The Chair of the Aotearoa New Zealand National Committee wrote to Dame Helen Stokes Lampard, National Chief Medical Officer at Te Whatu Ora, in response to an invitation to comment on and discuss the draft Guidelines to manage secondary employment – Conflict of Interests.
A significant number of surgeons are simultaneously employed by Te Whatu Ora, affiliated with RACS and ASMS, have employment, contracts, or shares in members of the NZ Private Surgical Hospitals Association or other private or public entities. For some surgeons, Te Whatu Ora is their ‘secondary employment’ with the roles in private or alternative settings serving as their primary source of income. Consequently, the premise of the guidelines should be duality of paid roles, rather than categorising them as primary and secondary.
RACS is deeply invested in ensuring the Guidelines accurately reflect this reality of our members’ professional lives; they should be clear, widely available, well understood, and consistently applied. The draft Guidelines primarily address the needs and perspective of Te Whatu Ora and do not acknowledge the broader commitments of doctors in working across the public and private healthcare sectors – particularly the significant probono work provided to Te Whatu Ora by many doctors.
We submitted the Guidelines as drafted would disadvantage patients, trainees, and Fellows. They would lead to either:
- an increase in the number of surgeons opting for primary employment in the private sector, adversely affecting public health services, or
- an increase in the hours spent by surgeons dedicated to alternative employment than that within the public system, particularly in the private sector, again impacting public health services
They must explicitly acknowledge the growing involvement of surgeons and other medical professionals in outsourced surgical waiting lists and training in private facilities, including a provision to supervise registrars in the private sector during their own or outsourced lists.
Our submission also commented on the provisions relating to disclosure of private work, referrals between public and private practice, communication with patients about private treatment, non-poaching and non-solicitation, and access to patient information held by Te Whatu Ora.