Cost-cutting chairman slams door over hospital offices

By CATHERINE MASTERS

Plans to remove doctors from their offices in the new multi-million-dollar Auckland Hospital have brought board chairman Wayne Brown under attack from senior staff yet again.

Senior doctors are taking legal advice on whether the board's latest plan - to put many of them in open plan offices alongside and within earshot of each other, nurses, managers and possibly some administration staff - will breach patient confidentiality and their work conditions.

The Herald understands some walls already built at the Grafton site may be knocked down to make way for the open-plan style.

Some doctors believe open-plan offices may even breach the Hippocratic oath sworn by doctors, which includes promises to treat the sick to the best of their ability and to preserve patient privacy.

Original plans for the new building, which brings Auckland, Greenlane and National Women's hospitals under one roof, contained space for offices which had been carefully negotiated with doctors.

But doctors accuse Mr Brown (who has apologised to doctors offended at comments he made on a television programme) and the Auckland District Health Board of changing the plans without telling them.

Mr Brown said he expected millions of dollars in savings to be made - but did not know the exact amount.

The new hospital was the size of 16 rugby fields, he said. "Imagine the cost of the walls where you don't need to have them."

He urged doctors to contact him directly to discuss the issue.

Chief executive Graeme Edmond said he accepted plans had been changed on the doctors but said there would still be a mix of individual and open-plan offices and interview rooms.

Open-plan offices in hospitals were not new and were consistent with best practice. The more full-time a doctor, the more likely he or she was to have an office, he said.

However, senior doctors said that in some cases they would be expected to work 15 to a room instead of the individual and shared offices they now had. That would affect patient privacy and safety.

Professor Stephen Munn, the clinical director of the Liver Transplant Unit, is annoyed because although he is keeping an office his staff will lose theirs.

"I'm not going to lose offices - we will fight it," he said.

"When there's a sick patient, I sleep in my office."

Internationally an office was a recognition of employment for senior doctors, he said.

Dr Jon Skinner, a paediatric cardiologist, said he took 20 to 30 telephone calls from relatives of sick children each day. People also often turned up unexpectedly.

The privacy and quiet of an office - not the bustle and distractions of an open-plan one - were vital to deal with often desperately worried people and to make crucial, often life-and-death, decisions.

Another senior clinician, who did not want to be named, said the board was trying to reduce the power of senior doctors. The result could be an exodus of good staff.

"Managers come and go, CEOs come and go. The doctors spend most of their working lives here - they provide the continuity and ethos of a place."

Ian Powell, the executive director of the Association of Salaried Medical Specialists, said the changed plans might breach the doctors' collective contract.

Feature: Our sick hospitals