While the College acknowledges the government's intention to strengthen clinical governance and leadership in healthcare, it is deeply concerned that the current proposal, which includes reducing the number of chief medical officers (CMOs) from 18 to 14 nationwide, falls short of the mark.
Dr Ros Pochin, chair of the Aotearoa New Zealand National Committee, says: "We welcome Te Whatu Ora's commitment to enhancing clinical leadership, but the current proposal risks undermining the quality of care and patient outcomes, especially in our rural communities. We need a robust, evidence-based plan that includes medical expertise at every stage of the design process, not a rushed decision that could have far-reaching negative consequences."
She says the reduction in CMO roles is disproportionately skewed towards rural distracts, where significant health inequities already persist.
"We should be strengthening leadership in these communities, not diminishing it. The proposal is metrocentric and fails to acknowledge the unique needs of rural and Māori populations," she says.
In its submission, the College adds the reductions will create excessive workloads for the remaining CMO roles, noting workloads are already stretched for these critical healthcare leaders.
"The proposal doesn't provide sufficient evidence that the current clinical leadership model is failing or that these changes will improve clinical governance. If it's not a step in the right direction, then the rationale for this change has to be questioned," Dr Pochin adds.
RACS is calling for Te Whatu Ora to halt the decision-making process until a more comprehensive case for change can be developed; one that includes input from medical professionals at every stage. The College recommends that a clear commitment to quality and safety be embedded in any restructuring efforts, with mandatory safeguards to prevent compromising patient care.
"We need to see a clear, thoughtful, and evidence-based approach to clinical leadership reform. Cutting corners at this stage could jeopardise the future of our healthcare system. If the government is serious about providing high-quality, equitable healthcare, it must act with the foresight and consultation that this critical issue deserves."
