ASMS Direct - Issue 2010-21

16 December 2010

Dear Member

We welcome any feedback on the contents of the 21^st issue for 2010 of ASMS Direct, our national electronic publication.

• 1. December issue of the Specialist
• 2. Clincal Governance Development Index
• 3. Frustrated specialist turns to poetry
• 4. Reminder: Pike River Miners’ Families appeal
• 5. Reminder: National Executive Elections
• 6. Reminder: University of Otago, Wellington Inaugural International Cancer Symposium, 13-19 February 2011

1. December issue of the Specialist

The December issue of The Specialist is now out. The main features are:

• Front page article on current developments in the DHB MECA negotiations (“MECA cup getting closer to political lips”)
• Dr Jeff Brown’s Presidential Address to ASMS Annual Conference.
• “Be careful what you ask for! You might get it!”; comment on the chief medical officers’ statement on industrial action.
• Surveying the implementation of In Good Hands in DHBs, including the clinical governance development index (also discussed below).
• Senior dentist workforce challenges in DHBs (Dr Robin Whyman).
• Medical Protection Society on “a family affair”.
• ASMS Conference highlights.

2. Clincal Governance Development Index

As part of his analysis of the survey of ASMS members employed by DHBs on the application of In Good Hands on clinical governance and leadership in DHBs, Dr Robin Gauld has developed a new analytical tool that offers potentially valuable insights and assessments of DHB performance. He has developed a 13 point scale with the national mean being 5.41 (Dr Gauld will be looking at revising this index with a view to reducing the scale to perhaps 10 points) This is not an impressive performance with all DHBs less than half-way) which, I suspect, two overriding factors contributed to:

1. There is simply not the senior doctor/dentist workforce capacity (numbers) to generate the time necessary for members to be engaged in clinical governance at the level required to make a difference. To overcome this we need to have terms and conditions of employment sufficiently competitive to retain the doctors we train and recruit those we need to find internationally. Currently DHBs are not in this position and the ASMS is endeavouring to address this in our MECA negotiations.

2. The managerial culture in DHBs is generally not sufficiently in tune with the need to embrace genuine and effective clinical governance and engagement. There is still much more work to do in this respect.

Below is a table outlining individual DHB’s performances (note that although now merged Otago and Southland are treated as separate DHBs for the purpose of this survey):

A fuller analysis of this result will be reported in the March 2011 issue of The Specialist. An important qualification should be made about Taranaki at 21^st. This is a surprise result because in many respects this DHB’s culture is similar to Lakes at 1^st. A contributing factor may be some skewing by dissatisfaction in a single department in a DHB that employs a relatively small number of senior doctors. One positive message, however, is that once learning of this the Chief Executive has been proactive in initiating discussion over why the low score and how the situation might be improved. Hopefully his colleagues in all the other DHBs will similarly respond.

3. Frustrated specialist turns to poetry

Ever since the Minister of Health Tony Ryall announced the six hour target for emergency departments as one of his top priorities, Dr John Chambers (clinical director of the emergency department at Dunedin Hospital) has, alongside his emergency medicine specialist colleagues been trying to persuade his DHB management to give this the priority the Minister expects. Unfortunately the net result has been Dr Chambers and his colleagues over consuming on aspirin due to the experience of beating their heads against a brick wall and Dunedin Hospital achieving the lowest ranking in the country.

However, the indefatigable Dr Chambers has not given up. This aspirational Robbie Burns has resorted to poetry to try to get the message through. His poem is below:

We’re busy doing nothing… and the patients wait for hours,

In the cubicles, in the corridors, by the toilets, by the doors,

The nurses are going frantic and the Minister ’s bemused,

What about the “ED Target” every option should be used.

We’re busy doing nothing ...and the patients wait for hours

Lets have meetings lets start projects show the Board the Targets ours,

But lets not rush there is “no money “ we would not want to get it wrong,

And anyway who are these patients,

Does it harm them waiting long.

We’re busy doing nothing ...and the patients wait for hours

Mainly old folks lie on stretchers some with cancer some with sores,

Doctors nurses pleads don’t matter

Dismissed by managerial chatter.

We’re busy doing nothing ...and the patients wait for hours

Lots of data lots of figures lots of graphs upon the walls

But nothing changes with these efforts where can we be going wrong,

We all know there is a problem why not fix it why so long

We’re busy doing nothing ...and the patients wait for hours.

Dunedin Hospital December 2010

4. Reminder: Pike River Miners’ Families appeal

Members are encouraged to send donations if you have not already done so to the trust fund for the 29 families established by the Engineering, Printing & Manufacturing Union. Their situation has been made worse by the news of receivership and redundancies. Donations can be made at any Kiwibank branch or direct to bank account: Kiwibank 38-9011-0165987-00. Cheques made out to "EPMU Pike River Miners Family Support Trust" can also be sent by post, care of EPMU, PO Box 14-277, Kilbirnie, Wellington 6241. The ASMS has already made a donation of $10,000.

5. Reminder: National Executive Elections

The biennial term of the current National Executive ends on 31 March 2011. All ASMS members should now have received the special circular from National Secretary, Dr Brian Craig calling for nominations. It was enclosed with the December issue of The Specialist. The closing date for nominations is Thursday 3 February.

6. Reminder: University of Otago, Wellington Inaugural International Cancer Symposium, 13-19 February 2011

The University of Otago is organising an Inaugural International Cancer Symposium at the Duxton Hotel, Wellington, from 13-19 February 2011. The Symposium consists of five programmes and two special sessions. Each programme is distinct and stand-alone but the common thread of translating today’s clinical excellence into tomorrow’s cure runs strong in each presentation. Part of the programme will include a session on Professional Burnout: The Hidden Cost of Healthcare, on Tuesday evening 15 February. Further information is available at www.uow.otago.ac.nz/cancersymposium.

Ian Powell
EXECUTIVE DIRECTOR

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