ED doctor says helping Northland patients ‘the best job imaginable’

Whangarei emergency medicine specialist Dr Gary Payinda says Northland has the best patients. Photo / Denise Piper

After a nationwide strike in May, about 250 Northland senior doctors and dentists will be striking again on June 18, in protest of better pay and conditions from Health NZ Te Whatu Ora. Reporter Denise Piper speaks with Northland emergency doctor Dr Gary Payinda, who is a member of the Association of Salaried Medical Specialists, to find out more about his role and what he thinks is needed to make it work.

Being a Northland senior emergency department (ED) doctor may mean having to sleep at the hospital and battling with a lack of staff, but Dr Gary Payinda said it is still the best job in the world.

“In Whangārei ED, we get 50,000 patient visits a year who range from a sprained ankle to a very severe heart attack, motor vehicle accident or a stroke.

“It’s very exciting work - it’s the best job that I can imagine.”

Payinda is a delegate for the Association of Salaried Medical Specialists and spoke publicly during the doctors’ strike on May 1 about his concerns over a lack of medical staff in public hospitals.

He said a typical ED shift might start at 2pm, giving him time during the day for his other roles, including being an assisted dying doctor and being the medical director of a rescue service.

Payinda’s hospital shift, where he is the duty doctor, runs from 2pm to midnight, then he is on call until 8am.

“I will sleep on the hospital grounds in a room that they provide, from around midnight until 8am. If the junior doctors working overnight have a critical patient or anything that they can’t handle, I will come and help them.”

While this is a typical shift, Payinda said Northland doctors are constantly being asked to cover extra shifts due to vacancies in all four hospitals or unexpected leave.

He believed the pay bargaining should include a financial disincentive for Health NZ to leave shifts unstaffed, because the burden falls on the remaining clinicians.

Whangarei home caregiver Sharon Clements was among those showing unity for better health services, in addition to the nationwide strike by Association of Salaried Medical Specialists senior doctors, on May 1. Photo / Denise Piper

“It’s not pleasant for the doctor and it’s not pleasant for the patient. At the end of the day the needs of doctors and nurses pale in significance of what the patient goes through.”

Many of the patients who come into Northland’s EDs are very unwell, in part because it is very difficult to see a GP, Payinda said.

“We’ve got a perfect storm of problems going on that means that people are coming to us sick and in more desperate situations.”

Payinda said adequate nursing numbers is key to making the hospital run smoothly, not only in the ED but also in the wards, so there are beds available for patients who need to be admitted.

He gave the example of elderly patients sick with pneumonia, who present in the ED but need to be admitted to a ward. On days with not enough nurses, the patient may have to wait hours in ED.

“On days that we have enough nurse staffing, we can see the true potential of the place. Patients can be cared for and moved [onto wards] and get the antibiotics and nursing care they need,” he said.

New Zealand is short thousands of nurses, Payinda said. The exact number is disputed but Health NZ’s 2024 Health Workforce Plan estimated 2250 more nurses were needed.

Whangārei Hospital has a busy ED, with nearly 50,000 presentations each year. Photo / NZME

He said more pay is needed for both doctors and nurses, to ensure more are not lured over to Australia.

Payinda, who hails from the US but has been in Northland 18 years, said he personally would not want to go anywhere else.

Northland patients are “amazing” and make him feel valued, he said.

“I have the best patients imaginable. I’m still happy to care for the patients, even though the system is being squeezed.”

Health NZ did not want to comment in detail about its negotiations while it is going through the Employment Relations Authority for facilitation, but said it believed it had made “a fair and reasonable offer”.

It provided a fact sheet about its offer to doctors, where a first-year specialist would receive a 9.5% increase and a more senior doctor 1% in 2025.

It also revealed an offer of a new allowance for four hard-to-staff areas, including Northland.

The payment of $25,000 a year is offered for all fulltime senior doctors in Northland, Tairāwhiti, Mid-Central and Nelson-Marlborough, to support recruitment and retention in these areas.

Health NZ Te Tai Tokerau group director of operations Alex Pimm said the organisation remains focused on ensuring patients can get the timely and quality healthcare they need, with Northland EDs staffed by skilled healthcare professionals 24/7.

“We are committed to safe staffing,” he said.

Health NZ uses a programme, care capacity demand management, in all hospitals to inform day-to-day staffing needs. In EDs, it also looks at the current number of patients, how serious they are and the number of presentations in the previous hours to inform if more support is needed.

Sick leave and other unplanned absences are anticipated, with average unplanned leave built into the roster so safe staffing can be maintained, even if staff need leave at short notice, he said.

• of Salaried Medical Specialists’ Northland strike will run for 24 hours from 10am June 18. A public meeting called Your Health System in Crisis will be held the night before so people can understand more about what’s happening. It will be held at Forum North from 6pm on June 17.

Denise Piper is a news reporter for the Northern Advocate, focusing on health and business. She has more than 20 years in journalism and is passionate about covering stories that make a difference.