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The Association of Salaried Medical Specialists (ASMS) is the professional association and union uniting doctors and dentists in New Zealand.

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Opinion: Ian Powell – Leadership needed on safe staffing

12 February 2019 Opinon: - Ian Powell

When Health Minister David Clark was publicly criticised for dropping a requirement on his health ministry to publish the results of a set of narrow and misleading health targets in public hospitals, I defended him.

The Minister’s decision to drop this reporting showed a willingness to engage in a more thoughtful and effective fashion with his portfolio, which included exploring more robust alternatives.

Politically-driven targets cause potentially dangerous unintended consequences, especially in an environment of sustained underfunding. They are highly likely to have contributed to some patients going blind while waiting for eye-care appointments. It’s what can happen when DHBs are pressured to put crude surgery volumes ahead of monitoring patients with chronic conditions and necessary clinical follow-ups.

That is the legacy of the previous Government’s targets, particularly those in hospitals, and its overall approach to health. It tacitly encouraged poor decision-making, short-term thinking, and in some cases, neglect. The health system has too many moving parts and complex problems to distil into simplistic widget counts. The damage caused by the rigid application of targets was exacerbated by underfunding and short-staffing.

The false sense of productivity and transparency engendered by the targets (reinforced by financial retrenchment) papered over a workforce staffing crisis and poor service planning (within and between DHBs). It’s easy to see their attraction for publicity-sensitive politicians, so we admired Dr Clark for doing something brave and sensible.

We are less impressed by his attitude to an idea we put forward to combat the crisis in specialist staffing. We believe the specialist workforce is short by about 20%, an estimate derived from surveys of clinical leaders around the country. What more damning evidence is required than the shocking 50% burnout rate experienced by our highly qualified overworked hospital specialists.

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