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NZMA supports professionalism in health care

FROM: Dr John Adams, NZMA Chairman

DATE: Wednesday, 21 November 2001

SUBJECT: NZMA supports professionalism in health care

Support for professionalism and clinical authority are important steps to improve quality in our health services, says New Zealand Medical Association Chairman Dr John Adams.

Speaking to the Clinical Governance and Quality Assurance in Healthcare conference in Auckland today, Dr Adams criticised developments in the health sector which had seen the rise of a management culture and a reduced leadership role for health professionals.

"A good manager is not necessarily a good leader. I think this was a fundamental mistake in our public health system. There was a wholesale removal of medical influence and authority from policy and financial matters. Doctors were said to have a vested interest which distorted things. Of course medical people had a vested interest - in treating patients well."

Dr Adams also said the current attitude and culture of blame needed to change before more effective quality systems could be introduced into our health services.

Changing the environment needed to happen at all levels - government, Ministry of Health, organisational, clinical teams and individuals.

"Valuing and supporting professionalism is the way to get individual doctors involved with quality systems, speaking out about peers or systems that are not functioning well, and feeling part of an overall team striving to provide quality care.

"Leadership and quality will come from the true devolution of responsibility and authority to clinical teams and the true involvement of those teams in providing management solutions.

"Time means money. We know that quality takes time. Quality improvement cycles cost. We cannot expect more for less. Leadership and involvement will depend on the services being adequately funded whether that be in primary or secondary care. This can not be overemphasised.

Dr Adams said all health professionals needed to work together to produce the best care for the patient, and an environment where excellence is cultivated.

"To work, quality improvement needs to come from the ground up, where the health professionals 'in the trenches' see it as a part of their daily work to be doing problem identification, audit, planning, improvement and re-audit. It is absolutely no use if the health professionals see it as an imposed waste of time and scarce resources. If the impetus and ideas are imposed rather than generated from the people on the ground, it becomes just 'lines on paper'."


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