A blood service strike will from tomorrow cause even urgent cancer and cardiac elective surgeries to be postponed - and the few planned cases that do proceed will in some cases be warned by surgeons that there’s no guarantee of a blood transfusion if something goes wrong.
However, the Public Service Association (PSA) says blood products will definitely be provided when needed, and its underpaid members have worked extremely hard to ensure the strike proceeds safely.
More than 290 lab workers, scientists, technicians and administrators at the NZ Blood Service will strike for four hours on Friday, and for 24 hours on June 4, after seven months of stalled negotiations to be paid the same as their counterparts in Health NZ-Te Whatu Ora.
In addition, workers at the service won’t do work outside of paid hours from May 29 to June 6, and won’t do duties associated with processing AHF plasma over the same period.
Emergency and life-preserving services will be maintained, but all but a few elective surgeries will be cancelled, across both public and private hospitals.
The Herald has obtained advice from Southern Cross Healthcare - the country’s biggest private hospital provider - to staff, outlining the strike’s impact.
No blood products will be supplied to its hospitals from May 30 to the morning of June 5, and even the highest priority cancer and cardiac elective surgeries will be postponed.
Medical specialists have been told to take “a significantly more conservative approach to case selection” and not proceed with procedures that carry a risk of 5 per cent or above for blood transfusion.
The advice states that it isn’t safe to do complex surgeries or those involving the abdomen. Patients who can’t be treated include those on anticoagulants, those with high comorbidities or a higher risk to anaesthetic.
Surgeons must discuss the implications of the strike with patients who are operated on during the informed consent process, the advice states, telling them “In the event of bleeding, we will not have our usual ability to receive blood products. I cannot guarantee you will be able to receive a blood transfusion or blood products if an emergency was to occur during your operation.”
The PSA told the Herald that blood products will be provided when needed.
“[Members] will make sure blood services are available to patients in emergency situations throughout the strike by conducting life-preserving services. If a patient is in a life-threatening situation, our members will perform their duties to ensure their care,” it stated.
“Surgeries that can safely be postponed will have to be rescheduled. However, if a hospital chooses to proceed with a surgery that could have been safely postponed and something goes wrong causing blood products to be needed, they will be provided. Our members are in a caring industry and will rise to the occasion – a huge amount of work has gone into ensuring this can and will be done over the strike period.
“In order to guarantee products can be provided for urgent and emergency care that can’t be rescheduled, it is crucially important that hospitals only undertake those cases.”
The PSA announced the strike action with the APEX union last Friday, saying it came after “fruitless promises” from the NZ Blood Service that they were negotiating funding for pay parity with Health NZ. It says lab technicians are paid between 22 and 35 per cent less by NZ Blood Service than Health NZ lab technicians, administrators are paid between 13 and 36 per cent less and scientists between 19 and 35 per cent less.
PSA members are deeply sympathetic to patients facing strike disruption, the union said, and Health NZ could stop the strikes by negotiating a funding agreement with the Blood Service.
“Aotearoa needs a strong and valued blood service to make sure our communities’ healthcare is looked after, but right now that’s under threat as skilled and experienced people are pushed out of NZBS and recruitment becomes impossible,” the PSA said.
“Our members have been pushed to take strike action now to stop this instability getting worse and threatening the dependability of the service.”
Dr Richard Sullivan, chief medical officer for Health NZ-Te Whatu Ora, said the blood service strike and that by Resident Medical Officers “will have a significant impact on the delivery of planned care within our hospitals”. Impacts would vary by hospital and no estimate was available for how many surgeries would be postponed.
Blood would be available when needed for acute care at public hospitals, and for patients already receiving treatment using blood products.
“This planned strike will affect the supply of blood and therefore it needs to be reserved for the high-risk patients and treatments. Extensive contingency planning is in place and hospitals will assess patients on a case-by-case basis, prioritising those who need urgent care,” Sullivan said.
“Where it is safe for hospitals to defer a patient’s care or treatment, they will do so – while we acknowledge that is not ideal, it’s an important step in ensuring patient safety at this time. Doctors and other health professionals will still be available during any strike action to ensure the continued availability of urgent and non-deferrable health services for those who need them.”
Dr Sarah Morley, chief medical officer of the NZ Blood Service, said there were detailed contingency plans to mitigate any risk to patients. Decisions around informed consent discussions were for hospitals to make.
“Over the strike period, we are asking hospitals to assess patients on a case-by-case basis and to use blood and blood products judiciously for patients requiring urgent/emergency care only.
“Where it is safe for hospitals to defer a patient’s care or treatment until after the strike action, we are asking them to do so to limit any risk to patient safety. By being proactive at this time, we hope to limit any longer-term disruption and be able to return to supporting planned care as usual after the strike.”
The Blood Service’s chief executive officer, Sam Cliffe, said the organisation recognised that the bargaining process had been protracted, and the considerable patience shown by union member staff. Cliffe said pay equity claims raised last year by APEX and the PSA were with Health NZ-Te Whatu Ora, not the Blood Service.
“We are committed to matching the agreed Te Whatu Ora pay rates and we’re having ongoing discussions with the Ministry of Health as we seek to reach a satisfactory resolution, while operating in an environment of financial restraint.”
Dr Erica Whineray Kelly, Southern Cross Healthcare’s chief medical officer, told the Herald its primary focus was on the safety and welfare of patients, and it had contacted everyone affected by the strike. She could not yet say how many surgeries would be postponed.
“Specialists who have planned procedures will carefully assess the risk associated and, if necessary, will reschedule surgery if they believe it is unsafe to proceed. They will only proceed with surgery if the patient is aware of the risk and provides informed consent,” Whineray said.
“We will continue to actively engage with specialists and patients, and we are grateful to our hospital clinical teams for their flexibility and continued patient focus as we navigate through this challenging issue.”
The disruption to elective surgeries will put more pressure on wait lists. Delays in many speciality areas are already at or near record lengths.
Health NZ-Te Whatu Ora advice to patients
* All emergency departments will remain open during the blood service strike period, and hospital patients will receive safe care.
* Unless contacted directly, patients should attend any scheduled outpatient appointment or treatment.
* People with non-urgent ailments or injuries should contact their GP in the first instance, or call Healthline (0800 611 116) for free advice.
Nicholas Jones is an investigative reporter at the Herald. He was a finalist for Reporter of the Year at the 2024 Voyager Media Awards, and has won numerous national media awards for his reporting and feature writing.