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Presidential Address, ASMS Annual Conference, 2003

Presidential Address, ASMS Annual Conference, 2003

Dr Jeff Brown, National President

A Brave World - Anew

Colleagues and guests, distinguished and otherwise, it gives me both honour and trepidation to follow a tradition of Presidential addresses to this gathering. ASMS has a record number of delegates to this 15th Annual Conference, in a year which has offered watershed and opportunity.

A year of conflict and triumph. A year of strike and of speaking out. A year of hard work and moral high ground.

We are at a watershed in our evolution as an organisation. Where we proceed next year is up to you. How you want your union to act and progress is for you to direct. What your National Executive facilitates is yours to determine.

I am going to briefly outline one view of the challenge in front of us in this brave world. I will look at the new opportunity to make a difference. As an individual, as a health worker, and as a national political organisation.

Before examining this challenge I acknowledge the untiring dedication and hard work of the national office. The profile of Ian Powell means he is well known to most of you, others are less obviously visible, but no less important. Angela Belich and Henry Stubbs have helped individuals in their difficulties, and the organisation to shape itself. Yvonne Desmond runs the show, with able assistance from Angelina Hachey, Abbie, and Katherine. If you intersect with any of them in the course of the next two days, please take a moment to thank them for the continued superb job they do. Their teamwork and professionalism enables your executive to function on your behalf, and has made the transition from Peter Roberts to David Galler to myself very smooth. Vice President David Jones has given wise counsel has only he can, and National Secretary Brian Craig has been his dedicated supportive self. Members of your executive have embraced a shift in style and fashion. Thank you all.

This address could not proceed without admiring Peter Roberts. He has stepped down from the Presidency leaving huge shoes to fill. His dogged integrity in the face of many battles is an example to us all of the importance of principles, of not giving up, of pursuing professionalism, of listening to stories, of wisdom. Thank you Peter for the legacy you have left us. For reminding us of the importance of individuals.

Looking after the individual

As an individual it is not trite, and can never be repeated too often, that we self-select and train to improve the lot of our patients. Much of how we behave stems from this tenet.

To know even one life has breathed easier because you lived.

This is to have succeeded. [Ralph Waldo Emerson]

We need to understand, and help those who attempt to manage our places of work understand, how vitally important this success is - to us, to them, and to our patients.

We must not shrink from speaking out loud about what we see as success, and supporting those of us brave enough to do so. Many of our managing colleagues do not operate within the same framework - if they did they would be us. They would often have an easier job it we did not. Their measure of success is different. But our individual patients will not do as well if we remain silent.

If we are to do our best for our patients, and be in a position to support our colleagues, we must look after ourselves. Another trite but unfortunately too often true saying is that doctors are the worst patients. At this conference your Executive has invited Philippa Gander to address guilt free sleep. To help us with a reality check on our own sleep deprived existence, and the measurable effects it can have on our own health, performance, and the safety of our patients. To give us some practical help on how we can better look after our individual selves.

Looking after each other

At a hospital level there are various gatherings of senior doctors, some formal, some informal. While their prime purpose may be other than the health of their members, they can serve a useful supportive function. Provided that they do not operate dysfunctionally. Too often ASMS in the guise of Henry Stubbs is called into or becomes aware of situations where our own members have been the architects of dispute. Sometimes wittingly but mostly not, the rage and fallout are out of all proportion to the putative problem. All too often the collegial opportunities to help others and ourselves have been bypassed. Passions have been fuelled and fires ignited. Whilst the public perception may be that we cover up for each other, we all know that we can be the quickest to round on our colleagues. Yet when we unite, and, yes, even strike, the public support can be truly salutary and humbling.

Your Executive is considering, and this Conference will discuss, how we may help empower members at a local level to improve not only pay and rations, but the workplace, including how we treat each other. One suggestion is a series of regional membership seminars as a springboard to strengthen local branches. Another and complementary option is to develop a system of local delegates. I urge you to engage in robust discussion over the next two days to explore unity. How we can help local branches and gatherings of senior doctors to look after the health of each other.

Looking after the system

Nationally the political networks, influence, and strategy of ASMS and in particular Ian Powell have occasionally been interpreted as beyond the core role of our union, beyond pay and rations. The past 15 years have, however, increasingly demonstrated that political activity is not extra to, but a fundamental function of any union. Probably more important than pay and rations, to how we work and work well, is the environment in which we work. In the health sector, for doctors, and for senior doctors in salaried positions, political influence and policy shape the environment in which we work, affect us every hour of every day. Affect the expectations and relationships with our managers, our colleagues, and our patients.

Our health is dependent on the environment in which we live and work. That environment, for us as much as any group, is radically affected by the wheelings and dealings of those in public and appointed offices, by those manipulating the sector to achieve their aims. Not that these aims are necessarily malign, or badly intended. Just that the implementation can often go awry with toxic consequences for us and those we care for. We are uniquely placed, through personal longevity in our jobs, through our cutting edge contacts with the ill and injured, with our experience of when things go right and when they go horribly wrong, to advise, to influence, to help others avoid serious mistakes.

We can speak out when other avenues have been closed to us. Bruce Twaddle has recently shown how important that bravery can be. And the unity of his colleagues, their strength of collective character, ensured that the moral high ground was maintained. The subsequent support of the Health and Disability Commissioner, of the NZMA, of the NZNO, demonstrated the power of political networks, influence and strategy to rapidly mobilise behind matters of principle, of importance to not only the individual, but to the profession and the wider health workforce. And ultimately for the good of the patient.

We can improve the health of our national membership by influencing those who have the power to affect for better or for worse the structure of the sector in which we have chosen to work.

I have touched on the need for us to look at our individual health, at how we work together, and how we can influence others locally and nationally to improve the systems and places within which we work. As we reflect on ASMS over the last 15 years, on those who have gone before and their achievements on our behalf, on the huge successes we have come to accept as almost routine, it is also time to contemplate where we will evolve. The move toward a national DHB MECA, the changing relationships and contacts that will bring at local level, the slow engagement of our professionalism in DHB decision-making, the subtle shifts in national policy, all present an opportunity to evolve as an organisation.

To face the challenge in front of us in this brave world. To look anew at opportunities to make a difference.

To look after ourselves. To look after others we work with. To look after the system we work within. Only then can we really help those who depend on us so much, and so often.

He aha te mea nui? He tangata, he tangata, he tangata.

What is the most important thing? It is people, it is people, it is people.

Dr Jeff Brown


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