Anaesthesia meeting with the Minister of Health

On Thursday April 6 representatives of ANZCA and the New Zealand Society of Anaesthetists met with the Minister of Health, Hon Dr Ayesha Verrall. We are thankful to the Minister for the invitation to meet with her and her team.

Some key topics we wanted to address were identified in advance of the meeting and are summarised briefly below:

Chronic Pain Services

We highlighted the lack of chronic pain management services and the critically low number of Specialised Pain Medicine Physicians (SPMP) in Aotearoa New Zealand. We discussed how the current funding structure and service provision are inadequate, how historically this service has been given a low priority and that there is a need for an integrated healthcare team approach. Some of the current situation has arisen due to the differential funding by ACC for pain services, and pain centres often being set up around ACC funding rather than what is best for the patient.

The Minister acknowledged she was aware of the impact well-managed chronic pain services can have on patient outcomes and the economic advantages of well-run pain services to the health system. She tabled this with her team for review and discussion.

Anaesthesia Workforce

The multi-faceted workforce issues facing the health service are well known and it was valuable to discuss these directly with the Minister. We raised the challenge of addressing inequitable pay and conditions across the motu for anaesthetists, and indeed across all specialties, over and above the MECA agreement and how this contributes to the maldistribution of SMOs and the subsequent impact on access to services for the people of Aotearoa New Zealand.

This variation in contracts has really come to light through recent health reforms and organisational review. Nationalising conditions under the single employer, Te Whatu Ora, is a challenging piece of work. For a start, the multiple payroll systems will need to be amalgamated and that will take time and money. An agreement was reached that transparency and fairness are what we are all aiming for.

Anaesthesia Assistance

The Minister acknowledged that the anaesthetic technician shortage has recently been a key piece of work for the Manatū Hauora Ministry of Health and Te Whatu Ora, with the implementation of a tactical working group specifically to address this element of the workforce. The New Zealand Anaesthetic Technicians’ Society (NZATS) is a key stakeholder when it comes to addressing the shortage of anaesthetic technicians and should be included in any future work.

We advocated that the Ministry and Te Whatu Ora need to promote and support training as part of the AUT Perioperative Practice Programme outside of Tamaki Makaurau, offering incentives and clinical placements in regional centres. We highlighted that a key aspect of the provision of planned care is the retention of our anaesthetic technician workforce, and like many other members of the health workforce this comes down to pay and conditions and feeling valued in the workplace.

Anaesthetic Patient Records

The importance of a national anaesthetic patient record was highlighted, with the acknowledgement that starting with a regional focus will be the most pragmatic short-term solution. Anaesthetic patient passports are already being developed, these include key information like anaesthetic adverse reactions, but a national record and national electronic medical record would be ideal.

ANZCA expressed interest in working with Manatū Hauora Ministry of Health to achieve this goal.

Planned Care Oversight Committee

A Planned Care Oversight Committee was established earlier this year off the back of the recommendations report from the Planned Care Taskforce. Clinical representation on this committee does not include anaesthesia, clearly a key member of planned care delivery with oversight of the perioperative journey. We suggested an anaesthetist should be part of this committee and are now in the process of ensuring that happens.

Following the meeting, the Minister notified us that work was underway to ensure the tactical working group addressing the anaesthetic technician shortage would include a representative from NZATS. An anaesthesia representative was also to be added to the Planned Care Oversight Committee.

We are planning a further meeting in 3-6 months to follow up on these issues and will update you when this occurs.