GUEST BLOG: Ian Powell – ‘Delusional’ and ‘a spit in the ocean’ – absolutely; but also sinister!

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On 26 November Minister of Health Dr Shane Reti and Commissioner of Health New Zealand (Te Whatu Ora) Lester Levy made what was promoted (ie, spun) as a major health workforce announcement:

Official announcement.

This was that 50 new senior doctors, along with extra specialist nurses, would be employed by Health New Zealand.

It was also reported that that there would be a peculiar ‘bidding process’ for these positions. No less than Commissioner Levy would make the final decision over these ‘bids’.

Health Minister Shane Reti claims announcement will help fill critical workforce gaps

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Reti claimed that this would help fill critical workforce gaps, particularly in regional or provincial hospitals. It would, he asserted, help reduce wait times and support vulnerable specialties like dermatology.

Previously I have posted (10 August) on the demoralising impact of disingenuous and misleading ‘good news’ spin by health bosses on overworked, fatigued and burnt-out health professionals:

Health professionals to health bosses; stop the spin.

I would not have thought this possible but the Reti-Levy announcement has taken this kind of demeaning media ‘spin’ to an even higher level. Hospital corridor discussions have no difficulty in seeing through this nonsense.

Hospital corridor discussions know the difference between fact and fiction (NZ Doctor)

Sceptical media coverage

Perhaps the gentlest, but nevertheless firm and accurate, response came in a Kathryn Ryan interview on Radio with Sarah Dalton, Executive Director of the Association of Salaried Medical Specialists (26 November):

ASMS on 50 new senior doctors farce.

Among other things the interview was brought out that estimated senior doctor shortages in Health New Zealand hospitals were in the vicinity of 1,000 to 1,200.

Te Whatu Ora claim there are 1,700 vacancies for all hospital doctors (senior and junior/resident) and general practitioners.

However, this is disingenuous as it only includes the hospital positions that it choses to advertise. The reality is that shortages can be higher than vacancies by a variable factor of two or three to one.

That same day Newsroom managing editor Jonathan Milne had no difficulty seeing through the smoke and mirrors:

Sleight of hand.

Dr David Galler made mincemeat out of the Reti-Levy announcement

And, on 27 November, in an on-the-button Radio New Zealand Morning Reportinterview retired intensive care specialist and now health commentator Dr David Galler intelligently made mincemeat of the announcement:

A band-aid.

Gritty masterclass

Lisa Owen Checkpoint interview trumps media coverage

However, this coverage was trumped a Lisa Owen Radio New Zealand Checkpoint interview with Dr Norm Gray, clinical head of Wairarapa Hospital’s emergency department (26 November):

Delusional spit in the ocean.

Lester Levy knows more about recruiting overseas senior doctors than senior doctors involved in trying to recruit them!!!

Dr Gray gave a gritty, but matter-of-fact, masterclass in cutting to the chase which included effectively rebutting various Commissioner Levy claims. Among his observations were:

  • When ask whether the announcement had given him hope, he replied not at all. Instead it left him despondent and despairing.
  • The number of new senior doctor specialists was negligible.
  • His hospital even now can’t recruit from overseas.
  • The announcement was “delusional” with facts contradicting its fiction.
  • Wairarapa Hospital is already short of around 20 senior doctor positions.
  • The announcement was not even a drop in the bucket; instead it was a “spit in the ocean.”
  • The intended bidding process was wrong; there should not be competition.
  • Around one-third of locally trained doctors leave New Zealand because work conditions and remuneration are not comparable with overseas options. [Note: Australian specialist core salaries are at least over 60% higher]
  • Commissioner Levy’s claim that this announcement would succeed because it was a “different approach” was “delusional”.
  • His overall conclusion was that the announcement was an embarrassment for the government that would come back to bite it.

From delusional to sinister

Dr Gray is right. The Reti-Levy announcement is delusional, arguably deliberately so. However, in the context of the announcement itself and Levy’s “different approach” (bidding process), there is also a sinister element potentially undermining employment law.

Something sinister

In the national collective agreement covering the core terms of conditions of senior doctors and dentists employed by Health New Zealand, there is an important entitlement covering hours of work and job sizing. Specifically:

13.1  An employee’s hours of work and job size shall be mutually agreed and shall objectively reflect the requirements of the service and the time reasonably required for the employee to complete their agreed duties and responsibilities, as set out in their job description.

13.2  An employee’s job size is the average weekly number of hours the employee is required to undertake:

(a)  routine duties and responsibilities, including such scheduled activities as out-patient clinics, theatre lists and departmental meetings;

(b)  non-clinical duties and responsibilities [refer to Clause 48.2(d)];

(c)  duties at locations other than the usual workplace; and

(d)  rostered after hours’ on-call duties, including telephone consultations and other relevant discussions.

This is one of the strongest hours of work clauses in a collective agreement in New Zealand; arguably the strongest. [Disclosure: I was the advocate who first negotiated and then subsequently strengthened it over the years; just saying!]

It requires agreement over the hours of work and an objective methodology (as one can get in medicine and dentistry) to determine the average time necessary to perform the agreed duties and responsibilities.

Senior doctors in hospitals and related services don’t work as isolated individuals. They are part of a team, usually known as departments and services.

Consequently, to job size a specific position requires an implied or explicit agreement on the total senior doctor job size of the department or service.

The unilateral nature of the Reti-Levy announcement coupled with the top-down determinative “different approach” of Levy runs contrary to, and potentially breaches, this employment law obligation.

 

 

 

 

Ian Powell was Executive Director of the Association of Salaried Medical Specialists, the professional union representing senior doctors and dentists in New Zealand, for over 30 years, until December 2019. He is now a health systems, labour market, and political commentator living in the small river estuary community of Otaihanga (the place by the tide). First published at Otaihanga Second Opinion

13 COMMENTS

  1. Our public health system is being deliberately underfunded. At the same time it is being underfunded it is being stealthily privatised. More and more of of the health budget is going to middle men. Private catering companies, private parking companies. All taking their cut. In Auckland even the hospital beds are privately owned and leased out to public hospitals by private health contractors at a profit.

    All these parasites making money out of peoples illness, who contribute nothing to their care and only increase its cost.

    The reaction to the assassination of a private health contractor in the US should be a warning to all of us.

    We don’t want to go there.

    In the US the killer has become a folk hero on the internet.
    I condemn his violence. we don’t want anything like that here, ever. Which is why we must fight harder to get public health system properly funded and keep the private profit motive out of health care.

    Opinion | The Rage and Glee That Followed a C.E.O.’s Killing Should Ring All Alarms

    https://www.nytimes.com/2024/12/06/opinion/united-health-care-ceo-shooting.html

    New York Times Dec. 6, 2024, 12:51 p.m. ET

    …….Some of the posts that went most viral, racking up millions of views by celebrating the killing, I can’t repeat here.

    It’s true that any news with shock value would get some of this response online — after all, trolling, engagement bait and performative provocation are part of everyday life on digital platforms.

    But this was something different. The rage that people felt at the health insurance industry, and the elation that they expressed at seeing it injured, was shocking. It was also widespread and organic. It crossed communities all along the political spectrum and took hold in countless divergent cultural clusters.

    Even on Facebook, a platform where people do not commonly hide behind pseudonyms, the somber announcement by UnitedHealth Group that it was “deeply saddened and shocked at the passing of our dear friend and colleague” was met with, as of this writing, 80,000 reactions; 75,000 of them were the “haha” emoji.

    Politicians offering boilerplate condolences were eviscerated. Some responses came in the form of personal testimony. I don’t condone murder, many started, before describing harrowing ordeals that health insurance companies had put them through.

  2. Nothing surprises me anymore about these right wing national / act / nz1st assholes.

    By the time we kick these assholes out our health system is going to be beyond decimated and in the realms of total collapse .

    Meanwhile middle NZ starts screaming blue murder when Ian and I for that matter have been predicting it for over a decade when many of you were in total denial believing the political spin .

    Meanwhile hospital beds and hospitals both private and public were being reduced or closed right under your noses SINCE 1980.

    And that’s not even bringing medicines funding into the discussion.

    DAMN GOOD PIECE AGAIN IAN POWELL.

  3. Imagine, for a moment, that we never had 14 multi-billionaires, 3118 multi-millionaires each with an after tax starting gate fortune of $50 million and no Australian owned banks taking $180.00 a second after tax 24/7/365? Imagine that? Imagine also that we were peacefully neighbourly to them Aussies while allowing our farmers free rein to farm the Australian farmers into the floor boards as we once did. Imagine that?
    Lets ask Watties etc about our neo-neighbourly neoliberal neo-neighbours over the septic bog shall we?
    Did you know? That the Apple and Pear marketing board, like we fucking needed one of those, placed local embargoes on OUR export grade fruit so one was no longer LEGALLY able to gas up the Holden up and drive into Central Otago to buy the best, and I mean THE BEST fruits and vegetables from the road side stalls because the best was now legally obliged to travel to Australia via the A&P mafia. Gee thanks Wattie. You’re gosh darn cunts.
    Imagine the money that once cascaded into AO/NZ? We had the third highest standard of living in the world in the 50’s, 60’s and 70′. The only homeless people were nutty people who felt more comfortable bedding down with hedgehogs in gorse hedges. Imagine now, if you will, the fabulous Dunedin Hospital, a world leader in medicines and surgical techniques. I lived next door to a surgeon who pioneered kidney transplants. A lovely unassuming fellow who was educated in Dunedin. Today, the best we can expect from our abusive, arrogant, lazy, useless-fucker politicians is a half arsed half-build onto a once was world leading hospital and university educator and will end up deteriorating into the ground where it will be de-established and a hole will be all that will be left.
    I read that little jonky boy, the tugger of tantalising hair and cheap (Though not so inexpensive ) pervert is back! Yes! Hooray! We should schmooze China so he reckons. I think we should export The Jonk to China then revoke his NZ passport. I’m thinking a nice Yurt on the China/Russia border. Give him a sack of hair and a box of tissues as a gone forever gift.
    But imagine that, right? We good AO/NZ’ers standing up for ourselves and kicking up a fuck of a fuss?
    Look to John Minto as an example? That guy’s got Balls. He’s organised a country wide protest at the basic, common or garden variety fascist genocide of the Palestinians but yet we slink back into the darkness when Balls are needed to protect ourselves from our own.
    Wouldn’t it be interesting, as part of the royal commission of inquiry, to have an independent board of psychiatrists look us and our history over then give is a report? I wonder what they’d think of our own people back dooring competitors into our AO/NZ then making off with our money and our goods while we stood about helpless and immobile but for getting pissed and bashing each other up?

  4. Imagine, for a moment, that we never had 14 multi-billionaires, 3118 multi-millionaires each with an after tax starting gate fortune of $50 million and no Australian owned banks taking $180.00 a second after tax 24/7/365? Imagine that? Imagine also that we were peacefully neighbourly to them Aussies while allowing our farmers free rein to farm the Australian farmers into the floor boards as we once did. Imagine that?
    Lets ask Watties etc about our neo-neighbourly neoliberal neo-neighbours over the septic bog shall we?
    Did you know? That the Apple and Pear marketing board, like we fucking needed one of those, placed local embargoes on OUR export grade fruit so one was no longer LEGALLY able to gas up the Holden up and drive into Central Otago to buy the best, and I mean THE BEST fruits and vegetables from the road side stalls because the best was now legally obliged to travel to Australia via the A&P mafia. Gee thanks Wattie. You’re gosh darn cunts.
    Imagine the money that once cascaded into AO/NZ? We had the third highest standard of living in the world in the 50’s, 60’s and 70′. The only homeless people were nutty people who felt more comfortable bedding down with hedgehogs in gorse hedges. Imagine now, if you will, the fabulous Dunedin Hospital, a world leader in medicines and surgical techniques. I lived next door to a surgeon who pioneered kidney transplants. A lovely unassuming fellow who was educated in Dunedin. Today, the best we can expect from our abusive, arrogant, lazy, useless-fucker politicians is a half arsed half-build onto a once was world leading hospital and university educator and will end up deteriorating into the ground where it will be de-established and a hole will be all that will be left.
    I read that little jonky boy, the tugger of tantalising hair and cheap (Though not so inexpensive ) pervert is back! Yes! Hooray! We should schmooze China so he reckons. I think we should export The Jonk to China then revoke his NZ passport. I’m thinking a nice Yurt on the China/Russia border. Give him a sack of hair and a box of tissues as a gone-forever gift.
    But imagine that, right? We good AO/NZ’ers standing up for ourselves and kicking up a fuck of a fuss?
    Look to John Minto as an example? That guy’s got Balls. He’s organised a country wide protest at the basic, common or garden variety fascist genocide of the Palestinians but yet we slink back into the darkness when Balls are needed to protect ourselves from our own.
    Wouldn’t it be interesting, as part of the royal commission of inquiry, to have an independent board of psychiatrists look us and our history over then give is a report? I wonder what they’d think of our own people back dooring competitors into our AO/NZ then making off with our money and our goods while we stood about helpless and immobile but for getting pissed and bashing each other up?

  5. Health is a major voter concern and spin isn’t going to cut it.

    Voters want to see improvements, yet spin is all they are seeing. And a good number of us can see through it.

    So yes, this will come back to bite this Government come election time.

  6. I was talking to an USA health professional last week and he said we should be driving a recruitment program in the USA right now as there will be lots wanting to skip the country now the asylum has been taken over buy the lunatics .He also had a warning about our own lunatics that are in charge which may well be off putting ,jumping from the pan into the fire comes to mind .

  7. We look forward to the day that Reti and Levy are struck off.
    Conduct unbecoming.
    Crimes against New Zealanders.
    Crimes against their own colleagues – gross disloyalty.
    Bringing their profession into disrepute.
    What else can we think of?

  8. We have 3 BBB women stomping on as many people as they can the we have these two dick heads trying to privatise the health system for the wealthy .Best they watch their backs like that heath care rip off fella in the USA failed to do

  9. Cuts are actually costing public system more

    “For instance, we’ve had a clinician, who was in a management role for one day a week and four days in clinical practice, take voluntary redundancy.

    “So we’ve lost those four days’ of clinical practice – in a shortage speciality – and they are having to bring in a locum.

    “We’ve paid redundancy to someone and then replaced them with someone on a higher hourly rate.”

    https://www.rnz.co.nz/news/national/535973/health-workers-say-cuts-are-actually-costing-public-system-more

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