The Dunedin School of Medicine should be recognised as a national asset, medical school dean Professor Barry Taylor says.
Prof Taylor and health sciences pro-vice-chancellor Professor Peter Crampton spoke to the Otago Daily Times on Friday about a report prepared for the Dunedin Hospital rebuild which has challenged the city’s medical establishment.
It suggested research, teaching and private work might be a burden on the Southern District Health Board.
The University of Otago has approached the issue cautiously and seems reluctant to criticise the Government-run process.
Prof Crampton and Prof Taylor were at pains to emphasise they support the overall direction signalled by the report, and both played down the strong criticism of the medical school in the report.
But they admitted they were concerned by what they believed was an inaccurate portrayal of the relationship between the medical school and Dunedin Hospital.
"It’s been mischaracterised in that report, and I don’t accept that some of the issues raised are issues," Prof Crampton said.
The report uses anonymous comment to criticise supposedly "opaque" work arrangements of some staff who work in clinical and academic roles.
"The individual clinicians are upset that there’s any implication that they don’t put the patient first."
They are concerned by the report’s heavy use of anonymous anecdote and Prof Taylor said consultation had been rushed.
"I think the anecdotes are unhelpful," Prof Taylor says.
Most staff worked more hours than they had to, Prof Taylor said.
"Across the whole system I think about 90% of our joint clinical staff actually put in more clinical time than [they were obliged to].
"There are one or two individuals where it might be the other way round but the bulk of the relationship is to the benefit of the DHB."
Prof Taylor said drug and other clinical research was funded separately and was not a financial burden on the DHB.
Oncologist Chris Jackson was an example of a clinician who contributed to healthcare at a national and local level, Prof Taylor said.
As medical director at the Cancer Society, Dr Jackson played a leading role in the national debate about funding melanoma drugs Keytruda and Opdivo, and as a researcher he ran trials that gave patients access to new drugs at no cost to the public health sector.
"We’re not just contributing to the local but we actually have a national role.
"It’s both of benefit not just to the southern region but also nationally and increasingly we want to push the idea that what we have here in the southern region is unique in the country ... and I personally think it’s got to be recognised more nationally, rather than saying it’s all got to be Auckland or Christchurch," Prof Taylor said.
Dunedin’s size meant people in different departments and disciplines liaised in ways that were impossible in larger centres.
Prof Crampton said the set-up of the teaching hospital was something other centres aspired to.
"We’ve got something special that the country has invested in for [more than 130 years].
"That specialness exists in the context of a health system that is nationally under a lot of [financial] stress."
Prof Crampton said he understood the financial challenge of providing healthcare in the relatively sparsely populated south.
He said the medical school was an asset in that respect, partly through attracting clinicians with new ideas.
The medical school has been accused of being a burden before but a a report by economist Suzanne Snively in 1997 found it was an asset to southern health, Prof Taylor said.
"That’s been an argument that goes back many years . . . the Snively report for one quite clearly said there’s benefits for both and I believe that’s still the case," Prof Taylor said.
Last year, Ms Snively told the ODT that she had told the health bosses who commissioned the report to stop complaining as they were getting a "great deal".
"The nature of the people who are attracted to doing clinical and research work at the same time are the kind of people who are really devoted to their work.
"People were parroting unsubstantiated evidence that training and teaching hospitals were always a drag on the hospital," Ms Snively told the ODT.
Prof Crampton said he would liaise with Government-appointed Southern Partnership Group chairman Andrew Blair, to improve his understanding of the relationship with the medical school.
In addition, staff in the department of medicine (a division of the medical school) are preparing a formal written response to the report.
The Ministry of Health and the Southern Partnership Group are in charge of the $300 million rebuild.
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If it is a burden on the DHB how would it be any less of a burden elsewhere. Are they suggesting NZ doesn't have one? Moving it would cost millions probably 100's of millions looking at what they have spent elsewhere let alone the costs involved to staff and students i.e. higher costs of living etc. It must be cheaper all round to leave it where it is. I believe moving it has long been a goal and this govt is just seizing the opportunity to progress their agenda to strip the south of services and centralize in the north.