The Medical Council of New Zealand’s statement on Medical Certification is intended to outline, in a simple and direct manner, the responsibilities of doctors when completing a medical certificate. The Council is currently undertaking a review to ensure that the resource is accessible and useful to doctors and members of the public, and to ensure that the standards outlined are appropriate, clear, easy to follow and informative. We are seeking your views on the standards outlined in the statement, and on changes that we are proposing to make.

The Southern District Health Board has been accused of inaccurately presenting the situation faced by the Otago Fertility Service in its bid to outsource the service. In a highly critical submission, staff, supported by health and education unions, called on the board to halt the proposal. ''The DHB proposal makes claims about the OFS that are simply not true. There are no difficulties with on-call rosters, the service is not vulnerable, there have been no problems concerning staff replacements, and there have been no issues concerning staff absences,'' the submission said.

Junior doctors have called on the BMA to reject any attempts to introduce a new sub-consultant grade which could be on the table if negotiations on a new consultant contract go ahead. The idea has been proposed by a Department of Health commissioned review of clinical excellence awards (CEAs) by the Pay Review Body which recommended changes to the pay structure to recognise different stages in a consultant’s career. The report suggested introducing a break point in the pay scale and a new “principal consultant” grade to reward up to 10% of the senior consultant workforce.

Sir David Nicholson, the NHS chief executive caught up in the Stafford hospital scandal, has announced that he will step down from his post next March. Nicholson came under intense political pressure after publication of the Francis report, which looked at scandalous lack of care at the hospital for four years from 2005. He was briefly head of the local strategic health authority when the first of the serious concerns about Mid Staffs began to emerge. Campaigners – led by Julie Bailey and Cure the NHS – whose family members died "unnecessarily" at Stafford hospital called for him to go and the Daily Mail branded him as "the man with no shame" for staying in post.

The growing number of female senior medical professionals entering the workforce is exacerbating a much larger problem - not enough people are graduating from medical schools in New Zealand. This would leave the health system dependent on attracting graduates from overseas for many years to come, cardiologist and Waikato District Health Board member Dr Clyde Wade said. The Waikato Times reported this week that Association of Salaried Medical Specialists executive director Ian Powell had warned, in a briefing to Parliament, that New Zealand's district health boards could expect to face growing pressure to recruit and retain specialists, partly because female medical specialists worked fewer hours and wanted a better work-life balance.

Waikato Hospital cardiologist Raewyn Fisher said female medical specialists are naturally inclined to choose general practice and specialist areas that are more suited to working part-time and allow breaks for having children. An increasing number of female medical specialists is putting district health boards under growing pressure because women work less than men, a senior doctors' advocate says. Association of Salaried Medical Specialists [ASMS] executive director Ian Powell says recruitment pressures are escalating because female medical specialists work less than men and want a better work-life balance.

Representatives from PHOs and DHBs have completed negotiations on a new PHO Services Agreement to be implemented from July 1. The new Agreement is designed to strengthen primary care and clinical integration across the health system. It creates a base from which to support the changing needs of our population. It clarifies roles and accountabilities for providing health care at a local level and increases the range and quality of services available to patients closer to home. It spells out the objective that health services should be provided on a ‘best for patient’ and ‘best for system’ basis. Copies of the new Agreement are being sent to all DHBs and PHOs this week, with updated contracts due to be signed by the end of June. I believe the new Agreement strengthens relationships between local service providers. It ensures a direct line of sight between national health priorities and targets and the services provided in primary care. To download the full statement click here.

The New Zealand Medical Association (NZMA) welcomes the increased spending in health announced in today’s Budget, particularly measures to support the most vulnerable in the community, such as the $92 million to pay family members who care for their disabled adult children. “Social factors, such as housing, play a major part in influencing health,” says NZMA Chair Dr Paul Ockelford, “so the announcement of the extra $100 million over three years for the Healthy Homes insulation programme is also welcomed – particularly the targeting of low-income households with children or high health needs. On top of the $21 million over four years already announced for rheumatic fever prevention, this is a useful investment in the health and future wellbeing of the country’s young people.”

This is a brief report on some of the Budget highlights. There has not yet been an opportunity to analyse all aspects of the Budget so this report does not attempt to provide a full commentary. You will see that funding increases are often stated as over 4 years and we also need to factor in demographic changes as well as an inflation adjustment before real increases can be assessed.
To download the full report click here.

New Zealand’s public health services receive the largest increase in funding in the Budget, Health Minister Tony Ryall says.  “Budget 2013 is making available $1.6 billion for Health over four years for new initiatives and to meet cost pressures and population growth. This includes an average of $352 million in new funding a year,” he says.  This will increase total health spending to $14.7 billion in 2013/14 – the highest ever.  “Of this new funding, $250 million a year is going straight to district health boards, to take account of population changes and inflationary pressures. DHBs will receive further funding from the Ministry of Health on top of this.

Lyndon Keene, Researcher 

Dr Jeff Brown, President

Ian Powell, Excutive Director

Alan Doris, MPS