At the same time as collective agreement negotiations with Te Whatu Ora have broken down and senior doctors and dentists are about to embark on unprecedented strike action, the Association of Salaried Medical Specialists - Toi Mata Hauora is releasing a new report - A Less Public Place - exploring what drives senior doctors and dentists to reallocate potential working hours from Te Whatu Ora to employment outside the public health system.

"Employment with other employers is mostly working for private hospitals and/or in private clinics," says ASMS Executive Director Sarah Dalton. "It is a growing trend and, in the context of Te Whatu Ora’s current refusal to offer pay rates that keep up with inflation, it is further evidence of Te Whatu Ora’s failure to get a handle on the problems of recruitment and retention for medical professionals in our public hospitals."

A Less Public Place is based on a survey this year of ASMS members working for Te Whatu Ora. The survey found 59 per cent of members already do work outside the public health system and a further 13 per cent are actively considering it. Only a little over a quarter now work exclusively in the public health system.

General and orthopaedic surgery, anaesthesia, neurology, diagnostic and interventionalist radiology, ophthalmology, gastroenterology and cardiology have the highest proportion of respondents already working outside the public system - all more than 70 per cent.

"Given the pressures our public system health is facing - the stretched services, the waiting times, the unmet need - that’s an enormous amount of workforce capacity that is slipping away," says Dalton.

"The reasons our members give for making the move away all relate to terms and conditions. Remuneration - yes, but also burnout from high workloads and lack of colleagues, and feeling unvalued in a controlling management culture."

"A simple step right in front of Te Whatu Ora would be to accept our members’ wage claim, that would maintain the value of their wages and is not a real pay cut. Less than that would seem to be exactly the sort of undervaluing our survey identified."

More than half of specialists who already worked outside of Te Whatu Ora identified better remuneration, more ability to manage time and workload, and greater clinical satisfaction as the most important reasons behind their decision to work for themselves or someone else.

A full copy is the report is available at https://asms.org.nz/a-less-public-place.

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