A survey has shown progress towards getting doctors and nurses more involved in running public hospitals, but also revealed many senior staff don't have the time or support needed for clinical leadership.
The survey of more than 10,000 health professionals employed by district health boards was commissioned by the Ministry of Health and DHBs and carried out by Otago University researchers.
Having medical staff deeply involved in decision making, along with hospital managers, is Government policy and seen as critical to delivering better care in tight times.
Otago University says the survey shows good progress towards the goal, but also serious shortcomings.
Of those who responded, 36% felt they had enough support for extra leadership positions.
Health Minister Tony Ryall said clinicians need to speak up if they think patient safety may at risk.