Dr. Derek Keith Sage BSc(Hons), MB, BCh(Wales), PGCertClinEd, MRCP(UK) FRCP(London), FRCS(Edin), FCEM, FACEM.
Bachelor of Science(Honours) (University College Cardiff, 1985)
Bachelor of Medicine (University of Wales, College of Medicine, 1988)
Bachelor of Surgery (University of Wales, College of Medicine , 1988)
Post Graduate Certificate in Clinical Education (University of Auckland 2010)
Membership of the Royal College of Physicians of the United Kingdom (1996)
Fellowship of the Royal College of Surgeons of Edinburgh (1999)
Fellowship of the Faculty of Accident and Emergency Medicine (UK, 2000)
Fellowship of the College of Emeregncy Medicine (United Kingdom, 2008 - formerly Faculty of A&E Mediine)
Fellowhip of the Royal College of Physicians of London (2007)
Fellowship of the Australasian College for Emergency Medicine (2008)
Qualified instructor for Advanced Life Support (RCUK), European Paeditric LIfe Support , Advanced Paediatric Life Support (international), Advanced Trauma Life Support /Early Management of Severe Trauma (international), Ill Medical Patient's Acute Care and Treatment (RCPUK)
I am married to Teresa who is a registered nurse and in her final semester of her bachelor’s degree in counselling. We have 3 children: Nathaniel age 11 at Aquinas school in Pyes Pa and Victoria and Ethan (aged 8-twins) who attend the local primary school (Omokoroa Point School).
Teresa and I are originally from Wales and we have practised in healthcare in the UK, North America and New Zealand. Nathaniel was 2 years of age when we originally arrived in Dunedin 9 years ago and that is where Victoria and Ethan were born. Eight years ago we moved to Omokoroa when I took up the clinical director role in the BOPDHB which has seen me involved in both Tauranga and Whakatane emergency departments.
In addition to my formal training and fellowships in medicine, surgery and emergency medicine I have had formal training in clinical education and population based (public) health medicine. My current medical leadership role has involved me in the current Whakatane hospital redevelopment and development of new models of acute care for the BOPDHB.
I am involved in the local community in that I am a committee member of Omokoroa Junior soccer club as well as player – coach of Te Puna Fury reserves soccer team.
Outside of sport I am a member of the Omokoroa Settler’s Hall Committee. I am director of and major shareholder of Celtic Pacific Holdings Limited (house rental).
My family and I are committed to the BOP community and as such being a member of the DHB would be a positive expression of this commitment.
I have no political party affiliations but respect honesty in actions. To me, being a doctor is a vocation and not merely a profession, and certainly not a business. And it is through my concern for both the individual patient who I treat and for the population as a whole I strive to get the best value for the health dollar.
Having worked for the BOPDHB for nearly 9 years, I have seen CEOs and managers come and go and have experienced more than one restructuring exercise to the DHB. I have watched as clinicians have been ignored just to see us make the same mistakes as the UK. I am privileged to have personally had the experience of what has worked well and not so well in the UK which would be a valuable asset to the DHB.
I seek to add the dimension of clinical leadership and involvement in the DHB advocated by the current minister of health, and I feel that I have both the clinical and managerial experience within the NZ public sector to influence clinically sensible, ethical, morally just and fiscally prudent decision making by the DHB. I have a grass roots understanding of the practical difficulties in achieving our current health targets and I am passionate about delivering an efficient and effective health service to the people of the Bay of Plenty.
Top 5 Issues
- Clinical Leadership: Clinical leadership and guidance is required at all levels within the DHB and it should be vocationally driven healthcare professionals leading, assisted by business and legal experts, rather than the opposite situation. We should be making clinically driven fiscal decisions rather than fiscally driven clinical / healthcare decisions.
- Common sense approach to health targets: We must move towards making what is important measureable, rather than pursue the bureaucratic habit of making what is measureable, important. -The latter leads to perverse behaviours counterproductive to safe, efficient and cost effective healthcare designed to make the DHB look good rather than improving healthcare access and outcomes. Clinical leadership is required to ensure that the politics does not contaminate the ethics of healthcare and that the principle behind or ‘the spirit of’ the target is utilised to improve healthcare. The DHB needs the input of frontline healthcare ‘streetwise’ experts committed to the public hospital system.
- DHBs as advocates: DHBs have a moral and ethical duty to their local population not to become purely the instruments of a central political agenda but to visibly advocate for their population based on the local population health needs otherwise there is no purpose to electing DHB members.
- Value for the healthcare dollar: This requires tough decision making which should be explicit / transparent decision making no matter how politically unpalatable. It should be made as part of evidence based healthcare applicable to the realities of our local situation and needs.
- Bureaucracy and over-management: Whilst it has been argued that the DHBs (BOPDHB included) have an over representation of bureaucrats / managers creating unnecessary expense and inefficiencies, they have become necessary due to the central reporting / political / legal compliance demands placed upon DHBs. The blind removal of administrators is not the streamlining of bureaucracy but may remove the support teams necessary for the clinicians to efficiently execute their duties. It is only through the removal of unnecessary central bureaucratic demands that will allow sensible removal of bureaucrats / managers.
Conflicts of Interest
I am an employeee ofthe BOPDHB
I am a member of the Association of Salaried Medical Specialists
Authorised by Dr Derek Keith Sage of 60 Western Avenue, Omokoroa, Tauranga 3172
Questions answered by Derek Sage
Derek Sage's Reply
The balance of evidence favours fluoridation of the drinking water but ‘you do not keep a dog and bark yourself’ and so surely a DHB must act upon the expert advice of the local public health experts (Toi Te Ora) who are paid good money to advise us. It is a waste of tax dollars to pay someone for their expertise and direction just to ignore them. I would look to these same population health experts for what extra measures besides water fluoridation had evidence to support them.
The evidence on the relationship between water fluoridation and tooth decay and an excellent analysis by a UK PCT (comparable to a DHB) is available:
Awaiting responsecheck out other candidate's answers
Monica, in response to your two part question I will deal with the second part first. Ethically and as part of a caring society we have deal with fixing what’s already damaged. However it makes no sense to ignore preventative measures when this makes both ethical and fiscal sense. Therefore the answer is that it is important to spend health dollars on both preventing disease and fixing what is already damaged.
With respect to the first part of the question, patients already have freedom of choice with regard to their ‘informed’ management and of course any DHB should work to maintain this. However there is a requirement to ensure the greatest good for the greatest number and therefore there is a careful balance to be achieved between ‘individual freedom’ and the opportunity lost to the community. The DHB should provide freedom of choice for evidence based interventions but at the same time be willing to consider interventions requested by the patient for which there is little or no evidence for their effectiveness. This would be with the proviso that it will cause no harm and does not deprive others of proven effective treatments. The public expectation is that we invest in proven treatments but at the same time do not become ‘narrow minded’.
This is a rather general answer to the first part of the question because your example of Vitamin C was not given in a specific context. I therefore I have attempted to answer in this rather generalised way based on the aforementioned principles.check out other candidate's answers
Results - Final
- Mark Arundel
- David Stewart
- Matua Parkinson
- Marion Guy
- Yvonne Boyes
- Mogens Poppe
- Ron Scott
- Andrea Marsh
- Derek Sage
- Tommy Kapai Wilson
- Andrew von Dadelszen
- Jo (Josephine) Gravit
- Stewart Ngatai
- Mike Mills
- Jorg Prinz
- Veronica (Ronnie) Haylings
- Russell Clements
- Don Archer