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The Southern District Health Board has ranked poorly in a survey of senior doctors.
The board was ranked 18th of the 20 health boards in terms of the support it gave doctors to assume leadership roles in the workplace.
Asked specifically about chief executives, southern specialists ranked Carole Heatly 12th of the 20 board heads, while senior management in the South ranked 16th.
Association of Salaried Medical Specialists executive director Ian Powell said he was not surprised Ms Heatly fared better than her senior management team.
''The problem is not so much Carole Heatly. She's somewhere in the middle of the pack [of chief executives].''
''My take on Carole is that generally she interacts with medical staff well. They find her good to talk to, good to engage with.''
At the ''core of the problem'' were senior managers, he believed.
He suggested Ms Heatly needed to ''ferret around'' when issues arose in individual health services, rather than taking managers' advice at ''face value''.
''I think she has been poorly advised in a number of areas.''
In an emailed response, Ms Heatly told the Otago Daily Times: ''I am pleased with the results, given that the senior management team had only been in place for a year when the survey was undertaken.
''We are working hard to engage with the clinical staff and I'm looking forward to further improvement next time the survey is conducted,'' she said.
In general, health boards performed poorly in the survey, which was conducted at the end of last year, Mr Powell said in a media statement.
''A few DHBs and chief executives are doing well, and they're to be commended, but most are really failing.
''Frankly, they're missing the point of clinical leadership. It's not a luxury or a nice-to-have, but an essential part of a safe modern health system.
''It's a no-brainer to involve a highly skilled professional and committed workforce in leadership decisions about the services they then have to deliver,'' he said.
Blame for the lack of support for clinical leadership could be apportioned to the Government for not sufficiently investing in the specialist workforce, Mr Powell said.