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Source: Association of Salaried Medical Specialists

ASMS executive director Sarah Dalton’s first column for New Zealand Doctor looks at the role of the union, the inconsistencies of health IT, and wider issues in an election year. 

Kia ora koutou katoa. Ehara taku toa i te toa takitahi, engari he toa takitini – or, very loosely translated, we do our best work by working together. This whakataukī is a touchstone for me as I step into my role as executive director at Toi Mata Hauora/Association of Salaried Medical Specialists.

Unions are all about collectivity. Together we are stronger! This holds for negotiating (and enforcing) our members’ terms and conditions of employment and, importantly, using the power of the collective to influence public health provision in ways that matter.

Health equity is key to proper public health provision and it’s time to challenge the notion that what seems to work for most is, therefore, best for all. We need to look and listen more carefully, and to approach health need and provision from a range of perspectives.

The whakataukī also reminds us to foster our external relationships. ASMS is one strand of a rich tapestry of health providers, sister unions and a range of workforce groups. We are proud to be part of this community. We will continue to work together for the big picture – which is best care for all of our people, because caring for people is at the heart of what we do.

On a more prosaic note, I have been thinking a lot about health IT. I find it a mystery that, in an age of helpful apps and free downloads, we don’t seem to have universal, accessible, user-friendly IT systems in health or education. I can sort out my car parking and line up TV shows on my iPhone, but good luck where health data are involved.

I use a “manage my health” service for GP appointments, and it has made my life easier. What I don’t know is whether it’s making my GP’s life easier. Does it contribute to her likelihood of burnout? Is her working day better or worse because of it? There is some interesting research by Melnick and colleagues from the Mayo Clinic on the subject.1

Hospitals have a multitude of IT systems, but none seems to be able to talk to each other and many are painfully slow. Add lack of non-clinical spaces, computer terminals and desks to the mix, and you have a perfect storm of irritation. We should be seeing waves of innovation instead.

I’ve also been thinking about ASMS’ non-hospital doctors and dentists. Contrary to popular belief, we have quite a few members in hospices, Family Planning, ACC, iwi health organisations, union health practices, community labs, and sexual health providers. And thanks to a recent amendment to our constitution, along with an amicable agreement with the PSA, we now cover government-employed doctors at the Ministry of Health as well. We are thrilled to welcome these new members.

It is, of course, election year and ASMS will be part of the public health debate. While this is nothing new, we have growing concerns that health provision is framed as a business, with targets and KPIs (key performance indicators; you know the jargon), and the health spend is seen as a cost rather than a public good.

Given the Government’s wellbeing agenda, wouldn’t it be better to look at hospitals through the same lens – what is best for the people being treated, and what is best for the people providing the treatment?

When people are unwell, be it acute or chronic, they need access to appropriate care. There was a long discussion on RNZ recently (“Nine to Noon”, 20 January) about the multiple barriers to accessing prescriptions, and a new study testing whether fees-free access helps. That would seem like a no-brainer, but we know there are often complex factors in play – as well as cost – when it comes to getting treatment and staying well.

Ngā mihi nui ki a koutou mo te hau hou.