A suggestion that the most significant barrier to clinical leadership at the Otago District Health Board is a lack of money and time has been described as "a cop-out" by Association of Salaried Medical Specialists executive director, Ian Powell.
The board could pay clinical leaders more - "that's been their call".
Mr Powell was commenting on a paper produced by the Otago and Southland boards as a response to a request from a ministerial group asking for comments on clinical leadership.
Health Minister Tony Ryall has been emphasising the importance of clinically led services.
In the paper, the boards say that in Otago, despite there being a defined structure for medical leadership, there was limited reimbursement and not enough time.
"Senior medical staff therefore remain reluctant to take on additional requirements."
Mr Powell said he considered some of the difficulties in this area related to the culture of the board management and its relationship with senior doctors, rather than its structure.
While the relationship had been worse, particularly in the late 1990s when it was "absolutely toxic", it could be better, with some senior doctors feeling frustrated and constrained.
He also foresees difficulties with the two boards developing joint clinical services, not because of difficulties with clinicians working together, but because Southland management could feel threatened.
The "halfway house" situation the boards were in, in which they shared a chief executive, was not helpful to that situation, regardless of who the chief executive was, he said.
Regional chief executive Brian Rousseau did not wish to comment on Mr Powell's remarks.
