Improved accountability for millions of dollars spent on
district health board senior doctors' continuing education is
being sought by Audit New Zealand.
In its audit report for the Southern District Health Board
for last financial year, released under the Official
Information Act, Audit NZ noted the board was aware of its
deficiency in guidance on what constituted ''actual and
reasonable'' continuing medical education (CME) expenses.
Last financial year, the board spent $3,049,419 on the
expenses and it has spent $2,688,802 in the nine months to
March this year.
The CME clause in the senior doctors' collective agreement
allows for up to 10 days' leave for continuing education,
plus travel time and reimbursement of actual and reasonable
expenses up to $16,000 a year (able to be accumulated for
Audit NZ said it did not regard this entitlement as straight
remuneration to be taken at the discretion of the employee,
as some boards had suggested.
As with other types of sensitive expenditure, it was prudent
to have a policy on what would be regarded as actual and
reasonable expenses, including such things as classes of
travel, price of meals and purchase of alcohol.
Also, there needed to be some guidance on what qualified as
continuing education and what did not.
The board, in its response agreed with the Audit New Zealand
view, saying it had a policy drafted which was awaiting
Board executive director of human resources John Pine, in an
emailed response to questions, said the board was still in
the process of finalising the guidelines.
Generally, what were acceptable activities and what was
actual and reasonable were well understood.
Senior doctors were required to specify the relevance of the
activity to their medical specialty, the number of days'
leave required and an estimate of the expenses as part of the
Applications were dealt with on a case by case basis,
''within appropriate delegations''.
The former Otago and Southland boards had different approval
processes and delegations and some differences in what had
historically been approved.
For this reason, there was a need to develop a single set of
guidelines for the Southern Health Board.
Draft guidelines had been available since 2011, but ''we held
off finalising them until the district leadership structures
were in place''.
The guidelines had been used as the basis for other South
Island boards, with the aim of ensuring some consistency.
The Canterbury board had been consulting the Association of
Salaried Medical Specialists (ASMS) on behalf of the other
Mr Pine said the Southern District Health Board had recently
discussed the guidelines with ASMS and noted comments on
points of difference from the Canterbury document.
A draft would shortly be submitted to the executive for
consideration of the differences and eventual approval.
ASMS executive director Ian Powell said the issues involved
were mainly to do with inconsistencies in application across
the services in a large organisation.