A sign held by a protester at Christchurch Hospital. Photo: RNZ / Nate McKinnon
The disruption to patient care from a nationwide junior doctors strike is bordering on unsafe, one senior doctor claims.
Resident medical officers - junior doctors - picketed outside hospitals in eight main centres on Tuesday morning in protest of a proposed pay cut for trainees in psychiatry, radiation oncology, pathology, public health and general practice.
While most junior doctors had been offered a 20 percent pay rise by Health New Zealand / Te Whatu Ora, doctors in those specialities singled out would receive a 12 percent pay cut.
Te Whatu Ora chief clinical officer Richard Sullivan said the country's emergency departments remained open and patient safety and welfare were the top priority during the 24-hour strike.
However, a source inside Waikato Hospital told RNZ it was not business as usual and the strike had brought huge ramifications for patients.
The senior doctor, who did not want to be named, said it was very distressing that officials appeared to be minimising the impact on patients by implying there was "no meaningful disruption to services and that almost everything is going ahead as normal".
"Certainly in Waikato, there are plenty of elective services cancelled today - clinics, surgery, day stay procedures etc," they said.
"And although I can only speak for my department, we are really tight for cover from SMO (senior medical officers) staff for acute services and pretty much all elective work has been cancelled.
"So it's actually pretty dire, and if next week's planned strike goes ahead it's going to be worse. I'd go as far as to say that it's bordering on unsafe."
Junior doctors picketing outside the Waikato Hospital campus on Tuesday morning. Photo: RNZ / Natalie Akoorie
Sullivan did not address the concerns at Waikato but said the impact of the strike on planned procedures varied by hospital, depending on the number of New Zealand Resident Doctors Association (NZRDA) members in each area.
"In areas with a higher number of NZRDA members a small number of surgeries and procedures have gone ahead today for high-risk cases and non-deferrable and other scheduled cases have been postponed and will be rescheduled.
"In other areas with lower NZRDA membership there has been less disruptions, and more procedures are able to proceed. However, this remains limited by the overall staff availability."
He said junior doctors were a "vital and valued part of the health workforce, and we are proposing a very significant investment in settling the NZRDA collective agreement".
The average pay rise proposed was 18 percent, he said.
"We have guaranteed that no current RMO would receive a pay cut under this offer.
"We are highly focused on settling this bargaining so we can avoid any further disruption to patients and the wider health system."
Sullivan said Te Whatu Ora's application for facilitation had been granted by the Employment Relations Authority.
"We encourage the union to accept the authority's recommendation that the union withdraws its current strike notices as an act of good faith due to the facilitation process."
A junior doctor named Minesha, spoken to by RNZ on the picket line outside Waikato Hospital, said it was hard to strike knowing the impact on patients.
"I'm starting as a paediatric surgery registrar, so next week on Thursday/Friday when we're striking again I would have just started a job and have to be here striking for two days.
"It is hard to do that. It's distressing to have to leave when we know that there's so much going on and our patients really need us, but this is really important so that we have a future of doctors."
Natalie, a Waikato Hospital medical registrar also picketing, said the whole service at the major tertiary hospital was forced to change for the day, with most of the hospital's 300-400 junior doctors on strike, because we are such an undervalued but integral part of the hospital".
"We were just looking through the roster and there were no covers anywhere - there were not many [junior] doctors left in the hospital.
"So lots of services did have to stop and I think, although that's terrible for a day, it just shows how important we are and how we need to be valued for what we do in the hospital."
Photo: RNZ / Nate McKinnon
Resident Doctors Association Waikato representative Dr Visharn Sathiyakumar said the targeted specialities already had workforce shortages, and he worried about access to treatment, particularly for cancer patients, if radiation oncology trainees left.
"Cancer in New Zealand I know gets a lot of attention, but when it comes to specialist care it's always historically been not as supported... especially when it comes to doctor training pathways.
"We have shortages currently in our department when it comes to specialists and across the country where wait times are getting longer, there's entire machines - we use radiotherapy machines to treat cancer which are these multimillion-dollar machines - that we cannot run because we don't have enough people to staff them.
"And in this situation, offering a pay cut to these class of trainees I think it's going to worsen that inequity."
He was concerned about the trickle-down effect of a pay cut on resident medical officers (RMOs) who were already burned out and considering leaving for Australia.
Photo: RNZ / Nate McKinnon
The same applied to general practice, where there was a dire nationwide shortage and weeks-long waits to see a GP.
"It's the pay cut that's difficult to swallow, regardless of the fact that you're losing all these people, and you're telling us actually we're not valued."
The roughly 2500 strikers made up about a half of the junior doctor workforce, who joined forces for the industrial action because about 600 positions were in line for the pay cut.
Psychiatry registrar Sarah Hanson was picketing with about 50 doctors outside Wellington Hospital. Her speciality was one where pay cuts were planned, which she said was very unfair given there was already a shortage.
"I've got colleagues who aren't sure whether they can afford to continue on the training programme because they have families to look after, so it is a very real threat to our retention and recruitment of staff."
Even though they were called junior doctors, some of those striking had more than 10 years' experience and would soon become specialists. Others were just out of medical school.
Jamie Hogg worked in mental health, and said some GP trainees were also set to get a cut even though they were facing shortages too.
"Do we want to be the training ground for Australia? No I don't think so, I think we want to keep New Zealand trainees in the country and value us."
If the two sides could not reach agreement by next week, a second, two-day strike was planned from 16 May.