National President’s report

The National President reported briefly on the forthcoming elections for positions on the National Executive, and thanks Executive members for their hard work and support during the term of his presidency.

Subsequent to the meeting, the positions of National President and Vice-President for the new National Executive have been confirmed (Murray Barclay and Julian Fuller respectively), along with Immediate Past President Hein Stander, and the representatives for Region 2 (Paul Wilson and Annette van Zeist-Jongman) and Region 3 (Tim Frendin and Angela Freschini).

More nominations than positions were received for Regions 1 and 4, and elections are being held in those two areas.

The new National Executive will take office on Wednesday 1 April for a three-year term. The Executive will meet informally in Wellington on 11 April, and the February meeting discussed possible topics for that meeting. These are likely to include financial reporting, the Executive’s governance roles and responsibilities, as well as ASMS strategic priorities such as distributive clinical leadership.

In his report to the February Executive meeting, Hein Stander also noted the long service (14 years) of retiring ASMS staff member, Membership Support Officer Kathy Eaden. Kathy has been a very loyal, conscientious and valued staff member. For most members who have joined ASMS over the past 14 years she has been the first welcoming point of contact.

1. Branch officers’ triennial elections

The National Executive discussed the upcoming elections for ASMS branch officers, and authorised the Executive Director to call for nominations by special circular on Monday 2 April 2018. Nominations will close on Friday 18 May.

Elections will be held if the number of nominations exceed positions in any of the branches, with a closing date for votes of Friday 29 June.

The new branch officers will take office on 1 July 2018, and will be invited to the annual ASMS national branch officers’ workshop in Wellington on 31 August.

2. Meeting with MAS

ASMS enjoys a very good relationship with the Medical Assurance Society and we meet regularly with their senior staff to discuss issues of shared interest. MAS Chief Executive Martin Stokes and Chief Finance Officer Matt Judge joined the National Executive for a discussion on MAS’ ethical investments and supporting ‘good causes’ initiative. Following this presentation, the Executive decided to look at how ASMS could support this initiative.

3. ASMS relationship with New Zealand Medical Students Association (NZMSA)

The National Executive discussed the continued development of the relationship between ASMS and NZMSA in light of the joint Memorandum of Understanding guiding engagement. The Executive agreed to make a financial contribution of $10,000 to support the MSA’s clinical leadership forum and annual conference this year, on the basis that ASMS will have a reasonable presence at both events.

The Executive expressed interest in holding a joint special conference next year, with the theme and programme to be agreed.

There was also some discussion of the new NZMSA-ASMS mentoring arrangement, which is underway following discussion at last year’s ASMS Annual Conference.

4. ‘High Performance High Engagement’

The Executive considered further developments in the ‘High Performance High Engagement’ initiative being driven through the tripartite (Government through Ministry of Health, DHBs and the health unions affiliated to the Council of Trade Unions) Health Sector Relationship Agreement. Last year the Executive resolved not to be part of this initiative for several reasons including the potential risks it created for continuous quality improvement activities. This resolution was reported to members in an earlier issue of Executive Direct.

This was also reported in ASMS’ Annual Report adopted at last November’s Annual Conference. It stated that:

This initiative has been the subject of much discussion within the sector in the past year, and has included a good deal of consideration within the Association at both Executive and national office level. HPHE levers off the Kaiser Permanente experience in California and has been in operation in Air New Zealand for some time. More recently, it is being trialled in Kiwi Rail.

In the health sector, there is broad agreement over its principles but no consensus over the form of application which includes the use of a particular business consultancy, a specific training programme run by this company, and purchase of its ‘intellectual property’.

With regard to the Association, our focus is on membership involvement in quality and systems improvement initiatives within and across services. We have expressed some reservations about HPHE and its June meeting, your National Executive carried the following motion:

‘That the National Executive reserves the Association’s position as the union through which senior medical and dental officers engage with DHBs as expressed in the multi-employer collective agreement and as evidenced by the Association’s longstanding commitment to distributive clinical leadership and engagement with DHBs including the Time for Quality Agreement (2008), In Good Hands (2009) and the joint ASMS-DHBs Business Case (2009) on the ‘High Performance High Engagement’ initiative. Reservations include:
 

• Concerns over where it fits in with clinically led quality and systems improvement initiatives (distributive clinical leadership).
   
• Concerns over the overly structural approach and the risk of high transaction costs for Association industrial staff.
   
• Lack of confidence in DHB leadership to the underpinning culture necessary to make the initiative succeed reinforced by the unexpected attempt by the DHBs to undermine the consultation and engagement in our national multi-employer collective agreement.
   
• Limitations in the relevance of the Kaiser Permanente experience to DHBs.’

There are concerns about the process used to promote this initiative which, despite its title, has more in common with ‘low performance, low engagement’. Individual DHBs are free to adopt HPHE with those unions who wish to engage through this process. But with this lack of consensus (only two small DHBs at most appear seriously interested in implementing HPHE), it would undermine the robustness of the tripartite Health Sector Relationship Agreement (to which the Association is a party) should it be deemed a national initiative under the umbrella of this Agreement. The Association will continue to monitor developments.

After further discussion at its February meeting, the Executive passed the following resolutions:

• That the National Executive endorse the concerns raised by the Executive Director in his correspondence to the HSRA Steering Group dated 20 November, 8 December and 31 January [these concerns are based on the above extract from the Annual Report].
   
• That the Association refuse to accept Steering Group decisions that constrain our ability to report back on issues to our members or our ability to advocate our views on them in various quarters.
   
• That the Association remind DHBs of their obligation to respect the engagement obligations and rights under the multi-employer collective agreement covering members where they might be affected by HPHE initiatives [this has already been actioned].
   
• That the promotion and advocacy of ‘distributive clinical leadership’ be reaffirmed as a major priority for the Association and that this be discussed further at the informal Executive meeting on 11 April.

5. Initiative for an ‘exemplary employment relations practice in the state sector’

The Executive considered the initiative of the Council of Trade Unions’ for an ‘exemplary employment relations practice in the state sector’ agreed between its affiliated unions and the new Government. A draft model has been forwarded to the Minister of State Services before Christmas. Unwisely ASMS was initially marginalised in this process indirectly linked to our concerns over the HPHE initiative immediately discussed above.

Nevertheless, with two main exceptions, it is a good initiative (arguably it could have been more ambitious). The two exceptions are:

• An unfortunate use of the term ‘legitimate unions’ to whom any eventual agreement would apply. The threshold for legitimacy is CTU affiliation. The large majority of unions, including ASMS, are affiliated but there are a small number of significant unions who are not including the Police Association, Resident Doctors Association, Corrections Association and the Airline Pilots Association. Normally the term ‘legitimate unions’ is used to refer to so-called unions that are created by employers to serve the latter’s interest. However, regardless of how these unions might be regarded, they are certainly not employer created.
   
• The draft includes the form of ‘higher performance high engagement’ that is being advocated in DHBs and which ASMS considers unsuitable as a way of engaging with senior medical and dental staff as discussed above.

Consequently, the National Executive at its February meeting passed the following two resolutions:

• That while disappointed with the initial marginalisation of the Association, the National Executive welcome the Council of Trade Unions’ initiative in proposing a model exemplary employment relations practice in the state sector and expresses a willingness for the Association to become involved in its development.
   
• That while welcoming the broad direction of the draft model, the National Executive has some concerns over its content and considers the sections in their current form (15 December 2017) the references to ‘legitimate unions’ and ‘high performance high engagement’ unacceptable.

It is important to clarify that the model, although forwarded to the Minister of State Services, is a draft only. Further each of the seven affiliated unions covering the public service, health and education sectors have the right not to sign it. While ASMS has advised the CTU and the other affiliated unions that we can’t support the model in its current form, there will be further discussions and we hope that a satisfactory consensus will be reached.

6. Reports

The Executive also considered reports on non-DHB collective bargaining and meetings of various national health sector bodies such as the National Joint Consultation Committee and Health Workforce New Zealand.

7. Acknowledgement

The Executive formally thanked Dr Hein Stander for his exemplary service as National President in the past five years.

New Industrial Officer Phil Dyhrberg was also welcomed to ASMS (this was his first Executive meeting). He is currently undertaking an orientation programme and will eventually assume prime responsibility for Waitemata and Counties Manukau DHBs.

Kind regards,

Ian Powell
EXECUTIVE DIRECTOR