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Too Many DHBs Irresponsible And Negative


“Too Many DHBs Irresponsible And Negative Over Professional Guidelines For Senior Doctors”

“Too many district health boards are being irresponsible and negative over the importance of allowing senior doctors to meet professional guidelines,” said Mr Ian Powell, Executive Director of the Association of Salaried Medical Specialists, today. Mr Powell was referring to a comparative league table of the attitude of the 21 DHBs prepared by the Association (attached).

“It is recognised in our national DHB collective agreement that the professional guideline for time for non-clinical duties such as peer review, clinical audit, teaching and other professional and administrative duties should be a minimum of 30% of their total hours of work (excluding after hours call duties and leadership roles).”

“This league table provides the clearest indication of how committed or not DHBs are to supporting ongoing quality improvement for senior doctors and whether they are two-faced about it or not.” DHBs who perform poorly on the league table are more likely to view senior doctors as production workers and to devalue the importance of professional standards and guidelines which are critical to quality improvement and standards of patient care.”

“On the positive side 10 DHBs are graded between A- and B. On the negative side 5 DHBs are D+ or worse including an E and an F. The remainder are in-between.”

“Several DHBs will have to pull their socks up if they are to be genuinely committed to quality improvement and high standards of patient care,” concluded Mr Powell.

Ian Powell


DHB League table: Non-Clinical Duties

A- Northland Already had strong commitment to 30% minimum in local collective agreement prior to MECA.
B+ Waikato

Bay of Plenty




Hutt Valley Has adopted a positive attitude consistent with the ASMS’s approach including an agreed process for implementation. [Waikato will have a new chief executive and chief operating officer next year and it will be important that this doesn’t disrupt progress].
B Lakes Initially negative comments from lower level management but Chief Executive and senior management have recently affirmed a positive approach consistent with the ASMS’s. An implementation process has also been agreed.
B MidCentral Positive promising approach consistent with ASMS’s although yet to confirm implementation process
B West Coast Owing to recent change In chief executive, the opportunity to engage over this issue has been recent. But the signs are encouraging with this DHB expressing an approach consistent with the ASMS’s. There has been insufficient opportunity to agree upon an implementation process
B- Waitemata First DHB to make a commitment in a collective agreement (set 30% minimum as a medium term objective in 2001; medium term is now up). But there are unfortunately some managerial pressures to renege on this commitment
B- Tairawhiti

South Canterbury Implementation is being pursued incrementally but no indication at any disagreement with the ASMS approach
C Southland Position unclear due to high level of internal instability but no outward negativity expressed
C Nelson Marlborough Struggling to understand why professional standards need to be made explicit and why there are advantages in an agreed implementation process. But it has accepted the importance of recognising time for non-clinical duties and is not demonstrating negativity or hostility
C- Canterbury In the past, prior to the MECA, has taken a positive approach with the 30% minimum implemented in a number of departments. More recently other attitudes emerging from negative hostility and a narrow contractualist misrepresentation of its obligations under the MECA (employment relations section) to flakiness and uncertainty. Hopefully this DHB’s new Chief Executive will provide much needed positive leadership
D+ Counties Manukau Position unclear but negativity and confusing messages coming from some managerial personnel. Chief Executive known to respect importance of quality improvement and professional standards; it is important that he asserts leadership
D Auckland Too blinded by deficit challenges to grasp importance of the issue. Needs to move out of crisis management mode and look ahead
D Capital and Coast Ducking for cover by claiming that this is a national issue; utter nonsense and procrastination. But we are edging closer towards an agreed implementation process
E Otago Has adapted a negative attitude, quite hostile from its human resources section, based on a failure to appreciate the importance of meeting professional standards and a narrow contractual misrepresentation of its obligations under the MECA. The fact that it has nevertheless come close to agreeing upon an implementation process with ASMS mean that it is rated 20th rather than 21st.
F Hawkes Bay Although camouflaged in ‘warm and fuzzy’ rhetoric, this DHB has also displayed a thoroughly negative attitude which includes a narrow contractualist misrepresentation of its obligations under the MECA

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