'People are suffering': Head of emergency dept on understaffing

The head of Wairarapa Hospital's emergency department (ED) Dr Norman Gray says it was not a hard decision to walk off the job on Tuesday. 

He says years of pent-up frustration is boiling over, and is concerned people are dying because they are not getting the care they should be, thanks to massive staff shortages.

Hospital doctors and other health professionals went on strike for two hours at midday, forcing the deferment of around 250 procedures. The Association of Salaried Medical Specialists says the pay offer from Te Whatu does not even keep up with inflation, let alone make working in the New Zealand health system attractive. 

Gray told Checkpoint on Tuesday he estimated the nationwide staff shortage, including doctors, assistants and nurses, was about 1700. 

"Including nurses and healthcare assistants as well as the doctors, I've only had two days where we've been fully staffed for 24 hours since last October. We rely heavily on locums, which make up 60 percent of our medical shifts… doctors who aren't full-time ED doctors."

Of their regular doctors, three-quarters were from overseas - but attracting new talent was difficult, with countries like Australia offering far better pay.

"The problem is patients have to wait because we're understaffed and under-resourced. That waiting causes suffering, both psychologically and physically… 

"The staff get quite stressed because they feel responsible for the patients that are there. They don't have any real control over giving them the best of care, and this eventually leads to burnout and early retirement."

While the pay was adequate for him, a doctor nearing the end of his career, for others it was not.

"It's certainly not attractive to a new specialist who's probably got a family, a student loan and a mortgage, and it's certainly not attractive if you're coming from overseas."

Te Whatu Ora chief people officer Andrew Slater on Monday told Morning Report the current offer was the best it could provide.

"We think that there's a fair offer on the table, we re-shaped the offer last week, we added about an additional $16 million to the deal and we really were hoping that the union would take that out to its members and test it," he said.

"The offer that's on the table is the best offer that we can provide."

Gray said doctors were "absolutely" prepared to strike again if the offer was not improved, with the low staffing causing "higher mortality" in EDs than would otherwise be the case.

"As much and as long as it takes. There may be short-term pain for a lot of people, but there's going to be a lot more pain if we don't do something about the system that's declining at the moment. Long-term there will be a lot less pain if we can get some action now." 

As for the 250 postponed operations, Gray said that was on Te Whatu Ora. 

"You've got to put the ball back in [Te Whatu Ora's] court. We're propping up the system with a lack of numbers and they're relying on our goodwill, and all that does is enable the system to keep failing. I don't want to be part of that enabling." 

'It's the moral injury'

Developmental paediatrician Dr Rachel Beard was on the picket line outside Wellington Regional Hospital holding a piece of broken spouting in one hand and a sign saying: 'Don't let our public hospitals go down the drain.'

"The public needs to know that if they don't change things we will lose our public health system. When I started as a consultant over a decade ago, there wasn't really private work for paediatrics, it just wasn't a thing really," she said.

"Now lots of people are talking about it. And our hospitals will become just ICUs and EDs."

Beard said starting salaries for consultants in Australia were higher than what she now received.

"I'm 53 and have only ever worked in the public system."

A survey released by the Association of Salaried Medical Specialists this week found nearly 60 percent of members already work outside the public system and another 13 percent are actively considering the move.

Most of her senior colleagues had either burned out or gone overseas.

"I work in disability services, and it takes over a year for a child to see a behavioural specialist.

"So if I've got a child who's smashing up the house, hitting their parents, I can't do anything for them for a year."

Radiologist Leo Kallarackel said shrinking salaries meant vacancies could not be filled.

But the low-ball offer from Te Whatu Ora Health New Zealand showed it was not taking the crisis seriously.

"Either they want a public health service or they don't. It's as simple as that. Don't pretend you want one, just for the sake of politics."

It was devastating for doctors to see patients suffering because of long wait times or denied care, he said.

"The money is the least of it, it's the moral injury to doctors that really hurts."

Hutt Hospital obstetrician-gynaecologist Ed Hyde said the workforce shortages were putting patients at risk.

"Various hospitals can't even be staffed safely overnight, like Timaru a couple of weeks ago, it's having a significant impact on patient safety and our wellbeing as doctors. It's actually making work intolerable, which is a further driver to leave the profession."