’ continuing medical education and the Association’s air travel.

Process for appointment of new Executive Director

The Executive discussed the process to appoint a new Executive Director, following indications by current Executive Director Ian Powell that he will be leaving the Association at the end of 2019. The Executive agreed to seek a recruitment firm to assist with the process of identifying, shortlisting and reference checking applicants for the position. The aim is to appoint the new Executive Director with enough time for a handover and transition before the end of the year. The position will be advertised in both New Zealand and Australia.

Institute of Directors training days

Executive members discussed the follow-up required to their training days with the Institute of Directors. The main focus of these days was on the processes required for good Board governance and best practice corporate governance.

The Executive will endeavour by the next meeting to adopt a charter, code of conduct, conflicts of interest register and annual workplan for the Executive. They also agreed to work towards a more strategic focus in their meeting agendas, and to apply the principles of best practice governance wherever applicable.

Employment Relations Amendment Bill 2018

The Executive considered a report on changes to employment legislation following the passing of the Employment Relations Amendment Act 2018. The main purpose of these amendments was to reverse changes made by the last Government which adversely affected employment rights. Key amendments which come into effect on 6 May 2019 include:

  • the right of unions to initiate collective bargaining first (ie, before employers)
  • the reintroduction of a rule that new employees will be employed under the terms of an applicable collective agreement for their first 30 days, by which time they can elect to be employed on either an individual agreement based on an existing collective agreement or (by joining the applicable union) the collective agreement itself
  • a duty to conclude collective agreement negotiations
  • the right of union delegates to reasonable paid time in work to undertake their duties, and reintroduction of rest and meal breaks.

Industrial report

The Executive considered a report on the Association’s industrial activities, including the development of a Standard for Sustainable Work, which is available on the ASMS website at https://www.asms.org.nz/wp-content/uploads/2019/03/Standard-for-Sustainable-Work-wellbeing_171281.2.pdf.

Collective bargaining outside DHBs

The Executive considered a report on collective bargaining with non-DHB employers. At the time of the Executive meeting, ASMS had about 242 members employed outside of DHBs. This number is steadily increasing, and a range of collective agreements had been negotiated to cover these members. Six collective agreements for non-DHB members are due to expire this year. The Association is continuing to look for opportunities to increase our non-DHB membership.

Executive Director’s report on international conferences

The Executive considered a report from Executive Director Ian Powell on his attendance last year at the third international conference of doctor unions in Lisbon and the World Medical Association General Assembly in Reykjavik, including the medical ethics programme organised by the Iceland Medical Association. Both events were relevant to the Association’s work in terms of providing valuable insights into issues of global significance to the wider medical profession.


Kind regards

Ian Powell