1. DHB MECA negotiations

The Executive discussed the progress of the DHB MECA negotiations (as reported in previous ASMS Bargaining Bulletins) at its informal strategic meeting the previous day, and noted that informal discussions with the DHBs would resume on Monday 13 March.

2. ASMS strategic direction for 2017

The Executive discussed and subsequently confirmed the strategic direction and priorities for ASMS in 2017. This work supports our ongoing national DHB MECA negotiations, with the over-arching theme of achieving patient-centred care and sub-themes of unmet need, entrenched shortages, SMO workforce capacity and workforce stresses.

The work programme builds strongly on messages from the 2016 Annual Conference about the need to speak out on health issues, supported by research. Opportunities to do this include the regular Joint Consultation Committee (JCC) meetings we hold with DHB chief executives and senior managers, the joint ASMS-DHB SMO engagement workshops, along with the other communication channels we currently use.

The work programme for 2017 to support the Association’s strategic priorities includes publication of a Health Dialogue on research into SMO career and retirement intentions, further work on patient centred care, surveys of clinical leaders to gain greater understanding of the SMO staffing shortages, analysis of health funding information, and investigating the feasibility of monitoring individual DHBs’ ‘good employer’ performance.  Alongside this will be work to enhance members’ understanding of their MECA and further advisory publications.

3. Relationship with the Medical Students Association

The Association’s relationship with the New Zealand Medical Students’ Association has been growing over the past two years. In 2016 the two organisations published a joint communique on the need for a sustainable medical workforce, and ASMS has supported NZMSA attendance at our Annual Conference and so on.

After discussion, the Executive agreed to contribute $9000 toward the costs of the NZMSA’s clinical leadership forum and annual conference this year. They agreed to support NZMSA attendance at the ASMS Annual Conference this year on the same basis as 2016, and they also authorised the Executive Director to develop a draft memorandum of understanding for consideration.

4. Funding formula for vocational training

In December 2016, Health Workforce New Zealand (HWNZ) held its second national workshop to discuss its proposal to change the funding formula for vocational medical training. 

Prior to the meeting a discussion paper was circulated stating that HWNZ needed to adapt its funding model from one that “passively subsidises training costs to meet current service needs to one that strategically invests in training to meet future needs”. The paper reflected a significant shift from the first national workshop from focusing on medical vocational training to focusing on health vocational training.

ASMS has been concerned about both the process and the focus of this work.  The medical profession had been side-lined from some of the discussions and was then significantly under-represented at the second national workshop, as we the nursing and allied health professions. The exclusion of the medical profession from the decision to shift the direction of the paper was a source of tension at the second workshop. 

HWNZ hopes to have the funding model confirmed in order to start implementation in July this year but it was made very clear that this would be problematic if it continued to marginalise the medical profession.

The National Executive discussed this matter and agreed that the focus should be on refining the current College-based system for vocational medical training rather than replacing it with a high risk radically new unproven system that would require a significantly increased bureaucratic process.

5. Health implications of RCEP and TiSA trade agreements

The Executive discussed the potential impact of two free trade agreements currently being negotiated by the New Zealand Government: the Regional Comprehensive Economic Partnership (RCEP) and the Trade in Services Agreement (TiSA). Both have considerable implications for the provision and delivery of health care.

There are 15 countries are involved with RCEP – the 10 members of ASEAN plus the 6 countries with which ASEAN has had free trade agreements (Australia, China, India, Japan, Korea and New Zealand). It is intended that RCEP will supersede existing free trade agreements and bring together all trading partners, including India (which New Zealand does not currently have a free trade agreement with).

The concerns about the RCEP are the same as those for the Trans Pacific Partnership Agreement in terms of the potential implications for issues involving patent lengths, biologics, and Investor State Dispute Settlements constraints on labelling requirements and trademark protection.

Similarly, the Association has concerns about the potential ramifications of TiSA.  This agreement treats services as marketable commodities where those who supply or provide the services do not need to have any connection to the people or communities that rely on the service. They can be supplied from offshore with no localisation requirements. Under TiSA, governments are required to treat offshore providers the same as locals, but simultaneously not subject them to the same regulations governing local service providers. In addition, there are significant implications for data privacy under TiSA.

Following discussion, the Executive decided to continue monitoring and, where appropriate, comment on RCEP and TiSA with respect to their potential impact on New Zealand’s health system.

6. Consultation on strengthening recertification for vocational registration

The Executive discussed the Medical Council’s consultation on new standards for the Colleges to use in recertifying vocationally registered doctors. 

The Medical Council appears to take the view that current recertification standards require strengthening, but ASMS Executive members have raised a number of areas of concern.

As a result, the Executive decided to invite Medical Council Chair Andrew Connolly to the next Executive meeting, and also to make an ASMS submission to the Medical Council on the proposal.

7. Presidential address: Mid-Staffordshire and chief medical officers

Following the address by ASMS National President Dr Hein Stander to our Annual Conference in November last year, the Association was approached by Dr Ken Clark, Chair of the Chief Medical Officers’ Forum. He particularly noted references to the vulnerability of New Zealand’s public health service and comparison with the events of Mid-Staffordshire. He advised that the CMOs were willing to engage with the Association on these issues.

After discussing this approach and the issues raised, the Executive voted to express their willingness to the Chair of the CMO Forum to engage with chief medical officers and the Health Quality & Safety Commission.

8. Other matters

The National Executive agreed to form a working group to review the ASMS Constitution, with particular reference to representation on the Executive and management/governance issues. They also considered updates on non-DHB collective bargaining, a meeting of the Council of Trade Unions’ Affiliates Council, and job vacancies on the ASMS website.

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 6 April 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