NATIONAL 9 August 2016
Dear Member,

Welcome to the fourth issue for 2016 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

1. Panel discussions on speaking out

2. Hawke’s Bay survey

3. DHBs overboard? ‘Suits me down to the ground’

4. The Specialist magazine

5. On the ASMS website

6. ASMS Annual Conference

7. Did you know ...

8. ASMS hompepage news items

Panel discussions on speaking out

ASMS members are invited to two public panel discussions on the importance of professionals speaking out. These are taking place in Auckland and Wellington next week, and details are below along with links to further information and short bios of the speakers.

ASMS members Dr Joshua Freeman and Dr George Laking will be speaking at the Auckland event on Thursday 11 August, and Dr Erik Monasterio at the Wellington discussion on Friday 12 August.

Other speakers include Jessica Walker, a high school teacher from Brisbane who has been active in speaking out for refugees, physicist and author Professor Shaun Hendy, and principals from schools in Auckland and Wellington who have spoken out about the introduction of national standards.

The two events are designed to be short and stimulating, and hopefully at a time that will suit a wide range of people. They have been organised by the education union NZEI Te Riu Roa in conjunction with a number of other unions, including the ASMS.

The rights and responsibilities associated with speaking out is an issue directly relevant to your work as health specialists in the public health system, and I encourage as many people as possible to attend these two panel discussions.

  • The Auckland event is on Thursday 11 August from 5pm to 7pm – full details are here and speaker bios are here.
  • The Wellington event is on Friday 12 August from 4.30pm to 6.30pm – full details are here and speaker bios are here.

A Facebook page has been set up for each event. Please note the request on the flyers to RSVP to for catering purposes.

Hawke’s Bay survey

ASMS has begun surveying the heads of departments in public hospitals to get an accurate picture of specialist shortages. The first survey, at Hawke’s Bay DHB, confirms the DHB is significantly short of the SMOs it needs.

As you would all appreciate, there is a difference between the number of vacancies a DHB advertises and the number of hospital specialists it actually needs to provide health services. The ASMS surveys aim to draw out the distinctions between these to give us a better picture of senior medical workforce shortages.

The survey findings are summarised in an ASMS Research Brief, which can be read online here.

Of the 12 heads of department (HoDs) invited to participate in the survey, 11 took part (a 91.7% response rate).

Here’s a snapshot of what they told us:

  • 8 HoDs said they did not have enough full time equivalent (FTE) senior doctors for their service at the time of the survey.
  • Overall, they estimated they needed an extra 20.6 FTE – or 22% of the current senior doctor staffing level – to provide safe, quality and timely health care at the time of the survey.
  • The extra FTE required above current staffing levels ranged from 12% (2 FTEs) to 88% (3.8 FTEs).
  • Despite this shortfall, there were only 4.4 FTE vacancies at the time of the survey.
  • Just over half of the HoDs – 54% – believed there was inadequate internal senior doctor cover for short-term sick leave, annual leave or continuing medical education leave.
  • Well over half of them – 64% – believed there was inadequate access to locums or additional staff to cover for long-term leave.
  • 73% of the HoDs surveyed believed their senior doctors did not have enough time to spend with patients and their families to provide good quality, patient-centred care.
  • An estimated 27% of senior doctors were ‘never’ or ‘rarely’ able to have the recommended amount of non-clinical time, which is when doctors do other activities such as supervision, quality assurance, or professional development.

ASMS will be following up the results of the survey with the DHB’s senior management, and is planning further surveys of heads of departments at selected DHBs.

DHBs overboard? ‘Suits me down to the ground’

I had the opportunity recently to once again address the annual conference of hospital and community dentists (an event I always enjoy). Naturally, I decided to draw on the individual and collective wisdom of the Borgia papacy, Tudor monarchy and Yertle the turtle, along with some lessons learned from Donald Trump and Captain Pugwash.

My address focused on some of the major challenges for public health, including the need for an honest appraisal of the amount this country spends on public health. The truth is that government spending as a whole is low compared with most other OECD countries – and as ASMS Policy & Research Director Lyndon Keene spells out in the latest Specialist magazine, New Zealand can and should be spending more. Treasury, in particular, deserves a smack on the hand for its widespread use of a misleading graph that suggests health expenditure is excessive and growing alarmingly.

However, focusing on health funding is not enough. We also need to shift the focus onto investment and, in particular, investment in the specialist workforce. DHBs have unrecognised significant entrenched specialist shortages that have become the subconscious norm and are fudged by official vacancy data.
It is clear that innovation in the health sector requires attention to three things: the workforce, technology, and implementation of distributive clinical leadership.

The full text of my address is available online at

The Specialist magazine

The latest issue of your ASMS magazine, The Specialist, is packed with articles we hope you will find both interesting and relevant. These include:

  • An update on the DHB MECA negotiations
  • A taste of the ground-breaking research into burnout which ASMS has carried out
  • Reflections on fatigue and exhaustion from ASMS National President Hein Stander
  • A workforce shortage in forensic pathology that is pushing the national service to the brink
  • The need to put senior doctors and dentists in the driving seat of the public health system
  • The argument for the Government spending more on public health
  • ASMS member Tony Haycock, former national resident doctors’ national association president and now working for ACC, tells us what inspired his medical career
  • Recognising medical contributions in New Zealand’s honours lists
  • And a new feature introducing some of the ASMS national office staff.

On the ASMS website

We have a couple of new features on the ASMS website that you might like to keep an eye on. The first is our regular updates on the progress of the DHB MECA negotiations. We post a Bargaining Bulletin following each round of talks, and they can be found at

We have also started a new series of discussion papers on patient centred care from ASMS Policy & Research Director Lyndon Keene. Two papers can be read online now and we will continue adding to the series:

ASMS Annual Conference

The ASMS Annual Conference will be held in Wellington on 17-18 November (Thursday-Friday). This will cover a range of relevant health policy and industrial issues. Assessing the progress of the national DHB MECA negotiations, which are now underway, will be a major issue. The Minister of Health has confirmed that he will again speak and be available for Q&A.

You are encouraged to enter this into your diaries and advise our Membership Support Officer Kathy Eaden at if you are interested in attending.

Did you know ...

...That the clinical director of your department (or a nominated SMO/SDO from the department) must sit on any SMO/SDO appointments committee. The local senior staff committee (or agreed body) also has the right to nominate a further member of the interview panel, from an appropriate specialty, for SMO and senior clinical positions. You can read clause 52 here.

ASMS homepage news items

The following items can be downloaded from

  1. Staffing shortage pushes national forensic pathology service to the brink (ASMS media release)
  2. More palliative care positions to be established (Government media release)
  3. Northland’s Lance O’Sullivan joins Ko Awatea as research fellow (NZ Doctor)
  4. Widened prescribing rights for registered nurses (Government media release)
  5. Health care out of reach: six month wait for child who talks of dying (Stuff)
  6. David Galler: stories of life and death (Radio New Zealand)
  7. Wellington DHB Chief Executive’s email breached primacy of grieving mother (Stuff)
  8. Concerns hospitals may rely on charity to buy critical equipment (TVNZ)
  9. Sick Kiwis used in PR campaign to win public cash from Pharmac (Stuff)
  10. Publicly-funded surgery granted days after Doug Pike sold his house to pay for surgery (Stuff).


Kind regards

Ian Powell