Calm before storm on the wards

The emergency care ward at Middlemore is coping well but under pressure as an influx is expected. Picture / Kenny Rodger

Emergency departments around the country coped with higher than expected levels of patients yesterday as a number of dissenting junior doctors ignored their union's call and turned up for work.

Hospitals reported coping well as most of the country's 2500 junior doctors went on the first day of a five-day national strike at 7am.

But the unprecedented industrial action by junior doctors was also unusual in its silence, with no picket lines or placard-waving accompanying the mass walkout.

Some junior doctors broke ranks, a small number joining their non-unionised colleagues in keeping emergency and maternity services running.

The district health boards' national co-ordinator, Anne Aitcheson, said hospitals were busier than expected yesterday with acute medical patients, children and neonates.

"Although we haven't got some of the less acute patients coming into EDs, a lot of the hospitals are reporting they have more patients than they'd hoped to have before the strike."

Auckland City Hospital's chief medical officer, Dr David Sage, said the hospital had a smooth handover at 6.30am yesterday.

"With the limited number of doctors available, we had hoped to reduce our beds as far as we could go.

"Now we're on emergency rostering. The hospital is open for emergencies, and we're still 90 per cent full. So far, everything's under control."

The hospital had cancelled 2100 outpatient appointments to date, he said.

"We've freed up senior doctors from the clinics and so they're all pitching in one way or another."

Middlemore Hospital, meanwhile, was not as busy, but still expected about 1500 outpatient appointments to be cancelled.

Rachel Haggerty, Waitemata DHB general manager of adult health services, said 20 of the district's 250 junior doctors have turned up for work. Most were union members.

"We really appreciate those people who've come to work and provided care. "It's been superb. They've really stepped out there in support."

The health board has cancelled 1832 outpatient appointments, 184 elective surgeries and 450 mental health appointments over the strike period.

Ms Haggerty said the hospital was concerned about coping with admissions today and tomorrow night, as well as the Sunday night-Monday morning period, the hospital's busiest.

"Those are our busiest days traditionally, and we expect Monday to be very difficult. We can only encourage people to see their GP early and get help."

Dr John Cullen, North Shore Hospital's clinical director of orthopaedic surgery, said some patients may wait longer during a busy period as staff attended to more urgent cases.