ASMS Direct - Issue 2010-11
24 August 2010
Dear Member
We welcome any feedback on the contents of the 10th issue for 2010 of ASMS Direct, our national electronic publication. This copy of ASMS Direct focuses on:
1. TVNZ apologises for offence caused by Paul Henry
2. Medical Council and DHBs sign Memorandum of Understanding
3. Medical Council online survey
1. TVNZ APOLOGISES FOR OFFENCE CAUSED BY PAUL HENRY
In the last issue of ASMS Direct we reported the unfortunate and derogatory comments about overseas trained doctors made by co-host Paul Henry on TVNZ’s Breakfast programme (9 August). The ASMS formally complained to TVNZ and on 20 August Tony Davenport, Editor of Breakfast, after a useful telephone discussion with me, made the following apology including the comment that Mr Henry “wasn’t fluent in his delivery” and that he “made a spontaneous observation that missed the mark”:
Dear Ian
I apologise for any offence caused by Paul’s post-interview comments on August 9.
If you join his comments in a single train of thought, what he was trying to ask, quite legitimately, was that if foreign-trained doctors were as good as NZ doctors, why didn’t they beat the departing NZ doctors to many of those higher paying overseas jobs.
“Well, these immigrants can't be as good as our doctors or they would stay overseas if there's an opportunity to make more money overseas”
But as Pippa pointed out, there could be various non-monetary reasons for foreign doctors coming to work in NZ.
Unfortunately, Paul wasn’t fluent in his delivery with a pregnant pause after “can't be as good as our doctors”…and with both Paul and Pippa talking, Paul’s point was probably lost on many viewers, although his conclusion that the issue was a complicated one seemed apt.
This was a spontaneous observation that missed the mark and we apologise for that.
Thanks so much for donating your time to discuss the wider issue involved which I believe we both delivered with absolute clarity.
I also apologise for the delayed response. Your initial email was sent to the general Breakfast email box which can get up to 1500 messages a day and sometimes ‘out of hours’ emails are missed.
It’s best to send them direct to me or a TVNZ/Breakfast staff member who’ll forward it on.
It is hard to think of a broadcaster who has generated more complaints than Mr Henry; almost certainly many more than the combined total of complaints about the conduct or performance of overseas trained broadcasters working in New Zealand. It is also interesting to note that one “immigrant doctor” who “can’t be as good as our doctors” is one of the leading international clinical quality and safety experts, Professor Alan Merry, who the government wisely appointed to chair the establishment board for the newly created Quality and Safety Commission. Yet another Susan Boyle moment from our domestically trained broadcaster.
2. MEDICAL COUNCIL AND DHBS SIGN MEMORANDUM OF UNDERSTANDING
The Medical Council and the DHBs have signed a memorandum of understanding (www.mcnz.org.nz). This is far more detailed and comprehensive than the statement of collaboration that they have had in the past. The Memorandum includes the establishment of an oversight group with DHBs represented by a chief medical adviser, chief operation officer, human resources general manager and primary care adviser, and the Medical Council by the Chief Executive and relevant senior staff. This group will report to the quarterly national meeting of DHB chief medical advisers. The Memorandum will be reviewed two yearly or earlier if required.
The elements of the memorandum set out detailed undertakings from both parties on registration, practising certificates, orientation, induction and supervision of IMGs, recertification, the environment for intern learning, competence and conduct, sharing of information on doctors who are not employee’s and doctors health. As well the statement has appended a glossary, the Council’s protocol for decision-making and a list of Council statements and some other publications.
Overall the memorandum sets parameters for both parties. The standards are particularly useful on recruitment where DHBs are required to get sign off from both the relevant clinical director and chief medical adviser and required to reference check. This approach resonates with the appointments clause in the national DHB MECA. The information exchange standard requires DHBs to share any relevant information with the Council even for unsuccessful applicants. DHBS should identify this fact to potential applicants before they apply.
The Memorandum includes requirements that:
• DHBs are to provide sufficient non-clinical time for supervision and requirements;
• DHBs are to provide an environment supporting learning and development;
• DHBs are to encourage progress through vocational training programmes; and
• DHBs are to ensure that intern supervisors have 1 tenth protected time for each 10 interns.
There are potential concerns about some of the issues to do with notification on competence issues. Though most statements are a reflection of the requirements of the Health Practitioners Competence Assurance Act, there may be an issue of natural justice where unproven concerns about competence can be passed on from DHBs to the Medical Council without being necessarily raised with the doctor concerned. There is a risk that a doctor wishing to preserve their career will not be able to allow assertions of incompetence to go uncontested.
On 18 August the 20 DHBs and Medical Council made the following slightly edited media statement:
The Medical Council and the country’s 20 District Health Boards (DHBs) today signed a Memorandum of Understanding (MoU). The document signed by Dr Don Mackie, chair of the DHB chief medical officer group and Mr Philip Pigou, the Medical Council’s chief executive enable DHBs and the Council to work collaboratively together, clarifying their respective roles and responsibilities on the regulation of doctors in New Zealand.
The Medical Council’s, chief executive Philip Pigou said today, “The Council and the national Chief Medical Officer group have a very positive relationship which is critical to the success of this MoU. The signing of this MoU recognises the need for clinical governance and leadership between DHBs, the Council and clinicians. The MoU will help achieve our joint objective of ensuring the competence and quality of our medical workforce. It will also in turn benefit patients by contributing to quality and safety in our health system. It also recognises that DHBs and employers have responsibility to provide health and disability services and the Council has a responsibility to ensure the competence and fitness to practice of doctors. Failure to provide these services and the registration of doctors who may not be competent to practise, are both risks to public health and safety. The MoU outlines several new joint initiatives between the Council and DHBs including the development of processes for international medical graduates to assist with their orientation and induction into the New Zealand health system. A planned online portal will offer information and links on cultural issues, how the New Zealand health system works, as well as immigration and other support services.
Commenting on the signing of the MOU, Dr Mackie says because the roles and responsibilities are clearly set out both time and money will be saved. “There are now very clear expectations about the registration, reference checking and sharing of any information or concerns we might have about a particular doctor with the Medical Council. “We’re also strongly committed to ensuring the orientation and induction of new doctors into our health system and to providing an environment which supports learning and development.”
Issues of competence and conduct are also addressed by the MoU.
The notification process by DHBs (or other employers) to the Council of concerns about a doctor’s competence is another step in safeguarding public health and safety. As is the exchange of information by Council to DHBs about competence and conduct processes.
It also provides clear processes for sharing information about doctors who are not DHB employees but may pose a risk to public health and safety.
The MoU contains information relevant to the Council and DHBs in the employment of doctors within the service of the DHB. The next step is to work with the RNZCGP and other stakeholders to explore how the MoU can be extended to include those doctors working in primary care.
3. MEDICAL COUNCIL ONLINE SURVEY
The Medical Council has asked TNS New Zealand, a market research company, to replicate research it undertook for the Council in 2007. On Friday, 27 August the Council will be sending 500 randomly selected doctors an invitation to go online and participate in its online survey about the Council and it hopes those selected will take the opportunity to have their say.
The research will look at perceptions of the Council’s objectives and performance:
1. Determining the key audiences understanding of our role and functions
2. Whether our communications (through publications and media comments) are clearly understood and effective
3. Practitioners awareness and understanding of –
• Councils Role and Functions (health; registration; competence and conduct; education; standards and guidelines (including policy); and the Executive (Chair and Chief Executive).
• The difference between competence and discipline and our role in these areas
• Purpose and use of the annual practising certificate fee
• Efficacy of communications through our publications as well as public comments made through the media.
The key audiences the Medical Council is aiming at are:
• Stakeholders (including medical groups and colleges (eg, Health & Disability Commissioner, ACC, Ministry of Health), advocacy groups and media (journalists).
• Consumers (ie, the general public).
• Practitioners (includes specialists and general practitioners as well as international medical graduates, allowing for analysis among these specific groups).
The Medical Council hopes for the following outcomes:
• A greater understanding of the way the Council’s objectives and performance is perceived by stakeholders, practitioners and consumers recommendations on how communications with different audiences can be improved.
• The research may also form the basis of social marketing or the development of consumer documents.
If you’d like any further information, please George Symmes (Council Communications Manager) at (04) 381 6782 or email him at gsymmes@mcnz.org.nz.
Ian Powell
EXECUTIVE DIRECTOR
