DHB and doctors disagree over staff shortage

The Bay of Plenty District Health Board and the Resident Doctors' Association are at loggerheads over junior-doctor numbers in Tauranga and Whakatane hospitals.
Doctors' association general secretary Deborah Powell said the health board was experiencing a shortage of resident medical officers (RMOs), also known as junior doctors, adding that the Bay was largely dependent on locums and foreign medical staff.
"We sometimes joke that it is hard to find a New Zealand accent among the RMOs in Bay of Plenty," she said.
However, health board acting chief operating officer Julie Robinson said the board did not have a shortage of RMOs, noting just four vacancies existed in a workforce of 110 RMOs at Tauranga Hospital, and all 12 RMO positions at Whakatane were filled.
Dr Powell said nationwide problems with RMO shortages could be traced to a lack of money, with doctors able to earn more overseas, particularly in Australia, or as a locum.
"DHBs have focused on their financial bottom line at the expense of staff retention and now we are feeling the effects of that approach. It is unfortunate that in having an almost total focus on budget, the DHBs miss the real costs. We are spending more on recruitment and locums whilst we fail to reward our permanent staff, so they continue to leave."
Describing the Bay of Plenty District Health Board as "not a leader among the DHBs", Dr Powell said it had a "head in the sand" approach to the junior-doctor shortage.
She said recent publicity surrounding 2-year-old Reef Steiner, who died following an asthma attack initially treated at Tauranga Hospital, illustrated the risks a staff shortage posed.
"Overseas, qualified people are not trained as New Zealanders are and are not attuned to our system as New Zealanders would be. They therefore need more time and attention to orientate adequately. When short-staffed, our DHBs' attitude seems to be 'anybody will do'. Unfortunately, if that means an inexperienced person ... Reef Steiner is the outcome."
A Health and Disability Commissioner's report found the doctor who treated Reef breached the Health and Disability Services Consumers' Rights Code. The doctor was from the United Kingdom, had 14 months' experience, and was on just his seventh night as the sole doctor on duty for paediatrics.
Ms Robinson said the Bay of Plenty was seen as an attractive region in which to live, and more graduates than the health board had places for had made the Bay their preferred placement choice.
The Bay was also attractive to United Kingdom-based doctors because of lifestyle and learning opportunities - about 40 per cent of the health board's staff trained in the United Kingdom.
On recruitment, all overseas-trained RMOs were assessed by the health board and a Medical Council-retained clinician. Locums were used only to cover unexpected gaps.
A spokesperson for Health Minister Tony Ryall said the shortage was a worldwide problem, which was not going to be fixed overnight, and just throwing money at the problem would also not fix it.
However, the Government planned to ensure medical and GP training opportunities increased, and long-term, anticipated its voluntary bonding scheme would also help the situation.
Labour health spokeswoman Ruth Dyson said the shortage was only going to get worse. All hospitals had workforce shortages and the Minister of Health seemed to think they could be fixed by refusing to increase salaries and demanding DHBs trim budgets.